Urinary Incontinence Problems Research Articles

Associations Between Serum Estrogen Levels and Urinary Incontinence in Women: A Cross-sectional Analysis of NHANES 2013 to 2016

ObjectiveTo explore the relationship between serum estrogen levels and UI in a nationally representative female population. Materials and MethodsWe included women who had serum estradiol measurements and self-reported urinary incontinence problems in the 2013-2016 National Health and Nutrition Examination Survey cycles. A weighted multivariable logistic regression model was used to determine the association between urinary incontinence and serum estrogen levels after adjusting for age, race, Body Mass Index, diabetes, venipuncture, hypertension, poverty-to-income ratio, smoking, marital status, alcohol use, education and menopause. ResultA total of 4114 individuals were ultimately included in our study. Of these women 1200 (29.17%) complained of urge urinary incontinence (UUI), 1674 (40.69%) complained of stress urinary incontinence (SUI), 730 (17.74%) complained of mixed urinary incontinence (MUI). Women in the lowest quartile of serum estrogen were more likely to complain of UUI compared to those in the highest quartile (OR = 1.885; 95% CI = 1.042 - 3.412, p = 0.039). No association was noted between serum estrogen levels and SUI or MUI. ConclusionOur study shows a significant association between low serum estrogen level and the increased likelihood of UUI in women. Further research is required to validate our findings, elucidate the physiological mechanisms that underlie them, and assess potential therapeutic implications.

Parir después de los 50 años. Estudio piloto observacional

ObjectivesTo assess whether there is a higher rate of adverse obstetric outcomes, postpartum urinary incontinence, and sexual problems among women who give birth over 50. Material and methodsA single-center ambispective observational study. Rate of cesarean birth, gestational diabetes, preeclampsia, intrauterine growth restriction (IUGR), prematurity, urinary incontinence (Incontinence Questionnaire Short Form [ICIQ-SF]), and sexual dysfunction (Female Sexual Function Index [FSFI-6]) were recorded. ResultsTwenty-five (0.06%) of 38,510 births occurred in women over 50 during the study period. There were 16 (64%) cesarean births. Seven (28%) women had gestational diabetes. Preeclampsia was diagnosed in 3 (12%) women. There were 5 (20%) cases of IUGR. There were 5 (20%) preterm births. The differences in the rate of cesarean birth, gestational diabetes, and IUGR between the study group and the total population were statistically significant. The results of the ICIQ-SF and FSFI-6 questionnaires were obtained from 17 women. Some degree of urinary incontinence was found in 7 (41.1%) and sexual dysfunction in 9 (52.9%) women. ConclusionsPregnancies in women over 50 may be associated with a higher rate of gestational diabetes, IUGR, and preeclampsia. There is a high prevalence of urinary incontinence and sexual problems among these women.

Urinary incontinence in obese women

In recent decades, obesity has assumed the features of a pandemic. Leading to the development of many complications, obesity also contributes to the development of urinary incontinence. The review presents current data on the etiology, pathophysiology and approaches to the treatment of stress urinary incontinence in obese patients. There are a large number of publications by foreign authors on the problem of urinary incontinence in patients with obesity. The results of the studies allow us to say with confidence about the direct relationship between an increase in body mass index and the risk of developing urinary incontinence. Long-term results of surgical treatment of urinary incontinence in obese patients require reflection and further observation. It is noteworthy that this problem is practically not reflected in the works of domestic authors. It is relevant to conduct domestic clinical studies on the problems of urinary incontinence in patients with obesity.

Comprehensive Geriatric Assessment of Elderly Adults

The geriatric population is increasing all over the world. Aging people have special health requirements and comprehensive medical checkups prevent physical, functional and mental decline during the aging period. This study aimed to examine the fitness level and identify problems with the well-being of elderly persons. In this context, the study also attempted to determine the relationship between socio-demographic factors and the health status of elderly adults. In this cross-sectional study, 168 elderly adults (≥65 years old) from 12 central villages of Kars, Turkey were examined. The home home comprehensive geriatric assessment was performed by a family physician in participant. In this study group, more than half of the participants reported urinary incontinence problems (51.2%) and a very high rate of generalized pain (58.3%). The most frequently observed chronic disease was hypertension (45.2%). The percentage of chronic dental oral problems was 57.1% in the current study group. Comorbidity and polypharmacy rate among the participants was 19.0%. The reported health problems in order to frequency in the study group were; heart disease: 17.3%, benign prostatic hypertrophy:16.7%, gastric diseases: 16.3%, diabetes mellitus (type II): 13.1%, chronic obstructive pulmonary disease: 11.6%, depression: 10.9%, the audio impairment:10.7%, visual impairment: 8.3%. There was a statistically significant relationship between advanced age, low economic level, low education level, lack of social support, co-morbidities, polypharmacy, depression, and impaired health status. Comprehensive geriatric assessment of elderly adults is essential for managing geriatrics health problems. With the comprehensive geriatric assessment, pre-frail individuals could be detected and early medical care would be planned for this population.

Urinary incontinence in the postpartum 1-year period: Its prevalence and effect on psychosocial status of women.

In this study, it was aimed to determine the prevalence and effect of urinary incontinence in the postpartum 1 year period on psychosocial status of women. This study with a cross-sectional and descriptive design was conducted between 01.10.2021 and 01.04.2022. There were 406 women in the postpartum 8 weeks to 1 year period who participated in the study. The data were collected through Identifying Information Form, Edinburgh Postnatal Depression Scale, and Nottingham Health Profile. In the study, it was determined that 21.9% of the women in the postpartum period experienced urinary incontinence problems, and that the most common type of incontinence experienced was stress incontinence (62.9%). Edinburgh Postnatal Depression Scale mean score of the women who experienced urinary incontinence problems in the postpartum period was found to be significantly higher compared to those who did not experience this problem (P < .05), but no significant difference was found between the rates of those with depression risk according to the cutoff point of the scale (≥13 points). As a result of the regression analysis, it was determined that the increase in depression risk resulted not from urinary incontinence but from age and parity. It was also determined that the mean scores of the women who experienced incontinence problems from the subscales of Nottingham Health profile was significantly high (P < .05). In conclusion, urinary incontinence in the postpartum period is a prevalent problem affecting approximately one-fifth of women. In addition, this problem negatively affects the psychological and social dimensions of women's health.

Prevalence and associated skills of Australian general practice registrars seeing children with functional bowel and bladder problems.

Functional bowel (constipation and faecal incontinence) and bladder (urinary incontinence and enuresis) problems in children are often treated by paediatricians yet should mostly be managed by general practitioners (GPs). To understand whether the necessary skills and knowledge are being built in general practice, this study aimed to establish the prevalence and associated skills of Australian general practice registrars managing children with functional bowel and bladder problems. Together as paediatricians and GPs, we use these data to determine how best to ensure high quality, equitable care for children. We drew on 16 rounds of data collection from the Registrar Clinical Encounters in Training (ReCEnT) multi-site cohort study (2010-2017) of general practice registrars' in-consultation experience. It included a measure of paediatric consultations in which a functional bowel or bladder problem was managed, as well as demographic information. Out of 62 721 problems/diagnoses for paediatric patients (0-17 years), 844 (1.4%) were coded as functional bowel (n = 709; 1.13% (95% confidence interval, CI: 1.05-1.22)) and/or bladder (n = 135; 0.22% (95% CI: 0.18-0.25)) presentations. Registrars were more likely to prescribe medication for bowel problems (odds ratio (OR) = 2.22 (95% CI: 1.86-2.64)) than for all other problems, but less likely to prescribe medication (OR = 0.31 (95% CI: 0.18-0.52)) for night-time wetting and more likely to make a specialist referral (OR = 1.99 (95% CI: 1.22-3.25)) compared to all other problems. Only a small proportion of children with functional bowel and bladder problems were seen by registrars despite high prevalence in the community and amenability to management in the general practice setting (i.e. generally low morbidity and low complexity) versus need for specialists. Registrars appeared to be managing functional bowel and bladder problems according to evidence-based guidelines, but with relatively high levels of referral. Given the inequitable access to specialist care, paediatricians should support local general practice management of these problems. This might include (i) engaging with training programs to ensure appropriate education and (ii) liaising with individual registrars/practices to provide management advice for individual or example cases.

Effect of pilates performed during pregnancy on postpartum stress urinary incontinence in primipara women

IntroductionStress urinary incontinence (SUI) constitutes the majority of urinary incontinence (UI) cases that occur due to anatomical and physiological changes during pregnancy and postpartum period. The objcetive of this study was to evaluate the effect of pilates in preventing the occurrence of SUI in the postpartum period. MethodsA retrospective case-control study was conducted in a private hospital. Participants consisted of patients who gave birth vaginally at the hospital and were admitted to the hospital for routine control at the postpartum 12th week. The women did pilates for two days a week from the 12th week of pregnancy until the birth were included in the case group. The women did not do pilates in the control group. Data was collected using the “Michigan Incontinence Symptom Index”. To detect the presence of SUI, researchers asked women “Do you have urinary incontinence problems in your daily life?”. STROBE research check-list was used for reporting the study. ResultsThe study was completed with a total of 142 women consisting of 71 women in each group. Of the women, postpartum SUI occurred in 39.4%. The severity score of women who did pilates were found to be statistically significantly lower than those who did not do pilates. ConclusionDuring pregnancy, women should be encouraged to do pilates about the prenatal period by health professionals.

Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?

Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2-γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence.

The Application of Physiotherapy in Urinary Incontinence

Objective: The problem of urinary incontinence affects half of the adult female population, impacting adversely on their comfort of life and significantly hindering ordinary life activities (laughing, sneezing, coughing, physical activity); it also affects the quality of their sexual life. Physiotherapy is an increasingly common method for the conservative treatment of genital static disorders and stress urinary incontinence. Mechanism: In this article, the authors consider the following aspects: the use of various physiotherapy interventions as adjunctive treatment for urinary incontinence. The authors reviewed the literature databases in PubMed, Medline and Embase to identify links between the applied physiotherapeutic treatment and its effectiveness. Findings in Brief: The applied physiotherapeutic treatments and their effectiveness in urinary incontinence are presented. Conclusions: Physiotherapy treatments are effective and supportive of the treatment process in women of all age ranges with urinary incontinence, thus improving their quality of life.

Применение объемообразующих препаратов для коррекции стрессового недержания мочи у женщин

The problem of stress urinary incontinence (SUI) has become particularly important in recent years. Increasing life expectancy and the desire to improve the quality of life have led to a greater emphasis on these complaints and early referral to specialist care. There are various treatment options for SUI in women that aim to prevent involuntary urination when intra-abdominal pressure increases during physical activity, coughing or sneezing. Among these options, bulking agents occupy a certain niche. Objective. To study the efficacy of bulking agent injections depending on the angle of urethral mobility and to analyze the longterm results of treatment. Patients and methods. This prospective study included 35 women with SUI who experienced failure of behavioral therapy. Patients were divided into two groups depending on urethral mobility: group 1 (n = 15) included patients with a Q-tip angle &lt;30°, group 2 (n = 20) – patients with a Q-tip angle ≥30°. The injection of bulking agent was performed in all patients, and a viscoelastic hyaluronic acid-based filler for contour plasty was used for peri-urethral injections. Treatment results were assessed after 3, 6, 12 and 24 months. Results. The most pronounced positive dynamics was observed in group 1 (with a lower Q-tip angle). Significant improvement at 3 months after injection was noted in 66.7% of patients (n = 10). In group 2 with urethral hypermobility, improvement was noted only in 45% of women (n = 9), which is 21.7% less. After 12 months, the effect in group 1 (with a Q-tip angle &lt;30°) was 26.9% higher than in group 2, and after 24 months it was 20% higher. Conclusion. Peri-urethral injections of bulking agents are most effective at a lower angle of urethral mobility. Further research in this area is needed. Key words: stress urinary incontinence, bulking agents

Хирургическая коррекция стрессового недержания мочи: множество способов при отсутствии стандартной техники

Stress urinary incontinence is a common pathology among middle-aged and older women that significantly reduces the quality of life. According to numerous data, despite the introduction of new technologies in the surgery for stress urinary incontinence, the results of treatment remain unsatisfactory, and addressing the problem of urinary incontinence in women is still one of the priority tasks in modern urogynecology. The article presents general information about the causes of this condition, ultrasound diagnostic approach, advantages and disadvantages of sling operations as the most common method of surgery for stress urinary incontinence. Technical specifications for synthetic sling placement are discussed. Key words: treatment, sling tension, stress urinary incontinence

[Overview of risk factors for stress urinary incontinence and strategies in its prevention and treatment].

Stress urinary incontinence is a medical problem that afflicts women worldwide. The causes can be mainly divided into 4 parts: increased abdominal pressure and chronic ischemia of pelvic floor muscles, endocrine changes, pelvic structural damages, inflammatory and consumptive states. The choice of prevention and treatment should also be based on a comprehensive assessment of individualized factors. Treatment techniques which are more minimally invasive or even non-invasive than surgery are currently a hot topic of research in the field of pelvic floor and urinary control, including laser and radiofrequency therapy, periurethral injection therapy, exogenous stem cell therapy and technology for activation of endogenous stem cells. They are expected to solve the clinical problem of stress urinary incontinence with a wider scope of application, lower trauma and fewer complications in the future.

Bilateral complete duplication of ureter with ectopic ureter presenting as persistent urinary dribbling with normal voiding pattern in 17-year-old female: Case report

and importance: Bilateral complete ureteral duplication is a rare urinary tract abnormality and presence of unilateral ectopic ureter makes it a rarest entity. Continuous urinary dribbling with normal voiding pattern and recurrent UTI are frequent presenting complains in case of ectopic ureter. Long term childhood problem of urinary incontinence with delayed diagnosis in adult in this case makes it a perfect case to report. We present a case of 17-year-old girl with continuous urinary dribbling and constant wetting with normal voiding pattern since childhood. She also had recurrent history of urinary tract infections. Local external examination of genitourinary system was found to be normal. There were skin lesions on buttocks and thighs suggestive of urine dermatitis. There were no examination findings of other congenital anomalies. Complete blood count, Renal function test, Serology, Urine R/ME, Urine culture and sensitivity, Ultrasound abdomen and pelvis, Computed Tomography scan, intraoperative cystoscopy were done. Right upper pole hemi nephroureterectomy was performed. She was post operatively managed with IV Fluids, antibiotics, analgesics, antipyretics and antiemetics. She is asymptomatic now and regularly followed up on OPD basis. Congenital abnormalities of the genitourinary system like ectopic ureter should be clinically suspected in case of persistent urinary problems like urinary dribbling with normal voiding pattern and recurrent urinary tract infections. Upper pole heminephrectomy is an ideal choice of treatment in case of nonfunctional upper moiety. This case emphasizes the early detection of genitourinary abnormalities and provide the perspective on late diagnosis and management in such cases.

Sehat dan Bahagia (SETIA): Optimalisasi dalam Meningkatkan Kesehatan Reproduksi pada Perempuan Menghadapi Menopause

Abstract: Women when entering the age of aging or approaching menopause often experience physical and psychological symptoms that can cause disruption of daily activities. Often women at the age of menopause feel themselves old, judge and think themselves sluggish and feel insignificant, causing stress to women. Adverse effects or severe symptoms of menopause can cause osteoporosis, heart disease, urinary incontinence and other health problems. The purpose of this activity is to increase the knowledge and insight of women in general to maintain menopausal reproductive health. The method of this activity is divided into several steps, starting with the socialization of the activity agenda, providing educational materials to women through face-to-face meetings, demonstrations of facial and muscle-relaxing exercises and finally an evaluation of menopause reproductive health knowledge. The result of this activity is an increase in knowledge of reproductive health in women before and after attending education. The provision of education packaged with demonstrations of gymnastic movements has proven to be effective in increasing women's knowledge about menopausal reproductive health.

Prevalence of Urinary Incontinence in Pregnant Women: A Cross Sectional Survey Study

Although urinary incontinence is not life threatening, it is burdensome physically, mentally, emotionally and economically. During pregnancy many factors like emotional changes mechanical, hormonal and circulatory changes, musculoskeletal changes are occurring in the pregnant women and causing pelvic pain and urinary incontinence. Objective: To determine the prevalence of urinary incontinence among pregnant women. Methods: A cross sectional survey study was conducted in Jinnah Hospital and Services Hospital Lahore. All those females who were in healthy pregnancy condition were included in this study. This convenient sampling was conducted in which sample of 323 were included with estimated population of 2000 women with 95% of confidence interval and 5% margin of error. In this study statistical analysis was done by using SPSS version 16. Results: Majority of females having age groups of 20 to 24 years and 25 to 29 years had mild problems of urinary incontinence. There were 14 subjects of age group 25 to 29 years that had moderate problem of urinary incontinence. There were 3 subjects of age group 25 to 29 years that had severe problem of urinary incontinence. Urinary incontinence was common in females having 2 or 3 previous pregnancies or multiparous females. Conclusions: Hence, it is concluded that urinary incontinence is very common in pregnant females. Majority of females from age group 20 to 29 years had mild problem of urinary incontinence. Its incidence was greater in those females having 2 or 3 previous pregnancies or multiparous females

Senam Kegel Sebagai Upaya Mengurangi Nyeri Luka Perineum Pada Ibu Nifas di Klinik Bersalin Pera Simalingkar B Medan Tahun 2022

Tears that occur in the perineum during labor or also called perineal lacerations that occur during labor with procedures such as forceps extraction, vacuum extraction, version extraction, kristeller (push on the uterine fundus) and episiotomy. Birth canal tears always provide bleeding in varying amounts. The source of bleeding can be from the perineum, vagina, cervix, and uterine rupture (uterine rupture). Birth canal tears are often found in childbirth assistance by traditional birth attendants. Delivery assistance by health workers with low risk has mild complications so that it can reduce maternal and perinatal mortality (Manuaba, 2013). Morbidity rates due to perineal lacerations include various infections and diseases that accompany pregnancy, childbirth and the puerperium (Friedman, 2012). High risk/complication is a state of deviation from normal, which directly causes morbidity and mortality for both mother and baby. There are several ways that can be used to prevent the occurrence of perineal tears due to normal delivery, including teaching the mother to often do Kegel exercises. Kegel exercises are exercises to strengthen the pelvic floor muscles before delivery, the goal is to strengthen the pelvic floor muscles, help prevent urinary incontinence problems, and can flex the perineal tissue as the baby's birth canal. So that all mothers should be motivated to move the pelvic floor muscles as little and as often as possible, slowly and quickly in the period approaching labor. The Kegel exercise procedure can be remembered and carried out with activities related to the mother's daily activities. Like when you sit in the bathroom after urinating and this is a relaxed position to contract these muscles, and when you want to sleep and under any circumstances. Doing Kegel exercises regularly can help flex the mother's perineal tissue.

Spiritual Care Needs of Patients with Urinary Incontinence and Affecting Factors: A Cross-Sectional Descriptive Study in Turkey.

This study was conducted to determine the spiritual care needs of patients with urinary incontinence and variousinfluencing factors. Determining the spiritual care needs of individuals with urinary incontinence maymake patients feel more hopeful, peaceful, and stronger. It can alsoencourage individuals towards positive health behaviors, and canhelp nurses in choosing appropriate coping methods. Adescriptive and cross sectional study was conducted with 220 patients with urinary incontinence who applied to the urology outpatient clinic of a university hospital in Turkey. In the study, data were collected using the descriptive features form, the incontinence severity index, and the Spiritual Care Needs Inventory. Kruskal-Wallis test and Mann-Whitney U test were used to evaluate the data. This study is reported following the STROBE recommendations. In this study, mean scores of the patients' spiritual care needs scale and the severity of incontinence, age, gender, andthe effect of urinary incontinence on daily life,determined that there was a statistically significant difference between the state of being disturbed by urinary incontinence, the state of performing religious rituals regularly, the state of incontinence affecting religious rituals, the importance of religious beliefs in daily life, and the level of defining spirituality (p < 0.05). In this study, it was determined that the spiritual care need scores of the patients with urinary incontinence were above the medium level, and the sub-dimension scores of meaning and hope, caring, and respect were high. In this context, it is very important to consider the spiritual care needs of patients with urinary incontinence problems.

Prolaps of Internal Female Genital Organs and Urinary Incontinence, in the Early Stages of this Pathology: Methods and Means of Recovery Treatment

The article presents the results of a study devoted to the practical aspects of the application of a number of techniques of curative physical training and special physical exercises in the omission of internal female genital organs and the accompanying problem of urinary incontinence.

Assessment of the Effectiveness of the Sonofeedback Method in the Treatment of Stress Urinary Incontinence in Women-Preliminary Report.

Urinary incontinence is a common problem that affects postmenopausal women. This ailment has a negative impact on many aspects of life, significantly limiting everyday functioning related to professional work, physical activity or the intimate sphere. The aim of the study was to assess the effectiveness of the sonofeedback method in reducing the severity of urinary incontinence in postmenopausal women with a urinary incontinence problem. A total of 60 patients aged 45–65 with stress urinary incontinence, confirmed by a gynecologist, were qualified for the study. All persons qualified for the study were randomly assigned to study group A (n = 20), comparative B (n = 20) and control C (n = 20). Patients from group A were treated with sonofeedback of the pelvic floor muscles. In group B, the combined electrostimulation method was used with biofeedback training. Group C was a control group in which only the measured parameters were measured at the same time interval as those carried out in groups A and B. In all patients, three times: before the therapy, after the fifth procedure and after the end of the therapy, the incidence and severity of stress urinary incontinence were assessed—Gaudenz questionnaire and the intensity of urinary incontinence—a modified 1 h pad test. The obtained results have an application value giving the possibility of using effective therapy with sonofeedback in women in whom the recommended electrostimulation method cannot be used due to health and behavioral reasons.

Life satisfaction and anxiety in women with urinary incontinence.

This study aimed to examine satisfaction with life in patients with urinary incontinence and patients who underwent an operative procedure due to urinary incontinence. Women with amedical indication for surgery due to urinary incontinence problems but who had not yet had surgery (N = 110) and same-age women who had had asurgical procedure for urinary incontinence (N = 101) completed aset of questionnaires. The results showed that women with urinary incontinence had significantly higher life satisfaction than women who underwent the operation. Contrary to expectations, women with urinary incontinence problems reported equal levels of life satisfaction to acomparable sample of postmenopausal normative women. Higher levels of life satisfaction were related to higher education level, employment, higher perceived socioeconomic level, and urban place of living. It is important for physicians to address the problem of urinary incontinence with their patients and to examine the present anxiety symptoms, given that they may affect their subjective wellbeing.