Prevalence Of Stress Urinary Incontinence Research Articles

Lower urinary tract symptoms 7 years after the first delivery: Correlation to the mode of delivery

To investigate the extent of lower urinary tract symptoms (LUTS) during pregnancy and 7 years after birth in primipara and their association with delivery mode history and other factors. A longitudinal cohort study was conducted in 12 hospitals representative of the diversity of the seven administrative regions of China. Of 10 098 women recruited at the third trimester, 3862 (38.25%) responded at 1 year, and 1115 (11.04%) responded at 7 years. A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. No intervention was implemented. Among the participants, 75.4% reported nocturia during gestation, followed by frequency (58.4%), which gradually decreased after delivery. The prevalence of urge urinary incontinence (UUI) increased from 5.7% during pregnancy to 22.8% at 1 year after delivery and 10.2% at 7 years postpartum. The prevalence of stress urinary incontinence (SUI) increased from 29.9% during pregnancy to 46.4% at 1 year postpartum and 23.7% at 7 years after delivery. The odds of storage LUTS and voiding LUTS 7 years after delivery were lower for the cesarean section (CS) group than for the vaginal delivery (VD) group (OR = 0.49, 95%CI, 0.36-0.68; OR = 0.25, 95%CI, 0.09-0.70). The most frequent moderately to severely bothersome LUTS after VD was SUI (19.18%), while that for CS was UUI (19.18%). The incidence of storage LUTS was higher than that of voiding LUTS both during pregnancy and postpartum. The most frequently reported LUTS during pregnancy were nocturia and frequency, while the most frequent LUTS after delivery were urgency and SUI. CS was associated with a decreased prevalence of both storage and voiding LUTS after delivery.

Urinary Incontinence Amongst Malaysian Women in Selangor: Prevalence, Types and Risk Factors

Information on urinary incontinence (UI) amongst Malaysian women remains incomplete and inconclusive. Of the few available studies, none had used the holistic approach to study UI amongst Malaysian women and information on the prevalence and the types of UI experienced by the Malaysian women therefore remains debatable. The objectives of this study were to estimate the prevalence of UI and its types in Malaysian females, determine the demographic characteristics of those with UI and to elucidate the association between potential risk factors and female UI. A validated, standardised Malay Monash Women Health Questionnaire (MMWHQ) was administered to 350 community dwelling, Malaysian women. The response rate was 86% (n=301). The dropout rate for interviews was 30%. Descriptive statistics and multinomial regression were applied. The estimated prevalence of UI (n=52) was 17.3 ± 4.65% (95% Confidence Interval 16.95 - 26.25%). Majority of respondents had reported no UI (82.7%; n=249), while 8.0% of the respondents complained of stress urinary incontinence (SUI), 5% reported urge urinary incontinence (UUI) and 4.3% had mixed urinary incontinence (MUI). Most women with UI were of middle age, of Chinese ethnicity, with secondary education, with an income of <RM999/- per month, married, had undergone vaginal childbirth with or without episiotomy and had 1 to more than 4 children. There was a significant association between UI and risk factors including menopause, increased BMI, straining hard during defecation, coffee consumption and depression in the risk factor model. The Malay version QUID was found to be a user-friendly diagnostic tool to identify types of UI. The prevalence of SUI was higher than previously reported. The association between risk factors and UI observed in this study was somewhat similar to those previously reported in a number of studies in other populations.

Interventions and Quality of Life in Stress Urinary Incontinence.

Introduction:Stress urinary incontinence (SUI), though is more prevalent than many chronic diseases, has remained largely underreported and underdiagnosed condition. We aimed to find the improvement in the quality of life (QoL) of women with SUI after individual interventions, namely mid-urethral sling (MUS), pelvic floor muscle training (PFMT), and no treatment/control group, as primary treatment modalities.Materials and Methods:This was a prospective interventional case–control study conducted at a university teaching hospital, over a period of 2 years. Parous women with at least one vaginal delivery, attending the gynecology outpatient department, were encouraged to fill the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Those with SUI were divided into three arms (MUS, PFMT, and no treatment/control group), according to the informed decision for choice of management. Baseline QoL was documented for all with King's Health Questionnaire. QoL was again recorded after 3 months of the start of treatment and was compared with the baseline.Results:In our study cohort, the prevalence of SUI was 15.2%, with a consultation rate of only 30.7%. MUS surgery improves QoL significantly in women with SUI, followed by PFMT. We found 100% symptomatic relief, high rate of improvement in QoL with minimal easy to manage complications, in the surgical intervention arm. PFMT, though has a positive impact on QoL, requires continuous motivation, as 22% discontinued. Without treatment, QoL in SUI patients remained more or less the same.Conclusion:The help-seeking behavior (consultation rate) for SUI is poor. MUS (surgical arm) had 100% symptom relief in 3-month follow-up. MUS showed the best results in terms of QoL improvement, followed by PFMT in SUI in our study. It is important not only to educate women about the problem but also to encourage them to seek treatment and indicate that it is a treatable condition.

Prevalence of Stress Urinary Incontinence in Women with Premature Ovarian Insufficiency.

Background: To determine the prevalence of stress urinary incontinence (SUI) and associated factors in women with premature ovarian insufficiency (POI). Materials and Methods: The study included 149 patients with POI and 303 control women without POI. Age, body mass index (BMI), gestational history, time since onset of POI, and status of hormone therapy (HT) for POI were recorded. Results: There was no statistical difference in the mean age, BMI, and parity between the two groups. The prevalence of SUI in the POI group tended to be higher than that in the control group (20.9%, 30/149 vs. 16.2%, 49/303), although not significantly (p = 0.297). About 41.6% (62/149) of patients with POI received HT. Patients with POI and SUI were older (p = 0.018) and had higher BMI (p = 0.007) than women with POI without SUI (p = 0.007). Compared to nulliparas, primiparas were more likely to have SUI (p = 0.046). However, SUI developed irrespective of time since onset of oligomenorrhea/amenorrhea or HT use. Furthermore, regression analysis showed that the prevalence of SUI was higher in women 30-39 years of age (odds ratio [OR] = 3.27, p = 0.002) and older than 40 years (OR = 7.78, p = 0.001). Primiparas (OR = 2.89, p = 0.001) and vaginal delivery (OR = 2.58, p = 0.023) were associated with SUI. Conclusions: The prevalence of SUI was fairly high among patients with POI, and age, parity, and vaginal delivery were the main risk factors. However, duration of POI and HT use had no effect on SUI. Increasing awareness of the importance of urinary system health in this population will improve the quality of life for these women.

External validation of de novo stress urinary incontinence prediction model after vaginal prolapse surgery.

Stress urinary incontinence (SUI) may appear after the correction of pelvic organ prolapse (POP). The aim of this study was to externally validate a described predictive model for de novo SUI and to assess its clinical performance when used as a diagnostic test. This was a retrospective descriptive study on a cohort of consecutive women treated in our institution. The main outcome used to validate the model was the presence of objective or subjective SUI 1year after surgery. A receiver operating characteristic curve was generated from our population to evaluate the predictive accuracy and to compare it with the original model. A cutoff point of ≥50% was used to evaluate its clinical performance as a diagnostic test. Of the full cohort, 169 women were suitable for analysis. The rate of de novo SUI was 11.8%. The predictive accuracy of the model in our population was similar to the original [area under the curve (AUC) = 0.69; 95% confidence interval (CI) = 0.58-0.80). However, its performance measures when evaluated as a diagnostic test were low: positive likelihood ratio = 2.71 and negative likelihood ratio = 0.86. Only 15 women presented a positive test result. External validation of the model found a global predictive accuracy similar to that of the original model. Despite the study being underpowered to give firm conclusions, the test did not show a good clinical performance when applied to our population with low de novo SUI prevalence. A larger sample size is needed to validate the model conclusively.

Coital Incontinence in Women With Urinary Incontinence: An International Study

IntroductionCoital urinary incontinence (CUI) is not much explored during clinical history, and this could lead to an underestimation of the problem. AimTo evaluate the prevalence and clinical risk factors of CUI in women with urinary incontinence (UI), and to measure the impact of CUI on women’s sexuality and quality of life. MethodsThis was a multicenter international study, conducted in Italy, Greece, the United States, and Egypt. Inclusion criteria were: sexually active women with UI and in a stable relationship for at least 6 months. Exclusion criteria were: age <18 years and unstable relationship. The UI was classified as stress UI (SUI), urgency UI (UUI), and mixed UI (MUI). Women completed a questionnaire on demographics and medical history, in particular on UI and possible CUI and the timing of its occurrence, and the impact of CUI on quality and frequency of their sexual life. Main Outcome MeasuresTo evaluate the CUI and its impact on sexual life we used the open questions on CUI as well as the International Consultation on Incontinence questionnaire and Patient Perception of Bladder Condition questionnaire. ResultsIn this study 1,041 women (age 52.4 ± 10.7 years) were included. In all, 53.8% of women had CUI: 8% at penetration, 35% during intercourse, 9% at orgasm, and 48% during a combination of these. Women with CUI at penetration had a higher prevalence of SUI, women with CUI during intercourse had higher prevalence of MUI with predominant SUI, and women with CUI at orgasm had higher prevalence of UUI and MUI with predominant UUI component. Previous hysterectomy was a risk factor for CUI during any phase, while cesarean delivery was a protective factor. Previous failed anti-UI surgery was a risk factor for CUI during penetration and intercourse, and body mass index >25 kg/m2 was a risk factor for CUI at intercourse. According to International Consultation on Incontinence questionnaire scores, increased severity of UI positively correlated with CUI, and had a negative impact on the quality and frequency of sexual activity. Clinical ImplicationsThis study should encourage physicians to evaluate the CUI; in fact, it is an underestimated clinical problem, but with a negative impact on quality of life. Strengths & LimitationsThe strength of this study is the large number of women enrolled, while the limitation is its observational design. ConclusionCUI is a symptom that can affect sexual life and should be investigated during counseling in all patients who are referred to urogynecological centers.Illiano E, Mahfouz W, Giannitsas K, et al. Coital Incontinence in Women With Urinary Incontinence: An International Study. J Sex Med 2018;15:1456–1462.

Can we prevent stress urinary incontinence by elective caesarean delivery for twins?

Can we prevent stress urinary incontinence by elective caesarean delivery for twins?

Impacts of Childbirth on the Subsequent Risk of Stress Urinary Incontinence

Objectives: The aim of the current study was to investigate the role of childbirth parameters on the development of stress urinary incontinence (SUI). Methods: One hundred-one healthy women (control group) and 98 patients with SUI (study group) were included in this study between March 2008 and April 2009. Obstetric history of participants was taken and labor parameters were compared between the groups. Results: The prevalence of SUI reported in the study period was 17.2%. Gravidity and parity was significantly higher in study group (P&amp;lt;0.001). Vaginal delivery, Kristeller manauver, operative delivery by vacuum or forceps extraction and delivery of macrosomic fetus was found to be significant risk factors for SUI (P&amp;lt;0.05). Conclusions: Mode of delivery and obstetric history have significant impact on subsequent SUI. Timely cesarean section in women with obstructed labor may prevent the later occurrence of SUI.

Six-Week Pelvic Floor Muscle Activity (sEMG) Training in Pregnant Women as Prevention of Stress Urinary Incontinence.

BackgroundPelvic floor muscle exercises are a widely used and well-established form of stress incontinence treatment, with success rates varying from 21% to 84%, although with a better subjective than objective outcome.Material/Methods“Incontinence Impact Questionnaire” (IIQ), PFM EMG assessment was done at the beginning and after the 6-week training program.ResultsStatistically significant differences appeared in the BASE and R values. In the symptomatic group (with SUI symptoms), the value of BASE was 3.26 μV, and after training it was 3.95 μV. The R values before and after training were 4.55 μV and 4.25 μV. In the symptomatic group (without SUI symptoms), the value of BASE was 2.88 μV and 3.52 μV and R values were 7.16 μV and 3.92 μV. In the control group, BASE was 3.05 μV and 4.11 μV and R was 7.82 μV and 4.39 μV.ConclusionsThe results indicate that a 6-week training process influences PFM EMG activity in pregnant women. During Q, the value of PFM activity after a training session tended to increase in the symptomatic and control groups, but in the symptomatic group it remains practically unchanged. Our results show the probable process of decreasing control of PFM activity during long-lasting contractions in symptomatic and control women. The comparison of BASE before and after training averaged the values of R after five 10-s contractions and showed an increase in the Base and decrease in the R.

The impact of physical activity measured by the International Physical Activity questionnaire on the prevalence of stress urinary incontinence in young women

ObjectiveThe aim of this study was to determine the prevalence of SUI symptoms in sportswomen (with a high intensity of physical activity) and non-sportswomen (with a low intensity of physical activity), according to the estimated intensity of physical activity in metabolic equivalents using the IPAQ questionnaire. Another goal was to identify relationships between SUI symptoms, intensity of physical activity, and quality of life. Study designA total of 1005 participants were enrolled into the study. We used the International Consultation on Incontinence Questionnaire (ICIQ-UI SF), the Overactive Bladder Questionnaire (OAB-q), the Urinary Incontinence Quality of Life scale (I-QoL) and the International Physical Activity Questionnaire (IPAQ). ResultsOut of the 1005 participants, the final sample of 557 women is the result of the adoption of exclusion criteria. The sample consisted of 557 women (270 sportswomen and 287 non-sportswomen) with an average age of 20.9 ± 2.8 years. The ICIQ-UI SF confirmed slight urinary leakage in 33 (6.14%) sportswomen and 11 (2.04%) non-sportswomen. The risk of reporting SUI was higher in the sportswomen group (odds ratio: 3.49; 95% CI: 1.727–7.064, p < 0.001). Significant positive correlation was observed between SUI (assessed by ICIQ-UI SF) and high intensity physical activity (in metabolic equivalents (r = 0.242, p < 0.01). Significant negative correlation was observed between SUI and quality of life (I-QoL) (r = −0.648, p < 0.001). OAB symptoms were not present in the monitored groups. (OAB – q – SS in sportwomen were 4.3 ± 5.4, in non-sportwomen 4.5 ± 4.9, p = 0.265). ConclusionsSportswomen with high-intensity physical activities in metabolic equivalents measured by the IPAQ have a greater chance of reporting SUI than non-sportswomen, resulting in a negative impact on quality of life.

Poor level of information for young athletes regarding stress urinary incontinence: Reference to a survey conducted on the Internet

Physical exercise performed intensively is a serious risk factor of stress urinary incontinence. Despite a better knowledge of the risks factors and the existence of available therapeutics measures, urinary incontinence remains taboo. The major purpose of this study was to assess the knowledge and expectations of athletes regarding stress urinary incontinence. We have released an anonymous questionnaire using “Google Form”. This questionnaire was developed by experts. The release took place on social networks and on sports women forums from 5 to 20 May 2016. We have obtained 178 answers and 163 were selected for the study. Then, we have accomplished a global statistical study as well as a statistical study in groups of the achieved outcomes. The average age of the athletes was 29 years old of which 77% were nulliparous. They practiced an average of 3.9 hours of sport per week. Eighty-three percent practiced sports as a hobby and 17% took part in competitions. The prevalence of stress incontinence was up to 45% of which 66% had an inconvenience in their everyday life. Sixty percent had never been informed of urinary incontinence. Eighty percent had no idea that this phenomenon may occur at a young age. Eighty-six percent had no knowledge of the physiopathology of the urinary incontinence. Sixty-seven percent knew that reeducation could help athletes to prevent stress urinary incontinence and only 34% thought they could improve it once it is established. Among the athletes affected by stress urinary incontinence, 67% had never dared speaking of it and only 19% benefited from rehabilitation. The results of our study confirmed a high prevalence of stress urinary incontinence among athletes with a real impact on their well-being. However, knowledge of the subject remains very poor due to a clear lack of information. This subject is taboo, partially explained by the lack of education of athletes.

Are Home Based Pelvic Floor Muscle Exercises (PFMES) Effective in Prevention of Stress Urinary Incontinence During Pregnancy? A Randomized Controlled Trial

ABSTRACT: Objectives: To determine effectiveness of 8 weeks home based PFMEs in the prevention of stress urinary incontinence (SUI) during pregnancy and to see how many women were consistent with them. Materials And Methods: This randomized controlled trial was conducted in the outpatient department (OPD) of Obstetrics/Gynaecology, Kahuta Research Laboratories (KRL) hospital, Islamabad during Nov, 2017 to Jan,2018. After fulfilling the inclusion/exclusion criteria, women were randomly divided into two groups. One group learned to perform PFMEs. A telephonic survey was conducted after 8 weeks andall the women in the study were asked about presence/absence of perceived urinary incontinence. Data were analysed using descriptive statistics. Results: A total of 120 women were randomized into the study. Amongst those who were followed, 63.4% from intervention group didn’t adhere to PFMEs and dropped out from study. A total of 42 women were analysed from both groups. Mean age was 25+-3 years and mean gestational age was 23+-4 weeks. Thirty nine percent were nullipara. Amongst women in the intervention group, majority were still continent after 8 weeks of PFMEs (86.6%) and only few experienced SUI (13.4%). However, when these women were matched with controls, fewer women as compared to intervention group were continent after 8 weeks (55.6%). Conclusion: Home based pelvic floor muscle exercises are very effective in prevention of stress urinary incontinence in only highly motivated patients.

Prevalence and Risk Factors of Urinary Incontinence and Overactive Bladder in Japanese Women.

The prevalence of storage symptoms, including stress urinary incontinence (SUI) and overactive bladder (OAB), is high in women worldwide. In Japan, there have been few large-scale epidemiological surveys of lower urinary tract symptoms (LUTS), and the risk factors for these symptoms are unclear. The aim of this study was to explore the prevalence and risk factors of storage symptoms in Japanese women. A cross-sectional Internet survey was conducted in Japan. Five thousand women aged 20-79 years were selected to answer demographic questionnaires, Japanese version of International Consultation on Incontinence Questionnaire-Short Form, and the Overactive Bladder Symptom Score (OABSS) pertaining to their symptoms in the previous month. Descriptive statistics were used to evaluate the prevalence of storage symptoms. Logistic regression analysis was performed to determine risk factors for SUI and OAB. The answers from 4804 women (average age, 40.4 years) were analyzed. The prevalence of SUI was 16.7% (SUI, 13.0%; mixed urinary incontinence, 3.7%). The prevalence of OAB diagnosed on OABSS was 8.1%. The prevalence of SUI and OAB symptoms increased with age, and 68.0% of women had one or more storage symptoms. Age ≥40 years, body mass index ≥25 kg/m2 , and constipation were common risk factors for SUI and OAB. Childbirth was an additional risk factor for SUI. The prevalence of storage symptoms in Japanese women was high, and risk factors associated with these symptoms were similar to those reported in studies in other countries.

Association between body mass index and pain following transobturator sling

We aimed to prospectively evaluate the association between body mass index (BMI) and development of postoperative-onset pain in women undergoing transobturator midurethral sling procedures. We conducted a prospective, observational cohort study of women undergoing inside-to-out transobturator midurethral sling. At preoperative visit, height, weight, self-reported activity level and baseline pain were documented. At postoperative visits, patients indicated pain location and severity, procedure success, and satisfaction. We used log binomial regression to calculate risk ratios, controlling for potential confounders. For the 129 women included, median age was 50.0 years and BMI was 27.2 kg/m2. Adjusting for age and activity level, overweight and obese women had significantly increased risk of postoperative-onset pain compared to normal BMI women. Overweight women were at 1.70 (95%CI 1.05–2.75) times the risk compared to leaner counterparts, whereas obese women were at 1.76 times the risk (95%CI 1.04–2.89). Neither success nor satisfaction was associated with BMI.Impact statementOver three million midurethral slings have been placed worldwide for the treatment or prevention of stress urinary incontinence. The procedure has been studied in lean, overweight and obese populations, and found to have similar efficacy regardless of BMI. Similarly, the risks of midurethral sling have been well-documented, including the risk of pain after transobturator sling. Little attention has been given to whether this risk of postoperative pain varies based on patient BMI. Our previous work suggesting that leaner patients might be at increased risk of postoperative pain following transobturator sling was limited by the shortcomings of a retrospective study design.In this prospective study, we were able to adjust for age and activity level, finding that higher BMI women were at increased risk of postoperative pain, while reporting similar levels of satisfaction with the procedure. Future research is needed to find what differences in anatomy or physiology can explain this finding. From a clinical standpoint, thorough counselling of all patients but particularly those with elevated BMI, is required so that appropriate expectations regarding recovery can be set preoperatively.

Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women

Background: Mode of delivery and some certain risk factors have a relationship to postpartum stress urinary incontinence (SUI). For that reason, the objective of this study was to assess the prevalence of postpartum stress urinary incontinence (SUI), the relationship between postpartum SUI and mode of delivery; and the association between SUI and other demographic and obstetric factors.Methods: In this prospective observational cohort study, all primiparous women who were under postpartum care in obstetric and gynecologic ward were recruited. Four hundreds primiparous women with no history of urinary incontinence (UI) who fulfilled the criteria and would like to participate in this study were followed up for three months after delivery. The analysis was done using Stata 12. Bivariate analysis using Chi-square test and multivariate analysis using logistic regression test were done to obtain associated risk factors to postpartum SUI.Results: The prevalence of postpartum SUI was 8.8%. The mode of delivery was significantly associated with postpartum SUI, there were more women who got vaginal delivery that had stress urinary incontinence (14.1%) compared to women caesarean section (7.1%) with OR=2.1 (95% CI=1.05-4.31), this risk increased when vaginal delivery was assisted with vacuum instrument (OR=9.1, 95% CI=3.9-21.6). There was no statistical difference of stress urinary incontinence incidences in patients with emergency or elective caesarean section with OR=0.84 (95% CI=0.28-2.57). Based on multivariate analysis BMI ≥30 kg/m2 at labor, vacuum assisted delivery, birth weight more than 3,360 g, and second stage labor more than 60 minutes appeared to be associated with an increased rate of postpartum SUI.Conclusion: Stress urinary incontinence increased in the early postpartum period of a primiparous woman. Although vaginal delivery increased the risk of postpartum SUI, elective nor emergency caesarean delivery without vaginal delivery id not appear to increase the risk of stress urinary incontinence.

Stress Urinary Incontinence in Women With Multiple Sclerosis.

PurposeTo report the prevalence and risk factors of stress urinary incontinence (SUI) and the prevalence of intrinsic sphincter deficiency in women with multiple sclerosis (MS).MethodsWe conducted a retrospective study. Female patients with MS, followed for lower urinary tract symptoms (LUTS) during a 15-year period were included. Demographic data, MS history, expanded disability status scale (EDSS) score at the urodynamic visit, obstetrical past, birth weight, LUTS, and urodynamic findings were collected. SUI was defined as incontinence during cough, or any effort. A maximum urethral closure pressure less than 30 cm H2O defined intrinsic sphincter deficiency.ResultsWe included 363 women with a mean age of 46.7±10.8 years and a mean disease duration of 12.9±8.7 years. The incidence of relapsing remitting MS, a secondary progressive form, and a primary progressive form was 60.6%, 32.8%, and 6.6%, respectively. The prevalence of SUI was 31.4%. The prevalence of intrinsic sphincter deficiency was 1.4% and 0.8% of these patients had a SUI (P=0.300). In a multivariate analysis, women with a SUI had significantly higher birth weight (P=0.030), a pelvic organ prolapse (P=0.021), urgent urinary incontinence (P=0.006), a lower EDSS score (P=0.019), and a weaker containing effort (P<0.001).ConclusionsThe prevalence of SUI in women with MS was 31.4%. This symptom could affect the quality of life of women with MS.

To evaluate the safety and efficacy of the TVT-Secur procedure in the treatment of stress urinary incontinence in women

BackgroundThe prevalence of stress urinary incontinence (SUI) in the middle-aged Indian women is around 16%. The use of transvaginal tapes (TVTs) has revolutionised the surgical management of SUI. Patients who undergo placement of the tape via the transobturator route often complain of persistent thigh pain at the site of trocar insertion. The use of minimally invasive tapes with a single suburethral incision reduces surgical trauma by eliminating thigh incisions, while maintaining the cure achieved by conventional TVTs. The study was conducted to test the efficacy and safety of minimally invasive TVT-Secur tape placement for treatment of SUI in women. Methods20 women with stress incontinence were implanted with TVT-Secur tapes and followed up for a year. ResultsThe objective cure rate of SUI was 85% at the end of a year. The improvement in the patient satisfaction and Incontinence-specific QOL scores, of both Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7), was statistically significant at 95% and 99% confidence levels. There were no complaints of thigh pain; however, there were intraoperative complications in the form of bladder perforation in 5% (n=1), urethral injury in 5% (n=1) and urethral tape exposure in 10% (n=2), at 3 months requiring tape sectioning. ConclusionsThese cure rates and complications are comparable to the standard TVT implantations at the end of a year, without thigh pain; however, a greater number of patients and a longer follow-up is required to see whether the long-term cure is maintained or not, before recommending the same as a standard of treatment.

The Prevalence and Risk Factors of Occult Stress Urinary Incontinence in Women Undergoing Genitourinary Prolapse Surgery

De novo stress urinary incontinence (SUI) may occur in up to 80% of clinically continent women following genitourinary prolapse surgery. This had resulted in an increase in the rate of concurrent continence surgery during prolapse repair from 38% in 2001 to 47% in 2009 in the United States. To date, there is no local data available to estimate the prevalence of occult SUI (OSUI) among Malaysian women awaiting surgery. Therefore, this study was conducted to elicit the prevalence of occult SUI and its associated risks factors in patients awaiting prolapse surgery. We retrospectively studied the records of 296 consecutive women with significant pelvic organ prolapse awaiting reconstructive repair. All patients attended the Urogynaecology Unit in Hospital Kuala Lumpur Malaysia between October 2007 and September 2011. They had undergone standardized interviews, clinical examinations and urodynamic studies. During the urodynamic testings, all prolapses were reduced using ring pessaries to elicit OSUI. Primary outcome was the prevalence of OSUI with prolapse reduction to predict possibility of developing de novo SUI following prolapse surgery. Secondary outcome was the assessment of potential risk factors for OSUI. Among the 296 women studied, 121 (40.9%) were found to have OSUI. The risk factors associated with OSUI included age, BMI, numbers of SVD, recurrent UTI, reduction of urinary flow symptoms and grade 2 to 4 central compartment prolapses. We concluded that preoperative urodynamic testing with reduction of prolapse is useful to identify women with OSUI. This is important for preoperative counselling as well as planning for one step approach of prophylactic concomitant anti-incontinence procedures during prolapse surgery in order to avoid postoperative de novo SUI.

Two-Year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary Incontinence: Correction.

Two-Year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary Incontinence: Correction.

MP65-02 EFFECTS OF A SELECTIVE ANDROGEN RECEPTOR MODULATOR, GSK2849466A AND TESTOSTERONE ON STRESS URINARY INCONTINENCE IN OVARIECTOMIZED RATS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II1 Apr 2016MP65-02 EFFECTS OF A SELECTIVE ANDROGEN RECEPTOR MODULATOR, GSK2849466A AND TESTOSTERONE ON STRESS URINARY INCONTINENCE IN OVARIECTOMIZED RATS Takahiro Shimizu, Katsumi Kadekawa, Naoki Kawamorita, Philip Turnbull, Alan Russell, and Naoki Yoshimura Takahiro ShimizuTakahiro Shimizu More articles by this author , Katsumi KadekawaKatsumi Kadekawa More articles by this author , Naoki KawamoritaNaoki Kawamorita More articles by this author , Philip TurnbullPhilip Turnbull More articles by this author , Alan RussellAlan Russell More articles by this author , and Naoki YoshimuraNaoki Yoshimura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1213AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Stress urinary incontinence (SUI) is common in post-menopausal women, indicating that estrogen deficiency is one of the major causes of SUI that induces atrophic and degenerative changes in urethral and pelvic floor muscles. Selective androgen receptor modulators (SARMs) selectively stimulate anabolic pathway of the androgen receptor (AR) in muscle and bone while sparing the androgenic effects. In this study, we examined effects of a SARM (GSK2849466A, GSK) and dihydrotestosterone (DHT) on urethral continence function in a bilateral ovariectomy (OVX)-induced rat SUI model. METHODS Female nulliparous Sprague-Dawley rats with bilateral OVX were used. Rats were divided into 5 groups; sham operated (S), vehicle-treated OVX (O-V), GSK-treated OVX (0.005 or 0.03 mg/kg/day, po, O-L or O-H, respectively), and DHT-treated OVX (1 mg/kg/day, sc, O-D) groups. At 2 or 3 weeks after OVX, GSK (or vehicle) or DHT treatment was started. Six weeks after OVX, rats were subjected to the evaluation of sneeze-induced continence reflex and sneeze-induced leak point pressure (SLPP) measurements, followed by histological analyses of urethral tissues. RESULTS Urethral baseline pressure (UBP) and the amplitude of urethral responses during sneezing (AURS) were significantly reduced in O-V rats (n=11) by 46% and 38%, compared to S rats (n=8). Compared to the O-V, UBP was significantly increased in the O-L (n=6) and O-H (n=9) by 123% and 86%, and AURS was significantly increased in the O-H and O-D (n=10) by 106% and 60%. Fluid leakage was observed during sneezing in all O-V rats (n=8, SLPP=59.9 ± 9.5 cmH2O) whereas sham rats (n=8) did not leak. The leakage was also observed in O-L (7 of 9 rats, SLPP=67.4 ± 3.0 cmH2O), O-H (1 of 8 rats, SLPP=82.9 cmH2O) and O-D rats (3 of 8 rats, SLPP=73.2 ± 12.8 cmH2O). O-H rats showed hypertrophy/reversal of atrophy of striated (ST) and smooth (SM) muscles in urethral transverse sections, compared to O-V rats. CONCLUSIONS These results indicate that OVX significantly impairs urethral continence function after 6 weeks, and that GSK dose-dependently restores the reductions in UBP, AURS and SLPP accompanied with urethral muscle hypertrophy, leading to the prevention of SUI. Based on our previous studies, UBP and AURS predominantly reflect urethral SM and ST activity in rats. Considering that DHT restores the reduction in AURS without affecting reduced UBP and partially prevents SUI in OVX rats, SARMs could be more effective for the treatment of SUI by enhancing both SM and ST-mediated urethral function under stress conditions such as sneezing. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e864 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Takahiro Shimizu More articles by this author Katsumi Kadekawa More articles by this author Naoki Kawamorita More articles by this author Philip Turnbull More articles by this author Alan Russell More articles by this author Naoki Yoshimura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...