Therapy For Urinary Incontinence Research Articles

In silico identification of a biarylamine acting as agonist at human β3 adrenoceptors and exerting BRL37344-like effects on mouse metabolism.

Human β3-adrenoceptor (β3AR) agonists were considered potential agents for the treatment of metabolic disorders. However, compounds tested as β3AR ligands have shown marked differences in pharmacological profile in rodent and human species, although these compounds remain attractive as they were successfully repurposed for the therapy of urinary incontinence. In this work, some biarylamine compounds were designed and tested in silico as potential β3AR agonists on 3-D models of mouse or human β3ARs. Based on the theoretical results, we identified, synthesized and tested a biarylamine compound (polibegron). In CHO-K1 cells expressing the human β3AR, polibegron and the β3AR agonist BRL 37344 were partial agonists for stimulating cAMP accumulation (50 and 57% of the response to isoproterenol, respectively). The potency of polibegron was 1.71- and 4.5-fold higher than that of isoproterenol and BRL37344, respectively. These results indicate that polibegron acts as a potent, but partial, agonist at human β3ARs. In C57BL/6N mice with obesity induced by a high-fat diet, similar effects of the equimolar intraperitoneal administration of polibegron and BRL37344 were observed on weight, visceral fat and plasma levels of glucose, cholesterol and triglycerides. Similarities and differences between species related to ligand-receptor interactions can be useful for drug designing.

New technologies for noninvasive aesthetic treatments

In recent years, the demand for noninvasive aesthetic treatments has increased significantly. New systems and technological innovations open new possibilities for practitioners and patients in the field of body contouring, noninvasive face lifting, skin tightening and rejuvenation, as well as effective therapies for urinary incontinence or erectile dysfunction. Currently, the most well-known innovations include technologies such as high-intensity focused electromagnetic field (HIFEM™) and radiofrequency (RF), which, after more than 30years of research, could be combined in the RF-SYNCHRODE™ (BTL Medizintechnik GmbH, Prague, Czech republic) without any health risks for the patient. This allows the reduction of adipose tissue and the building of muscle in asingle treatment. The newer HIFES™ technology was developed specifically for the treatment of the facial area and facial muscles. It is used with synchronized radiofrequency for noninvasive, painless face lifting and skin tightening, and is also suitable for botulinum toxin patients. Visible, noticeable, and long-lasting treatment results are achieved without significant side effects after only 4-6sessions. These noninvasive, FDA(Food and Drug Administration)- and CE-certified systems are used in everyday practice and clinical routine in dermatology, gynecology, urology, and physiotherapy and represent areal alternative to invasive aesthetic plastic surgery.

A comprehensive review on hydrogel materials in urology: Problems, methods, and new opportunities.

Hydrogel materials provide an extremely promising group of materials that can find an increasingly wide range of use in treating urinary system conditions due to their unique properties. The present review describes achievements to date in terms of the use and development prospects of hydrogel materials applications in the treatment and reconstruction of the urinary system organs, which among others include: hydrogel systems of intravesical drug delivery, ureteral stents design, treatment of vesicoureteral reflux, urinary bladder and urethral defects reconstruction, design of modern urinary catheters and also solutions applied in urinary incontinence therapy (Figure 4). In addition, hydrogel materials find increasingly growing applications in the construction of educational simulation models of organs and specific conditions of the urinary system, which enable the education of medical personnel. Numerous research efforts are underway to expand the existing treatment methods and reconstruction of the urinary system based on hydrogel materials. After conducting the further necessary research, many of the innovative solutions developed to date have high application potential.

A Novel Concept for Unidirectional Communication With an Active Implant Based on Deliberately Produced Human Body Signals.

A new patient-friendly and discrete approach to build a unidirectional communication path with active implants based on deliberately produced human body signals is presented. The application for which this approach is intended is an artificial urinary sphincter implant, the closure mechanism of which is wirelessly actuated in the event of micturition need. Conventional implant communication methods can be associated with limitations regarding technological implementation and usability, and are used by medical professionals only. In order to enable patients to discretely and directly communicate with their implant without the need for an external handheld device, the feasibility of a communication approach based on manually applied 'knocking' signals on abdominal tissue is examined in the presented work. A gelatin-based phantom model is used to mimic vibro-acoustic properties of human soft tissue in vitro. A piezoelectric element and an electret microphone are applied as sensors for signal detection at the implantation site and are investigated with respect to their suitability for the intended application. Clinical Relevance- The presented implant communication method can contribute to urinary incontinence therapy by enabling patients to discretely and user-friendly actuate their artificial sphincter implant and can provide a basis for future research into new implant communication technologies.

The effect of pelvic floor muscle training on urinary incontinence in patients with stroke: a systematic review and meta-analysis.

No other systematic review presented the effectiveness of pelvic floor muscle training (PFMT) in individual with stroke. The purpose of this systematic review and meta-analysis was to demonstrate the effectiveness of PFMT for urinary incontinence in patients with stroke. "Web of Science (WoS), Cochrane Library, PubMed and Scopus" databases were searched. "Revised Cochrane risk-of-bias tool randomized trials (RoB 2)" and "PEDro" were used to assess the risk of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were conducted to present the results. A total of 8 articles were included in the review. Seven articles were classified as "good" level evidence. Four articles were considered to have "high risk" of bias for the overall score. Regarding two homogenous studies, PFMT-based rehabilitation was not superior standard urinary incontinence therapy on SF-36-Social Function score at 12-week follow-up (ES 0.47, 95% CI - 0.16-0.96). Data pooling of two studies did not provide an additional advantage of pelvic muscle training on 3days voiding diary (night, total day) score at 12-week follow-up (ES 28, 95% CI - 0.61-0.48; ES 0.30, 95% CI - 0.23-0.95). On the other hand, low-quality evidence demonstrated that pelvic muscle training yielded better results on daytime voiding (ES 0.28, 95% CI 0.04-1.16). The results demonstrated that PFMT had positive effects in terms of daytime urination frequency and incontinence. Although some studies have reported positive effects on symptoms, function, strength, and endurance, the generalizability of these results is controversial. Further studies should assess the quality-of-life and function with urinary incontinence and stroke-specific tools.

MP18-04 ENURESIS AND LOWER URINARY TRACT DYSFUNCTION: A RELATIONSHIP NOT TRULY DISCUSSED

You have accessJournal of UrologyCME1 May 2022MP18-04 ENURESIS AND LOWER URINARY TRACT DYSFUNCTION: A RELATIONSHIP NOT TRULY DISCUSSED Ana Castro, Glicia Abreu, Bruna Venturini, Eliakim Massuqueto, and Ubirajara Barroso Ana CastroAna Castro More articles by this author , Glicia AbreuGlicia Abreu More articles by this author , Bruna VenturiniBruna Venturini More articles by this author , Eliakim MassuquetoEliakim Massuqueto More articles by this author , and Ubirajara BarrosoUbirajara Barroso More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002551.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Enuresis is one of the most common medical complaints in pediatric urology. In non-monosymptomatic (NME) enuresis, lower urinary tract dysfunction (LUTD) needs further investigation, as daytime symptom control is crucial for enuresis therapy. Although NME corresponds to 50%-80% of all enuresis cases, the relationship between daytime and nighttime symptoms is poorly understood. NME is highly heterogenous and may not be the cause, but only overlap with enuresis. Therefore, a better description of lower urinary tract symptoms (LUTS) in patients with enuresis is of paramount importance. The aim of this study is to estimate the prevalence and impact of LUTS enuresis and characterize the determining factors of this clinical condition. METHODS: This is an observational, cross-sectional, descriptive and analytical study, which included individuals aged 5-17 years who answered yes to the presence of enuresis. To assess LUTS, the Disfunctional Voiding Scoring System (DVSS) was used. Participants with at least 1 symptom according to the DVSS were considered to have NME. NME group was further divided into Overactive Bladder (OAB), Voiding Postponement (VP) and Dysfunctional Voiding/Hypoactive Bladder (DV/HB) for intragroup analysis. RESULTS: 84 participants were included, with a median age of 7.00 (Interquartile Range 6.00-10.00) and 47 (56.0%) male participants, with no difference between the MNE and NME groups. There was no difference between the two groups also regarding the rate of constipation (p=0.369) and the whether the enuresis was primary or secondary (p=0.148). 71.4% presented NME. Daytime symptoms included holding maneuvers (71.7%), urgency (68.3%), incontinence (26.7%), increased urinary frequency (10%), effort to urinate (1,7%) and dysuria (1,7%). Enuresis was more severe in patients with holding maneuvers (p=0.029) and urgency (p=0.045). According to the type of LUTD, OAB was present in 63.3%, VP in 13.3% and DV/HB in 23.3%. Primary NME was associated with OAB and the secondary NME had more VP and DV/HB. An association was found between the severity of enuresis and the type of LUTD (p=0.002), with a higher prevalence of patients with Overactive Bladder in the frequency > 3 times a week. No Voiding Postponement had >3x enuresis in a week. CONCLUSIONS: To our knowledge, this is the first study that evaluate the relationship of enuresis and the LUTD subtypes and the severity of enuresis and daytime symptoms. The presence of urgency and holding maneuvers is associated to a more severe enuresis. Of interest, no VP patient has more than 3 times per week enuresis episodes. Most of non-monosymptomatic enuretic patients have OAB. We expect that patients with primary NME have more OAB and those with secondary NME have more VP and DV/HB. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e296 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ana Castro More articles by this author Glicia Abreu More articles by this author Bruna Venturini More articles by this author Eliakim Massuqueto More articles by this author Ubirajara Barroso More articles by this author Expand All Advertisement PDF DownloadLoading ...

Exploratory evaluation of baseline cognition as a predictor of perceived benefit in a study of behavioral therapy for urinary incontinence in Parkinson disease.

While behavior-based pelvic floor muscle exercise therapy is an effective treatment for overactive bladder in Parkinson's disease (PD) patients, cognitive function may be a predictor of rehabilitation outcomes. In a planned exploratory analysis, participants who had a Montreal Cognitive Assessment (MoCA) with a score ≥18 who were randomized in a clinical trial to behavioral treatment were classified by perceived improvement (Benefit vs. No Benefit) as reported on a validated Satisfaction and Benefit Questionnaire. General cognition (MoCA), motor procedural learning (Serial reaction time task), verbal memory (Buschke delayed recall), spatial memory (Nonverbal/Spatial selective reminding test), and working memory (Wisconsin card sorting task) were compared between the two groups using Wilcoxon rank-sum test. Of the 26 participants randomized to behavioral treatment (70% male, mean age 71 ± 6.1 years), 22 participants (85%) reported Benefit and four reported No Benefit. General cognition, motor procedural learning, verbal memory, spatial memory, and working memory did not differ between these groups. While the difference between the time to complete the final practiced series and the random series of the Serial Reaction Time Task (SRTT) was statistically similar between the groups, the Benefit group performed the random sequence more quickly (567.0 ± 136.5 ms) compared to the No Benefit group (959.4 ± 443.0 ms; p = 0.03) and trended toward faster performance in the final practiced series. Perceived benefit from behavioral treatment for overactive bladder was not associated with measures of baseline cognition other than faster completion of the SRTT. This is noteworthy because many behavior-based therapy studies exclude participants with mild cognitive impairment. Additional studies may evaluate if domain-specific cognitive function, particularly the assessment of implicit memory, could lead to individualized behavioral therapy recommendations.

Effects of nonsurgical, minimally or noninvasive therapies for urinary incontinence due to neurogenic bladder: a systematic review and meta-analysis.

Objective:To determine the effects of nonsurgical, minimally or noninvasive therapies on urge urinary incontinence (UUI) symptoms and quality of life (QoL) in individuals with neurogenic bladder (NGB).Data Sources:Cochrane library, EMBASE, MEDLINE, PEDro, Scopus, and Web of Science databases were searched from inception to September 2021.Review Methods:Randomized controlled trials that compared therapies such as intravaginal electrical stimulation (IVES), transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), transcutaneous tibial nerve stimulation (TTNS), pelvic floor muscle training (PFMT), and behavioural therapy (BT) to control were included. Study screening, data extraction, and study quality assessments were performed by two independent authors.Results:Fourteen trials with 804 participants were included in the study after screening of 4281 potentially relevant articles. Meta-analyses revealed a significant effect of electrical stimulation on UUI due to multiple sclerosis (standardized mean difference (SMD): −0.614; 95% confidence interval (CI): −1.023, −0.206; p = 0.003) and stroke (SMD: −2.639; 95% CI: −3.804, −1.474; p = 0.000). The pooled analyses of TTNS (weighted mean difference (WMD): −12.406; 95% CI: −16.015, −8.797; p = 0.000) and BT (WMD: −9.117; 95% CI: −14.746, −3.487; p = 0.002) revealed significant effects of these interventions on QoL in people with Parkinson’s disease. However, meta-analyses revealed nonsignificant effects for PFMT (WMD: −0.751; 95% CI: −2.426, 0.924; p = 0.380) and BT (WMD: −0.597; 95% CI: −1.278, 0.083; p = 0.085) on UUI due to Parkinson’s disease.Conclusions:Our meta-analyses found electrical stimulation to be beneficial for improving the symptoms of UUI among people with multiple sclerosis and those with stroke. Our review also revealed that TTNS and BT might improve QoL for people with NGB due to Parkinson’s disease, although the effects of PFMT and BT on UUI warrant further investigation.

Inkontinencia moču a Medilady

Introduction: Within the framework of the use of various aids for the therapy of urinary incontinence, a wide space has opened up for the autonomous activity of the nurse. In her own way, the nurse is the main point of communication for all other members of the team, including the doctor himself, precisely in the assessment and reporting of the information found. The paper analyzed the types of physical therapy for stress urinary incontinence and conducted research on a selected group of female respondents who used the patented Medilady rehabilitation aid in the treatment of incontinence. Objective: The objective of the contribution was to monitor the impact of urinary incontinence on the quality of life of women using the Medilady rehabilitation aid. Methodology: The research file consisted of female respondents with a diagnosis of stress urinary incontinence (SUI), who used the Medilady rehabilitation aid to strengthen the pelvic floor muscles for more than 90 days. Data collection took place between 08/2021 - 01/2022 at the Viennese Private Clinic in Vienna, after the agreement of the clinic management with the subsequent approval and publication of the questionnaire for the designated group of female respondents, in the form of quantitative research. 96 female respondents were approached. Of these, 81 questionnaires were completely filled out and returned. The data were processed by statistical analysis using the binomial test and the paired Wilcoxon test Results: The treatment of urinary incontinence in women with the rehabilitation aid Medilady is a relative novelty. This greatly limited the selection of suitable respondents for the conducted research. According to the selected criteria, 91% of the clients increased the weight of the weights, so we can evaluate that the pelvic floor was effectively strengthened in the specified cohort of clients. 71% of users reported no negative experiences with the use of Medilady. Conclusion: The limits of the research were in the relatively low number of respondents and the patented device Medilady, which is new in the treatment of urinary incontinence, where comparisons of results in professional studies were not available. Further research needs to be continued due to urinary incontinence and its impact on the quality of life of the woman herself.

Pelvic floor muscle exercise and training for coping with urinary incontinence.

The pelvic floor consists of levator ani muscles including puborectalis, pubococcygeus and iliococcygeus muscles, and coccygeus muscles. Pelvic floor muscle exercise (PFME) is defined as exercise to improve pelvic floor muscle strength, power, endurance, relaxation, or a combination of these parameters. PFME strengthens the pelvic floor muscles to provide urethral support to prevent urine leakage and suppress urgency. This exercise has been recommended for urinary incontinence since first described by Kegel. When treating urinary incontinence, particularly stress urinary incontinence, PFME has been recommended as first-line treatment. This article provides clinical application of PFME as a behavioral therapy for urinary incontinence. Clinicians and physical therapist should understand pelvic floor muscle anatomy, evaluation, regimen, and instruct patients how to train the muscles properly.

Intraurethral Energy Harvesting from Urine Flow as an Approach to Power Urologic Implants.

Active urologic implants, such as bladder stimulators or artificial sphincters, are a widely-used approach for therapy of urinary incontinence. At present these devices are powered by primary batteries or conventional wireless power transferring techniques. As these methods are associated with several limitations, human body energy harvesting can be a promising alternative or complement for power supply. This paper introduces an approach to harvest energy from the urine flow inside the urethra with a mechatronic harvesting system based on a hubless flow turbine. Using a test bench approximating the flow conditions of the lower urinary tract, the feasibility of the harvesting principle is shown in-vitro.

Effectiveness of Structured teaching programme on knowledge regarding Pelvic floor muscle exercises in prevention of Urinary incontinence among premenopausal women admitted in selected hospital Bangalore

Introduction: Urinary incontinence, loss of bladder control, is a common and often embarrassing problem which may have a profound impact on quality of life. Women in their premenopausal period may find pelvic muscles are simply weaker than they were before. These muscles may not have enough strength to hold the sphincters close and may cause unwanted leakage of urine. Pelvic floor exercises often also called kegel exercises after their originator, Dr. Arnold Kegel are widely promoted as the starting point for building pelvic floor strength. As urinary incontinence is not a life threating condition, quality of life takes precedence over other issues when deciding the therapy. Pelvic floor muscle education is a well acceptable therapy for urinary incontinence. Assessing patient’s knowledge regarding pelvic floor muscle exercises in an effort to improve their quality of life may be a reasonable starting point. Materials and Methods: It is quantitative quasi experimental research conducted among 40 premenopausal women who were admitted in St. Martha’s Hospital Bangalore. Self-structured questionnaire was used to assess the knowledge on pelvic floor muscle exercises. The pretest was administered to control and experiment groups, followed by which post-test was done for the control group. Whereas the experiment group were given a Video Assisted Teaching Programme on Pelvic Floor Muscle Exercises and then administered a post-test. Result and Conclusion: The mean of pretest was 13.02 with standard deviation of 4.02 whereas the post-test mean score was 19.22 with the standard deviation of 3.62. The present study concluded there is an improvement in the knowledge level after the administration of Video Assisted teaching programme on pelvic floor muscle exercises and the study also revealed there is no association between the knowledge scores and the selected demographic variables (age, educational status and place of residence) and clinical variables (parity, type of delivery and urinary incontinence).

Behavioral therapy for urinary incontinence in elderly women: an experience of trans personal care

Behavioral therapy for urinary incontinence in elderly women: an experience of trans personal care

Long-term results of augmentation ileocystoplasty in spinal cord injury patients.

IntroductionThe aim of this article was to report the long-term results of increased ileocystoplasty in 58 patients with spinal cord injury (SCI) with an impact on overall renal function and quality of life. In a representative number of patients, where we followed individual subjects for more than 20 years, we wanted to determine their quality of life and preservation of renal function after surgery.Material and methodsAfter unsuccessful conservative therapy of urinary incontinence, increased ileocystoplasty was performed. In addition to biochemical analysis, intravenous urography (IVU) was performed preoperatively (urography and/or ultrasound assessment of the upper urinary tract) and urodynamic tests were performed in all patients preoperatively.ResultsAfter a follow-up of patients within the group (>20 years), 2 patients reported being incontinent. The median elapsed time of action was 20 (13–24) years. Vesical capacity increased in all cases postoperatively when the median vesical capacity was 420.0 (387.5–460.0) ml (p <0.001). Long-term complications included use of bladder chambers, kidney stones and urosepsis. Creatinine clearance confirmed satisfactory renal function after the elapsed time period from surgery.ConclusionsThe results confirmed that augmentation ileocystoplasty had excellent long-term outcomes in the definitive therapy of refractory neurogenic detrusor overactivity in patients with SCI.

EFFECTIVENESS OF KEGEL’S EXERCISES IN ELDERLY MALE AND FEMALE WITH URINARY INCONTINENCE

Objective: to determine the effectiveness of Kegel exercises in elderly male and female patients with stress urinary incontinence. Methodology: A quasi experimental study was conducted at In Department of urology of Shaheed Mohtarma Benazir Bhutto medical university, Chandka medical college Larkana Sindh from January 2017 to June 2019. The non-probability convenient sampling technique was used for sample selection. The n=43 patient with the age above 55 years was included in the study. Patient with neurological, cognitive and male with prostate problem were excluded from the study. Both male and female were received intervention of Kegel exercise (KE) for three months and 3-4 time/day. The urinary distress inventory (UDI) and Incontinence impact questionnaire was used for urinary distress and quality of life. The data was obtained at baseline, at 6th week and after 12th week. The mean±SD, n(%), Mean difference (MD), p-value (p&lt;0.05) and effect size (Cohen’s d &amp; partial eta square was use to describe the data. For within group analysis Repeated Measure ANOVA was used and for between the groups analysis independent t-test was used. SPSS ver 21 was used for data analysis. Results: The mean age of the study participants was 64.97±9.36 year. Within group analysis showed large significant improvement in both, males and females (p&lt;0.05). However, between group differences showed significant improvement with larger effect size in males as compared to females (p&lt;0.05). Conclusion: Kegel exercises are effective therapy for urinary incontinence in both genders. But Kegel exercises are more effective in males for urinary incontinence in improving urinary distress and quality of life. Keywords: Geriatric population, Kegel exercises, Urinary incontinence

Biofeedback in Treatment and Rehabilitation of Urinаry Incontinence in Women

Urinary incontinence is one of the most common urological pathologies and reduces the quality of life of patients. In the development of stress and mixed urinary incontinence in women, an important part belongs to the failure of the pelvic floor muscles. Pelvic floor muscle training has changed the approach to treating these patients. Pelvic muscle training in combination with biofeedback (BFB) makes it possible to teach patients how to perform exercises correctly, increasing their effectiveness, as a result. This leads to a decrease in the duration of treatment and an improvement in the quality of life of patients. This review deals with mechanisms of urinary retention in women, and presents the pathogenetic rationale for the use of pelvic muscle training and biofeedback in the treatment of urinary incontinence in women. The possibilities of biofeedback therapy for urinary incontinence are shown, treatment methods are described in detail, and the analysis of current results of clinical trials is carried out. To date, it has been proven that the use of pelvic floor muscle training under the control of biofeedback is an effective, available and safe method of treating urinary incontinence inwomen.

Laser therapy for urinary incontinence and pelvic organ prolapse: a systematic review.

Laser therapy is now being proposed for the treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). To systematically review the available literature on laser therapy for POP and UI. PubMed, Web Of Science and Embase were searched for relevant articles, using a three-concept (POP, UI, laser therapy) search engine composed as (concept 1 OR concept 2) AND concept 3. Only full-text clinical studies in English. Data on patient characteristics, laser setting, treatment outcome and adverse events were independently collected by two researchers. There was a lack of methodological uniformity so meta-analysis was not possible and the results are presented narratively. Thirty-one studies recruiting 1530 adult women met the inclusion criteria. All studies showed significant improvement either on UI, POP or both; however the heterogeneity of laser settings, application and outcome measures was huge. Only one study was a randomised controlled trial, two studies were controlled cohort studies. All three were on UI and used standardised validated tools. The risk of bias in the randomised controlled trial was low on all seven domains; the controlled studies had a serious risk of bias. No major adverse events were reported, mild pain and burning sensation were the most commonly described adverse events. All studies on vaginal and/or urethral laser application for POP and UI report improvement, but the quality of studies needs to be improved. There is weak evidence that laser therapy is effective for urinary incontinence and pelvic organ prolapse #LASER#UI#POP.

Modern Therapy of Urinary Incontinence Using Muscle Stem Cells

Modern Therapy of Urinary Incontinence Using Muscle Stem Cells Abstract. Urinary incontinence affects a large number of patients, and the cost of treatment continues to rise with the demographic change. There are various conservative and surgical therapies, which are often limited in their effect or limited in time. We are lacking long-term and sustainable solutions, whereas the treatment with a regenerative approach using stem cells forms a promising alternative. Various preclinical and clinical studies have investigated the use of precursor cells to strengthen the urinary sphincter muscle. This review discusses the issue of stress incontinence from the physiological point of view to conventional treatment and novel therapies using muscle stem cells. In addition, the authors inform about an ongoing prospective trial at the University Hospital in Zurich, which makes use of this modern and regenerative therapy form.

Which procedure for stress urinary incontinence? Injectable.

Which procedure for stress urinary incontinence? Injectable.

Quality and Reliability of Publicly Accessible Information on Laser Treatments for Urinary Incontinence: What Is Available to Our Patients?

To determine the quality and reliability of the top 20 internet search results for laser treatment of stress urinary incontinence (SUI). Review of 20 websites. N/A. None. An internet search with the most popular search engine, Google, was undertaken to identify the top 20 websites for laser treatment of SUI. The DISCERN instrument, Journal of the American Medical Association (JAMA) benchmarks, and Health on the Net Foundation Code of Conduct certification, which are standardized, validated tools for the analysis of website quality, credibility, and transparency, were used independently by 7 healthcare workers. The readability of the information was assessed by a single reviewer using the Flesch-Kincaid Grade Level and Automated Readability Index. The intraclass correlation coefficient was calculated to document the reliability among website assessors. Of the 20 websites reviewed, 15 were created by private clinics, 2 by online newspaper or newsletter sites, and 3 by laser medical device manufacturers. None of the websites met all of the JAMA criteria: 1 had attained authorship, 1 had clear attribution, none had adequate disclosure, and 2 achieved currency. None of the websites took part in the Health on the Net Foundation Code of Conduct certification program. The mean DISCERN score (to determine the quality of websites) was 40 (out of 80), with the lowest average scores within the DISCERN tool primarily associated with clarity around sources of information, website bias, posting dates, risks of treatment, and shared treatment decision-making. The intraclass correlation coefficient was calculated for the DISCERN tool (0.72; 95% confidence interval, 0.48-0.87) and JAMA benchmarks (0.85; 95% confidence interval, 0.73-0.93). The mean Flesch-Kincaid Grade Level was 13.2 (±3.1) and the Automated Readability Index scores ranged from 7.6 to 22.8 (mean 13.5 ± 3.5). There is a lack of good quality, reliable, and unbiased information available to patients on laser treatment of SUI on the most commonly searched websites. Information is presented at a reading level that is above that of the average reader, which may indicate that patients will have trouble comprehending the information.