Treatment Of Female Urinary Incontinence Research Articles

Pelvic floor therapy program for the treatment of female urinary incontinence in Belize: a pilot study.

Urinary incontinence (UI) is highly prevalent in low- and middle-income countries (LMIC). Concurrently, the availability of surgical or conservative UI treatments in LMIC is limited. We conducted a prospective feasibility study of Belize women with UI treated with pelvic floor physical therapy (PFPT) and education (PFE). Patients received individual PFPT/PFE over 2 days, consisting of biofeedback-enhanced PFMT in addition to behavioral, dietary, and general pelvic education. Patient completed a daily 6-month home regimen including 7 PFMT exercises (total 70 repetitions) comprising both endurance and quick flick exercises. Patients also performed comprehensive dietary and behavioral modification activities. Outcomes were assessed at baseline and 6-months, including validated symptom (ICIQ-FLUTS) and QOL (IIQ-7) questionnaires, and strength testing (PERFECT score, perineometry). Twenty-eight patients underwent baseline assessment. Four patients were lost to in-person 6-month follow-up, with two of these patients completing subjective assessment only by telephone. The mean (±SD) patient age, BMI, and parity were 50.0 (±10.0) years, 33.2 (±5.8), and 2.8 (±1.5). Provider assessment demonstrated patient comprehension of basic, endurance, and quick flick pelvic floor contractions in 28 (100%), 24 (86%), and 24 (86%) patients, respectively. At 6-month follow-up, significant improvements were seen across multiple validated questionnaire and strength measurement assessments. Median patient-reported improvement level was 7.0 on a 10-point Likert scale. Study patients demonstrated good understanding of PFMT/PFE and program completion was associated with significant improvements across a variety of subjective incontinence and quality of life outcomes, as well as objective strength testing.

Digital physical therapy intervention to treat female urinary incontinence: a semi-experimental study

Background: Urinary incontinence affects 15-40% Brazilians in rural areas, indicating the necessity of treatment for people in remote regions. Digital technology could be an option, but the evidence-based digital health intervention remains untapped. Objective: To assess whether a group intervention by synchronous video call reduces the severity of female urinary incontinence symptoms and to assess woman’s perception on this modality. Methods: Incontinent women who had digital access were invited to this semi-experimental study. An 8-week protocol was conducted through video calls once a week. Lifestyle counseling and exercises were performed. Pre- and post-evaluations were done exclusively by phone call. Results: 48 women were enrolled in the study and 40 concluded the protocol. They were 56.5 years (±12.0) and most of them had mixed urinary incontinence. The impact on quality of life and the severity of urinary incontinence symptoms was significantly improved and most of the participants were completely satisfied with the intervention. A large effect size was observed (Glass’s delta = 0.83) Conclusion: Our findings support a digital group approach for the treatment of female urinary incontinence as an alternative to be further explored. Combining digital service with group assistance brought satisfaction and clinical results for the participants and it can be promising for public health services.

Pippi is lost - what do we do? Conservative treatments for female urinary incontinence - a practical report based on the current S2k guideline for urinary incontinence

Female urinary incontinence can occur at any age. There is a wide range of diagnostic and therapeutic tools, the application of which is based on the patient's suffering and the motivation for therapy. Conservative measures should be considered before surgical treatment of incontinence. Professional diagnostic testing and well-founded advice can give every affected woman the chance of individualised treatment. The aim of this article is to formulate practical and patient-oriented tips from the point of view of a clinician.

The impact of socio-demographic factors on adherence and persistence to the treatment of female urinary incontinence aided by an app: a randomized longitudinal study

The impact of socio-demographic factors on adherence and persistence to the treatment of female urinary incontinence aided by an app: a randomized longitudinal study

The Effects of Extracorporeal Magnetic Innervation in the Treatment of Women with Urinary Incontinence: A Systematic Review.

The aim of this study is to identify and critically evaluate literature regarding the clinical efficacy of extracorporeal magnetic innervation (ExMI) in the treatment of female patients with urinary incontinence (UI). An analysis was carried out using the following electronic databases: Medline, PubMed, ScienceDirect, and the Cochrane Library (data published between 2008 and 2023). Searches of the above databases were conducted in April 2023. Only randomized clinical studies (RCTs) in English studies were eligible for the study. Randomized controlled trials were included in the review and evaluated with the Downs and Black checklist. Eleven studies met the inclusion criteria. Among these, two studies examined the use of ExMI and PMFT (pelvic floor muscle training) and three studies compared active ExMI versus sham ExMI. Four studies evaluated solely ExMI, and moreover, there was no control group in two of these studies. One study compared the effects of Kegel exercises with ExMI, while another study compared electrostimulation with ExMI. The reviewed studies exhibited significant differences in interventions, populations, and outcome measures. Extracorporeal magnetic stimulation has shown promise as an effective treatment for female urinary incontinence. Whether used alone or as a component of combination therapy, ExMI has the potential to enhance patients' quality of life (QoL) without significant safety concerns.

Care provider views on app-based treatment for female urinary incontinence: a mixed-methods study.

App-based treatment for female urinary incontinence (UI) is a cost-effective alternative to care as usual. For successful implementation it is of major importance to involve stakeholders like care providers. To explore the views and preferences of care providers on app use for the treatment of UI and to identify the anticipated barriers to, and facilitators of, implementation. We performed an exploratory, two-phase, sequential mixed-methods study. In phase 1, the views of care providers were explored through five focus group sessions with care providers involved in UI: GPs, practice assistants (PAs), pelvic physical therapists (PPTs), and (uro)gynecologists (UGs). In phase 2, the identified themes and subthemes were quantified in an online survey distributed among different care providers matching these groups. In the focus group sessions, 30 female and two male care providers participated. Survey participants included 351 PAs and 76 PPTs (all female) next to 124 GPs and 183 UGs (70% female). Caregivers generally considered UI treatment apps as having a supportive role, being less convinced about their advantages in the absence of a care provider. Additionally, they required that the effectiveness of an app should be proven first, and that privacy and safety should be ensured. Contrasting with other research, lack of time and financial compensation were not considered important barriers to implementation. Our results add to the existing knowledge about eHealth-related barriers and facilitators. These findings can be used to optimise implementation strategies for other apps and to enhance the uptake of app-based treatment for UI in the Netherlands.

69 — Telerehabilitation in the treatment of female urinary incontinence

69 — Telerehabilitation in the treatment of female urinary incontinence

2 F - The use of mobile applications for pelvic floor training in the home treatment of female urinary incontinence

2 F - The use of mobile applications for pelvic floor training in the home treatment of female urinary incontinence

Care provider views on app-based treatment for female urinary incontinence: A mixed-methods study

Objective:To explore the views and preferences of care providers on app use for the treatment of UI and to identify the anticipated barriers to, and facilitators of, implementation. Patients and Methods:We performed an exploratory, two-phase, sequential mixed-methods study. In phase 1, the views of care providers were explored through five focus group sessions with care providers involved in UI: general practitioners (GPs), practice assistants (PAs), pelvic physical therapists (PPTs), and urologists and (uro)gynecologists (UGs). In phase 2, the identified themes and subthemes were quantified in an online survey distributed among different care providers matching these groups. Results:In the focus group sessions, 30 female and two male care providers participated. Survey participants included 351 PAs and 76 PPTs (all females) next to 124 GPs and 183 UGs (70% females). Caregivers generally considered UI treatment apps as having a supportive role, being less convinced about their advantages in the absence of a care provider. Whereas most PPTs (89%) and the majority of participants overall (56%) agreed that app use should be supervised, most GPs considered apps to be suitable alternatives for women who do not visit a care provider. Additionally, caregivers required that the effectiveness of an app should be proven first, and that privacy and safety should be ensured. Contrasting with other research, lack of time and financial compensation were not considered important barriers to implementation. Although care providers shared a positive view of app use for UI treatment, most never to seldom referred their patients to existing tools. Conclusion:Our results add to the existing knowledge about eHealth-related barriers and facilitators. These findings can be used to optimize implementation strategies for other apps and to enhance the uptake of app-based treatment for UI in The Netherlands.

How about the RCTs' quality of acupuncture treatment for female urinary incontinence in recent 20years? A report quality assessment.

To evaluate the quality of randomized controlled trials (RCTs) of acupuncture on female urinary incontinence (UI). We searched for related RCTs of acupuncture on female UI from seven databases (PubMed, Embase, Cochrane library, Web of Science, Medline, ClinicalKey, and Clinical trials). We applied CONSORT (2010year) and STRICTA criteria to evaluate the relevant factors of included RCTs. Two trained researchers scored independently, and concordance was assessed by Cohen's к-statistic. The median and interquartile range summarized the CONSORT and STRICTA scores of the included studies. In addition, two independent sample t tests were used to assess the differences in the study quality between the 2000-2010 and the 2011-2022years. A total of 25 RCTs were finally included, and the scores were consistent between different assessors. The average CONSORT score was 10.50 (IQR 9.0-15.0) (total score was 25.0). Overall, the studies generally included scientific background (24/25, 96%), inclusion and exclusion criteria (24/25, 96%), outcome indicators (24/25, 96%), randomization methods (21/25, 84%), generalizability (19/25, 76%), and financial support (15/25, 60%). Most lacked sample size calculation (5/25, 20%), type of randomization (5/25, 20%), blinding (6/25, 24%), case screening period and follow-up (4/25, 16%), and study registration (6/25, 24%), etc. The average STRICTA score was 3.380 (IQR 3.02-3.95) (total score was 6.0). There had a lack of education on treatment methods for patients (3/25, 12%) and the qualification of acupuncturists (6/25, 24%). The overall quality of RCTs on acupuncture treatment of female UI was suboptimal. It is still necessary to improve the research methods, especially the application of random methods, blinding, the interpretation of treatment, and the identification qualification of acupuncturists.

Clinical Outcomes of Mid-Urethral Sling (MUS) Procedures for the Treatment of Female Urinary Incontinence: A Multicenter Study.

Stress urinary incontinence (SUI) has a significant impact on the quality of life of many women. Due to embarrassment, most women do not seek medical attention for this condition. The treatment of this problem includes preventive therapies, and in the more advanced stage of urinary incontinence, surgery is a solution. Despite doubts regarding the implantation of urological tapes, the use of tension-free minimally invasive methods constitutes the "gold standard" in the treatment of stress urinary incontinence in women. The purpose of this article was to evaluate the efficacy and safety of ultralight, polypropylene urogynecological tape (Dallop® NM ULTRALIGHT, Tricomed S.A., Poland) in the surgical treatment of female stress urinary incontinence and mixed urinary incontinence. This is a multicenter, retrospective cohort study. The included women were adults with stress urinary incontinence (Grade 2 with a positive cough test or Grade 3) or had mixed urinary incontinence and who had undergone "retropubic" or "transobturator" surgery and completed a postoperative follow-up. The study included 68 women from three hospitals. All women completed <6-month and >6-month follow-ups. The median age was 55 (range 36-80). The average value of BMI in the "retropubic" group was 28.6 ± 5.58, and in the "transobturator" group, it was 26.1 ± 4.60. Sixty-three percent (63%, n = 43) of patients were operated on using the "transobturator" method, while thirty-seven percent (37%, n = 25) were operated on using the "retropubic" method. Both the "retropubic" and "transobturator" groups had comparable results in the treatment of SUI. The study showed efficiencies of 84% for the "transobturator" method and 80% for the "retropubic" method. In the "retropubic" group, intraoperative complications were reported in three patients (7%), in comparison to none in the "transobturator" group. There were no tape-related adverse events or infections reported in any case. The presented research confirms the safety and efficacy of retropubic and transobturator tape methods in both short- and long-term follow-up-the success rate was over 80%. In addition to the surgical method used, the experience of the surgeons also has an impact on the final outcome of the surgery. The conducted multi-center study offers the opportunity to eliminate the influence of the human factor on the effectiveness of the procedure.

Tension-Free Vaginal Tape and Polyacrylamide Hydrogel Injection for Primary Stress Urinary Incontinence: 3-Year Followup from a Randomized Clinical Trial.

We sought to determine whether polyacrylamide hydrogel (PAHG) is noninferior to tension-free vaginal tape (TVT) in the treatment of women with primary stress urinary incontinence (SUI). In this noninferiority trial, 223 women eligible for operative SUI treatment were randomized for TVT (110) or PAHG (113). Primary outcome was patient satisfaction and the noninferiority margin for the difference was 20%. Secondary outcomes were effectiveness and complications. At 3 years, 188 (84.3%) women attended the followup. The satisfaction score (visual analogue scale 0-100) median was 98.5 (IQR 90-100) in the TVT group and 90.0 (IQR 70-100) in the PAHG group, whereas a score ≥80 was reached in 87 (94.6%) and 65 (67.7%), respectively (difference 26.9%, 95% CI 16.7% to 36.8%). Thus, PAHG did not meet the noninferiority criteria set in our study. The cough stress test was negative in 88 (95.7%) of TVT patients vs 75 (78.1%) of PAHG patients (difference 17.5%, 95% CI 8.6% to 26.9%). Any peri- or postoperative complication before crossover between the groups was detected in 40 (43.5%) women in the TVT group and 23 (24.0%) women in the PAHG group (difference 19.5%, 95% CI 6.8% to 31.4%). In midterm followup, PAHG did not reach in patient satisfaction the noninferiority set in our study. Furthermore, mid urethral TVT slings show better subjective and objective cure rates than PAHG. However, complications were more often associated with TVT. Since the majority of PAHG treated women were also cured or improved, primary SUI women can be offered PAHG as a safe and durable alternative treatment.

History of Surgical Treatments for Female Urinary Incontinence

History of Surgical Treatments for Female Urinary Incontinence

One year effectiveness of an app-based treatment for urinary incontinence in comparison to care as usual in Dutch general practice: A pragmatic randomised controlled trial over 12 months.

ObjectiveTo assess the long‐term effectiveness of app‐based treatment for female stress, urgency or mixed urinary incontinence (UI) compared with care‐as‐usual in primary care.DesignA pragmatic, randomised controlled, superiority trial.SettingPrimary care in the Netherlands from 2015 to 2018, follow up at 12 months.PopulationWomen with two or more UI episodes per week and access to mobile apps, wanting treatment. A total of 262 women were randomised equally to app or care‐as‐usual; 89 (68%) and 83 (63%) attended 1 year follow up.InterventionsThe standalone app included conservative management for UI with motivation aids (e.g. reminders). Care‐as‐usual was delivered according to the Dutch GP guideline for UI.Main outcome measuresEffectiveness assessed by the change in symptom severity score (ICIQ‐UI‐SF) and the change in quality of life (ICIQ‐LUTSqol) with linear regression on an intention‐to‐treat basis.ResultsClinically relevant improvement of UI severity for both app (−2.17 ± 2.81) and care‐as‐usual (−3.43 ± 3.6) groups, with a non‐significant mean difference of 0.903 (−0.66 to 1.871).ConclusionApp‐based treatment is a viable alternative to care‐as‐usual for UI in primary care in terms of effectiveness after 1 year.Tweetable abstractApp‐based treatment for female urinary incontinence is a viable alternative to care‐as‐usual after 12 months.

Efficacy of 3 Tesla Functional Magnetic Stimulation for the Treatment of Female Urinary Incontinence.

Functional magnetic stimulation (FMS) is a new technique for the conservative treatment of Urinary incontinence (UI), based on magnetic induction. It induces controlled depolarization of the nerves, resulting in pelvic muscle contraction and sacral S2-S4 roots neuromodulation. The aim of this study was to assess the efficacy of the new 3 Tesla FMS chair, both in patients with pure stress urinary incontinence (SUI) and in women with pure overactive bladder (OAB) symptoms. A prospective observational study was conducted in our urogynaecologic unit. All the patients involved were consecutive women with pure SUI or pure OAB symptoms treated by a 3 Tesla electromagnetic chair. The primary outcome was a subjective outcome evaluation by the PGI-I Scale and a patient-satisfaction scale. The secondary outcome was the change score of the UDI-6, IIQ-7, ICIQ-SF and OAB-q SF questionnaires from baseline to final visit. At 2 months follow-up, 28 out of 60 patients (47%) with SUI symptoms and 20 out of 40 patients (50%) with OAB symptoms declared themselves cured. Considering cured and improved patients, the subjective cure rates were 68.3% (41/60) and 70% (28/40) for patients with SUI and OAB symptoms, respectively. The results of this study showed that the 3 Tesla electromagnetic chair may be an effective option for the treatment of UI.

Barriers and Facilitators Associated With App-Based Treatment for Female Urinary Incontinence: Mixed Methods Evaluation.

BackgroundApp-based treatment for urinary incontinence is a proven effective and cost-effective alternative to care as usual, but successful implementation requires that we identify and address the barriers and facilitators associated with app use.ObjectiveThe goal of the research was to explore the factors influencing app-based treatment for urinary incontinence and identify which barriers or facilitators are associated with treatment success or failure.MethodsWe used a sequential explanatory mixed methods design to connect the results of a randomized controlled trial with data from semistructured interviews. This previous RCT had shown the noninferiority of app-based treatment compared with care as usual for urinary incontinence over 4 months. Participants who reported success or failure with app-based treatment, as measured by the change in International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form symptom score, were selected for telephone interview by purposive sampling (n=17). This study reports mainly on the qualitative component of our mixed methods study. Qualitative analyses were conducted in two ways. First, we analyzed the qualitative data of all interviewed participants and discussed the relationships between the main themes. Second, the experiences between the success (n=9) and failure group (n=8) were compared and contrasted to explore factors that were positively or negatively associated with the quantitative effect of app-based treatment. These factors were then interpreted as barriers to and facilitators of successful app-based treatment.ResultsFour interrelated themes were identified as affecting the app based treatment effect: adherence, personal factors, app factors, and awareness. Qualitative analyses of the relationships between the themes showed that adherence-related factors directly influenced treatment effect in both a positive and negative matter. In turn, adherence was also positively and negatively influenced by the other 3 themes. Additionally, awareness was positively influenced by the treatment effect. Within these themes, several factors were identified that acted as barriers (eg, unrealistic expectation of time investment and interfering personal circumstances), facilitators (eg, strict integration of exercises and prior pelvic floor muscle therapy), or both (eg, personality traits and increased awareness of symptoms).ConclusionsThis study shows that the effect of app-based treatment for urinary incontinence is mainly influenced by adherence, which in turn is affected by personal factors, app-based factors, and awareness. The identified factors could function as both facilitators and barriers depending on the user and interaction with other themes. Insight into these facilitators and barriers could lead to improved implementation and increased treatment effectiveness by targeting women most likely to benefit and through further development of the app.International Registered Report Identifier (IRRID)RR2-10.1002/nau.23507

Effects of a disposable home electro-stimulation device (Pelviva) for the treatment of female urinary incontinence: a randomised controlled trial

AimsTo compare current General Medical Practitioner treatment as usual (TAU) for the treatment of female urinary incontinence with a novel disposable home electro-stimulation device (Pelviva).MethodsOpen label, Primary Care post-market evaluation. 86 women with urinary incontinence were randomly assigned to one of two 12-week treatments: TAU or Pelviva for 30 min every other day plus TAU. Outcome measures included ICIQ-UI (primary), PISQ-IR, PGI-S / PGI-I and FSFI (secondary) at recruitment and immediately after intervention, 1-h pad test at recruitment and usage diaries throughout.ResultsPelviva plus TAU produced significantly better outcome than TAU alone: 3 versus 1 point for ICIQ-UI (Difference − 1.8 95% CI: − 3.5 to − 0.1, P = 0.033). Significant differences were also observed for PGI-I at both 6 weeks (P = 0.001) and 12 weeks (P < 0.001). In the Pelviva group, 17% of women described themselves as feeling very much better and 54% a little or much better compared to 0% and 15% in the TAU. Overall PISQ-IR score reached statistical significance (P = 0.032) seemingly related to impact (P = 0.027). No other outcome measures reached statistical significance. Premature termination due to COVID-19 meant only 86 women were recruited from a sample size of 264. TAU did not reflect NICE guidelines.ConclusionsThis study suggests Pelviva is more successful than TAU in treating urinary incontinence in Primary Care. The study had reduced power due to early termination due to COVID-19 and suggests TAU does not follow NICE guidelines.

Application of ultra pulse CO2 lattice laser in the treatment of female urinary incontinence.

BackgroundThis study aimed to explore the application of CO2 lattice laser in the treatment of mild and moderate urinary incontinence in female patients.MethodsWe analyzed the clinical data of 33 female patients with mild to moderate urinary incontinence from a prospective cohort study, who were treated with FemiLift CO2 lattice laser instrument (Alma Laser Ltd, Caesarea, Israel) at our hospital from January 2018 to December 2018. All the female patients were married and fertile, with a mean age of (43.15±6.49) years old (35–62 years old). There were 18 participants with mild urinary incontinence and 15 with moderate urinary incontinence. All participants received laser treatment 3 times, with an interval of 30 days. The International Consultation of Incontinence Questionnaire- Short Form (ICIQ-SF) survey was conducted before the treatment, 3 months after, and 6 months after the treatment. A 1-hour urine pad test was used to quantify the leakage of urine. Residual urine and urine routine examination were performed to exclude other combined diseases.ResultsAfter 3 times of treatment with FemiLift CO2 laser, 13 cases were cured in 3 months, and 16 cases were cured in 6 months. 10 cases and 15 cases were significantly improved in 3 or 6 months, respectively. 2 patients had no significant changes, and no adverse reactions were recorded. The pad test showed that the symptom of all 33 patients were significantly improved, and the average scores of ICIQ-SF were significantly decreased (P<0.05) from 12.36 (Grade I) and 15.67 (Grade II) (5-21) before treatment to 3.73(Grade I) and 5.49 (Grade II) (1-12) after 6 months of therapy.ConclusionsThe CO2 lattice laser is safe and effective in the treatment of mild and moderate urinary incontinences in female patients, which can effectively improve the symptom of urinary leakage without obvious adverse reactions.

Supervised pelvic floor muscle exercise for the treatment of female urinary incontinence

Supervised pelvic floor muscle exercise for the treatment of female urinary incontinence

Auto-rééducation pour le traitement de l’incontinence urinaire féminine : revue de la littérature

Literature review on the home-based options for the conservative management of stress urinary incontinence including biofeedback and weighted vaginal cones.. Research was conducted in the Cochrane Library and Pubmed to find articles, published until March 2020, dealing with the conservative management of incontinence. A total of 9 randomized controlled trials were included, 4 concerning biofeedback and 5 concerning vaginal cones. Most of them highlighted the superiority of these three methods compared to the absence of treatment but were not superior compared to the pelvic floor muscles training in the clinic setting. Home-based devices for female stress urinary incontinence is a safe and effective treatment for female urinary incontinence. It has not shown superiority to physiotherapist-guided pelvic floor muscle reinforcement and needs more evidence to gain its place as a first line therapeutic option.