Type Of Incontinence Research Articles

Pelvic floor muscle function in the standing position in women with pelvic floor dysfunction.

Clinical assessment of the pelvic floor muscles (PFMs) in a standing position may provide a more valid representation of PFM function experienced by patients in daily life than assessment in the lying position. The primary aim of this study was to examine PFM function in a standing versus a lying position in parous women with any type of urinary incontinence and/or pelvic organ prolapse. In this exploratory cross-sectional study, participant symptom status was determined using the Australian Pelvic Floor Questionnaire. Pelvic floor muscle function was assessed in standing and lying positions with a randomised order of testing. The primary outcome measure was vaginal squeeze pressure (VSP) using intra-vaginal manometry. Secondary outcomes included vaginal resting pressure, total PFM work and digital muscle testing. The difference between PFM function in a standing position compared with a lying position was analysed using paired t test or Wilcoxon's signed rank test. Vaginal squeeze pressure assessed with manometry was higher in a standing than in a lying position (p = 0.001): standing (mean [SD]) 24.90 [12.67], lying 21.15 [14.65]. In contrast, PFM strength on digital muscle testing was lower in a standing position than in a lying position. This study has demonstrated that PFM function in a standing position is different from that in a lying position in women with pelvic floor dysfunction. Whether the higher VSP observed in a standing position reflects a true difference in strength between positions, or a higher pressure reading due to incorrect PFM contraction technique in a standing position is uncertain. Further research with larger cohorts and a measurement tool that can accurately distinguish a rise in intra-vaginal pressure from PFM contraction rather than increasing intra-abdominal pressure is required to confirm this difference, and the clinical significance of any difference.

Association between lower urinary tract symptoms (LUTS) and obsessive-compulsive disorders (OCD) in women: A study based on urodynamic findings and micturition problem.

This study focused on women with chronic lower urinary tract symptoms (LUTS) who simultaneously suffered from obsessive-compulsive disorder (OCD) to evaluate the association between micturition abnormality and OCD. A cohort case study was conducted on 128 women with chronic LUTS who visited the academic clinic from 2012 to 2018. The participants with a history of OCD were grouped together, whereas the other group consisted of those with no psychiatric issues. Data were analyzed using the Kolmogorov-Smirnov test and also the nonparametric Kruskal-Wallis and χ2 tests. The participants with OCD had a lower mean age (41.7 vs. 48.8 years) and longer symptom duration than the control group. Moreover, voiding phase problems were more prevalent among OCD patients (mean voiding score: 9.3 vs. 6.9). Urge urinary incontinence (UUI) was the most common type of urinary incontinence in OCD patients, and the most important urodynamic study finding was bladder outlet obstruction (45% and 17% in the OCD and control groups, respectively). Voiding disorders resulted in chronic renal failure in two patients (3.12%). It was shown that bladder outlet obstruction (odds ratio (OR) 4.43, 95% confidence interval [CI] 1.53-12.78, p = 0.006] was the strongest predictor of OCD and stress urinary incontinence (OR 0.20, 95% CI 0.07-0.53, p < 0.001) was the best protector against OCD. The findings revealed that chronic LUTS was related to voiding dysfunction and urodynamic abnormality in OCD patients. These disorders may be categorized as somatoform disorder that requires appropriate treatments.

Fecal incontinence in nonpregnant nulliparous women aged 25 to 64 years-a randomly selected national cohort prevalence study

The extent to which fecal incontinence is associated with obstetrical history or pelvic floor injuries is still a controversial andunresolved issue. One crucial first step toward answering this question is the need to study fecal incontinence in nonpregnant, nulliparous women. The aim of this study was to present detailed, descriptive measures of the accidental leakage of liquid or solid stool and gas in a randomly selected, large national cohort of nonpregnant, nulliparous women aged 25 to 64 years. The Swedish Total Population Register identified the source population. Four independent, age-stratified, simple random samples in a total of 20,000 nulliparous women aged 25 to 64 years were drawn from 625,810 eligible women. Information was collected in 2014 using postal and web-based questionnaires. The 40-item questionnaire included questions about the presence and frequency of the leakage of solid and liquid stool and gas, which provided the basis for the generic terms fecal and anal incontinence. Statistical analyses of the differences between the groups were performed using the Fisher's exact test for dichotomous variables and the Mann-Whitney U-test for continuous variables. The trend between >2 ordered categories of dichotomous variables was analyzed with Mantel-Haenszel statistics. When analyzing the trend between multiple ordered vs nonordered categorical variables, the Kruskal-Wallis test was used. The age-related probability and risk increase per 10 years for incontinence parameters was calculated from logistic regression models adjusted for body mass index. The study population was 9197 women, and the response rate was 52.2%, ranging from 44.7% in women aged 25 to 34 years to 62.4% among those from 55 to 64 years. All the types of incontinence, except severe isolated gas incontinence, increased with age up to 64 years. The estimated probability of fecal incontinence was 8.8% at age 25 years and 17.6% at age 64. The leakage of liquid stool was dominant, occurring in 93.1% (95% confidence interval, 91.4-94.5) of the women with fecal incontinence, whereas leakage of solid stool occurred in 33.9% (95% confidence interval, 31.1-36.7), of which approximately 80% also had concomitant leakage of liquid stool. The leakage of liquid stool increased markedly up to age 65, whereas the increase in the isolated leakage of solid stool was negligible across all ages (overall <0.4%). Liquid and solid stool, separate or in combination, co-occurred with gas in approximately 80%. The distribution pattern of the different types of leakage, single or combined, was similar in all the age groups. Both age and body mass index (kg/m2) were risk factors for fecal incontinence (P<.0001), with an interaction effect of P=.16. Abnormal stool consistency has been identified as the strongest risk factor for accidental bowel leakage. The same pattern characterized by a dominance of liquid stool and gas leakage, prevalent concomitant leakage of solid and liquid stool, and a negligible rate of isolated leakage of solid feces was observed across all ages. The low rates of isolated leakage of solid stool support the impression that dysfunction of the continence mechanism of the pelvic floor had a negligible role for bowel incontinence, which is essential information for comparison with women with birth-related injuries.

Evaluation of features associated with urinary incontinence in women

AbstractWe aimed to evaluate the features (occurrence, type, severity, risk factors and quality of life) associated with urinary incontinence in women. Urinary incontinence is a global issue. Many factors can lead to urinary incontinence, but some factors remain debatable. It is thought that the rate of urinary incontinence will decrease with the determination of risk factors. According to Abrams et al., urinary incontinence is three times more prevalent in women than in men. In a systematic review including 12 studies conducted by Seshan et al., it was concluded that the main risk factors for urinary incontinence are age, parity, body mass index, menopause, recurrent urinary tract infections, hysterectomy, miscarriage, fetal weight and comorbid conditions such as diabetes, chronic lung disease. Average life expectancy is increasing around the world. According to Milsom and Gyhagen with the increase in average life expectancy, it is predicted that the frequency of incontinence and the rate of women needing treatment will rise in the future and that health expenditures will increase consequently. A descriptive, cross‐sectional study was conducted from September to December 2020 using an online questionnaire. In total, 400 women were recruited. The online questionnaire contains questions to determine the socio‐demographic of women and urinary incontinence for risk factors in women and International Consultation on Incontinence Questionnaire‐Urinary Incontinence Short Form. Data were entered and analysed using SPSS. Chi‐square tests were used to assess associations between categorical variables. Statistically significant variables (p &lt; 0.05 and p &lt; 0.001) were then analysed by logistic regression. Occurrence of urinary incontinence was 39% (156/400). The top three types of urinary incontinence were found to be stress (38.5%), urgency (27%) and mixed (23.7%) incontinence. Frequency of urinary incontinence was once a week or less frequent in 54.5% of the women with urinary incontinence and that the severity of the urinary incontinence was mild in 70.5%. Risk factors for urinary incontinence included age, educational status, body mass index, history of macrosomic baby (birth weight &gt; or =4 kg), consuming acidic beverages and spicy foods, episiotomy, type of birth, menopause, recurrent urinary tract infection, having a member of family with a history of urinary incontinence, and lack of physical activity. It was determined that factors increasing the risk for urinary incontinence the most are age and body mass index. Urinary incontinence is an important public health problem affecting women in the reproductive age, too.Highlights Urinary incontinence is a global issue. Many factors can lead to urinary incontinence, but some factors remain debatable. Urinary incontinence is an important public health problem affecting women in the reproductive age, too. Average life expectancy is increasing around the world. Therefore, the number of women with incontinence problems is expected to increase.

Getting Ready for Continence Certification: Assessing and Managing Stress Incontinence.

Getting Ready for Continence Certification: Assessing and Managing Stress Incontinence.

Effect of vitamin D supplementation on urinary incontinence in older women: ancillary findings from a randomized trial

Observational studies among older women have associated vitamin D insufficiency with a greater prevalence and incidence of urinary incontinence. However, little is known about the effect of vitamin D supplementation in reducing urinary incontinence. This study aimed to evaluate the effects of vitamin D supplementation in reducing the frequency of urinary incontinence in older women. We conducted an ancillary study of women aged ≥55 years in the Vitamin D and Omega-3 Trial, a randomized trial with a 2×2 factorial design. Recruitment of participants started from 2011 to 2014 across 50 US states, and the follow-up of participants ended in January 2018. Randomized treatments in the parent study included (1) vitamin D3 (cholecalciferol) at a dosage of 2000 IU/d, (2) marine omega-3 fatty acids at a dosage of 1 g/d, and (3) matching placebo. Here, we analyzed women according to their randomization to vitamin D supplementation or placebo, regardless of treatment with omega-3 fatty acid supplementation. Validated frequency of urinary incontinence questions were added in year 2 of the study and were used again in year 5 at the end of trial. Prespecified ancillary outcomes included the prevalence of urinary incontinence at years 2 and 5, along with incident incontinence and progression of incontinence (from lower to higher frequency) from year 2 to year 5. Preplanned subgroup analyses examined the following outcomes: prerandomization of low serum levels of vitamin D (serum 25-hydroxyvitamin D<20 ng/mL), incontinence types, weight categories, and African American race. Among the randomized women who provided urinary incontinence data, 11,646 women at year 2 and 10,527 women at year 5, the mean age was 70 years at year 2, with 29% racial and ethnic minorities. The prevalence of urinary incontinence that occurred at least weekly was 29% at year 2 and increased to 37% at year 5. Vitamin D supplementation compared to with placebo was not associated with lower odds of urinary incontinence occurring at least weekly at year 2 (odds ratio, 1.08; 95% confidence interval, 0.99-1.19) or year 5 (odds ratio, 1.04; 95% confidence interval, 0.94-1.15). Vitamin D supplementation compared to placebo was not associated with lower incidence or progression of urinary incontinence from year 2 to year 5: incidence (odds ratio, 1.06; 95% confidence interval, 0.83-1.35) or progression (odds ratio, 0.94; 95% confidence interval, 0.82-1.08). Women with prerandomization of low serum levels of vitamin D (n=836) did not have lower odds of the prevalence, incidence, or progression of urinary incontinence. The findings were null in subgroups according to incontinence type, women with obesity, and African American women. Only women with healthy weight randomized to vitamin D had lower odds of progression of urinary incontinence (odds ratio, 0.78; 95% confidence interval, 0.63-0.95; P=.01). Vitamin D supplementation compared to placebo for 2 to 5 years was not associated with differences in the prevalence, incidence, or progression of urinary incontinence in older women with and without adequate serum vitamin D levels, with inconsistent differences among subgroups. The findings showed that the broad use of moderate doses of vitamin D supplementation did not reduce urinary incontinence in older women.

Urodynamic Values Role For Females With Different Types Of Urinary Incontinence

Aim — The aim of this study was to analyse how conventional urodynamic values differ between females with specific types of urinary incontinence (UI). Material and Methods — Cross-sectional study enrolled 666 females with UI. Based on patient history and questionnaires they were divided into three groups: stress (SUI), mixed (MixUI) and urgency (UUI). Physical investigation and urodynamics were performed. The continuous factors: age and urodynamic data were evaluated using Multinomial regression and ANOVA test using SUI, MixUI, UUI as outcome groups. Results — Analysing urodynamic parameters significant difference between at least two groups was shown by the cystometric capacity and maximum flow rate: both highest in the SUI group; residual urine, opening detrusor pressure, maximum urethral closure pressure at rest, functional urethral length at rest: all highest in the UUI group. Mainly all urodynamic data showed significant difference between SUI/UUI, and MixUI/UUI groups, while difference between SUI/MixUI were not significant. Conclusions — Most of urodynamic data for MixUI group patients do not differ from SUI group. UDS parameters like: maximum flow rate, residual urine, opening detrusor pressure, maximum urethral closure pressure at rest, functional urethral length at rest can help to distinguish SUI and MixUI groups from UUI group.

MP52-18 EFFECTIVENESS OF APP- BASED YOGA OF IMMORTALS INTERVENTION IN URINARY INCONTINENCE

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II (MP52)1 Sep 2021MP52-18 EFFECTIVENESS OF APP- BASED YOGA OF IMMORTALS INTERVENTION IN URINARY INCONTINENCE Hari Siva Gurunadha Rao Tunuguntla, Renuka Tunuguntla, Himanshu Kathuria, and Sadhna Verma Hari Siva Gurunadha Rao TunuguntlaHari Siva Gurunadha Rao Tunuguntla More articles by this author , Renuka TunuguntlaRenuka Tunuguntla More articles by this author , Himanshu KathuriaHimanshu Kathuria More articles by this author , and Sadhna VermaSadhna Verma More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002082.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Yoga of Immortals (YOI) is a unique combination of specific yogic postures, breathing exercises, sound therapy, and meditation and is practiced by many for general well-being. This also targets pelvic floor muscles and focuses on the specific energy centers. We therefore studied the effectiveness YOI intervention in participants with UI of all types. METHODS: In this prospective, IRB approved, App-based cohort study, a survey was sent to all subscribers of the app. Those who identified with UI and consented to participate in the incontinence study were sent a set of questionnaires including ICIQ-UI, SF, and ICIQ-LUTS-QOL at baseline, 4 and 8 weeks. Mean symptom score and severity of UI were assessed by ICIQ-UI, SF. The impact of UI on QOL was assessed by disease specific ICIQ-LUTS-QOL. Pre- and post-intervention mean scores on ICIQ-LUTS-QOL and ICIQ-UI, SF were compared using paired t test. Effect of YOI intervention on the frequency and severity of urinary leak, daily life activity, and on different types of urinary incontinence were assessed using the ICIQ-UI, SF questionnaire. Global impression of improvement was assessed by PGI-I (participant global impression of improvement) scale. RESULTS: 258 out of 479 participants who completed the baseline, 4, and 8 week questionnaires were included in the study. Participants had significant decrease in mean scores on both the ICIQ-LUTS-QOL (Figure 1) and ICIQ-UI, SF (Figure 2). Significant improvement was also noted in the frequency of urinary leak (Table 1), severity of urinary leak (Table 2), and in the interference in daily life activity (Table 3) after YOI intervention. Improvement in the stress urinary incontinence was significant (Table 4). Sixty percent of the participants felt 'very much better', 16% 'much better', and 12% 'a little better' at 4 weeks on PGI-I scale. CONCLUSIONS: Yoga of Immortals (YOI) intervention resulted in significant improvement in the mean scores of ICIQ-LUTS-QOL, ICIQ-UI-SF, frequency and severity of urinary leak, daily life activity and stress urinary incontinence. Majority of the participants felt 'very much better' at 4 weeks on PGI-scale. YOI may be an adjunctive treatment option in those inclined towards these practices. Being app- based, it has the added advantage of the ability to be used any time anywhere. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e937-e937 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hari Siva Gurunadha Rao Tunuguntla More articles by this author Renuka Tunuguntla More articles by this author Himanshu Kathuria More articles by this author Sadhna Verma More articles by this author Expand All Advertisement Loading ...

Effectiveness and safety of bulking agents versus surgical methods in women with stress urinary incontinence: a systematic review and meta-analysis.

The objective was to evaluate the efficacy and safety of bulking agents compared with surgical methods for female stress urinary incontinence. Inclusion and exclusion criteria: women with stress urinary incontinence. Bulking agents versus any surgical treatment as a comparison. Patients with other types of incontinence and treatment were excluded. Electronic databases (PubMed, MEDLINE, and the Cochrane Library) were searched from 2000 until 2021 to identify articles evaluating the effectiveness and safety of urethral bulking agents versus surgical methods. Risk-of-bias assessment tools recommended by the Cochrane Society were used to evaluate the risk of bias in the studies included. Six studies were included in the quantitative synthesis for a total of 710 patients. Our systematic review and meta-analysis showed that bulking agents are less effective than surgical procedures according to subjective improvement after treatment (RR = 0.70, 95% CI: 0.53 to 0.92, p = 0.01). There was no statistically significant difference between these two methods with regard to complications after the intervention (RR = 1.30, 95% CI: 0.30 to 5.66, p = 0.73). The main limitation of this systematic review and meta-analysis was the absence of a common objective outcome measure to evaluate effectiveness. However, it shows that bulking agents are less effective than surgical procedures in subjective improvement. Safety analysis showed no significant difference between these methods. Hence, we believe that the first and final surgery is considered to be the best.

Evaluation of the efficacies of methylphenidate and biofeedback treatments in giggle incontinence: One-year follow-up study

Giggle incontinence is a type of urinary incontinence (GI) that occurs with laughing due to the urinary bladder's involuntary contraction leading to complete emptying. There are studies in the literature that biofeedback therapy or methylphenidate can be effective in the treatment of this condition. This study aimed to compare the efficacies of biofeedback therapy and methylphenidate treatment in patients with GI. In this non-randomized observational study, children aged 5-18 years who were diagnosed with GI between January 2014 and December 2019 were included in the study. Patients who were treated by biofeedback were assigned to Group 1, while patients who were given methylphenidate treatment were placed in Group 2. Patients in Group 1 were treated with biofeedback, which was planned once a week for four weeks and once a month for the following two months. They continued their pelvic floor strengthening exercises at home for the following nine months. Patients in Group 2 were prescribed 5mg oral methylphenidate qid for three months. Patients in both groups were followed up with 3-month intervals within a year. The results were classified as complete response, partial response or no response as per The International Children's Continence Society (ICCS) recommendations. The study population consisted of 38 patients with GI. Mean age of the patients was 7.7 (5-11). Among these patients, 31 (81.5%) were female, while 7 (18.4%) were male. Two groups were similar regarding mean patient age and gender distribution. There was no difference between the two groups regarding treatment responses evaluated during the 1st, 3rd, and 6th-month outpatient clinic encounters (p>0.05). However, treatment responses assessed during the 12th-month outpatient clinic encounter revealed 15 (94.1%) patients with complete response in Group 1, while there were 10 (55.6%) patients who showed complete response in Group 2, with a significant difference (p=0.03). Our study showed that treatment responses were reduced after discontinuation of methylphenidate. We achieved high complete response rates in the first, third, sixth, and twelfth-month assessments by biofeedback treatment. Significantly more favorable treatment outcomes were achieved with biofeedback therapy than methylphenidate treatment after completion of 1-year. Multi-center, randomized studies are needed to evaluate efficacy and safety.

Overactive bladder

Urinary incontinence is a problem among both older and young women. The most common symptoms of this condition include urinary incontinence and an unpleasant odour. In order to conceal the ailments related to this problem, women change their lifestyle by limiting the amount of fluid consumed and not moving too far from home or places where toilets are located. The main source of information on this disease in women aged over 45 is books, magazines and websites. Medical personnel are only ranked behind them. In order to make a correct diagnosis of this disease and to start treatment, urodynamic examination, urinalysis, cystoscopy and imaging examinations should be performed. Urodynamic examination can be divided into two groups: invasive and non-invasive. The micturition diary is considered to be the basic urodynamic test. It allows for performing differential diagnosis of functional micturition disorders. It is characterized by high repeatability and correlation with clinical symptoms. Treatment options are dependent on the type of urinary incontinence. They may include conservative treatment, surgery and pharmacotherapy. Combining conservative methods with pharmacological or surgical methods brings the most beneficial results. Invasive methods are the last-line therapy.

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).

Postępowanie w nietrzymaniu moczu u kobiet z pęcherzem nadaktywnym w codziennej praktyce urologa

Urinary incontinence urinary incontinence is common among women and contributes to decreased quality of life. Several effective treatment options are available for the most common types of urinary incontinence (stress, urge, and mixed), including lifestyle modification and behavioral technique, drug therapy, and minimally invasive procedures. Most women improve with treatment, and urinary incontinence is not an inevitable part of aging. To maximize the opportunity for successful treatment, it is essential to align the therapeutic approach with patient goals and expectations for care, including an assessment of patient-driven priorities regarding potential adverse effects, costs, and expected benefit of different treatment approaches. There are many unique challenges in treating an overactive bladder in older women, such as functional and cognitive impairment, multimorbidity, polypharmacy, and estrogen deficiency, all of which contribute to treating symptoms in older women. This review highlights the current understanding of age-related changes in bladder function and proposes specific clinical considerations for overactive bladder management specific to older women.

ÜRİNER İNKONTİNANSIN HUZUREVİ VE EVİNDE YAŞAYAN YAŞLILARDA YAŞAM KALİTESİNE ETKİSİ

Aim: The aim of the study was to analyze the effect of urinary incontinence on the quality of life of elderly people living at home and those living in a hospice by focusing on the different demographic and incontinence related factors. Method: The study was designed as a cross-sectional descriptive study and was conducted between December 2015 and June 2016. Fifty participants aged ≥ 65 years who met the inclusion criteria were incruited in the study. Twenty-five of them were admitted by random sampling method from patients applying to faculty’s geriatric outpatient clinic with the complaint of incontinence. The other 25 were selected according to the study criteria out of elderly people living in the Darulaceze Institute. The International Consultation on Incontinence Questionnaire-ShortForm (ICIQ-SF), Incontinence Quality of Life (I-QOL) scale, and Katz Activities of Daily Living scale were used with all the individuals. Other variables were assessed using a demographic data form. Results: There was no difference between the quality of life (QOL) scores between the hospice and home groups (p=0.836, p=0.865, p=0.841, p=0.883). Social life was the most affected subdomain for both groups. Urinary incontinence (UI) affected psychologic effect (PE) and behavioral restriction (BR) aspects of QOL in individuals between the ages of 65 and 75 years more than those &amp;gt;75 years of age in the hospice (p=0.024, p=0.019). A higher UI output lowered BR scores only in hospice patients (p=0.016). For both groups, frequent incontinence episodes indicated a significantly lower QOL in terms of PE than rare episodes (p=0.032-home, p=0.022-hospice) and lower QOL in BR in home care (p=0.037). Mixed type incontinence affected QOL in terms of BR more than other types of incontinence in both groups (p=0.019-hospice, p=0.007-home). There was a significant correlation between I-QOL and ICIQ-SF visual analogue scale scores that measured quality of life (r=-0.64, p&amp;lt;0.001). Conclusions: Frequency of incontinence episodes is the major factor affecting QOL in both groups. Incontinence output has a significant role in QOL for hospice patients. The ICIQ-SF visual scale may be sufficient to evaluate the quality of life. I-QOL can be used for further evaluation of different aspects. Studies on incontinence and QOL in the institutionalized and home-care elderly population should be encouraged to improve conditions.

Clinical profile of Female Urinary Incontinence: A Hospital Based Study

Aim: To determine the prevalence of urinary incontinence of women attending gynae outdoor patient department.&#x0D; Method: It is a prospective cross sectional study conducted at Paropakar Maternity and Women’s Hospital for three months. Types of incontinence, their presentation, associated factors, age and parity were the variables studied. Data were analyzed by descriptive statistics.&#x0D; Results: Out of 950 gynaecological out-patients, 97 had urinary incontinence(10.2%); 34.1% were in 50- 59 years and 37.2% were multipara. Stressurinary incontinence (SUI) was the most common incontinence (56.7%) followed by mixed urinary incontinence (22.7%) and urge urinary incontinence (20.6%). Common complaints were leakage during coughing (63.6%) and sneezing(18.2%) in SUI;urgency and frequency were main problem in mixed and urge urinary incontinence. Three-fourth cases had associated medical conditions and rest had gynecological factors.&#x0D; Conclusions: Urinary incontinence is common in the fifth decade of life of women and more than half had stress incontinence.

Rehabilitation methods for patients with severe extragenital pathology after reconstructive plastic surgery for various types of urinary incontinence

In recent years, the frequency of operations for genital prolapse and urinary incontinence has been steadily increasing. Neurogenic disorders of urination can be the first manifestations of the disease of extragenital pathology. Neurogenic bladder is bladder dysfunction (lethargy or spasticity) caused by neurogenic damage. Any disease in which the afferent or efferent innervation of the bladder is damaged can lead to a neurogenic bladder.Purpose. To study the features of urinary disorders in women with severe extragenital diseases and to improve the methods of rehabilitation of patients after reconstructive plastic surgery for various types of urinary incontinence.Materials and methods. 153 patients aged 50-70 years (mean age 55.1 ± 6.3 years) and duration of postmenopause from 2 to 5 years (7.6 ± 4.1 years) were examined at the outpatient department of the of Moscow Regional Research Institute of Obstetrics and Gynecology, Russian Federation, who applied for various manifestations of urination disorders. All patients were offered the method of biofeedback in combination with electrical stimulation of the pelvic floor muscles as a treatment. When overactive detrusor therapy was detected, therapy was combined with medicamentous (solifenacin 5 mg [Vesicar] or myrobegron 50 mg [Betmiga] in the morning) in combination with estriol (cream or suppositories) 0.5 mg intravaginally 2 times a week. In the presence of symptoms of climacteric syndrome in the absence of contraindications, menopausal hormonal therapy was prescribed.Results. Subjectively, 150 (98.1 %) patients noted an improvement in their condition, 3 (1.9 %) patients did not notice the effect of treatment. The results showed a significant improvement in all OABSS and bladder diary scores, including frequency of urination during the day and at night, urgency and number of urge incontinence episodes, and urine volume. Analysis of the -hour pad test showed that the volume of urine lost, which averaged 16.5 g before treatment, was negative after treatment in patients who noted the effect. In 2 patients who did not notice the effect, no changes were found. Investigation of the intraurethral pressure profile in 23 (17.6 %) women before treatment revealed insufficiency of the internal sphincter of the urethra, leading to urinary incontinence during stress. After treatment, in 19 (82.6 %) patients, the insufficiency of the internal sphincter was not determined. In 3 (13.0 %) patients, intraurethral pressure remained in the range of 60 to 80 cm of water column and did not lead to urinary incontinence during stress. In 1 (4.3 %) patient, the insufficiency of the urethral closure persisted, which required repeated surgery.Conclusions. In patients with severe extragenital diseases against the background of vulvovaginal atrophy, an overactive bladder and a mixed form of urinary incontinence prevail. Extragenital pathology of various origins, especially concerning various parts of the central nervous system, obesity and diabetes significantly worsens the course of urination disorders in both conservative and surgical and combined treatment and requires additional treatment methods: pelvic floor muscle training, biofeedback therapy in combination with electrical stimulation of the pelvic floor muscles, local hormonal therapy, the use of M-anticholinergics, B-adrenomimetics.

The effect of Mirabegron and Duloxetine combination in mixed-type urinary incontinence treatment.

Stress-type and urgency-type urinary incontinence are seen together in mixed-type urinary incontinence. Treatment is usually chosen according to the predominant type of incontinence. The aim of this study is to evaluate the effect of mirabegron and duloxetine combination in the treatment of mixed-type urinary incontinence. The data of 88 mixed-type urinary incontinence patients who applied to the urology outpatient clinic between January 2018 and December 2019 were retrospectively analyzed. We applied mirabegron and duloxetine treatment to the patients. The International Consultation of Incontinence Questionnaire-Short Form, Overactive bladder symptom score questionnaire and daily pad count were statistically evaluated before and after the treatment. Statistically significant improvements were observed using the questionnaire forms and decreased daily pad usage after the eight-week treatment (p<0.001). Based on the clinical global effect scale, 62.50% of patients had a partial or complete response to treatment and also the use of daily pads were decreased from 3.7-0.89 on an average. Combination use of mirabegron and duloxetine in the treatment of mixed-type urinary incontinence improved symptom scores and decreased pad usage.

Relationship between the types of urinary incontinence, handgrip strength, and pelvic floor muscle strength in adult women.

To investigate the relationship between handgrip strength with types of urinary incontinence (UI) and pelvic floor muscle strength (PFMS) in women. Ninety-two women, who presented to the geriatric and urology outpatient clinics complaining of UI between July 2019 and February 2020 and had indicated to undergo urodynamic assessment after basic neurourological evaluation, were included in this cross-sectional study. The presence and types of UI were identified by clinical examination and urodynamic studies. Demographic parameters, anthropometric data, comorbidities and medications were recorded. The International Consultation on Incontinence Questionnaire-Short Form was applied. Handgrip strength (HGS) was measured by a hand dynamometer. The PFMS was subjectively assessed via vaginal digital palpation and measured quantitatively by the vaginal probe of the perineometer. Thirty-eight urodynamic stress, 28 detrusor overactivity, 26 urodynamic mixed UI patients were reported. Perineometer measurements were significantly lower in the urodynamic stress UI group compared to the other two groups (p = 0.020). There was no relationship between the types of urinary incontinence and HGS. However, a positive correlation was found between PFMS and HGS (p = 0.045, r = 0.298). The positive correlation between HGS and PFMS indicates that low HGS may be a marker for PFMS weakness. Furthermore, the association between sarcopenia and UI may be explained by this condition.

Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women

The objectives were to investigate the prevalence of urinary incontinence (UI) and its relationships with depression, stress, and self-esteem in older Korean women from the Korean Study of Women’s Health Related Issues (K-Stori), a nationally representative cross-sectional survey. A total of 3000 women between 65 and 79 years were the final study subjects. We applied multiple linear regression models to analyze associations with depression, stress, and self-esteem levels in relation to UI types. Types of urinary incontinence included stress, urge, and mixed UI. UI affects at least one in two older Korean women (52.2%). The prevalences of SUI, UUI, and MUI were 45.7%, 39.6%, and 33.1%, respectively. UI was found to be adversely associated with depression, stress, and self-esteem: women with UI reported significantly higher levels of depression and stress and lower levels of self-esteem than those without UI. Women with MUI reported significantly greater impairment than the women with SUI or UUI. Our results provide an evidence base for the evaluation of mental health in older women with incontinence. The prioritization of UI detection and the identification of psychological factors may help improve the diagnosis and management of UI and potentially yield significant economic and psychosocial benefits.

Effectiveness of Pelvic Floor Muscle Training and Yoga on the Quality of Life in Perimenopausal Women with Urinary Incontinence

Background: Urinary incontinence is a symptom of genitourinary disease in perimenopausal women that can seriously affect both physical and mental health and quality of life (QOL). Pelvic floor muscle training (PFMT) and yoga are the exercises that have been applied to treat urinary incontinence. Research that compares the effect of PFMT and yoga on improving the quality of life of women with urinary incontinence is necessary. Purpose: This study aimed to compare the effectiveness of PFMT and yoga to improve the QOL in perimenopausal women with urinary incontinence.Methods: A quasi-experimental study with a nonequivalent control group design involving 48 perimenopausal women with all types of urinary incontinence was conducted. The participants were selected by consecutive sampling and equally divided into two groups. Each group was given the PFMT intervention and yoga exercise three times a week for eight weeks. The QOL was assessed using the incontinence impact questionnaire short form (IIQ-7). The data were analyzed by the Mann-Whitney U test, Wilcoxon signed rank test, and paired sample t-test.Results: The mean (standard deviation) score of total IIQ-7 in the PFMT group were lower (3.58 [2.57]) than that in the yoga group (5.17 [2.14]; p=0.061). There were differences in IIQ-7 score in the domains of physical activity (p&lt;0.001), social relationships (p&lt;0.001), and traveling (p&lt;0.001) in the PFMT group. In contrast, in the yoga group, differences were found only in the emotional health domain (p=0.039). The IIQ-7 score was better in the PFMT group than in the yoga group.Conclusion: PFMT was as effective as yoga exercise to improve the QOL. PFMT and yoga should be taught to perimenopausal women with urinary incontinence.