History Of Urinary Incontinence Research Articles

Assessment of the Severity of Urinary Incontinence Among Elderly Women

Background: The International Continence Society (ICS) defines urinary incontinence (UI) as the complaint of any involuntary leakage of urine. It is a distressing and debilitating condition that is becoming more prevalent as our population ages. Pathophysiology of urinary incontinence during menopause the ovaries stop producing considerable quantities of estrogen; hence the symptoms and problems associated with estrogen deficiency occur gradually. Among the changes is reduction in the integrity of the pelvic floor, changes in the rate of different types of collagens and the preferential atrophy of type II muscle fibers, atrophy of urinary-genital tract which may be associated with problems such as urinary urgency, urinary frequency, nocturia, stress incontinence, urge incontinence, burning upon urination and an increased prevalence of urinary tract infections. Aim of the study: The study aimed to assess severity of urinary incontinence among elderly women. Design: A descriptive study design was utilized in this study. Sample: A purposive sample of 100 women diagnosed with stress urinary incontinence. Setting: gynecological and urological outpatient clinics Beni-Suef university hospital. Tools: (1) A structured interviewing questionnaire sheet was developed by the researcher in the Arabic language. It was containing of two parts; (1) personal characteristics data of the study women such, (2) urinary incontinence history; (2) The International Consultation on Incontinence Modular Questionnaire ICIQ-SF. Results: The mean weight of the studied sample was 82.680±11.8815, mean height was 160.420±2.8610, and mean of BMI was 32.1224±4.47973. It indicates that 42% of the study sample their frequency of urination was every 3-6 hours, 75% of them had a completely empty bladder after voiding, 37% did not used sanitary towel for urine leakage. Conclusion: Based on the results of the study; It can be concluded that most of elderly women suffer from sever urinary incontinence. Recommendations: Replication of the present study under different circumstances (sampling and setting) is recommended to validate its results.

Examining workplace behaviors in adult women with urinary incontinence: A pilot study.

Urinary incontinence is a growing issue among adult women globally. Limited data exist examining the impact of occupational, environmental, and behavioral factors on urinary incontinence. This quantitative, cross-sectional pilot study examined the workplace behaviors of adult women experiencing urinary incontinence. It was hypothesized that specific jobs and work environments would be associated with increased urinary incontinence and urgency based on identified behaviors and work-related conditions. This study is a quantitative, cross-sectional survey. Adult women (18 years and older) with a history of urinary incontinence were recruited from August 2022 to February 2023 to complete a one-time survey consisting of multiple-choice and short answer questions identifying specific workplace behaviors and symptoms of urinary incontinence. Descriptive statistics and data categorization were used to observe outcomes and examine relationships between urinary incontinence and particular professions. Urinary incontinence and urgency-related symptoms affected healthcare and business professionals at a higher prevalence. The most commonly reported behaviors across all professions consisted of withholding urine and utilizing absorbance products. The results of this study will help guide women's health practitioners in exploring current workplace behaviors that may contribute to urinary incontinence in adult women. With this knowledge, practitioners can provide meaningful education to employers and employees to prioritize toileting behaviors in the workplace.

HPV-infection status and urinary incontinence: a population-based analysis of the NHANES 2005-2016.

Urinary incontinence is a common condition and reduces the quality of life. The purpose of this study was to assess the association between HPV infection and urinary incontinence among adult women in the USA. We examined a cross-sectional study using the National Health and Nutrition Examination Survey database. Women who had valid HPV DNA vaginal swab test results and answered the questionnaire about urinary incontinence were selected from six consecutive survey cycles (2005-2006 to 2015-2016). The association between HPV status and urinary incontinence was analyzed using weighted logistic regression. Models adjusted for potential variables were established. In total, 8348 females aged between 20 and 59years old were enrolled in this study. 47.8% of participants had a history of urinary incontinence and 43.9% of women were HPV DNA positive. After adjusting for all confounders, women with HPV infection were less likely to have urinary incontinence (OR = 0.88, 95%CI 0.78-0.98). Low-risk HPV infection correlated with a lower incidence of incontinence (OR = 0.88, 95%CI 0.77-1.00). For women aged below 40years, low-risk HPV infection negatively correlated with stress incontinence (20-29ys: OR = 0.67, 95%CI 0.49-0.94; 30-39ys: OR = 0.71, 95%CI 0.54-0.93). However, low-risk HPV infection positively correlated with stress incontinence (OR = 1.40, 95%CI 1.01-1.95) for women 50-59years old. This study revealed a negative association between HPV infection and urinary incontinence in females. Low-risk HPV correlated with stress urinary incontinence, with the reverse trend for participants of different ages.

Correlation between trans-perineal ultra-sonography, urodynamic study and physical examination findings in female patients with stress urinary incontinence: Single center experience.

To evaluate the efficacy of Trans-perineal ultrasonography (TPUS) in assessment of stress urinary incontinence (SUI) and its correlation with urodynamic study (UDS) and physical examination in women with SUI. The study enrolled a total of 91 females including 66 women with SUI and 25 women with no history of urinary incontinence as control group. The α and β angles (anterior urethral and posterior urethro-vesical angle respectively) were recorded both at rest and at straining, using TPUS. The differences between these angles at rest and during the straining were considered as the rotational angles (Rα and Rβ). Urethral length and caliber, bladder neck funneling, and pubo-urethral distance were measured as well. The mean (SD) α angle at rest of the SUI group was 49.0 (±14.3)°, which was higher than the same parameter in the control group: 47.6 (±9.7)°. Similarly, the α angle at straining was significantly higher in the SUI group versus the control group, 61.0 (±15.4)° versus 55.8 (±15.8)°. The mean (SD) β angle in the SUI group at rest was 124.6 (±28.5)°, which was significantly higher than that of the control group at 114.0 (±22.5)°. The mean (SD) β angle at straining was also higher in the SUI group versus the control group: 151.8 (±90.6) versus 136.0 (±27)°. Moreover, higher Rα and Rβ angels were documented in the SUI group. Our data suggest that TPUS can be considered as a non-invasive, easily conducted, and accurate modality in early diagnosis of female SUI. It may reduce the need for performing relatively invasive UDS. However, the role of TPUS in assessment of SUI severity remains to be studied probably with a larger sample size.

Lower urinary system symptoms and affecting factors in female students staying in a dormitory.

SUMMARYOBJECTIVE:The aim of the study was to determine the lower urinary system symptoms and the factors affecting it among young women living in the dormitory.METHODS:This is a descriptive and cross-sectional study. A total of 355 women attending education in a public university were interviewed, considering a 95% confidence interval. Data were collected using the descriptive form and the Bristol Female Lower Urinary Tract Symptoms Scale. Necessary permissions were obtained, and appropriate analyses were carried out using the SPSS-22 program.RESULTS:Findings showed that 71.6% of women have problems with urine storage, 29.7% have urinating disorders, 18.4% have urinary incontinence, 8.8% have sexual life problems, and 37.2% have symptoms related to quality of life. Factors affecting the symptoms include history of chronic disease (such as neurological diseases and depression), smoking, low income, history of urinary incontinence in childhood, the presence of symptoms in the mother or family history, the presence and number of urinary tract infections, chronic constipation, and not paying attention to toilet cleaning.CONCLUSION:It is recommended to carry out community-based studies to raise awareness of women, support priority risk groups by screening, and increase the number of specialist healthcare personnel for quality care and treatment.

Frequency of Urinary Stress Incontinence in Women after Vaginal Delivery

Introduction: Stress urinary incontinence is defined as involuntary loss of urine on physical exertion like coughing, sneezing, laughing or jumping. This condition in women is very distressing and it is usually kept disguised, so women remain untreated. This condition also causes feeling of inferiority and depression. There are different risk factors identified in causing urinary stress incontinence like constipation, traumatic and operative vaginal births, pelvic organ prolapse, abdominal mass, smoking, obesity, old age and menopause. The present study is design to know the actual magnitude of stress incontinence. There by strategies could be devised to reduce this morbidity. Objective: To determine the frequency of urinary stress incontinence in women after vaginal delivery Setting: This study was conducted at ISRA University Hospital, Hyderabad. Duration: Six months from Jan 2020 to June 2020. Design: Descriptive cross sectional. Subject and Methods: There were 141 women with history of urinary incontinence within 40 days of vaginal delivery were included in this study. Patient who fulfill the inclusion and exclusion criteria and came within forty days after vaginal delivery. The final outcome that is urinary stress incontinence was labeled as positive or negative on approved proforma. Results: The average age of the patients was 26.75±5.72 years. Frequency of urinary stress incontinence in women after vaginal delivery was observed in 14.18% (20/141). Conclusion: Results of this study suggest that the mechanical strain during labor may add to the risk associated with pregnancy itself. Prenatal counseling about routes of delivery should provide a balanced account of the advantages and disadvantages for mother and child. The information from this study provides important information for clinicians, patients, and policymakers regarding childbirth and incontinence. Keywords: Stress Urinary Incontinence, Vaginal Delivery, Operative Vaginal Births

Bilateral ectopic ureteroceles complicated by a large calculus within the left ureterocele in a dog

AbstractA 4‐year‐old, entire female Siberian husky was presented with a history of urinary incontinence since she was a puppy and intermittent haematuria. A diagnosis of bilateral ectopic ureteroceles, calculus in the left ureterocele and bilateral pyelectasia was made by ultrasonography and CT excretory urography. The ureters were visualized communicating with opacified oblong structures, both located in the bladder neck, and the left one extended into the urethra. Resection of ureteroceles, neoureterostomy and calculus removal was performed. The dog made an uneventful recovery and was discharged from the hospital after 36 hours. A 2‐week course of antibiotic treatment was followed (marbofloxacin). Chemical analysis of the calculus revealed that it was composed of struvite. Treatment is mandatory at the time of diagnosis to prevent chronic kidney injury and urolithiasis secondary to obstructive uropathy. To the best of our knowledge, this is the first description of bilateral ectopic ureteroceles associated with calculus in a dog.

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 < 0.05 and p < 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 > 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.

Urodynamic and questionnaire findings in urinary incontinent women with and without diabetes. Data from a health study.

Our aim was to compare urodynamic findings in urinary incontinent (UI) women with and without diabetes. In the extensive Lolland-Falster Health Study, women with lower urinary tract symptoms were offered urodynamic testing. After excluding 6 women with incomplete urodynamic testing and 88 women without UI, our analysis ended up including 417 women (31 with and 386 without diabetes). Student's t-test and chi-squared test were used to compare differences of urodynamic findings. Urodynamic testing consisted of a 2-day bladder diary, post-void residual urine volume, filling cystometry, pressure-flow study, cough stress test, and uroflowmetry. Three experienced physicians in urogynecology evaluated all urodynamic findings leading to an overall conclusion of the test results. Self-reported data showed that compared to incontinent women without diabetes, incontinent women with diabetes had more frequent leakage, a larger amount of leakage, and a higher ICIQ score. A positive ICS Uniform cough stress test was more prevalent in women with diabetes. There were no significant differences in other urodynamic findings or overall conclusion between the two groups. Controlling for age and BMI did not affect our findings. Women with diabetes complained more about UI, had a higher ICIQ score, and had a positive ICS Uniform cough stress test more often than women without diabetes. Based on these findings, we recommend to include the history of urinary incontinence in the care of women with diabetes. This sample consists of women from a comprehensive health study with different severity of UI. Therefore, it can serve as a reference cohort for future studies.

Do community-dwelling pregnant women know about pelvic floor disorder?

ABSTRACT Our study aimed to assess the knowledge and awareness regarding pelvic floor disorders (PFDs) among pregnant women. We additionally evaluated whether the knowledge of PFDs was different in relation to gestational age, parity, the attendance to an antenatal education (ANE), and history of urinary incontinence (UI) and/or pelvic organ prolapse (POP). A cross-sectional descriptive study was conducted in pregnant women from all trimesters of pregnancy. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and three questions were used for knowledge and awareness. Two hundred and forty-one women participated in the study. Of them, 18.6% (n = 46) and 3.6% (n = 9) had UI and POP, respectively. The median of the PIKQ-UI and the PIKQ-POP scores were 6 (min-max: 0–11) and 5 (min-max: 0–12), respectively. The median PIKQ-UI and PIKQ-POP scores were higher in women who had attended ANE. There was no significant difference in terms of gestational age, parity, the attendance to ANE, and the history of pelvic floor disorder (p > .05). Knowledge and awareness were low among the women in all trimesters. Education programs involving pelvic floor training should be organized for pregnant women.

Cystoscopic-guided laser ablation for treatment of ectopic ureteroceles in 2 female dogs

Two female intact Labrador Retriever dogs (6 and 3 months of age, respectively) presented with a history of urinary incontinence. In both dogs, abdominal ultrasound revealed evidence of a unilateral ectopic ureterocele. Diagnosis of ureteral ectopia was established urethrocystoscopically by visualization of the ureteral orifice in the urethra, and an intramural course was confirmed via retrograde contrast fluoroscopy. Ectopic ureteral orifices were stenotic in both dogs. Cystoscopic- and fluoroscopic-guided laser ablation of the ectopic ureter were performed with a Hol:YAG laser. Following the procedure, both dogs were fully continent without any medical treatment. Cystoscopic- guided laser ablation of ureteroceles was effective and safe in these 2 dogs. Thus, this minimally invasive technique for the treatment of ectopic ureteroceles provides an alternative to surgical intervention.

Bladder Stone: An Uncommon Cause of Urinary Incontinence

Background: Bladder stones contribute about 5% to urinary tract stones. Bladder calculi is not a common cause of urinary incontinence and huge bladder stones are not common in routine clinical practice. Our aim, in this case, was to report a patient with huge bladder stone and share our experience in the management. Case presentation: She is a 41-year-old grand multipara who presented to the National Obstetric Fistula Centre, Abakaliki with a history of urinary incontinence. Presence of bladder stone was felt with a metal urethral catheter during clinical examination and this was confirmed with imaging. She was managed with transvaginal cystolithotomy. Conclusion: Huge bladder stone is uncommon but can be a cause of urinary incontinence. Transvaginal cystolithotomy is a safe approach to its management. Keywords: Bladder stone; Urinary incontinence; Cystolithotomy

MP31-18 CHARACTERIZATION OF URINARY INCONTINENCE BEFORE AND AFTER HOLEP

INTRODUCTION AND OBJECTIVE:To our knowledge, there has been no comprehensive prospective study using structured questionnaires regarding natural history of urinary incontinence (UI) before and afte...

Use of Monopolar Cauterization for Ectopic Intramural Ureter Correction by Cystoscopy in Bitch

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a position other than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics for surgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show the surgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guides monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few months of life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profound growth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Due to a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously of its intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostium could be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orient the ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EU channel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside the urinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed in both ureters. After bilateral repair of EU, the bitch showed a significative decrease of urinary incontinence, although completer resolution could not be obtained.Discussion:Studies showing the treatment of EU using the ablation of the tissue separating the ureteral and urethral or bladder lumen using cystoscopy-guided laser showed lower post-operative pain and hospitalization time, besides being a minimally invasive technique in comparison with traditional surgery. The limiting factor is the specialized equipment required for the procedure. In our surgical routine, there is a cystoscope, however, we do not own a diode laser or radiofrequency equipment. The adaptation of a monopolar cautery with the objective of correct an intramural EU proved to be feasible in practice since we achieved satisfactory recovery of the patient, similar than what is seen with lasers. Even after surgical repair of both EU, the patient sustained urinary incontinence, although lesser than before surgery. The remaining of the clinical sign, in this case, is compatible with the low rate of postoperative urinary continence in bitches, irrespective of the surgical technique, varying between 25% and 58% with or without medical treatment. To our knowledge, there was no published report on the use of monopolar cautery to treat EU. The monopolar cautery can be used as a less invasive and alternative technique to traditional surgery in the treatment of intramural EU through cystoscopy in bitches.

Clinical, Laboratory and Ultrasonographic Findings of Diabetic Dog with Emphysematous Cystitis

Background: Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the accumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detection of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact. Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 hours with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocytosis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the presence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis. Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog. Emphysematous cystitis is complicated, characterized by the presence of gas in the wall and lumen of the urinary bladder. It is usually reported in patients with diabetes mellitus. The patient presented with a very high glycemic index (376 mg/dL), in addition to having a history of urinary obstruction and presence of bladder stones, which may have acted as predisposing factors for the onset of emphysematous cystitis. In the present case, ultrasonography was the examination of choice. Hyperechoic reverberation-forming lines, identified as gas present in the topography of the urinary bladder, were easily visualized, as described in the literature. For the treatment of this condition, adequate management of the diet and the correct use of antimicrobials are of fundamental importance since the presence of diabetes mellitus in this patient can present serious complications in the future. This report shows the importance of the use of a combination of diagnostic tools to arrive at the correct diagnosis of the patient.

Baseline Understanding of Urinary Incontinence and Prolapse in New Urogynecology Patients.

Investigators sought to assess whether age was related to patient understanding of pelvic floor disorders; given studies show that increased age is associated with lower health literacy. This was a cross-sectional survey of new urogynecology patients. Enrolled participants completed a survey including demographics, history of urinary incontinence (UI) and pelvic organ prolapse symptoms and treatment, the Prolapse and Incontinence Knowledge Questionnaire (PIKQ), self-assessment of UI and prolapse knowledge, and a pelvic anatomy diagram to label. To achieve 80% power to detect a 2-point difference in PIKQ score, 33 subjects were required per age group (<65 and ≥65 years old). One hundred thirty-five of 160 new urogynecologic patients completed the survey (84% response rate). Thirty-seven participants were older than 65 years, and 98 were younger than 65 years. Total PIKQ scores (maximum, 24), the primary outcome, for the older and younger groups were 15.3 and 15.0, respectively (P = 0.7). The 2 groups self-rated UI and prolapse knowledge similarly, rating knowledge as excellent, very good, or good in 60% (P = 0.3) and 40% (P = 0.2) of subjects, respectively. Baseline patient understanding of UI and pelvic organ prolapse was low as assessed by PIKQ score and was not influenced by age.

Risk factors for urinary incontinence among Istanbul women: a hospital based case-control study

Aim: The study aimed to identify risk factors for urinary incontinence in women over 20 years of age in Istanbul. Design: The study was designed as a descriptive, retrospective, case control study. Methods: The study was conducted in a urogynecological unit at a university hospital in Istanbul. In total, 367 incontinent women who visited the urogynecological unit, and 401 continent women who visited outpatient clinics with other gynecological symptoms were included. Data were gathered via face-to-face interviews, using a questionnaire on risk factors for urinary incontinence. Adjusted odds ratios were given using logistic regression. Results: Variables which were found to be significantly different in chi-square analysis for urinary incontinence were age, education, marital status, number of pregnancies, birth and curettage, characteristics of first vaginal delivery (delivery mode, place, interventions), menopause, hormone therapy, history of gynecological operation, pulmonary disease, diabetes mellitus, hypertension, medicine use, constipation, flatus, hemorrhoids, herniated disc/varicose veins, stria during pregnancy, caffeine > 2 cups/day, body mass index (BMI 25 kg/m2), weight gain 10 kg, fecal incontinence, and history of urinary incontinence in childhood, in patients' mothers and relatives. When these variables were assessed in multivariate logistic regression analysis, number of births (1-birth OR = 38.8; CI = 2.2-669.5; 2-births OR = 20.1; CI = 1.2-327.4; ≥ 3-births OR = 35.0; CI = 1.9-621.8), BMI 25 kg/m2 (OR = 7.2; CI = 2.1-24.1), and history of incontinence in mothers (OR = 7.2; CI = 1.3-37.2) were identified as significant risk factors. Conclusion: The main risk factors for urinary incontinence in the population under study were identified to be the number of births as an obstetric risk factor, obesity as a lifestyle factor, and 'incontinence in mothers' as a familial factor.

Prevalence of urinary incontinence and its association with the body mass index (BMI) among pregnant women in Ternate Island

Urinary incontinence, a condition where a patient cannot withhold urinating, can cause health, social and psychological problems. This condition is not life threatening but can affect their quality of life due to the difficulties of treatment in the psychological and social problems. Even though this disorder is common in pregnancy, the exact cause is still unknown. Many researchers assert that urinary incontinence is due to multifactorial causes. This study aimed to determine the prevalence of urinary incontinence in pregnant women and its relationship with body mass index (BMI). A cross sectional study involving 224 pregnant women in the primary health centers on Ternate Island was conducted using the Questionnaire for Urinary Incontinence Diagnosis (QUID). Respondents with a history of urinary incontinence without pregnancy or positive urinary tract infection diagnosis were excluded from this study. Data were gathered through interviews and physical examinations. The total prevalence of urinary incontinence was 28.6%. Urge incontinence (39.0%) was the most common type followed by mixed (37.5%) and the least common was stress incontinence (23.4%). There was a significantly association between urinary incontinence and maternal BMI (p=0.045). Urinary incontinence occured as much as 2.167 (95% CI: 1.008 - 4.656) times greater in pregnant women with obesity than those who had an ideal BMI. In conclusion, urge incontinence is the most common type of urinary incontinence. There is a significant correlation between urinary incontinence and the BMI of pregnant women, especially in obese women.

EARLY OUTCOME OF TOT SURGERY FOR URINARY INCONTINENCE IN SULAIMANI TEACHING HOSPITAL

Background&#x0D; Female urinary incontinence is a major health issue affecting about 30% of adult women and majority of them is stress type. Transobturator tape (TOT) technique is relatively safe and associated with minimum complication rate.&#x0D; Objectives&#x0D; To identify the safety, success rate and efficacy of TOT procedures performed for female patients with stress urinary incontinence. &#x0D; Patients and Methods&#x0D; A prospective study included thirty patients with history of urinary incontinence (22 patients with stress type and 8 patients with mixed type UI). They underwent TOT procedure in Sulaimani teaching hospital under general or spinal anesthesia; they were collected over a year from June 2014 to June 2015, all of them referred from urological clinic with history of stress or mixed urinary incontinence. The response of TOT surgery was assessed in both subjective and objective ways, using the ICIQ-UI short form and both cough stress test and Q-tip test (before and after surgery), 20 of them had urodynamic study before surgery to confirm the diagnosis, follow up done at one week, three months and six months postoperatively. &#x0D; Results &#x0D; A total of 30 females with mean age (48.8±9.51) years, Mean number of deliveries for studied females was (4.9±2) deliveries. Main type of urinary incontinence among studied females was stress urinary incontinence (73, 3%); followed by mixed urinary incontinence (26, 7%), all of them were from Sulaimani city and its peripheries. In this study; we found that the success rate is 80% (considering both objective and subjective outcome) which is comparative to similar studies. The early complications were mainly perineal (groin) and upper thigh pain, while the late complications were the development of de novo detrusor over activity, there were no vaginal or urethral erosions. &#x0D; Conclusion&#x0D; Transobturator tape (TOT) is an efficient and safe way of managing stress urinary incontinence with high success rate and short hospitalization with minimum and simple early complications.

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

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