Urinary Incontinence In Adult Women Research Articles

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.

Methodologies Used in Studies of Self-Management Interventions for Urinary Incontinence in Adult Women: An Integrative Review.

Urinary incontinence (UI) affects approximately 60% of women in the United States and negatively impacts self-esteem, sexual function, participation in social activities, and quality of life (QOL). Self-management interventions show promise for improving UI symptoms and QOL. Previous reviews of UI self-management studies have focused on outcomes for older women. However, the literature lacks a synthesis of methodologies of these studies. The purpose of this integrative review was to synthesize and evaluate methodologies used in studies of self-management interventions for UI in adult women. Using an integrative review approach, a search of PubMed, CINAHL, and Embase was conducted yielding 1404 results, 23 of which met inclusion criteria. Data abstracted from each article included author(s), year of publication, study design and purpose, sample, country and setting, measures of UI symptoms, and intervention description. Findings showed methodological differences, particularly in design, assessment of UI subtypes, measures of UI symptoms, and intervention components. Multicomponent self-management interventions were used in 18 studies and 1 component used in 5 studies. Education, pelvic floor muscle exercises, and bladder training were the intervention components most frequently used, either alone or in combination; however, intervention components were not consistently aligned with the UI subtypes. Analysis of ethical matters revealed areas for improvement, specifically in reporting privacy and confidentiality and in methods to obtain informed consent. Results highlight opportunities to improve the rigor of methodologies used in studies of self-management interventions for UI in adult women.

Türkiye’de 25-64 yaş kadınlarda idrar kaçırma : kesitsel bir araştırma

Objective: The study aimed to determine the prevalence of urinary incontinence (UI) in a representative sample of women living in Turkey at the national level and to investigate predisposing factors. Methods: A cross-sectional study was conducted nationwide on women aged 25-64. Women were selected from Family Physicians' lists using random sampling. For data collection, a valid Turkish questionnaire; the international incontinence questionnaire - short form (ICIQ-SF) was used. An ICIQ-SF questionnaire is a form of inquiry that assesses the presence and severity of urinary incontinence and predisposing factors were Results: A total of 1,179 participants took part. The median age was 43±10.8 years. “Do you always leak urine?" the prevalence of UI was 43.9% in the answer to the question. Furthermore, the UI prevalence was 47.4% (559/1179) according to the ICIQ-SF survey. The prevalence of UI did not differ between regions, but the difference between increased vaginal births (≥3), advanced age, and low educational status was significant (p<0.05). Conclusion: The high rate of UI among women in Turkey indicates an important women's health problem that can be prevented by some studies. We believe it is important that this is taken into account in national preventive women's health programs. We recommend that the ICIQ-SF query form be included in national preventive women's health programs by taking routine practice as a screening tool to detect urinary incontinence in adult women.

Comparison of efficacy of extracorporeal magnetic innervation and Kegel exercises for stress urinary incontinence in adult women: study protocol for a randomized controlled trial.

Stress urinary incontinence (SUI) is defined as a complaint of inadvertent loss of urine occurring as a result of an increase in intraabdominal pressure. Strong evidence supports the use of pelvic floor muscle training (PFMT) as the first-line conservative treatment for SUI. Extracorporeal magnetic stimulation (EMS) is a non-invasive, effective, acceptable, and safe therapeutic modality for SUI. Although PFMT and EMS share most of their influences on the pathophysiology of SUI, it is unclear whether one of these routinely used treatment modalities is superior to another in terms of improvement of clinical outcomes or cost-effectiveness. To the best of our knowledge, no randomized controlled trials have so far directly compared PFMT with EMS. Our aim here is to describe a protocol for such a study.This will be a parallel-group, single-blind, randomised controlled trial compliant with the SPIRIT, CONSORT, and TIDieR reporting guidelines. Participants will be women aged 18 to 65 years who have previously given at least one vaginal delivery (at least 12 months before joining the study) who present with symptoms of SUI lasting at least 6 months yet have not previously received treatment for it. In the first study arm, patients will receive an eight-week, high-intensity, home-based Kegel exercises regimen. In the second study arm, the treatment scheme will consist of 2 sessions of EMS per week for a total of eight weeks. The primary outcome will be effectiveness of treatment as measured by the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form overall score, eight weeks, three months, and six months after commencement of treatment.

User Experiences and Preferences Regarding an App for the Treatment of Urinary Incontinence in Adult Women: Qualitative Study.

BackgroundAlthough several apps are available to support the treatment of urinary incontinence (UI), little has been reported about the experiences and preferences of their users.ObjectiveThe objective of this study was to explore the experiences and preferences of women using a mobile app for the treatment of UI and to identify potential improvements to the app. We developed this app for three types of UI: stress UI, urgency UI, and mixed UI.MethodsThe participants in this qualitative study were women with self-reported stress UI, urgency UI, or mixed UI who used an app-based treatment to manage their condition for at least six weeks. Following the intervention, semistructured interviews were conducted to explore the participants’ experiences and preferences regarding the app. All interviews were audio-recorded, transcribed verbatim, and analyzed separately by two researchers.ResultsData saturation was reached after interviewing 9 women (aged 32-68 years) with stress UI (n=1, 11%), urgency UI (n=3, 33%), or mixed UI (n=5, 56%). Accessibility, awareness, usability, and adherence emerged as the main themes. On the one hand, participants appreciated that the app increased their accessibility to care, preserved their privacy, increased their awareness of therapeutic options, was easy to use and useful, and supported treatment adherence. On the other hand, some participants reported that they wanted more contact with a care provider, and others reported that using the app increased their awareness of symptoms.ConclusionsThis qualitative study indicates that women appreciate app-based treatment for UI because it can lower barriers to treatment and increase both awareness and adherence to treatment. However, the app does not offer the ability of face-to-face contact and can lead to a greater focus on symptoms.

Serum Copper and Zinc Levels and Urinary Incontinence in Adult Women.

Recent findings show that oxidative damage may contribute to lower urinary tract symptoms. Copper can induce oxidative stress while zinc is involved in the defense against oxidative stress. We examined the associations between serum copper and zinc levels and urinary incontinence (UI) in adult women. Data were retrieved from the 2011-2016 National Health and Nutrition Examination Surveys. Outcomes for multivariate logistic regression were any UI (AUI), urge UI (UUI), stress UI (SUI), mixed UI (MUI), and moderate/severe UI. Questions on urinary incontinence were asked by trained interviewers. The weighted UI prevalences were 44.89% for AUI, 28.12% for UUI, 41.64% for SUI, 17.27% for MUI, and 20.79% for moderate/severe UI in adult women. After adjusting for multiple factors, serum copper levels in the highest quartile were associated with UUI [odds ratios (95% confidence intervals): 1.74 (1.11-2.74)]. In women older than 50years, serum copper levels in the highest quartile were associated with UUI [2.94 (1.57-5.49)], AUI [1.97 (1.19-3.27)], MUI [2.43 (1.19-4.97)], and moderate/severe UI [2.37 (1.06-5.31)]. Serum copper levels in the second quartile were also associated with MUI overall [1.75 (1.03-2.97)] and in young women (20-49years) [2.29 (1.02-5.17)]. Positive associations were also found between serum copper levels and UUI in non-obese women. There were no associations between serum zinc levels and UI outcomes. Serum copper levels were associated with UUI, MUI, AUI, and moderate/severe UI in adult women, especially women older than 50years. Causality deserves to be confirmed further.

Urethro-vaginal reflux during micturition: An underestimated cause of urinary incontinence in adult women.

To evaluate if urethrovaginal reflux (UVR) is an underestimated cause of insensible or postmicturition incontinence in adult women. An observational and retrospective study was carried out on the computerized records of a neuro-urology department. Female patients who had insensible or postmicturition incontinence were investigated. Retrograde and voiding urethrocystography (UCG), urodynamic evaluation, urethral pressure profilometry, and anamnestic and clinical examination had to be available. Among the 79 adult female patients with insensible or postmicturition incontinence in whom the whole set of required evaluations was achieved, 16 had a UVR (mean age 47 ± 15 years). There were no urethral diverticula, urethrocele, vesicovaginal, or urethrovaginal fistula on their UCG. All of them also had a cystoscopy and a CT urography which did not establish any abnormality. UVR is not an exclusive pathology of children. This mechanism seems to be an underestimated cause of urinary incontinence in adult women. Retrograde and voiding UCG appears to be the gold standard to confirm the intravaginal reflux.

Web-Based Treatment for Women with Stress Urinary Incontinence

This was a non-experimental, descriptive, correlational study designed to assess the feasibility and efficacy of an evidence-based online pelvic floor treatment program targeting stress urinary incontinence in adult women. The majority of the participants reported some level of improvement in their incontinence symptoms and overwhelmingly supported the web-based physical therapy program.

Percutaneous Tibial Nerve Stimulation for the Long-Term Treatment of Overactive Bladder: 3-Year Results of the STEP Study

We report the long-term efficacy and safety of percutaneous tibial nerve stimulation with the Urgent® PC Neuromodulation System for overactive bladder after 3 years of therapy. Fifty participants in the randomized, double-blind SUmiT (Sham Effectiveness in Treatment of Overactive Bladder Symptoms) Trial who met the primary effectiveness end point after 12 weekly percutaneous tibial nerve stimulation treatments were enrolled in this prospective study to assess long-term outcomes with percutaneous tibial nerve stimulation. STEP (Sustained Therapeutic Effects of Percutaneous Tibial Nerve Stimulation) Study patients were prescribed a fixed schedule 14-week tapering protocol followed by a personal treatment plan aimed at sustaining overactive bladder symptom improvement. Overactive bladder and quality of life questionnaires were completed every 3 months and 3-day voiding diaries were completed every 6 months. A total of 29 patients completed the 36-month protocol and received a median of 1.1 treatments per month after a 14-week treatment tapering protocol. A Bayesian model estimated that 77% (95% CI 64-90) of patients maintained moderate or marked improvement in overactive bladder symptoms at 3 years. Compared to baseline, median voids per day decreased from 12.0 (IQR 10.3-13.7) to 8.7 (IQR 7.3-11.3), nighttime voids per night decreased from 2.7 (IQR 1.7-3.3) to 1.7 (IQR 1.0-2.7) and urge incontinence episodes per day decreased from 3.3 (IQR 0.7-6.0) to 0.3 (IQR 0.0-1.0) (all p <0.0001). All quality of life parameters remained markedly improved from baseline through 3 years (all p <0.0001). One patient experienced 2 mild treatment related adverse events of bleeding at the needle site during followup. Most STEP participants with an initial positive response to 12 weekly percutaneous tibial nerve stimulation treatments safely sustained overactive bladder symptom improvement to 3 years with an average of 1 treatment per month.

The association between diabetes mellitus and urinary incontinence in adult women

Introduction and hypothesisThe purpose of the study was to investigate the relationship of diabetes mellitus and urinary incontinence in adult women.MethodsWe conducted a cross-sectional, comparative study with a case-control design. One thousand three hundred eighty-one women (aged 20–87 years) attending six Primary Healthcare Centers in Turkey were enrolled in this study, after giving their informed consent. Subjects were dichotomized into cases and controls according to presence of diabetes mellitus (DM) and were matched for the confounding factors age, body mass index (BMI), and reproductive history.ResultsNine hundred ten women were included: 273 diabetics and 637 non-diabetics. Diabetes was shown to be associated with a 2.5-fold risk increase for urinary incontinence (UI), and age and BMI were weakly associated with UI. UI was significantly more prevalent in diabetic women: 41% diabetic and 22.1% non-diabetic women reported UI (p < 0.001). Age, BMI, and DM were revealed as independent determinants of UI in adult women. Urge incontinence was more prevalent in non-diabetic women, whereas stress and mixed incontinence were more prevalent among diabetic women.ConclusionsDM is the most important independent determinant of UI.

Wie sinnvoll ist die medikamentöse Therapie der Belastungsinkontinenz?

In Germany, only duloxetine is registered for treating stress urinary incontinence in adult women; duloxetine treatment for stress urinary incontinence in children or men is poorly investigated and still off-label. Trials in women based on the evidence level 1B and meta-analyses have demonstrated that duloxetine significantly reduced the frequency of incontinence episodes and increased incontinence-related quality of life. However, duloxetine must be used on a regular base to maintain these positive effects. Therefore, duloxetine seems to be especially indicated in women who refuse or cannot be subjected to physical or surgical treatment and are willing to accept the long-term use and possible side effects of the drug. Furthermore, duloxetine could be useful in women to support pelvic floor physiotherapy or in female patients awaiting incontinence surgery.

Effect of Childhood Dysfunctional Voiding on Urinary Incontinence in Adult Women

To determine whether a history of childhood dysfunctional voiding is associated with urinary incontinence in adulthood. Using a case-control study, we surveyed patients presenting with or without urinary incontinence. Cases were patients referred to a tertiary urogynecology clinic, and controls were patients referred to a general gynecology clinic. Patients completed a validated childhood questionnaire about dysfunctional voiding. A total score of 6 or more in girls is indicative of dysfunctional voiding, a condition characterized by urgency, frequency, constipation, urinary or fecal incontinence, and/or urinary tract infections. Using an alpha of 0.05, a power of 80%, and a baseline prevalence of dysfunctional voiding of 8%, we determined that 170 patients were needed to show a 3-fold difference between groups. Cases (n = 84) and controls (n = 86) had similar baseline characteristics except for body mass index and incidence of previous pelvic surgery. Although the total dysfunctional voiding score was higher in cases than controls (7.3 versus 5.0, respectively; P = .001), the difference in the number (%) of patients with history of childhood dysfunctional voiding between the 2 groups was not significant (47 [56%] versus 36 [42%], respectively; odds ratio 1.76, 95% confidence interval 0.96-3.24; P = .07). When all patients from both groups were combined, there was a higher prevalence of a history of childhood dysfunctional voiding in women with or without current urinary frequency (P = .004), urgency (P = .03), stress incontinence (P = .01), and urge incontinence (P = .009). Women with adult lower urinary tract symptoms may have a higher prevalence of history of childhood dysfunctional voiding. II-2.

The Effect of Childhood Dysfunctional Voiding on Urinary Incontinence in Adult Women

Minassian, Vatche A. MD; Lovatsis, Danny MD; Pascali, Dante MD; Alarab, May MD; Drutz, Harold P. MD Author Information

Management of urinary incontinence in women: scientific review.

Urinary incontinence is a common health problem among women that negatively impacts quality of life. Therefore, it is important that primary care physicians have an understanding of how to manage urinary incontinence effectively. To review the most recent, high-quality evidence regarding the etiology and management of urinary incontinence in women. Searches of MEDLINE, EMBASE, The Cochrane Library, and the ACP Journal Club were performed to identify English-language articles published between 1998-2003 that focused on the etiology or treatment of urinary incontinence in adult women. The references of each retrieved article were reviewed and an expert in the field was contacted to identify additional relevant articles. Using a combination of more than 80 search terms, we included articles of etiology that were cohort studies, case-control studies, cross-sectional studies, or systematic reviews of cohort, case-control, and/or cross-sectional studies. Studies of treatment had to be randomized controlled trials or systematic reviews of randomized controlled trials. The quality of each article was assessed independently by each author and inclusion (n = 66) was determined by consensus. Multiple factors have been found to be associated with urinary incontinence, some of which are amenable to modification. Factors associated with incontinence include age, white race, higher educational attainment, pregnancy-related factors, gynecological factors, urological and gastrointestinal tract factors, comorbid diseases, higher body mass index, medications, smoking, caffeine, and functional impairment. There are several effective nonpharmacological treatments including pelvic floor muscle training, electrical stimulation, bladder training, and prompted voiding. Anticholinergic drugs are effective in the treatment of urge urinary incontinence. Several surgical interventions are effective in the management of stress incontinence, including open retropubic colposuspension and suburethral sling procedure. Urinary incontinence in women is an important public health concern, and effective treatment options exist.

Systematic Review: Efficacy of Silicone Microimplants (Macroplastique®) Therapy for Stress Urinary Incontinence in Adult Women

To assess the efficacy of silicone microimplants (Macroplastique; polydimethylsiloxane) therapy for stress urinary incontinence in adult women, using a systematic review of identified studies. A computer-aided and manual search for published studies investigating silicone microimplants therapy for stress urinary incontinence in adult women. The methodological quality of the included studies was assessed using criteria based on generally accepted principles of interventional research. Only two RCTs, only published as an abstract, were found. Eleven pre-experimental or observational studies were identified. Overall, the methodological quality was low. The main methodological shortcomings of the studies were: no random allocation procedure, lack of prestratification on prognostic determinants, no blinding, small sample sizes, and lack of proper analysis and presentation of results. There was variability in the indication for implantation, implantation procedure, rate and volume of silicone microimplants. The use of different outcome measures in most of the trials made comparison between studies difficult. Because of the low methodological quality of included studies, results should be interpreted with caution and no firm conclusions about the efficacy of silicone microimplants were possible. Randomized clinical trials, using valid and reliable subjective and objective measurements, are necessary to establish the efficacy of silicone microimplants therapy in treating stress urinary incontinence in adult women.

Overactive Bladder and Urinary Incontinence in Adult Women: Prevalence and Effects on Daily Life and Sexual Activity

The purpose of this study was to investigate the prevalence, relative factor and the effects that overactive bladder or urinary incontinence have on women's lives. Data was gathered through an internet survey. The subjects included 3,372 women ranging from 20 years old to 49 years of age. The questionnaire included general characteristics (age, parity, family history, and history of UTI), overactive bladder symptoms (urgency, frequency, nocturia, urgent incontinence), urinary incontinence, discomfort in ADL and sexual activity. The data was analyzed by the SPSS/PC+ program using frequency, test, and multivariate logistic regression. The results were as follows; 1. The prevalence was 12.7 % in overactive bladder and 21.0% in urinary incontinence. 2. 19.2% of the subject have urge incontinence, 5% of them have coped with the use of a pad. 3. The significant factors to overactive bladder were age(=6.6, p=50.8, p=26.1, p=6.2, p=11.0, p=20.2, p=8.6, p=4.9, p

The external urethral barrier for stress incontinence: a multicenter trial of safety and efficacy

Objective: To assess the efficacy and safety of an external urethral barrier for the management of mild to moderate stress urinary incontinence in adult women. Methods: Four hundred eleven women with the symptom of stress urinary incontinence in 12 United States centers participated. Additional inclusion and exclusion criteria were applied before protocol device use, and ultimately 390 subjects began device use. Outcome measures for efficacy and safety were assessed. Efficacy was evaluated by the number of leakage episodes using a voiding diary, subjective urinary leakage severity, incontinence impact scores, and pad testing. Safety was evaluated by symptom assessment, urinalysis, urine culture, measurement of postvoid residual urine volume, vulvar cytology, vaginal culture, and ( n = 81) cystometric testing. Results: Efficacy was indicated by statistically significant reductions in the number of leakage episodes, subjective leakage severity scores, incontinence impact scores, and pad-test loss during device use. The data also indicated that the device was safe, as evidenced by the lack of statistically significant changes in the percentage of subjects with urinary tract infections during device use or in postvoid residual urine volume and cystometric indices. Symptoms of vulvar irritation or lower urinary tract discomfort occurred in a small percentage of subjects but were generally transient, and only three women discontinued using the device. Conclusion: The external urethral barrier appears to be a safe nonsurgical alternative to absorbent products for the management of mild to moderate stress urinary incontinence in adult women.

A Study on urinary Incontinence of Adult Women: Preliminary Study

The purpose of this study was to identify the incidence of urinary incontinence in adult women and to identify factors related to life style and sexual intercourse that were related to incontinence. The sample consisted of 1,065 women living in Seoul or one of five provinces. Data for this study wer...

Multimodality pelvic physiotherapy treatment of urinary incontinence in adult women

The aim of the study was to evaluate the effectiveness of in-office physiotherapy for stress, mixed and urge incontinence. All subjects underwent urodynamics. Those with stress incontinence received pressure biofeedback pelvic floor exercises and electrical stimulation. Those with detrusor instability and mixed incontinence received bladder drills, anticholinergic medications, electrical stimulation and pressure biofeedback pelvic floor exercises. All those with atrophic vaginitis received vaginal estrogen. Weekly treatment sessions for 4 weeks and then monthly for 2 months were directed by a trained gynecologic nurse. Weekly bladder diaries were kept. Outcome measures included diary-recorded incontinence episodes and subjective reporting of continence. One hundred and four women completed the program. Weekly incontinence episodes decreased from 22 to 2 (<0.05) in both stress and detrusor instability/mixed incontinence groups. An average of 4.5 sessions over 6.1 weeks was necessary for optimal response; 86% reported subjective improvement. It was concluded that multimodality treatment of incontinence leads to a 90% reduction in incontinence episodes. The relative contribution of each treatment modality requires further study.

Postpartum onset of urinary incontinence associated with ureteral ectopia

The onset of urinary incontinence in adult women in association with extrasphincteric ureteral ectopia is rare. Herein we report 2 cases of this unusual occurrence. The incontinence in both patients began after significant obstetric trauma. Ureteral ectopia should be included in the differential diagnosis of incontinence beginning in the immediate postpartum period.