Urinary Incontinence In Postmenopausal Women Research Articles

The effect of kegel exercises on urinary incontinence in menopausal women in the Banyuwangi Hindu elderly community

Introduction: Urinary incontinence refers to an individual's inability to restrain or control the discharge of urine due to weakness of the pelvic floor muscles and bladder muscles that are unable to control urine. This causes contamination of skin diseases in the genital area, quality of sleep, and decubitus. Prevention efforts can be provided with non-pharmacological therapy by doing Kegel exercises to stretch the pelvic floor muscles. The mechanism of action strengthens the capacity of the bladder sphincter. Objectives: This study aimed to determine the effect of Kegel exercises on urinary incontinence in postmenopausal women in the Banyuwangi Hindu elderly community in 2023. Methods: This research employed a pre-experimental research design with a one-group pre-test post-test research design of 18 respondents using a purposive sampling technique. Statistical analysis using the Wilcoxon test. Results: The study's results before the intervention were those who experienced urinary incontinence in the elderly with a minimum value of 13, a median value of 17.50, and a maximum value of 22. After the intervention, those experiencing urinary incontinence had a minimum value of 4, a median value of 7.44, and a maximum value of 12. The findings of this research, analyzed using the Wilcoxon Test with SPSS, yielded a significance value of p = 0.000, which is less than 0.05. This indicates that Kegel Exercise has an impact on Urinary Incontinence in Menopausal Women in the Banyuwangi Hindu Elderly Community in 2023. Conclusions: Kegel exercises contract, increase muscle tone, improve healing by up to 50%, and form a supporting structure for the pelvis, vagina, urethra, and rectum to affect the inability to urinate under control.

Comparison of Low-Energy Radiofrequency Thermal Vaginal Therapy with Sham Treatment for Stress Urinary Incontinence in Postmenopausal Women: A Randomized Controlled Trial.

Low-energy radiofrequency (RF) thermal vaginal therapy for vaginal laxity and the genitourinary syndrome of menopause denatures collagen fibrils in the endopelvic fascia; fiber tightening during healing may stabilize the urethra and bladder neck, thereby resolving female stress urinary incontinence (SUI), especially in postmenopausal women. This study compared RF vaginal therapy with sham treatment for mild to moderate SUI. This double-blinded, randomized controlled trial, conducted at a tertiary center from September 2018 to April 2021, recruited postmenopausal women with mild to moderate degree of SUI who had never undergone surgery, energy-based therapy, or vaginal estrogen treatment. The intervention group received vaginal RF laser treatment; the sham group did not. The primary outcome was the 1-hour pad-weight test (PWT) result. Secondary outcomes were Incontinence Quality of Life (I-QOL), Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Patient Global Impression of Improvement (PGI-I), percentage of improvement among all participants, and adverse events. Data were analyzed using STATA 17.0. Forty-nine participants randomized to RF (n = 23) and sham (n = 26) groups were eligible for analysis. PWT decreased during follow-up in the RF group but remained stable in the sham group; PWT did not significantly differ between groups. The 1-year post-treatment success rate was higher in the RF group (69.6%) than in the sham group (38.5%). At 1 year post-treatment, there were no statistically significant differences in any secondary outcomes. Low-energy RF vaginal therapy is an alternative treatment for mild to moderate SUI in postmenopausal women without serious adverse events. Larger randomized controlled trials should be conducted.

Correlation of serum circulating testosterone levels with stress urinary incontinence in postmenopausal women.

Our study aimed to elucidate the possible relationship between endogenous circulating testosterone and the beginning and development of stress urinary incontinence (SUI) in postmenopausal women. The clinical data of female patients with SUI who underwent surgery at our hospital from January 2014 to February 2023 and healthy female volunteers recruited during the same period were retrospectively analyzed according to age and body mass index (BMI). Venous blood samples were taken from all subjects, and levels of estradiol, luteinizing hormone, prolactin, follicle-stimulating hormone, progesterone, and testosterone were measured by radioimmunoassay. After adjusting for age, BMI, hypertension, mode of delivery, hysterectomy, and profession, multiple logistic regression analysis was used to determine the relationship between SUI and serum testosterone levels in postmenopausal women. Serum testosterone levels were significantly lower in women with SUI than in healthy control women (0.92 ± 0.67 vs. 1.28 ± 1.10; P < 0.05). Further comparison of testosterone levels between postmenopausal SUI women and healthy postmenopausal women in postmenopausal subjects revealed that testosterone levels were significantly lower in postmenopausal SUI women than in healthy postmenopausal women (0.84 ± 0.64 vs. 1.23 ± 1.10; P < 0.05). This difference in testosterone levels remained significant after controlling for age, BMI, hypertension, mode of delivery, hysterectomy, and profession in postmenopausal women. The results of the present study indicate that low levels of serum testosterone are associated with an increased likelihood of stress urinary incontinence in women. Low serum testosterone levels may be a risk factor for SUI in postmenopausal women.

Treatment of urge incontinence in postmenopausal women: A systematic review.

Urinary incontinence and other urinary symptoms tend to be frequent at menopause because of hormonal modifications and aging. Urinary symptoms are associated with the genitourinary syndrome of menopause which is characterized by physical changes of the vulva, vagina and lower urinary tract. The treatment strategies for postmenopausal urinary incontinence are various and may include estrogens, anticholinergics, and pelvic floor muscle training. A comparison of these treatments is difficult due to the heterogeneity of adopted protocols. We systematically reviewed the evidence from randomized controlled trials (RCTs) focusing on treatment of postmenopausal women with urge incontinence. We conducted a systematic review and meta-analysis by searching PubMed and EMBASE databases for randomized controlled trials (RCTs) reporting results of treatments for postmenopausal urinary urge incontinence. Odds ratios for improvement of urinary incontinence were calculated using random effect Mantel-Haenszel statistics. Out of 248 records retrieved, 35 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared with placebo, systemic estrogens were associated with decreased odds of improving urinary incontinence in postmenopausal women (OR = 0.74, 95% CI: 0.61-0.91, 7 series, 17132 participants, Z = 2.89, P = 0.004, I2 = 72%). In most studies, no significant improvement in urinary symptoms was observed in patients treated with local estrogens, although they showed to be helpful in improving vaginal symptoms. Vitamin D, phytoestrogens and estrogen modulators were not effective in improving symptoms of incontinence and other symptoms of genitourinary menopause syndrome or yielded contradictory results. A randomized controlled trial demonstrated that oxybutynin was significantly better than placebo at improving postmenopausal urgency and urge incontinence. The combination of anticholinergics with local estrogens has not been shown to be more effective than anticholinergics alone in improving urinary incontinence symptoms in postmenopausal women. Physical therapy showed an overall positive outcome on postmenopausal urinary incontinence symptoms, although such evidence should be further validated in the frame of quality RCTs. The evidence for effective treatment of postmenopausal urinary incontinence is still lacking. Welldesigned large studies having subjective and objective improvement primary endpoints in postmenopausal urinary incontinence are needed. At present, a combination of different treatments tailored to the characteristics of the individual patient can be suggested.

Update on Overactive Bladder Therapeutic Options.

Millions of Americans are burdened by overactive bladder (OAB) syndrome and the psychogenic and economic hardships that accompany it. Several theories attempt to explain OAB as a neurogenic dysfunction, myogenic dysfunction, urothelial dysfunction, or decreased expression of a channel protein secondary to bladder outlet obstruction. Given that the etiology of OAB is a working theory, the management of OAB is also an evolving subject matter in medicine. There are uncertainties surrounding the pathophysiology of OAB, the strength of a clinical diagnosis, and accurate reporting because of the disease's stigma and decreased use of health care. This is a narrative review that used PubMed, Google Scholar, Medline, and ScienceDirect to review literature on current and future OAB therapies. Currently, first-line treatment for OAB is behavioral therapy that uses lifestyle modifications, bladder-control techniques, and psychotherapy. Second-line therapy includes antimuscarinic agents or beta 3 adrenergic agonists, and studies have shown that combination therapy with antimuscarinics and beta 3 adrenergic agonists provides even greater efficacy than monotherapy. Third-line therapies discussed include onabotulinumtoxinA, posterior tibial nerve stimulation, and sacral neuromodulation. OnabotulinumtoxinA has been FDA-approved as a nonpharmaceutical treatment option for refractory OAB with minimal side effects restricted to the urinary tract. Posterior tibial nerve modulation and sacral neuromodulation are successful in treating refractory OAB, but the costs and complication rates make them high-risk procedures. Therefore, surgical intervention should be a last resort. Estrogen therapy is effective in alleviating urinary incontinence in postmenopausal women, consistent with the association between estrogen deficiency and genitourinary syndrome. Potassium channel activators, voltage-gated calcium channel blockers, and phosphodiesterase inhibitors look to be promising options for the future of OAB management. As new therapies are developed, individuals with OAB can better personalize their treatment to maximize their quality of life and cost-effective care.

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

BackgroundUrinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women.MethodsIt was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021–2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence.ResultsThe overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18–0.77) and UUI (aOR 0.38; 95% CI 0.15–0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50–55 age range (aOR 3.88; 95% CI 1.16–12.93) than those less than 50 years.ConclusionDue to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.

Pelvic Floor Muscle Exercises as a Treatment for Urinary Incontinence in Postmenopausal Women: A Systematic Review of Randomized Controlled Trials.

Women frequently suffer from urinary incontinence due to atrophic changes in the urogenital tract. Recommended conservative treatment includes evaluation of pelvic-floor strength and the functional use of pelvic-floor-muscle (PFM) training. Following the PRISMA 2020 guidelines, a search was conducted in the electronic databases PubMed, Web of Science, and Scopus for articles with at least one group performing PFM exercises in post-menopausal women with urinary incontinence. Eight articles were included, and each study had at least one group of PFM exercise-based intervention alone or combined. The volume or duration, frequency, and number of sessions were heterogeneous. All the studies reported significant differences in favor of PFM exercise in strength, quality of life, and/or severity of urinary incontinence. PFM exercise is a highly recommended intervention to treat urinary incontinence in postmenopausal women. However, more research is needed to establish specific factors such as dose-response relationships and to standardize methods for measuring effects.

The impact of kapalabhati on menopausal women\'s pelvic floor muscle strength

The menopause is reached by females between the ages of 40 and 60. Menopause causes the body to go through a lot of changes. It frequently goes along with changes in how the female pelvic floor functions. The distresses associated with menopause are minimized by altering the routine and adopting a healthier diet and exercise regimen. Yoga may have an impact on the heart and core muscles, according to the evidence. The study's objective was to determine how yoga affected the strength of the pelvic floor muscles (PFMs) in women who had reached menopause by utilising the perineometer. Seventy menopausal females between the ages of 40 and 60 were the subjects of a study. On the first day, participants received instruction to perform Kapalbhati and were urged to practise for five weeks. PFM strength was the primary outcome measure, measured using a perineometer. In results, Kapalbhati was found useful in treating stress urinary incontinence in post-menopausal women.

Platelets Rich Plasma Injections in The Treatment for Stress Urinary Incontinence in Postmenopausal Women

Platelets Rich Plasma Injections in The Treatment for Stress Urinary Incontinence in Postmenopausal Women

Causes and treatment of urge incontinence in women

Journal of Prescribing PracticeVol. 4, No. 5 News AnalysisCauses and treatment of urge incontinence in womenAysha MendesAysha MendesE-mail Address: [email protected]Freelance journalist specialising in health, psychology and nursingSearch for more papers by this authorAysha MendesPublished Online:13 May 2022https://doi.org/10.12968/jprp.2022.4.5.186AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References Artusi CA, Romagnolo A, Ledda C et al. COVID-19 and Parkinson's disease: what do we know so far? J Parkinsons Dis. 2021;11(2):445–454. https://doi.org/10.3233/JPD-202463 Google ScholarAustralian Menopause Society. Stress and urge incontinence info sheet. 2013. https://www.menopause.org.au/images/stories/infosheets/docs/AMS_Stress_and_urge_incontinence.pdf (accessed 29 April 2022) Google ScholarBritish Medical Journal. Best Practice: Urinary incontinence in women. 2020. https://bestpractice.bmj.com/topics/en-gb/169 (accessed 29 April 2022) Google ScholarKołodynska G, Zalewski M, Rozek-Piechura K. Urinary incontinence in postmenopausal women – causes, symptoms, treatment. Prz Menopauzalny. 2019;18(1): 46–50 https://doi.org/10.5114/pm.2019.84157 Google ScholarNational Institute for Health and Care Excellence. Clinical Knowledge Summary: Incontinence, urinary, in women. 2019a. https://cks.nice.org.uk/incontinence-urinary-in-women#!scenario:1 (accessed 29 April 2022) Google ScholarNational Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. NICE guideline [NG123]. 2019b. https://www.nice.org.uk/guidance/ng123 (accessed 29 April 2022) Google ScholarZhou Y, Chi J, Lv W, Wang Y. Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes Metab Res Rev. 2021;37(2):e3377. https://doi.org/10.1002/dmrr.3377 Google Scholar FiguresReferencesRelatedDetails 2 May 2022Volume 4Issue 5ISSN (print): 2631-8385ISSN (online): 2631-8393 Metrics History Published online 13 May 2022 Published in print 2 May 2022 Information© MA Healthcare LimitedPDF download

Assessment of the Effectiveness of the Sonofeedback Method in the Treatment of Stress Urinary Incontinence in Women-Preliminary Report.

Urinary incontinence is a common problem that affects postmenopausal women. This ailment has a negative impact on many aspects of life, significantly limiting everyday functioning related to professional work, physical activity or the intimate sphere. The aim of the study was to assess the effectiveness of the sonofeedback method in reducing the severity of urinary incontinence in postmenopausal women with a urinary incontinence problem. A total of 60 patients aged 45–65 with stress urinary incontinence, confirmed by a gynecologist, were qualified for the study. All persons qualified for the study were randomly assigned to study group A (n = 20), comparative B (n = 20) and control C (n = 20). Patients from group A were treated with sonofeedback of the pelvic floor muscles. In group B, the combined electrostimulation method was used with biofeedback training. Group C was a control group in which only the measured parameters were measured at the same time interval as those carried out in groups A and B. In all patients, three times: before the therapy, after the fifth procedure and after the end of the therapy, the incidence and severity of stress urinary incontinence were assessed—Gaudenz questionnaire and the intensity of urinary incontinence—a modified 1 h pad test. The obtained results have an application value giving the possibility of using effective therapy with sonofeedback in women in whom the recommended electrostimulation method cannot be used due to health and behavioral reasons.

Effect of Aerobic Walking Exercise on Stress Urinary Incontinence in Postmenopausal Women

The purpose of this study was to explore the impact of aerobic walking exercise on stress urinary incontinence (SUI) among postmenopausal women. Thirty females diagnosed with SUI participated in the research. Participants were assigned randomly into two groups: The usual care group (UC) and the UC plus aerobic walking exercise (TMT) group. The UC group performed pelvic floor muscle (PFM) training only, while the TMT group performed PFM training in addition to aerobic exercise. Myomed biofeedback was used to assess the PFM strength both before and after a 12-week period. The Revised Urinary Incontinence Scale was utilized to assess changes in incontinence severity symptoms after intervention. Findings revealed a significant increase in PFM strength in both UC and TMT groups (p = .011 and p = .010, respectively) and a significant reduction in their Revised Urinary Incontinence Scale (p = .011 and p = .001, respectively) after the end of the 12 weeks of the training program. In addition, there was a more significant increase in PFM strength in the TMT group than in the UC group (p = .010) and a more significant decrease in Revised Urinary Incontinence Scale (p = .011) after 12 weeks of the training program. This study concluded that aerobic walking exercise with PFM training is more effective than PFM training only in increasing PFM strength and improving symptoms of SUI in postmenopausal women with SUI.

Low-fat dietary pattern reduces urinary incontinence in postmenopausal women: post hoc analysis of the Women's Health Initiative Diet Modification Trial

BACKGROUNDUrinary incontinence affects >40% of women in the United States, with an annual societal cost of >$12 billion and demonstrated associations with depressive symptoms, social isolation, and loss of work productivity. Weight has been established as an exposure that increases urinary incontinence risk and certain dietary components have been associated with urinary incontinence symptoms. We hypothesized that diet plays a key role in the association between weight and urinary incontinence in US women.OBJECTIVEThis study aimed to examine the effect of a low-fat diet on urinary incontinence in postmenopausal women as a post hoc analysis of a randomized controlled trial of diet modification.STUDY DESIGNThis was a post hoc analysis of the Women's Health Initiative Dietary Modification randomized controlled trial of 48,835 postmenopausal women from 40 US centers assigned to a dietary intervention (20% energy from fat, 5 fruits or vegetable servings, and 6 whole grain servings daily and an intensive behavioral modification program) or to the usual diet comparison group. The outcome was urinary incontinence at 1 year.RESULTSOf the participants, 60% were randomized to the usual diet comparison group and 40% to the dietary modification intervention. After adjusting for weight change, women assigned to the dietary modification intervention were less likely to report urinary incontinence (odds ratio, 0.94; 95% confidence interval, 0.90–0.98; P=.003), more likely to report urinary incontinence resolution (odds ratio, 1.11; 95% confidence interval, 1.03–1.19; P=.01), and less likely to develop urinary incontinence (odds ratio, 0.92; 95% confidence interval, 0.87–0.98; P=.01) in adjusted models.CONCLUSIONDietary modification may be a reasonable treatment for postmenopausal women with incontinence and also a urinary incontinence prevention strategy for continent women. Our results provide evidence to support a randomized clinical trial to determine whether a reduced fat-intake dietary modification is an effective intervention for the prevention and treatment of urinary incontinence. In addition to providing further insights into mechanisms of lower urinary tract symptoms, these findings may have a substantial impact on public health based on the evidence that diet seems to be a modifiable risk factor for urinary incontinence.

Physical Activity, Diet, and Incident Urinary Incontinence in Postmenopausal Women: Women's Health Initiative Observational Study.

Physical activity and macronutrient intake, important contributors to energy balance, may be independently associated with female urinary incontinence (UI). We evaluated the association of baseline self-reported physical activity and macronutrient intake, via food frequency questionnaire, with incident UI subtypes after 3 years among 19 741 postmenopausal women in the Women's Health Initiative Observational Study. Odds ratios (ORs) for incident urgency, stress, and mixed UI were calculated using multivariable logistic regression. Women who reported total physical activity (metabolic equivalent task [MET]-hours/week) ≥30 versus <0.1 were 16% less likely to develop urgency UI (OR = 0.84; 95% CI 0.70, 1.00) and 34% less likely for mixed UI (OR = 0.66; 95% CI 0.46, 0.95), although linear trends were no longer statistically significant after adjusting for baseline weight and weight change (p trend = .15 and .16, respectively). The association between physical activity and incident stress UI was less consistent. Higher uncalibrated protein intake was associated with increased odds of incident urgency UI (≥19.4% vs <14.1% of energy intake OR = 1.14; 95% CI 0.99, 1.30; p trend = .02), while CIs were wide and included 1.0 for calibrated protein intake. Other macronutrients were not associated with urgency UI and macronutrient intake was not associated with incident stress or mixed UI (p trend > .05 for all). Among postmenopausal women, higher physical activity was associated with lower risk of incident urgency and mixed UI, but not stress UI, independent of baseline weight and weight change. Higher protein intake was associated with increased risk of urgency UI, but no associations were observed between other macronutrient and UI subtypes.

Management of urinary incontinence in postmenopausal women: An EMAS clinical guide

IntroductionThe prevalence of urinary incontinence and of other lower urinary tract symptoms increases after the menopause and affects between 38 % and 55 % of women aged over 60 years. While urinary incontinence has a profound impact on quality of life, few affected women seek care. AimThe aim of this clinical guide is to provide an evidence-based approach to the management of urinary incontinence in postmenopausal women. Materials and methodsLiterature review and consensus of expert opinion. Summary recommendationsHealthcare professionals should consider urinary incontinence a clinical priority and develop appropriate diagnostic skills. They should be able to identify and manage any relevant modifiable factors that could alleviate the condition. A wide range of treatment options is available. First-line management includes lifestyle and behavioral modification, pelvic floor exercises and bladder training. Estrogens and other pharmacological interventions are helpful in the treatment of urgency incontinence that does not respond to conservative measures. Third-line therapies (e.g. sacral neuromodulation, intravesical onabotulinum toxin-A injections and posterior tibial nerve stimulation) are useful in selected patients with refractory urge incontinence. Surgery should be considered in postmenopausal women with stress incontinence. Midurethral slings, including retropubic and transobturator approaches, are safe and effective and should be offered.

Prevalence and Risk factors for Urinary Incontinence in postmenopausal women

Prevalence and Risk factors for Urinary Incontinence in postmenopausal women

Prevalence and Factors of Urinary Incontinence among Postmenopausal Women Attending the Obstetrics and Gynecology Outpatient Service in a Tertiary Health Care Center in Kochi, Kerala.

Introduction:Urinary incontinence has an immense impact on the social and mental health, and the quality of life of a person. Women neither come forward seeking medical consultation nor do they discuss about their incontinence openly, and the condition remains underestimated in the society. Hence, this study was undertaken to assess the type of urinary incontinence in postmenopausal women visiting obstetrics and gynecology (OBG) outpatient in a tertiary health care sector and to determine the risk factors of urinary incontinence.Materials and Methods:All postmenopausal women of age 45–90 years visiting the OBG Department of Amrita Institute of Medical Sciences in the months of May and June 2018 were assessed for urinary incontinence. QUID questionnaire - a six item urinary incontinence diagnostic questionnaire to diagnose and differentiate stress, urge and mixed incontinence - was used.Results:The prevalence of urinary incontinence was 26.47%, stress urinary incontinence contributing 13.9%, mixed urinary incontinence 7.2%, and urge urinary incontinence 5.4%. Chronic cough, recurrent urinary tract infections (UTI), and prolonged duration of labor were independent risk factors associated with urinary incontinence in postmenopausal women.Conclusion:Stress incontinence was found to be the major type of urinary incontinence in the postmenopausal women. Those having history of chronic cough, prolonged duration of labor, and recurrent UTI should be screened regularly for urinary incontinence.

Urinary incontinence in postmenopausal women - causes, symptoms, treatment.

Urinary incontinence (UI) is an important social problem that affects more than 50% of postmenopausal women. The number of patients increases from year to year. According to recent data, UI affects women twice as often as men. This condition occurs in about 20-30% of young women, 30-40% in middle age and up to 50% of women in old age. There are five types of urinary incontinence. The etiology of the problem of incontinence is not fully understood, because the problem can affect men and women of all ages and can be due to many changes in the human body. International Continence Society Guidelines indicate that treatment of urinary incontinence should begin with conservative treatment. Surgical treatment should be used when conservative treatment will not bring positive results. According to guidelines, conservative treatment should include pharmacotherapy, physiotherapy, and behavioral therapy. Numerous scientific reports indicate efficacy of physiotherapy in the treatment of urinary incontinence. Most recent reports indicate that physiotherapy gives a positive result in up to 80% of patients with stage I or stress urinary incontinence (SUI) and mixed form, and in 50% of patients with stage II SUI. Urinary incontinence is an interdisciplinary problem because in addition to the sphere directly related to medicine, it also concerns the economic and social spheres. The latest data show that incontinence in postmenopausal women occurs more often than other civilization diseases such as diabetes, hypertension or depression.

Endoplasmic reticulum stress contributes to the pathogenesis of stress urinary incontinence in postmenopausal women.

ObjectiveTo investigate the relationship between endoplasmic reticulum stress (ERS) and the pathogenesis of stress urinary incontinence (SUI) in postmenopausal women.MethodsAnterior vaginal wall tissue was collected from postmenopausal women with SUI and control subjects. Western blotting was performed for glucose-regulated protein (GRP78), inositol-requiring enzyme 1(IRE1), protein kinase-like endoplasmic reticulum kinase (PERK), activating transcription factor 6 (ATF6), C/EBP-homologous protein (CHOP), and B-cell lymphoma 2 (Bcl-2). Additionally, mRNA expression levels of PERK, activating transcription factor 4 (ATF4), and CHOP were examined by real-time polymerase chain reaction.ResultsGRP78 protein and mRNA expression levels were significantly lower in women with SUI, compared with control subjects. PERK and p-PERK expression levels were higher in women with SUI than in control subjects. However, no differences in IRE1 or ATF6 expression levels were observed in either group. Notably, higher CHOP and lower Bcl-2 protein expression levels were detected in women with SUI, compared with control subjects. Furthermore, PERK, ATF4, and CHOP mRNA expression levels were significantly higher in women with SUI than in control subjects.ConclusionsAlterations of ERS markers in SUI suggest that ERS may be involved in the development of SUI in postmenopausal women.

PD32-08 VITAMIN D SUPPLEMENTATION FOR URGENCY URINARY INCONTINENCE IN POST-MENOPAUSAL WOMEN: A PILOT RANDOMIZED CLINICAL TRIAL

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II1 Apr 2018PD32-08 VITAMIN D SUPPLEMENTATION FOR URGENCY URINARY INCONTINENCE IN POST-MENOPAUSAL WOMEN: A PILOT RANDOMIZED CLINICAL TRIAL Alayne Markland, T. Mark Beasley, Kathryn Burgio, Camille Vaughan, Vin Tangpricha, and Patricia Goode Alayne MarklandAlayne Markland More articles by this author , T. Mark BeasleyT. Mark Beasley More articles by this author , Kathryn BurgioKathryn Burgio More articles by this author , Camille VaughanCamille Vaughan More articles by this author , Vin TangprichaVin Tangpricha More articles by this author , and Patricia GoodePatricia Goode More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1551AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urgency urinary incontinence (UUI) is a very common, distressing condition. First-line behavioral and drug therapies are effective but novel therapies are needed. The primary aim of this study was to evaluate the efficacy of vitamin D supplementation compared to placebo to improve UUI in postmenopausal women with vitamin D insufficiency. METHODS This was a single-site pilot randomized trial conducted 2013-2017. Participants were community-dwelling postmenopausal women, 50 years of age or older, with at least 3 UUI episodes on 7-day bladder diary and 25(OH)D≤30 ng/mL (insufficiency). They were randomized to 12 weeks of weekly 50,000 IU vitamin D3 or placebo. Using Wilcoxon tests, we calculated the percent reduction in 24-hour UUI episodes (primary outcome), along with urinary frequency and nocturia episodes from the diaries for the overall group and for African American (AA) and obese women (higher-risk subgroups). Secondary outcomes included scores on validated bladder symptom questionnaires. RESULTS We randomized 56 women (50 to 84 years of age; mean age = 60.5 ±8.2; 70% AA; 64% obese), 28 to vitamin D and 28 to placebo; 51 completed treatment. For the completer analysis, mean 25(OH)D at baseline (21.2 ±5.2 and 18.2 ±5.6, p=0.30) improved to 57.9 ±16.3 for the vitamin D3 group and to 21.9 ±8.2 in the placebo group, p<0.001. UUI episodes per 24-hour day decreased 52.4% with vitamin D3 compared to 30.9% with placebo (p=0.09). Among Black women, changes in UUI episodes decreased 63.2% with vitamin D3 compared to 23.0% with placebo (p=0.03). There were no group differences among obese women (p=0.29). For all women, no differences between D3 and placebo were found for improvements in voiding frequency (p=0.40), nocturia (p= 0.40), incontinence symptom severity (p=0.80), or overactive bladder symptom severity (p=0.47). CONCLUSIONS Post-menopausal women with UUI and vitamin D insufficiency recorded a >50% decrease in UUI episodes that did not reach statistical significance compared to placebo, except in the subset of AA women. Based on these pilot study estimates for efficacy, further investigation of vitamin D3 alone or in combination with other treatments for UUI is warranted, particularly for women in higher-risk subgroups. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e648 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Alayne Markland More articles by this author T. Mark Beasley More articles by this author Kathryn Burgio More articles by this author Camille Vaughan More articles by this author Vin Tangpricha More articles by this author Patricia Goode More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...