Questionnaire-Urinary Incontinence Research Articles

Patient-reported outcome measures for assessing urinary dysfunction following gender-affirming genital surgery: A narrative review of the literature.

Gender-affirming genital surgery is one of several surgical procedures available to transgender and nonbinary (TGNB) individuals to improve congruence between their gender identity and sex assigned at birth. Despite increasing utilization of these procedures, patient-reported outcome measures (PROMs) to assess subjective outcomes following gender-affirming genital surgery remain limited. Our aim was to provide a synopsis of PROMs currently being used to evaluate urinary outcomes among TGNB patients following gender-affirming genital surgery and to assess each PROM for content that is relevant to TGNB patients. A multidatabase search was performed (Embase and PubMed) using search terms that included transgender, patient-reported outcome measures, questionnaire, and gender-affirming surgery. Studies that assessed subjective outcomes related to urinary outcomes and pelvic floor dysfunction following gender-affirming genital surgery were reviewed. Gender-affirming genital surgery included vaginal reconstruction (vaginoplasty) and penile reconstruction (phalloplasty and metoidioplasty). Included studies were evaluated for relevant content items and summarized in table. Our literature search identified 820 unique articles. Twenty-seven full articles were included in the final review. Until recently, measurement tools have been limited to unvalidated ad hoc questionnaires or PROMs developed for other conditions, such as urinary incontinence or vaginal prolapse, that are validated among the predominantly cisgender general population. Of the selected studies, PROMs used to evaluate urinary and pelvic floor dysfunction following gender-affirming genital surgery included self-construced ad hoc questionnaires (10 studies), Amsterdam Overactive Pelvic Floor Scale (four studies), King's Health Questionnaire (two studies), Pelvic Floor Distress Inventory (PFDI)-20 (two studies), Sheffield Pelvic Organ Prolapse (one study), International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) (one study), and ICIQ-Female Lower Urinary Tract Symptoms (one study). The PFDI-20 asked about the most relevant symptoms to TGNB patients following genital surgery; however, not all cisgender validated questionnaires included important questions about voiding position, splayed or misdirected stream. The Affirming Surgery Form and Function Individual Reporting Measure (AFFIRM) questionnaire is the first PROM for assessing subjective urinary outcomes that are validated for TGNB individuals, and the GENDER-Q is a promising new PROM with the aim of evaluating outcomes following surgical and other gender-affirming treatments. Despite recent advancements, a need remains for standardized assessment tools to evaluate pelvic floor dysfunction and urinary symptoms following gender-affirming genital surgery. Questionnaires developed for the general population to assess symptoms of pelvic organ prolapse and other urinary dysfunction do not fully capture the experiences unique to TGNB individuals undergoing this type of surgery. Nonetheless, PROMs validated specifically for TGNB individuals are necessary to more accurately evaluate outcomes of gender-affirming genital surgery, allow for informed patient counseling, and create evidence-based changes to improve these interventions.

Prevalence, Risk Factors, and Impact on Quality of Life Due to Urinary Incontinence Among Palestinian Women: A Cross-Sectional Study.

Urinary incontinence (UI) is a common condition that affects females with variable incidence. Factors like age, obesity, weak pelvic floor, and pregnancy contribute to UI pathogenesis. Our study aimed to determine the prevalence of UI and identify associated risk factors. A cross-sectional study recruited females aged 18-65 attending primary health care (PHC) centers. The collected data included demographic information and questionnaire scores for urinary incontinence diagnosis (QUID), International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI), and Incontinence Impact Questionnaire-Short Form (IIQ-7) scores. Three hundred and eleven females met our inclusion criteria, with 162 (52.1%) participants aged ≥ 42 years. Approximately 41.5% were college/university graduates, and 23.2% had an education level less than high school. Moreover, 108 (34.7%) participants were smokers, 223 (71.7%) drank coffee, and approximately 212 (68.2%) drank tea. Only 125 (40.2%) participants engaged in exercise at variable frequencies, and most of them exercised once per week. Approximately 27.3% of the participants had chronic medical illness with hypertension or diabetes mellitus (40 (12.9%) or 25 (8%), respectively). Stress urinary incontinence (SUI) was found among 152 (48.9%) participants, while urgency urinary incontinence (UUI) was found among 114 (36.7%) participants. Age ≥ 42, marital status, low educational level, unemployment, lack of physical activity, and chronic medical illnesses were significantly correlated with both SUI and UUI. There was a strong correlation between UI and the severity of symptoms and between UI and quality of life (QoL). The prevalence of UI is relatively high among Palestinian women. Many factors contributing to UI included age, marital status, the presence of other chronic medical diseases, and a lack of physical activity. Early detection and diagnosis are necessary to provide effective treatment and improve UI symptoms and QoL.

Long-term clinical and histological safety and efficacy of the CO2 laser for treatment of genitourinary syndrome of menopause: an original study

Objective This study aimed to evaluate histological modifications of the vaginal mucosa after repeated microablative fractional CO2 laser treatments. As secondary objectives we evaluated the clinical effects associated with repeated microablative fractional CO2 laser treatments using validated questionnaires. Methods A prospective intervention study was performed in the Division of Gynecology and Obstetrics, Urogynecology Unit, IRCCS San Raffaele Scientific Institute with 15 postmenopausal women complaining of genitourinary syndrome of menopause symptoms. The cohort of patients was submitted to at least two previous laser treatment cycles in the past years. The Vaginal Health Index (VHI), visual analog scale (VAS), Female Sexual Function Index (FSFI), Urinary Distress Inventory-6 (UDI-6), International Consultation on Incontinence Questionnaire – Urinary Incontinence (ICIQ-UI) and 5-point Likert scale were used. Moreover, histological examinations were carried out on all samples. Results At 4 weeks after the last treatment, the VHI score and all FSFI items were significantly increased compared with baseline. We observed a statistically significant decrease in both frequency and severity for all urinary symptoms after the follow-up. We observed a statistically significant increase in the number of epithelial cell layers with a consequent increase in epithelial thickness, in the number of glycogen-filled cells and in the number of papillae after the laser treatment. No signs of fibrosis were observed as neovascularization was observed in each woman. Conclusions This is the first study demonstrating the histological persistency of efficacy in repeated annually laser treatment cycles, with tissue changes always leading to regenerative results without any sign of fibrosis. Clinical Trial Registration ClinicalTrials.gov ID: NCT04868812 (release date: 27 April 2021).

Influence Of Self-Care Guidelines On Improving Menopausal Urogenital Symptoms.

To evaluate the effect of self-care guidelines on improving menopausal urogenital symptoms. The quasi-experimental study was conducted from September 2018 to February 2019 at the outpatient clinic at the maternity hospital of Ain Shams University, Egypt, and comprised menopausal women reporting urogenitalsymptoms. The participants were divided into 10 equal groups and were subjected to 30-minute theoretical and practicalself-care sessions 3 times per week for 4 weeks. Data was collected using interviews, Day-to-Day Impact of Vaginal Aging questionnaire and Urinary Incontinence Questionnaire. Data was collected at baseline, immediately after the intervention and after 3 monthsfrom the first evaluation. The collected data were statistically analysed using the statistical package forsocialscience (SPSS version 20), percentage (%), the arithmetic mean (),standard deviation (SD), and chi-square (X2 & P-value) were calculated. Of the 120 women with mean age 48.03±3.04 years (range: 45-50 years), 72(60%) had secondary education, 109(90.8%) were married, 44(36.7%) were working in an office and 7(55.8%) were housewives. The mean age at menopause was 46.57±2.33 years (range: 42-50 years). Urogenital symptoms post-intervention reduced significantly (p<0.05). Self-care intervention had a significant impact in terms of improving menopausal urogenitalsymptoms.

Prevalence of Urinary Incontinence among Post-Menopausal Females and Its Associated Factors

Abstract:&#x0D; &#x0D; Background: Urinary Incontinence is now recognized as a major public health concern globally. Urinary Incontinence affects a large of women worldwide and has a substantial socio-economic impact. It might also affect the quality of life and might lead to isolation and depression.&#x0D; &#x0D; Objective: The objective of this study is to find out the prevalence of Urinary Incontinence in Post- menopausal Females and its associated factors.&#x0D; &#x0D; Methods: This is a Cross- Sectional Study designed to investigate the prevalence of urinary incontinence among post-menopausal females and factors associated with it. Hundred post- menopausal females were recruited in this study from different health care provider and hospitals of Daska and Gujranwala, Pakistan. Their age ranged between 50 to 65 years and their previous menstruation was from at least 1 year ago. They all answered the Urinary Incontinence Questionnaire.&#x0D; &#x0D; Results: The result of this study concluded that prevalence of urinary incontinence among&#x0D; postmenopausal females is 71%. The prevalence of urinary incontinence according to its types&#x0D; was, Stress Urinary Incontinence was 45%, Urge Urinary Incontinence was 36% and Mixed&#x0D; Urinary Incontinence was 19%.The menopausal age, mode of delivery and parity were not significantly associated with urinary incontinence however, Diabetes was significantly associated with urinary incontinence. (p &lt;0.05)&#x0D; &#x0D; Conclusion: This study concludes that higher prevalence of Urinary Incontinence is found among postmenopausal females of Pakistan, however a study in future should be conducted to find out prevalence of Urinary Incontinence and more details of associated factors with a larger sample size to generalize the results.&#x0D; &#x0D; Key Words: Prevalence, Urinary Incontinence, Postmenopausal&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Pulsed Magnetic Stimulation for Stress Urinary Incontinence and Its Impact on Sexuality and Health.

We evaluated the efficacy and safety of a device that uses electromagnetic technology to treat urinary incontinence, with an emphasis on health-related quality of life. A total of 47 female subjects from 18 to 80 years old were enrolled. After block randomization, treatment consisted of 2 pulsed planar magnetic stimulation sessions per week for 4 weeks (8 sessions). Validated questionnaires: Female Sexual Function Index, International Consultation on Incontinence Questionnaire for Urinary Incontinence: Short Form, and Pelvic Floor Bothersome. Follow-ups were performed at weeks 1, 9, and 14. The present study is one of the first clinical trials published evaluating the efficacy and safety of the electromagnetism-based device with flat configuration in patients with stress urinary incontinence, showing a reduction in PFBQ, ICQSF, and Oxford test scores during follow-up, and significantly at week 14 of follow-up, which implied a favorable impact on clinical outcomes, quality of life, and sexuality. The improved results in the treatment group compared with the simulated group show that pulsed magnetic stimulation is a safe and attractive non-invasive alternative for patients who prefer non-surgical treatments.

Association of Urinary Incontinence and Body Mass Index with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is a metabolic disorder, which impacts and effects body's multiple system. Female with more fat deposition in her body and higher body mass index (BMI) will eventually face metabolic disorders like polycystic ovary syndrome, diabetes and urinary incontinence (UI). Muscles in the pelvic floor are susceptible and sensitive to androgen and are easily stimulated by presence or increased levels of androgen and due to hyperandrogenemia muscle mass increases and eventually pressure on Levator Ani and urethral sphincter increases and it causes muscle weakness in the pelvic floor and urinary incontinence and patients often complains with urine leakage. Objective: To describe the association between urinary incontinence and the body mass index with polycystic ovary syndrome. Methodology: The study was analytical cross-sectional study. This study included the sample of 113 nulliparous females having age between 18-45 years. Quota sampling technique was used in this study. Participants were divided into two groups, in one group females with diagnosed PCOS were taken and in other quota we had females without PCOS condition. We provided them the International Incontinence Consultation Questionnaire-Short Form (ICIQ-SF), which is a specific questionnaire that assesses the problem of UI symptoms. Results: ICIQ-SF statistics were checked applying chi-square testing. Results showed value less than Alpha value which was 5% (0.05) so, the results were statistically significant and alternate hypothesis was accepted which showed UI and BMI had a significant relation with PCOS. This study will be beneficial in creating awareness among society that endocrine system and body mass index play important role in causing Urinary Incontinence and other health issues. Conclusion: According to this study's findings, there is a strong correlation between UI and BMI with PCOS. Keywords: Urinary incontinence (UI), Body mass index (BMI), Polycystic ovary syndrome (PCOS), International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI), Pelvic Floor Dysfunction (PFD).

Assessment of Stress Incontinence in Indian Female CrossFit Trainers Aged 20-40 Years: A Cross-Sectional Study

Background: Stress incontinence is involuntary and uncontrollable loss of urine which is caused by activities that elevate intra-abdominal pressure. Cross fit training involves exercises which are performed above the normal level of intensity of other form of exercises. Although these set of exercises strengthen abdominal muscles, they eventually cause weakening of pelvic floor muscles making them susceptible to develop stress incontinence. Objective: To study and assess stress incontinence in Indian Female cross Fit trainers aged 20-40 years. Method: n = 100 subjects were included in the study who then performed pad test. Based on the results of pad test, they were classified as continent or incontinent. Further they filled Questionnaire for urinary incontinence (QUID) which confirmed whether they were suffering from stress incontinence or urgency incontinence Results: Female cross fit trainers in the age group of 20-40 years with an average of 23.67 (±5.92 years), were segregated into 4 age groups, that is 20- 25 years, 26-30 years, 31-35 years and 36-40 years. Majority of females in age group of 36-40 were positive for pad test. Out of the total females positive, in nulligravid females, only 1 female was positive for pad test, in females who were primigravid 7 females were positive for pad test and in multigravida females that is females with 2 children15 were positive for pad test. Conclusion: The study concludes that there is a positive correlation between age of women and parity on incontinence. Keywords: Stress urinary incontinence (SUI), Parity, Pelvic floor muscles (PFM).

Prevalence of urinary incontinence among young female adults.

A cross sectional survey was conducted in 2018-2019 to determine the prevalence of urinary incontinence among university going nulligravid young female adults in Rawalpindi/Islamabad, Pakistan. A total of 608 participants were included in the study via convenience sampling. Data was collected regarding demographic and personal information, in addition to Medical, Epidemiologic, and Social Aspects of Aging (MESA) Urinary Incontinence Questionnaire (UIQ). Independent t-test and One-way ANOVA were used for inter-group comparisons. Pearson and Spearman correlation was used to determine the relationship between variables. The overall prevalence of urinary incontinence was observed to be 193(31.7%) and of stress, urge and mixed incontinence was found to be 64(10.5%), 56(9.2%) and 73(12%) respectively. A significant difference (p<0.05) was observed in terms of MESA-UIQ stress incontinence and urge incontinence scores based on tobacco use, menstrual disorders, eating disorders and marital status.

Translation and Validation of Bristol Female Lower Urinary Tract Symptoms Questionnaire for Urinary Incontinence in Urdu.

BackgroundIn this study, we aimed to translate and validate the 19-item version of the Bristol Female Lower Urinary Tract Symptoms (Bristol FLUTS) Questionnaire in Urdu among women experiencing urinary incontinence at a tertiary care hospital in Karachi, Pakistan.MethodologyA cross-sectional validation study was conducted in the urology clinic at Aga Khan University Hospital, Karachi, Pakistan, between April and September 2021. After forward and backward translation of the Bristol FLUTS questionnaire, content validation was done by six experts, followed by the administration of the questionnaire to 10 respondents in the pilot phase of the study. In total, 207 participants were approached to fill the final version of the translated questionnaire. Overall, 188 respondents filled out the questionnaire, including 94 women with urinary incontinence and 94 women from the community to test construct validity. Finally, 30 women with urinary incontinence were asked to fill the form again two weeks later to determine test-retest reliability. Cronbach’s alpha was employed to assess the internal consistency of the questionnaire.ResultsThe questionnaire displayed good content validity for reliability (content validity index: 0.84) and clarity (0.89). The scores reported by cases were significantly higher than the controls in all but the sexual function domain, suggesting good construct validity. Cronbach’s alpha of 0.81 signified good internal consistency, and a Pearson’s coefficient of 0.993 (p < 0.001) comparing responses at baseline and after two weeks indicated good test-retest reliability.ConclusionsThe Urdu translation of the Bristol FLUTS is a valid and reliable questionnaire that can be used in the clinical setting.

Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial.

This single-blind, randomised controlled trial was aimed at determining whether peri-operative physiotherapist-supervised pelvic floor muscle (PFM) training was superior to standard care (handout) in terms of improvements in stress urinary incontinence (SUI) symptoms, cure rate, and/or post-operative filling or voiding symptoms among women undergoing surgical mid-urethral sling (MUS) insertion for SUI. Women with SUI were recruited from surgical wait lists at four participating urogynecology clinics. Participants were assessed at baseline (V1) then randomised (1:1 allocation) to receive supervised PFM training or a handout. Immediately following the 12-week intervention period (V2) and at 12weeks following surgery (V3) the groups were compared based on the Female Lower Urinary Tract Symptoms (FLUTS) questionnaire total score and urinary incontinence, filling, and voiding subscale scores as well as on a standardised 30-min pad test administered by a blinded assessor. Intention-to-treat analyses were performed. A total of 52 participants were randomised to physiotherapy and 51 to the control group between December 2012 and August 2016. The groups were not different on any outcomes at V1 and all were improved at V3 compared with V1 (p < 0.001). At V3 the physiotherapy group reported significantly fewer UI symptoms (FLUTS UI subscale score) than the control group; yet, there were no group differences in FLUTS overall score or the pad test (p > 0.05). Based on a FLUTS UI subscale score <4, the cure rate at V3 was higher in the intervention group (73%) than in the control group (47%); (2.36 < OR < 3.47, p = 0.012). There were no group differences in cure rate at V3 based on a pad test (p = 0.27). No group differences were found in the filling or voiding symptoms at V3 (p > 0.05). No adverse events were reported. Physiotherapist-supervised PFM training improves SUI cure rates associated with surgical MUS insertion when considering symptoms of SUI, but does not improve post-operative continence function as measured by a pad test, nor does it lead to fewer post-operative voiding or filling symptoms.

Effectiveness of transperineal pelvic floor electrical stimulation system in improving female stress urinary incontinence: a prospective pilot study

The present study aims to evaluate the effectiveness of the Transperineal Pelvic Floor Electrical Stimulation (TPFES) system as a treatment option for females with stress urinary incontinence (SUI). A total of 8 females who were diagnosed with SUI were included in the study. All the patients received TPFES and were educated to use it daily for 12 weeks. The patients completed ‘International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI)’ and ‘Overactive Bladder Symptom Score Questionnaire’ before and after applying NPFES at every visit. Age, body mass index (BMI), maximum flow rate, and postvoid residual of each patient were obtained before the study. Repeated-measures ANOVA was performed using the estimates of variables at each visit to evaluate the effectiveness of TPFES in SUI. Also, a linear mixed model was derived to verify the variables that affect the effectiveness of TPFES treatment. The mean age and BMI of the patients were 61.88 ± 16.49 years and 24.62 ± 2.87 kg/m2, respectively. Among the investigated variables, the mean ICIQ-UI total score showed significant change depending on the duration of TPFES treatment (p < 0.001); the mean ICIQ-UI total score tended to decrease as the duration of TPFES treatment increases. The post-hoc test revealed a significant decrease of mean ICIQ-UI total score at 8 weeks and 12 weeks compared to the baseline (p = 0.012 and p = 0.005, respectively). Also, the mean ICIQ-UI total score was significantly affected by the treatment duration of TPFES (p = 0.001). Thus, consistent and long-term use of the TPFES system can be a non-surgical treatment option that effectively improves SUI.

Prevalence and risk factors of urinary incontinence among Iranian women.

Urinary incontinence is a common condition among women. Although it is not a life-threatening condition, it dramatically influences the quality of life. This study aimed to estimate the prevalence of urinary incontinence and its risk factors among Iranian women in Kerman, Iran. This cross-sectional, population-based study was conducted on 3100 Iranian women aged 15-80 years in 2017 in Kerman, Iran. The participants were selected via cluster sampling and were invited to complete the questionnaires. Their demographic information and medical history were assessed, the urinary incontinence questionnaire was completed, and the associated risk factors were also recorded. Quantitative variables are reported as mean ± SD, while qualitative and ranked variables are expressed in percentage. All analyses were conducted in Stata version 12 (Stata Corp.). The mean age of the participants was 46 years, and the overall prevalence of urinary incontinence was estimated to be 63%. The highest and lowest prevalence rates of urinary incontinence were reported in the elderly and the youth, respectively (79% and 41%, respectively). Age, increase of body mass index (BMI), pregnancy, diabetes, anxiety, and depression were the associated risk factors. We found that the prevalence of urinary incontinence is high in Iran. Therefore, to control this condition and improve women's quality of life, effective plans are needed.

Efficacy evaluation of Lattice Carbon Dioxide Laser Therapy in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence.

Objectives:To investigate the efficacy and postoperative complications of lattice carbon dioxide laser in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence.Methods:A total of 30 postmenopausal female patients with mild to moderate stress urinary incontinence, recruited from the Affiliated Hospital of Hebei University from September to November 2019, were selected as the study subjects and treated with lattice carbon dioxide laser therapy. Treatment was given at intervals of one month. The degree of urinary incontinence, the urinary incontinence questionnaire (ICI-Q-SF) score, and the urinary incontinence quality of life scale (I-QOL)) Score, surgical satisfaction, one hour pad test and postoperative complications before treatment and after each treatment of all patients were respectively recorded and compared.Results:Compared with those before treatment, the grade of urinary incontinence and ICI-Q-SF scores of these 30 patients after each treatment were lower, and their I-QOL scores were higher. The difference of one hour urine pad test was statistically significant (P<0.05), but the follow-up data of three months after the third treatment was close to that of one month after the first treatment. The satisfaction rate of these 30 patients was 76.67% (23/30). After treatment, only one patient presented vaginal itching discomfort on the first day after surgery and the symptoms disappeared three days later. No obvious complications occurred in the other 29 patients.Conclusion:The treatment of mild and moderate postmenopausal patients with stress urinary incontinence with lattice carbon dioxide laser can effectively reduce the incidence of incontinence and improve the quality of life.

Single-incision mini-sling for the treatment of female stress urinary incontinence: Is it actually inferior to transobturator vaginal tape and tension-free vaginal tape?

Objectives:The aim of the study was to report the extended long-term results of the use of single-incision mini-sling (SIMS), tension-free vaginal tape (TVT), and transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI) at the Department of Gynecology and Obstetrics of the University Medical Center Ljubljana.Materials and Methods:Enrolled women were evaluated by Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), Sandvik severity scale, Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) Short Form and data about diagnosis, procedures, complications, reoperations, postoperative results, and satisfaction with procedure were recorded.Results:In analyzed group of patients (n = 357), 116 (32%) underwent SIMS procedure, 189 (53%) TOT, and 52 (15%) TVT. The SIMS, TOT, and TVT groups did not differ significantly from each other in PGI-S, PGI-I, Sandvik severity scale, UDI-6, IIQ-7, and ICIQ-UI Short Form or in postoperative complication rate. Repeat surgery was needed in 9.5% after SIMS, in 13.2% of TOT patients and in 23.1% of TVT patients (P = 0.194). Urinary retention occurred in 9.5% of the SIMS patients, in 9.5% of the TOT patients, and in 13.5% of the TVT patients (P = 0.682). Mesh erosion/inflammation occurred in 3.4% of the SIMS patients, in 6.3% of the TOT patients, and in 3.8% of the TVT patients (P = 0.485).Conclusion:The efficacy and safety of SIMS, TOT, and TVT in the surgical treatment of SUI are comparable. The choice of the technique should be based on the relative pros and cons of techniques and the surgeon's experience.

EFFICACY OF ANTICHLONERGIC DRUGS IN IDIOPATHIC OVERACTIVE BLADDER.

Background: Symptoms of overactive bladder include urgency, frequency, and urge incontinence, with or without noctiuria. Symptoms are common in adults. The two main treatment options for overactive bladder syndrome are bladder retraining and anticholinergic drugs. Study Design: Cross sectional study. Setting: Urology Department, Kot Khawaja Saeed Hospital, Lahore. Period: January to June 2017. Methodology: Eighty patients were enrolled after informed consent. All patients were subjected to 5mg solifenacin succinate for three months. International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) was utilized to assess patient symptoms. Results: There 56 males (70%) and 24 female (30%) with mean age of 43 ± 1.6 years. Efficacy of solifenacin was found in 61 cases out of 80 patients. On first visit 19 (31%) patients were cured, 17 (28%) on second month follow up and 25 (41%) were cured on third month follow up. Conclusion: Solifenacin has significant role in managing patients with overactive bladder. It has a relatively safe side effect profile.

Development of an ICF-based questionnaire for urinary and/or fecal incontinence (ICF-IAF): The female patients' perspective using focus groups (subproject).

The aim of this study was to identify the problems and resources of women with urinary or fecal incontinence based on the International Classification of Function and Health (ICF) framework and detecting the impact on the personal environment and quality of life. This study forms part of a project with an overall goal to enable standardized planning and evaluation of interventions in multi-professional settings. To answer the study question a mixed-method sequential design with a priority to the quantitative approach was considered appropriate. Regarding methods, focus groups were chosen to collect data. Transcripts were analyzed with content analysis and identified concepts linked to the corresponding ICF categories by two different raters. Cohen's kappa was calculated for interrater reliability. Thirteen women with a mean age of 69.9 years were recruited. Four focus groups were conducted, whereas saturation was reached after two focus groups. Overall transcripts 99 defined ICF categories at second level could be linked (body functions = 31, body structures = 5, activities and participation = 33, and environmental factors = 30) whereas 4 categories were not sufficiently covered by the ICF (3 = personal factors, 1 = not covered). This study has determined 103 resources and problems based on the ICF model of women with urinary and/or fecal incontinence. In spite of these results, it was shown that four concepts are not fully covered by the ICF framework. The current data highlight the importance of an extension of the ICF model, especially towards the personal factors of patients.

Development of an ICF-based questionnaire for urinary and/or fecal incontinence (ICF-IAF): The male patients' perspective using focus groups.

This study seeks to explore barriers faced by and resources available to male patients with urinary (UI) and/or fecal incontinence (FI) based on the ICF framework. As a result, this study contributes to the development of the ICF-Incontinence Assessment Form (ICF-IAF), which is designed to be a standardized planning and evaluation tool for interventions in a multidisciplinary setting. A mixed-method sequential design that places emphasis on the quantitative approach was considered appropriate for this study. Focus group interviews (FG) were chosen to collect data. Data were analysed with deductive content analysis and themes identified during FG were linked to the most corresponding ICF categories by two raters. Cohen's κ was calculated to determine interrater reliability. Four FG were conducted with a total of 13 male participants. The mean age of the participants was 74.7 years. A total of 73 barriers and resources on the second ICF level (body functions 26, body structures five, activities and participation 26 and environmental factors 16), whereby four categories were not sufficiently covered by the ICF, could be identified. The κ score for the two raters was 0.82. While barriers are fundamental factors affecting patients, this study found that resources are as important and should not be overlooked in the conventional treatment in both UI and FI-specific assessments.

Development and validity of a questionnaire for coital urinary incontinence: clinical and urodynamic analysis.

To develop and validate a questionnaire (coital incontinence questionnaire-CIQ) for CI and perform clinical and urodynamic analysis of patients with CI. A total of 414 female patients with urinary incontinence undergoing urodynamics were included in this study. All patients were evaluated with a detailed history, questionnaires, physical examination, relevant laboratory tests and urodynamics. Content, construct and convergent validity of the questionnaire were evaluated. Patients were divided into groups: with CI (group 1) and without CI (group 2). Overall test-retest reliability coefficients of CIQ were high (r = 0.968, p = 0.01), and the internal consistency was excellent (Cronbach's alpha, 0.964). The test-retest scores did not show a statistically significant difference (p= 0.158). Approximately 34% of these women had CI. Body mass index (BMI), parity, daily incontinence episodes, daily pad counts and 1-h pad test results were higher in group 1 than group 2 (p < 0.05). Multivariate analysis revealed that a daily incontinence episode, BMI, maximum cystometric capacity and PdetQmax were statistically significant factors associated with CI. Urinary incontinence types were different between groups (p < 0.0001). Incontinence with both penetration and orgasm was the most common form of CI (54.4%), and CI severity differed significantly among the forms of CI (p = 0.007). CI negatively interferes with patients' sexual life, their relationship with their partner and quality of life in most patients. The CIQ is a reliable, valid and useful tool for assessment of all aspects of CI in women. CI seems to be related to the severity of urinary incontinence. Further studies are needed to clarify this subject.

Cultural adaptation and validation of the Turkish CONTILIFE: a quality of life questionnaire for urinary incontinence

The objective of the present study was to adapt the CONTILIFE, a quality-of-life questionnaire, into Turkish and to reveal its psychometric properties in women suffering from stress urinary incontinence (SUI). Ninety-eight patients with a symptom of SUI participated in the study and filled out the Turkish CONTILIFE. Cronbach's alpha (α) and intraclass correlation coefficients (ICCs) were evaluated for the internal consistency and test-retest reliability, respectively. Exploratory factor analysis was performed to determine the underlying structure. Criterion validity was analyzed using the correlation coefficients between the total and subscale scores of the CONTILIFE and King's Health Questionnaire (KHQ), the Incontinence Impact Questionnaire-7 (IIQ-7), and the Urinary Distress Inventory-6 (UDI-6). Internal consistency was found to be strong to very strong (Cronbach's α: 0.90-0.96). Test-retest reliability was very strong (ICCs = 0.91-0.98, p < 0.001). Exploratory factor analysis revealed five significant factors, explained by 74% of the total variance. Total scores on the CONTILIFE were significantly correlated with the KHQ subscales (r = -0.43 - -0.81), IIQ-7 (r = -0.89), UDI-6 (r = -0.66), and ISI (r = -0.66); (p < 0.01). The Turkish CONTILIFE is a valid and reliable tool to determine the influence of SUI on health-related quality of life in Turkish women.