Urinary Incontinence Short Form Research Articles

Evaluation of the safety and efficacy of a monopolar nonablative radiofrequency device for the improvement of vulvo‐vaginal laxity and urinary incontinence

Vaginal childbirth, natural process of aging, congenital factors, and surgical interventions are considered the main causes of vulvo-vaginal laxity driven by changes in collagen and elastin fibers. This causes a loss of strength and flexibility within the vaginal wall. As a result, women may experience lack of sensation and stress urinary incontinence (SUI)-the condition of involuntary loss of urine associated with activities that cause an increase in intra-abdominal pressure (eg, sneezing, coughing, and lifting). Both vaginal laxity and urinary incontinence significantly affect patients' quality of life (QoL). The aim of this study was to evaluate efficacy and safety of a noninvasive radiofrequency device when used to treat SUI and vulvo-vaginal laxity through its heating effect which stimulates collagen and elastin fibers. Twenty-seven women (average age 44.78±10.04 years) with indications of mild/moderate SUI as well as vulvo-vaginal laxity were treated with a monopolar radiofrequency device. The treatment course consisted of three once-a-week sessions. Each session included intravaginal treatment followed by treatment of labia majora and the perineum. Improvement in the SUI condition was evaluated by applying the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF). Data were collected at the baseline, after the last treatment and at 1-month follow-up visit. Vaginal laxity was assessed by subjective vulvo-vaginal laxity questionnaire (VVLQ). Data were collected before the 1st treatment and during the 1-month follow-up visit. Patient's satisfaction was recorded using a satisfaction questionnaire. Data were collected after the last treatment and at the 1-month follow-up visit. Any adverse events related to the treatments were monitored. On a scale of 0 to 5, the average frequency of urine leak improved from "2-3 times a week" (2.15±1.03 points prior to treatment) to "once a week" (1.00±0.78 points post-treatment), and on to "never" (0.44±0.51 points at the 1-month follow-up visit). Sixteen subjects (59.3%) reported decrease in the amount of leakage, with 15 women (55.6%) becoming completely leak-free at the 1-month follow-up. At the 1-month follow-up visit, 24 subjects (88.9%) expressed their condition's interference with everyday life decreased and 17 patients (62.9%) said the condition did not interfere with their everyday life at all as a result of the treatment. All results are statistically significant (P<.05). No adverse events were recorded. All subjects reported improvement in vaginal laxity, from average perception of "very loose" (2.19±1.08 points prior to treatment) to "moderately tight" (5.74±0.76 points at the 1-month follow-up visit). During the follow-up visit, 89% of the patients "agreed" or "strongly agreed" that their SUI condition improved, and 93% of the patients "agreed" or "strongly agreed" that their gratification during intercourse improved. None of the subjects reported dissatisfaction. The study confirmed the monopolar radiofrequency method as an effective and safe treatment of SUI and vulvo-vaginal laxity. The treatments were well tolerated by all subjects with no adverse effects.

Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark.

Urinary incontinence (UI) is a prevalent condition that interferes with women's health-related quality of life. Prevalence rates from earlier studies are wide-ranging, due to heterogeneity in methodology, definition of UI and the populations included. We aimed to determine the prevalence of UI and associated risk factors in Germany and Denmark using the same methodology, definition and population. A postal survey was conducted in two regions in Germany and Denmark, including 8000 women aged 18+ years. UI was defined as any complaint of involuntary loss of urine. The questionnaire contained socio-demographic questions and the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF). The response rate in Germany and Denmark was 46.2 and 66.6% (p < 0.001) and the prevalence rate of UI was 48.3 and 46.4% (p = 0.188), respectively. Stress urinary incontinence dominated among younger women, and urgency urinary incontinence and mixed urinary incontinence among women 80+ years in Germany and Denmark, respectively. The subgroup of women with body mass index (BMI) ≥35 had the highest prevalence of UI (67.3%). The subgroup of women with BMI <35 were more likely to have stress urinary incontinence, and the subgroup of women with BMI ≥35 were more likely to have mixed urinary incontinence. UI was significantly associated with age as with BMI, vaginal delivery, chronic obstructive pulmonary disease, and having at least one co-morbidity. Prevalence rates in the two regions in Germany and Denmark were similar, despite significantly different response rates. This difference may reflect various attitudes towards answering a questionnaire, but the response rate on questions concerning UI seemed consistent.

Quality-of-Life Outcomes Following Surface Electromyography Biofeedback as an Adjunct to Pelvic Floor Muscle Training for Urinary Incontinence: A Case Report.

A non-invasive treatment for urinary incontinence (UI) is surface electromyography (sEMG) biofeedback with pelvic floor muscle (PFM) training. A lack of consensus and evidence exists on the Quality of Life (QoL) outcomes following sEMG biofeedback using surface electrodes at the perineum compared to the more invasive intravaginal probe. This case report examines QoL using sEMG biofeedback at the perineum with PFM training for UI. Single subject case report. The patient was a 61-year-old woman diagnosed with UI. Her chief complaints were nocturia, urine leakage with urgency, and urine leakage with sneezing and coughing. Physical therapy (PT) treatment focused on behavioral modification, PFM strengthening with and without sEMG biofeedback, and therapeutic exercises with PFM contractions. At four weeks from baseline, the patient's PFM strength increased from 2/5 to 4/5 based on the Modified Laycock Scale. Her PFM endurance contraction improved from two seconds to ten seconds. The International Continence Impact Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) score decreased from 6 to 0, the Incontinence Impact Questionnaire - Short Form (IIQ-7) score decreased from 14.3 to 0, and the 3 Incontinence Questions (3IQ) responses did not change. The outcomes from this case report demonstrate a brief course of PT treatment consisting of perineal sEMG biofeedback in conjunction with PFM training demonstrated clinically meaningful improvements in incontinence-related QoL, in addition to improvements in motor function in a woman with mixed UI and nocturia.

Prevalence, potential risk factors and sequelae of diastasis recti abdominis

There is scant knowledge on diastasis recti which occurs mostly in 3rd trimester of pregnancy. Our aim was to assign the prevalence of diastasis recti and the possible risk factors and to investigate its association with some chronical diseases, like low back pain and urinary incontinence. 200 women's interrectus distance was measured who filled out a self-made diastasis recti questionnaire, the SF-36, Oswestry Disability Index and the International Consultation on Incontinence Modular Questionnaire - Urinary Incontinence Short Form questionnaires. Prevalence of the condition was 46.5%. In case of risk factors, relationship between number of deliveries and interrectus distance was significant. We found a significant difference in quality of life, in presence of low back pain and urinary incontinence between the normal and the abnormal group. In line with the literature we found, that diastasis recti can predispose on serious sequelae, hence on decreased quality of life. Orv. Hetil., 2017, 158(12), 454-460.

198: THE EFFECT OF INSTRUCTING PELVIC FLOOR MUSCLE TRAINING FOR CONTROLLING URINARY INCONTINENCE AND ITS RESULTING STRESS, ANXIETY AND DEPRESSION IN PATIENTS WITH MULTIPLE SCLEROSIS

Background and aims:Urinary disorders are common problems in patients with multiple sclerosis (MS). Urinary incontinence largely affects the physical, social, and emotional characteristics and activities of these patients. The aim...

Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36months post-partum.

Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36months post-partum. This was a prospective observational study including 168 nulliparous women. All patients included were nulliparous with singleton gestation in cephalic presentation, at ≥37weeks and were recruited on the first day after delivery. Thirty-sixmonths after delivery, 3D-TpUS was carried out to identify LAM lesions (macro or micro). Clinical assessment of urinary stress incontinence (USI) was based on the ICIQ-UI-SF test; a simple stress test and urodynamic test were carried out in the same visit. A total of 105 nulliparous women were studied (51 spontaneous deliveries [SpD] and 54 vacuum-assisted deliveries [VD]). Microtraumas were identified in 35.3% of SpD and 20.4% of VD. Macrotraumas (avulsion) were identified in 9.8% of SpD and 35.2% of VD (p=0.006). No differences were found in USI between study groups or in relation to the identification of LAM defects (19.2% in the no lesion group, 25% in the macrotrauma and 13.8% in the microtrauma groups; p=not significant). Nor were significant differences found in the results from the different study groups in the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) test (12.7±2.2 in the no lesion group, 12.5±4.2 in the macrotrauma and 13.25±4.8 in the microtrauma groups; p=NS). No difference was observed in USI between patients with and without LAM lesions (microtrauma or macrotrauma) 36months post-delivery.

Pulsed Magnetic Stimulation for Stress Urinary Incontinence: 1-Year Followup Results

Despite significant differences in success rates between surgical and nonsurgical treatments for female stress urinary incontinence, a few cross-sectional surveys showed that most patients still prefer the latter. We evaluated the efficacy of the under studied nonsurgical treatment using pulsed magnetic stimulation for female stress urinary incontinence. This randomized, double-blind, sham controlled study was performed in 120 female subjects at least 21 years old with stress urinary incontinence. Treatment involved pulsed magnetic stimulation for 2 sessions per week for 2 months (16 sessions). After 2 months, subjects could opt for 16 additional sessions regardless of initial randomization. The primary response criterion was a 5-point reduction in the ICIQ-UI SF (International Consultation on Incontinence Questionnaire for Urinary Incontinence-Short Form) score. Key secondary response criteria included objective and subjective cure, supplemented by other secondary criteria. Followups were performed at months 1, 2, 5, 8 and 14. At 2 months 45 of 60 subjects (75%) in the active arm vs 13 of 60 (21.7%) in the sham arm were treatment responders (p <0.001). After 2 months 24 subjects (40%) in the active arm and 41 (68%) in the sham arm elected additional active pulsed magnetic stimulation. At 14 months, subjects who received 32 sessions of active pulsed magnetic stimulation had the highest percentage of treatment responders (18 of 24 or 75.0%), followed by those who received 16 sessions (26 of 36 or 72.2% and 28 of 41 or 68.3%) and those who did not receive any active pulsed magnetic stimulation (4 of 19 or 21.1%) (p <0.001). The encouraging long-term response rates show that pulsed magnetic stimulation is an attractive nonsurgical alternative for patients who do not want to undergo surgery.

Long-term functional outcomes after radical cystectomy with ileal bladder substitute: does the definition of continence matter?

Objective: Functional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre.Materials and methods: During 2005 − 2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, Malmö. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF).Results: Five of 37 evaluable patients (14%) were considered fully continent, reporting a pad-weighing test result of 0 g and an ICIQ-UI-SF score of 0. The median ICIQ-UI-SF score was 8 [interquartile range (IQR) 3–11], and seven patients (17%) were continent according to the ICIQ-UI-SF score only. In the pad-weighing test, 28 out of 37 patients (76%) reported 0 g day-time leakage whereas only 12 out of 37 patients (32%) reported 0 g night-time leakage. At follow-up, nine out of 39 (23%) of evaluable male patients were potent. The median ICIQ-UI-SF score was significantly lower during the second half of the study period [4 (IQR 0–8) vs 10 (IQR 6–14); p = .003]. The inverse applied to the median IIEF score [5 (IQR 3–12) vs 2 (IQR 1–4); p = .02].Conclusions: Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes.

Microablative fractional CO2-laser therapy and the genitourinary syndrome of menopause: An observational study

ObjectivesThis study aimed to assess the effect of the Microablative Fractional CO2 Laser (CO2-laser) therapy on vaginal pathophysiology and the symptoms of the Genitourinary Syndrome of Menopause (GSM). MethodsPostmenopausal women with moderate to severe symptoms of GSM underwent three sessions of CO2-laser therapy at monthly intervals. Participants were evaluated at baseline and 4 weeks after the last treatment. Main outcome measuresThe primary outcomes were Vaginal Maturation Value (VMV) and Vaginal Health Index Score (VHIS). Secondary outcomes included symptoms of GSM, Female Sexual Function Index (FSFI), International Consultation on Incontinence Questionnaire of Female Urinary Tract Symptoms (ICIQ-FLUTS) and Urinary Incontinence Short Form (ICIQ-UI SF), Urogenital Distress Inventory (UDI-6) and King’s Health Questionnaire (KHQ). ResultsFifty-three postmenopausal women completed this study. VMV, VHIS and FSFI increased significantly. Dyspareunia, dryness, burning, itching, dysuria, frequency, urgency, urgency incontinence, stress incontinence and scores on the ICIQ-FLUTS, ICIQ-UI SF, UDI-6 and KHQ decreased significantly. Factors predicting for which women the CO2-laser therapy was more effective were not identified. ConclusionThis study suggests that intravaginal CO2-laser therapy for postmenopausal women with clinical signs and symptoms of GSM may be effective in improving both vaginal pathophysiology and reported symptoms.

Mobile app for treatment of stress urinary incontinence: A randomized controlled trial.

To evaluate the effect of a mobile app treatment for stress urinary incontinence (SUI) in women. Randomized controlled trial, conducted 2013-2014 in Sweden. Community-dwelling adult women with ≥1 SUI episode/week recruited through our website and randomized to app treatment (n = 62) or control group (postponed treatment, n = 61). One participant from each group was lost to follow-up. Intervention was the mobile app Tät® with a treatment program focused on pelvic floor muscle training (PFMT), and information about SUI and lifestyle factors. Primary outcomes, 3 months after randomization: symptom severity (International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form [ICIQ-UI SF]); and condition-specific quality of life (ICIQ Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]). One hundred and twenty-three women were included (mean age 44.7), with moderate/severe SUI (97.5%, 120/123), mean ICIQ-UI SF score 11.1 (SD 2.8) and mean ICIQ-LUTSqol score 34.4 (SD 6.1) at baseline. At follow-up, the app group reported improvements in symptom severity (mean ICIQ-UI SF score reduction: 3.9, 95% confidence interval 3.0-4.7) and condition-specific quality of life (mean ICIQ-LUTSqol score reduction: 4.8, 3.4-6.2) and the groups were significantly different (mean ICIQ-UI SF score difference: -3.2, -4.3to -2.1; mean ICIQ-LUTSqol score difference: -4.6, -7.8 to -1.4). In the app group, 98.4% (60/61) performed PFMT at follow-up, and 41.0% (25/61) performed it daily. The mobile app treatment was effective for women with SUI and yielded clinically relevant improvements. This app may increase access to first-line treatment and adherence to PFMT.

Treatment of female stress urinary incontinence with Erbium-YAG laser in non-ablative mode

ObjectiveTo evaluate the efficacy of laser photothermal therapy in a group of Chilean women with SUI. Material and methodsLongitudinal prospective study based on 42 women with mild-to-severe SUI, intervened with non ablative Er:YAG laser, between July 2014 and October 2015, in Santiago, Chile. The therapy efficacy was evaluated through the difference between every patient's scores obtained, before and after treatment, with the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-SF), at a confidence level of 95%. Also, the patient satisfaction with treatment was reported through an ordinal scale. ResultsICIQ-SF median score was 11 before treatment and 3 after 6 months, with a significant difference per patient (p<0.001). 78.6% (n=33) reported improvement and 38.1% (n=16), a complete healing of SUI at follow up. 66.7% (n=28) reported high satisfaction and 81.8% (n=27) of sexually active women, also reported improvement of sexual gratification. Only mild pain during the procedure was reported as adverse effect. ConclusionsBased on this short-term pilot study, non-ablative Er:YAG laser procedure seems to be a safe and efficacious alternative for patients with SUI. Further controlled studies will help to validate the use of non-ablative Er:YAG for treatment of SUI.

Non-face-to-face treatment of stress urinary incontinence: predictors of success after 1year.

Introduction and hypothesisThe objective was to determine predictors of long-term success in women with stress urinary incontinence (SUI) treated with a 3-month pelvic floor muscle training (PFMT) program delivered via the Internet or a brochure.MethodsWe included 169 women with SUI ≥1 time/week who completed the 1-year follow-up (n = 169, mean age 50.3, SD 10.1 years). Three outcome variables defined success after 1 year: Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF), and sufficient treatment. Using logistic regression, we analyzed data from the baseline, and from the 4-month and 1-year follow-ups, for potential predictors of success.ResultsOf the participants, 77 % (129 out of 169) were successful in ≥1 of the outcomes, 23 % (37 out of 160) were successful in all 3. Participants with successful short-term results were more likely to succeed in the corresponding outcome at 1 year than those without successful short-term results (adjusted odds ratios [ORs]: PGI 5.15, 95 % confidence interval [CI] 2.40–11.03), ICIQ-UI SF 6.85 (95 % CI 2.83–16.58), and sufficient treatment 3.78 (95 % CI 1.58–9.08). Increasing age predicted success in PGI-I and sufficient treatment (adjusted OR 1.06, 95 % CI 1.02–1.10, and 1.08, 95 % CI, 1.03–1.13 respectively). Compared with not training regularly, regular PFMT at 1 year predicted success for PGI and sufficient treatment (adjusted OR 2.32, 95 % CI 1.04–5.20, and 2.99, 95 % CI 1.23–7.27 respectively).ConclusionThe long-term success of a non-face-to-face treatment program for SUI with a focus on PFMT can be predicted by successful short-term results, increasing age, and the performance of regular PFMT after 1 year.

Fulfilment of patient goals after tension-free vaginal tape operation for stress urinary incontinence.

The aim of this study was to investigate patient-reported goals after a tension-free vaginal tape operation for stress urinary incontinence and the correlation with postoperative incontinence. A prospective study involving 70 women was carried out. Preoperatively, patients completed the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) and stated three goals for the operation. A telephone interview was performed 3months postoperatively. A Visual Analogue Scale (VAS) score from zero to ten estimated the extent to which goals were achieved. Goals were divided into five groups: 1, symptoms; 2, quality of life (physical); 3, quality of life (emotional); 4, sexual function; 5, avoidance. ICIQ-UI SF preoperative mean was 14.9 and postoperative mean was 1.5 (p < 0.05). A total of 210 goals were stated. The majority of the goals (38%) were in group 2 concerning quality of life in the physical domains. Mean VAS score for all goals was 9.1 (SD 2). Thirty-seven patients (53%) fulfilled all their goals. Twenty-one patients (30%) did not have a VAS score of 10, although continent with an ICIQ-UI SF score of zero. Reasons for not achieving a full VAS score were that some still used pads out of fear (n = 10), that their mental focus was still on incontinence (n = 7) or that they had not yet tried some of the physical aims (n = 7). Most patients achieved their goals. The majority of the goals concerned quality of life in the physical domains.

Laparoscopic wrap round mesh sacrohysteropexy for the management of apical prolapse.

Interest in uterine-conserving surgery for apical prolapse is growing. Laparoscopic sacrohysteropexy is one of the conservative surgical options, although different surgical approaches have been described. We report medium-term outcome data using a bifurcated mesh implant, employing 'wrap round' uterine attachment. All procedures undertaken at our unit were reviewed. Study inclusion was contingent on the collection of baseline and 3-month anatomical and symptomatic outcome data. Medium-term follow-up data were collected by telephone review. Anatomical outcome was reported using the Pelvic Organ Prolapse Quantification scale. Symptom prevalence and treatment response were assessed using validated instruments including the Patient Global Impression of Improvement scale (PGI-I), and the International Consultation on Incontinence Urinary Incontinence Short Form (ICIQ-UI) and Vaginal Symptoms (ICIQ-VS) questionnaires. Patient satisfaction was reported using Kaplan-Meier survival analysis. Data were available for 110 patients. Of 80 patients providing PGI-I dataat 3 months, 75 (94%) described their prolapse symptoms as 'much better' or 'very much better'. Anatomical success in the apical compartment was 98%. ICIQ-UI and ICIQ-VS responses demonstrated significant improvement. Despite a concurrent vaginal repair in only 11% of patients, satisfaction at a mean follow-up of 2.6years was 96%. Repeat surgery for vaginal wall prolapse was required in only 5% of patients. No safety concerns or graft complications were recorded. This surgical variant of laparoscopic sacrohysteropexy is safe and highly effective. These data also cast doubt on the need for correction of modest vaginal wall prolapse at the time of surgery, and imply that apical prolapse may play a dominant role in the generation of symptoms.

Does episiotomy influence vaginal resting pressure, pelvic floor muscle strength and endurance, and prevalence of urinary incontinence 6 weeks postpartum?

The aim of the present study was to compare vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and endurance, and prevalence of urinary incontinence (UI) at 6 weeks postpartum, in women with and without lateral or mediolateral episiotomy. Two hundred and thirty-eight nulliparous pregnant women, mean age 28.5 years (SD 4.2) and pre-pregnancy BMI 23.8 (SD 4.0) participated in the study. Lateral or mediolateral episiotomy was only performed for indications such as fetal distress or imminent risk of severe perineal tear. At 6 weeks postpartum, a vaginal balloon connected to a high precision pressure transducer was used to measure VRP (cm H2 O), PFM strength (cm H2 O), and endurance (cm H2 O sec). All women completed the International Classification of Urinary Incontinence Short Form (ICIQ-UI-SF) by means of an electronic questionnaire. No statistically significant differences were found in VRP (mean difference 0.0 cm H2 O, 95%CI: -2.1 to 2.1), PFM strength (mean difference 1.3 cm H2 O, 95%CI: -1.9 to 4.6), or PFM endurance (mean difference 12.1 cm H2 O sec, 95%CI: -11.0 to 35.1) between women with or without episiotomy. No significant differences were found in prevalence of UI (37.5% vs. 46.6%) or SUI (23.6% vs. 35.6%), between women with or without episiotomy, respectively. PFM function and/or prevalence of post-partum UI were not affected by a lateral or mediolateral episiotomy. Neurourol. Urodynam. 36:683-686, 2017. © 2016 Wiley Periodicals, Inc.

S&T-62 EFFECT OF PULSED MAGNETIC STIMULATION ON SEXUAL FUNCTION IN COUPLES WITH INCONTINENT PARTNERS

You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-62 EFFECT OF PULSED MAGNETIC STIMULATION ON SEXUAL FUNCTION IN COUPLES WITH INCONTINENT PARTNERS Renly Lim, Men Long Liong, Wing Seng Leong, Nurzalina Abdul Karim Khan, and Kah Hay Yuen Renly LimRenly Lim More articles by this author , Men Long LiongMen Long Liong More articles by this author , Wing Seng LeongWing Seng Leong More articles by this author , Nurzalina Abdul Karim KhanNurzalina Abdul Karim Khan More articles by this author , and Kah Hay YuenKah Hay Yuen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2891AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The 5th International Consultation on Incontinence recommends that research in female stress urinary incontinence (SUI) should assess treatment impact on sexual function. Recent published studies have highlighted the interdependence between male and female sexual function. We evaluated the effect of the under-studied non-surgical treatment pulsed magnetic stimulation (PMS) on sexual function in female subjects with SUI and their partners. METHODS Couples with female SUI partners, at least 21 years old and sexually active were recruited. SUI subjects received 16 or 32 PMS sessions (twice a week) depending on treatment response. Treatment responders were defined as a 5-point reduction in the International Consultation on Incontinence Questionnaire for Urinary Incontinence-Short Form (ICIQ-UI SF) (range 0 to 21). Prior to and at 6-months post-treatment, the female subjects completed the ICIQ-UI SF, while both partners completed two key parameters; i) Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire (range 0 to 96) and ii) single-item question on overall sexual experience, ‘Over the past 4 weeks, how satisfied have you been with your overall sexual life?’. The GRISS questionnaire is a highly recommended questionnaire by the 5th International Consultation on Incontinence with comparable male and female subscales to assess sexual function in couples, and has been translated and validated by our research team in the Malaysian population. RESULTS 53 of 66 couples (80.3%) completed reassessments at 6-months post-treatment. Mean reduction (Mdiff) ± standard error (SE) in the ICIQ-UI SF score was -6.55 ± 0.46 (p<0.001). Based on the overall GRISS score, there were significant improvements in both female subjects (Mdiff -5.16, SE 1.31, p<0.001) and their partners (Mdiff -3.38, SE 1.21, p=0.008). Based on the single-item question on overall sexual experience, there was a significant increase in the percentage of female subjects who felt ‘moderately satisfied’ or ‘very satisfied’ (p=0.032) but no significant change in their partners (p=0.330). Subgroup analysis showed that female subjects who received 32 sessions (Mdiff -8.64, SE 2.09, p=0.015) had twice the mean reduction compared with 16 sessions (Mdiff -4.03, SE 1.57, p=0.002). In contrast, a longer treatment duration did not lead to significant improvement in sexual function of their male partners (Mdiff -2.23, SE 2.64, p=0.414). CONCLUSIONS PMS improve sexual function of both the female subjects and their partners. Increasing the number of PMS sessions may further improve female sexual function. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e334 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Renly Lim More articles by this author Men Long Liong More articles by this author Wing Seng Leong More articles by this author Nurzalina Abdul Karim Khan More articles by this author Kah Hay Yuen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Prevalence, quality of life assessment of urinary incontinence using a validated tool (ICIQ-UI SF) and bothersomeness of symptoms among rural community: dwelling women in Southwest, Nigeria

Background: Urinary incontinence (UI) is a debilitating disease which impacts on quality of life (QoL) of affected individuals. Estimates of the burden of the diseases varied widely due to different definitions of the disease by different researchers. With the use of a validated screening tool-International Consultation on Incontinence Questionnaire- Urinary Incontinence Short Form (ICIQ-UI SF) we sought to determine the prevalence of UI among women in a rural Nigerian community; examined their self-reported QoL and perceived bothersomeness of the symptoms. Methods: A cross-sectional descriptive epidemiological study among rural community-dwelling women in South west, Nigeria with 229 participants selected by multi-stage sampling technique. The study was conducted using ICIQ-UI SF questionnaire with additional data on socio-demographics and bothersomeness of the symptoms. Correlates of QoL were determined with Spearman’s rho correlation and associated factors of bothersomeness determined by chi square and logistic regression. Results: Prevalence was 12.6% and stress UI was the commonest type. Poor QoL reported in 65.5% of those afflicted with UI. Worsening QoL had a positive correlates with Age (p<0.010), amount of urine loss (p<0.001), frequency of urine leakage (p<0.001) and ICIQ scores (p<0.001). Perceived bothersomeness of symptoms were associated with ICIQ score of ≥8 (p<0.001; OR: 1.810; 95% CI: 1.220- 2.684) . Conclusions: Prevalence was 12.6% with poor QoL in substantial proportion of the respondents with UI worsened by advancing age, increase in quantity of urine loss, increase in frequency of urine leakage and ICIQ score. Perceived bothersomeness of symptoms was associated with ICIQ score of ≥8.

Effectiveness and Safety of Electroacupuncture on Poststroke Urinary Incontinence: Study Protocol of a Pilot Multicentered, Randomized, Parallel, Sham-Controlled Trial.

This pilot multicentered, randomized, parallel, sham-controlled trial is intended to evaluate the effectiveness and safety of electroacupuncture therapy for poststroke patients with urinary incontinence. Forty stroke survivors aged >19 years will be recruited in 2 hospitals in the Republic of Korea. Patients who experienced stroke within 2 years and satisfy criteria of urinary frequencies ≥2 with either 3 to 4 points on the Patient Perception of Intensity of Urgency Scale or 13 points or more on the Korean version of the International Prostate Symptom Scale (K-IPSS) will be identified, along with other eligibility criteria. Patients will be randomly allocated to either a treatment or control group to receive 10 sessions of electroacupuncture or sham therapies, respectively. Patients and outcome assessors will be blinded. The primary outcome is the change of Total Urgency and Frequency Score between the baseline and the trial endpoint. The K-IPSS, the International Consultation on Incontinence Questionnaire for Urinary Incontinence Short Form, and the Lower Urinary Tract Symptoms Outcome Score will be evaluated for effectiveness assessment. Adverse events will be reported after every session. The Blinding Index will also be calculated. Data will be statistically analyzed with 0.05 significance levels by 2-sided testing.

Corrélation entre le score de l’ICIQ-UI-SF et les résultats d’un test psychométrique de personnalité d’une population ayant une incontinence urinaire

We found out the personality pattern of an incontinent population and proceeded to a correlation between the personality inventory and the ICIQ-UI-SF (International Consultation Incontinence Questionnaire Urinary Incontinence Short Form) to demonstrate reliability and sincerity of the answers and to establish that a personality disturbance may impact the physiopathology of micturition. We performed an observational prospective study. It included patient's answers to a computed questionnaire combining a double ICIQ-UI-SF questionnaire and the 71 questions of the Minimult questionnaire. Forty-seven patients were asked to participate. Over 37 patients included, Wilcoxon-Mann-Whitney non parametric test confirmed agreement of the two ICIQ-UI-SF questionnaires with P=0.1792. Twenty-three patients were validated to the Minimult inventory with F scale<70. We analysed variability of the two global ICIQ-UI-SF score in regard with the validity scale using ROC analysis. We observed an AUC of 0.559 with sensitivity 78.6% and specificity 43.5%. No L score was above 70 demonstrating absence of lie. No personality disturbance was found in 9 cases. We observed six cases with a high hypochondric value, five with a high depressive value, and four with a high hysteric value. This neurotic triad was found in two cases. We noticed five cases with psychopathic deviance relative to antisocial behaviour while values of paranoia and hypomania were high in one case without any association of these personality aspects, which demonstrated absence of behavioural problem. Psychotic profile associating schizophrenia, paranoia, depression and hypomania was not found. We outlined in half of the valid population a significant high psycho-asthenic pattern. We conclude that a correlation between the personality inventory and the ICIQ-UI-SF is feasible. The comparative study demonstrate reliability of answers. Sincerity is established by the Minimult L scale. We confirm and precise literature information over clinical personality pattern of this population and observe relevant elements concerning the psycho-asthenic pattern which depicts an anxious personality with an important feeling of the problem. These elements permit to suspect that a personality disturbance may impact the physiopathology of the micturition. 4.

The Effect of Bariatric Surgery on Urinary Incontinence in Women.

Little is known regarding the effect of bariatric surgery on urinary incontinence. Between September 2008 and November 2014, 240 female patients underwent bariatric surgery. The prevalence of urinary incontinence preoperatively was 45% (108). Eighty-two (76%) completed urinary function questionnaires pre-operatively and post-operatively. Fifty-seven (70%) underwent laparoscopic gastric bypass, twenty-four (29%) underwent sleeve gastrectomy and one underwent a banding procedure. Thirty-one (38%) reported leaking on sneezing or coughing-stress urinary incontinence (SUI). Thirteen (16%) complained of leaking before reaching the toilet-overactive bladder syndrome (OAB). The remaining thirty-eight (46%) reported mixed symptoms. The mean pre-operative weight and BMI were 133 (18) kg and 50 (SD = 6.2) kg/m(2) respectively. The mean post-operative BMI drop was 16 (SD = 5.2) kg/m(2). Preoperatively, 61 (75%) reported moderate to very severe urinary incontinence compared to 30 (37%) post-operatively (χ (2) = 3.24.67, p = 0.050). Twenty-seven (33%) patients reported complete resolution of their urinary incontinence. Fifty-one (62%) patients required incontinence pads on a daily basis pre-operatively, compared to 35 (43%) post-operatively (χ (2) = 22.211.6, p = 0.00). The mean International Consultation on Incontinence Questionnaire- Urinary Incontinence short form (ICIQ-UI SF) score was 9.3 (SD = 4.4) pre-operatively compared to 4.9 (SD = 5.3) post-operatively (t = 7.2, p = 0.000). The improvement score post-operatively was 8 (SD = 3). A significant difference in the ICIQ-UI SF was identified between OAB and SUI groups when adjusting for age, number of children, type of delivery and pre-op BMI (t = 1.98, p = 0.05). Bariatric surgery results in a clinically significant improvement in urinary incontinence. However, this is not proportional to pre-operative BMI, weight loss, age, parity and mode of delivery.