Stress Urinary Incontinence Research Articles

The point prevalence of stress incontinence among young adult Jordanian women based on activity levels.

Stress Urinary incontinence (SUI) is a common condition among women of all ages. The point prevalence of SUI among young adult Jordanian women is less explored. To examine the point prevalence of SUI among this sample based on activity level, and whether the affected women have shared their complaints with healthcare providers and/or received education related to UI. This was a cross-sectional survey-based study. Participants with diseases that affect the control of micturition were excluded. The International Consultation on Incontinence Questionnaire-UI Short-Form was used to calculate the point prevalence of UI. The Tegner activity scale was used to classify participants based on their physical activity levels. The participants reported whether they shared their complaints with a healthcare provider or received education about this health problem. Five hundred women (median age=20years, BMI=22) participated (118 competitive athletes, 192 recreational, and 190 sedentary). The overall point prevalence of SUI was 14% (n=61). A chi-square test of independence showed a significant difference in the point prevalence of SUI between women with different activity levels, χ2 (12)=12.07, p<0.01. The point prevalence of SUI among competitive athletes, recreational women, and sedentary women was 21%, 8%, and 11%, respectively. None of those with SUI have shared their complaints with healthcare providers or received education related to SUI. SUI is prevalent among young adult Jordanian women, with the highest prevalence observed in those engaged in competitive athletic activities. The affected women refrain from disclosing their SUI-related concerns to healthcare practitioners and lack sufficient knowledge about this health issue.

Urinary Continence Restoration Through an Endourethral Device: A 3-Month Pilot Study on 10 Patients.

Background: Stress urinary incontinence (SUI) is a widespread and frustrating condition that affects millions of people worldwide, with severe consequences on patients' quality of life and health care systems' costs. Currently, the most severe cases of SUI are treated using implanted (and rather invasive) extraurethral artificial sphincters. The authors propose an innovative, minimally invasive endourethral device for the treatment of SUI. Methods: Ten patients with SUI were enrolled in three Italian centers and underwent device implantation. After 10, 30, 60, and 90 days, correct device position was confirmed by ultrasonography. Improvements in continence and quality of life were evaluated through a 24-hour pad-test, an International Consultation on Incontinence Questionnarie-Short Form (ICI-Q) and a custom checklist. The device was explanted after 90 days. Results: The proposed device was successfully implanted and explanted in 8 out of 10 patients. The results of the pad-test, ICI-Q, and custom checklist demonstrated remarkable improvements in continence (median improvement: 82% with respect to the initial condition) and quality of life (mean reduction of the impact of urine losses on the quality of life: 61%). No major pain or discomfort was reported. Conclusions: The results demonstrate the efficacy of the proposed endourethral artificial sphincter in addressing SUI. The proposed device was successfully implanted and explanted in a short time (∼10 minutes) without intrinsic side effects and without triggering pain or discomfort.

The Effect of Astragalus mongholicus Water Extract on Urinary Function in Rats

This study investigated the effect of combining Astragalus mongholicus (A. mongholicus) water extract with electroacupuncture to improve bladder urinary function in rats with stress urinary incontinence (SUI). 18 SPF-grade unfertilized female SD rats were used, among which 15 rats were selected to establish the SUI model through simulated labor injury combined with bilateral oophorectomy. The 15 SUI rats were randomly divided into three groups: the model group, the Astragalus group (treated with A. mongholicus water extract), and the Astragalus+acupuncture group, with 5 rats in each group. The remaining three rats constituted the control group. After 6 weeks of treatment, the study compared bladder function parameters before and after treatment, including the positive rate of sneezing test, urethral baseline pressure (UBP), the amplitude of urethral response during sneezing (A-URS), maximum bladder capacity (MBC) indicating bladder function, leak point pressure (LPP), abdominal leak point pressure (ALPP), urine output, residual urine volume, and urination efficiency. Masson staining was used to observe changes in collagen fiber proportion in bladder tissue. Compared to the control group, the model group exhibited increased positive sneezing test, urination output, and residual urine volume, while bladder function decreased. Both the Astragalus group and Astragalus+acupuncture group demonstrated significant improvements in UBP, A-URS, MBC, LPP, ALPP, urination efficiency, collagen fiber proportion, and other indicators compared to the model group. Furthermore, the Astragalus+acupuncture group exhibited superior treatment effects compared to A. mongholicus water extract alone, suggesting the potential of this combined approach for SUI.

Top cited articles about the stress urinary incontinence: A bibliometric analysis

ObjectiveTo produce a bibliographic source by compiling the most-cited articles about stress urinary incontinence to guide researchers for novel research topic ideas in urogynecology. Study designWe analyzed 200 most-cited articles (T200) between 1995–2022 by reviewing the Institution for Scientific Information (ISI) − Web of Science (WOS) and PubMed databases about the stress urinary incontinence. The time span-effect of publications was normalized by calculating average citations per item (ACI) index for each article. The publications were sub-classified by the publication year, journals, countries, surgical methods, and departments. ResultsThe median for total citation numbers and the ACI indices of T200 were 35 and 5 respectively. The top-cited articles were mostly published in USA with 91 articles (46.5 %) followed by Italy (22, 11 %), and United Kingdom (21, 10.5 %). Among T200, 149 were original research, 44 reviews, 4 meta-analyses, and 3 editorial articles. Further, 59 were about surgical procedures (of which 28 were about TOT-TVT comparison). M. Serati and L. Bruker were the most contributing authors to T200 with 19 articles. On the top of T200, the article of Pierre A. Clavien et al. (2009) sits with 6201 citations, published in the journal of “Annals of Surgery”. ConclusionsWe suggest that the most-cited articles commonly conducted in the high-income countries, mostly published between 2014–2018. Best of our knowledge, this is the first study analyzing the most-cited 200 publications in urogynecology field under two different perspectives of two different disciplines, namely urology and obstetrics and gynecology.

54 - Stress urinary incontinence during pregnancy. Does maternal weight matter?

54 - Stress urinary incontinence during pregnancy. Does maternal weight matter?

Effect of electromagnetic stimulation combined with visceral manipulation on stress urinary incontinence in postmenopausal women: A randomized controlled trial

ObjectivesThe aim of the study is to determine how electromagnetic stimulation and visceral manipulation can improve pelvic floor strength and reduce the severity of symptoms of postmenopausal stress urinary incontinence (SUI). MethodsThis randomized controlled trial was conducted on 50 postmenopausal female participants aged 50–66 years with a body mass index (BMI) ≥ 30 kg/m2. Participants were equally randomized into the study (A) and control (B) groups. The study group (A) underwent 36 pulsed electromagnetic stimulation (PEMS) sessions (20 min/session; 3 sessions a week/12 weeks), 12 sessions of visceral manipulation therapy (VMT) maneuvers (once weekly/weeks), and 24 supervised pelvic floor muscle training (PFMT) sessions (45–60 min/session; twice weekly/12 weeks), along with general advice. For 12 weeks, the control group (B) received the same PFMT and general advice. Kegel perineometer was used to measure vaginal squeeze pressure (VSP) and the urogenital distress inventory questionnaire-short form (UDI-6) to assess the severity of urinary incontinence (UI) symptoms in both groups before and after the treatment. ResultsThe results revealed statistically significant improvements (p < 0.05) in both VSP and UDI-6 scores in group A compared to group B. ConclusionElectromagnetic stimulation combined with visceral manipulation and supervised PFMT is more efficient than PFMT alone on SUI in postmenopausal women. Therefore, it is advisable to incorporate this combined approach into pelvic floor rehabilitation programs.

How does the pelvic floor respond to modulations in trunk pressure induced by a variety of voicing tasks? A cross-sectional, observational study.

The pelvic floor responds to changes in trunk pressure, elevating during low-pressure exhale and descending during high-pressure exhale. Voicing occurs during exhalation, spanning low-to-high trunk-pressure, yet it is unknown how voicing affects the pelvic floor. The aim of this study was to quantify pelvic floor response to voicing and identify if there are differences for women with stress urinary incontinence. We hypothesized that shouting would cause pelvic floor descent, with greater magnitude for incontinent women. Sixty women (38 incontinent, 22 continent) performed four voicing tasks (counting to "4" in speaking/shouting/low-pitch/high-pitch voice) while transperineal ultrasound measured changes in pelvic floor morphology. ANOVA compared variance of responses to voicing and t-tests compared groups. Bladder neck height shortened, levator plate length increased and levator plate angle decreased more during shouting compared to speaking; consistent with pelvic floor straining. There were no differences for high versus low pitch-voicing and small group differences based on continence status. Voicing causes pelvic floor muscles to strain, with greater strain during shouting. Changing vocal pitch does not affect pelvic floor morphology and incontinent women had slight differences from continent women. Voicing may be a safe way to lengthen the pelvic floor without provoking incontinence.

Active Compared With Passive Voiding Trials After Midurethral Sling Surgery: A Systematic Review

(Abstracted from Obstet Gynecol 2024;143(5):633–643) Up to 14% of younger women and 35% of older women are affected by stress urinary incontinence, which is commonly addressed using mesh midurethral sling surgery, with a cure rate of up to 84%. One potential adverse effect of this surgery is postoperative urinary retention, which is defined as an inability to voluntarily pass enough urine after a surgical procedure to avoid catheterization.

218 - Overactive bladder without stress urinary incontinence: The Pitfalls of Mid-urethral slings

218 - Overactive bladder without stress urinary incontinence: The Pitfalls of Mid-urethral slings

284 - Are muscle mechanical properties affected at lumbar and pelvic floor levels in women with stress urinary incontinence?

284 - Are muscle mechanical properties affected at lumbar and pelvic floor levels in women with stress urinary incontinence?

8 - Association between stress urinary incontinence with bladder neck descent in female runners: a nested case-control study.

8 - Association between stress urinary incontinence with bladder neck descent in female runners: a nested case-control study.

Skin preparation before artificial urinary sphincter surgery: is there a difference between protocols?

Artificial urinary sphincter (AUS) is the gold standard for severe male stress urinary incontinence (SUI). This study aims to evaluate the interest of a new cutaneous preparation regarding the risk of early device infection. A retrospective review of medical records has been built with all patients who underwent an AUS, implanted by experienced surgeons, between January 2010 and January 2023. Before January 2015, all AUS received a standard protocol (SP) of cutaneous cleansing with soap povidone iodine and disinfection with alcoholic povidone iodine. After January 2015, all AUS received the new protocol (NP) with two cleansings with soap povidone iodine and two disinfections with alcoholic povidone iodine. The primary focus was to compare the risk of early device infection between the two protocols. Multivariate analyses were done with several risk factors such as age, diabetes, underlying pathology (prostate cancer surgery, surgical treatment of benign prostatic hyperplasia or others), past history of pelvic radiation therapy and past AUS implantation. One hundred and fifty-six cases were enrolled, with 34 following the SP and 122 following the NP. In the univariate analysis, there were 15 explantations in the SP arm versus 8 for the NP arm due to infection (45.5% vs. 25%, P=0.09). The was no difference between the NP and the SP in multiparametric analysis [odds ratio (OR): 0.97; P=0.96]. No other risk factors were associated with increased risk of AUS removal. Our study showed no correlation between the two types of skin preparation and the risk of AUS removal or revision. Future studies are needed to highlight the legitimate risk factors.

Prevalence, characteristics, and risk factors for urinary incontinence among women attending Primary Healthcare Centers in Bahrain, 2023

BACKGROUND: Urinary incontinence (UI) is a common health concern of women that often goes untreated owing to a lack of awareness and social stigma. It is associated with a lower quality of life and negative bio-psycho-social consequences. Therefore, it is crucial to diagnose UI and manage it in its early stages. This study aimed to assess the prevalence, characteristics, and risk factors in females attending Primary Healthcare Centers (PHCCs) in Bahrain. MATERIALS AND METHODS: A cross-sectional study was conducted in 8 PHCCs in Bahrain in April 2023. Females aged 18 and above were included. A multistage sampling technique was adopted. A self-administered questionnaire consisting of sociodemographic characteristics, risk factors and the International Consultation on Incontinence Questionnaire Short Form was used. Univariate and logistic regression analyses were performed. RESULTS: A total of 875 adult females were enrolled in the study with an average age of 37.5 (standard deviation = 12.3) years. Of the cohort, 24.8% patients had UI with stress incontinence as the most common type (71%), followed by urgency UI (21.2%). However, only 21.7% women had sought medical attention. Being a widow (Odds ratio [OR] = 2.49, P=0.007), retired (OR = 1.98, P=0.016), having had multiple pregnancies (95% CI: 0.82, 0.98; P = 0.016), having urogenital infection (OR = 2.50, P=0.001), having undergone surgery other than C-section (OR = 1.60, P=0.017), and constipation (OR = 1.62, P=0.038) were associated with increased risk for UI. CONCLUSION: This study revealed a relatively high prevalence of UI in females attending PHCCs. Since most patients with incontinence did not seek medical care, primary care physicians should address UI in patients using a well-structured screening tool and provide relevant health education.

Long-term follow-up after laparoscopic reparation of pelvic organ prolapses in a large teaching gynecological center

ObjectiveTo provide a description of laparoscopic approach to correct pelvic organ prolapses and evaluate the risk factors associated with the prolapse recurrence Study designWe retrospectively analyzed 418 patients with symptomatic pelvic organ prolapse who underwent a laparoscopic reparation at our university center from 2010 to 2020. Prolapses were assessed by Baden-Walker system (stage I–IV). The association between the potential prognostic factors and the recurrence was analyzed using Cox regression. ResultsWe included 418 patients. Most patients (97.6 %) had at least one vaginal delivery and 92 (22 %) had a previous prolapse surgery. In 29.74 % of cases levator ani muscle avulsion was observed. We performed a cervicosacropexy in 336 (80.38 %) cases, a sacrohysteropexy in 13 (3.11 %), and a sacrocolpopexy in 69 (16.5 %). Also, concomitantly, 66 (15.79 %) patients with stress and occult urinary incontinence underwent TOT surgery. Surgical complications were low (9.51 %) and the majority were minor. Median follow-up was 37 months (IQR 10.5, 61.4 months), and the global recurrence rate was 9.57 %. Only 4.06 % of cases required reintervention. In Cox regression analysis only levator ani muscle avulsion remained as a recurrence-associated factor. ConclusionOur series is one of the largest and with the longest follow-up. Recurrence rate was low, and comparable to other large series. The only independent factor related to recurrence was the levator ani muscle avulsion.

187 - Extraperitoneal laparoscopic Burch colposuspension after suburethral mesh failure in female stress urinary incontinence

187 - Extraperitoneal laparoscopic Burch colposuspension after suburethral mesh failure in female stress urinary incontinence

12 - Comparing safety of tension-free vaginal tapes (TVT) and trans-obturator tapes (TOT) in treating stress urinary incontinence in women: emulation of a target trial (protocol and preliminary data)

12 - Comparing safety of tension-free vaginal tapes (TVT) and trans-obturator tapes (TOT) in treating stress urinary incontinence in women: emulation of a target trial (protocol and preliminary data)

146 - 9 year analysis of the efficacy, longevity and safety of the Adjustable Transobturator Male System® (ATOMS) in Managing Stress Urinary Incontinence in Men.

146 - 9 year analysis of the efficacy, longevity and safety of the Adjustable Transobturator Male System® (ATOMS) in Managing Stress Urinary Incontinence in Men.

78 - Prevalence and Risk Factors of Stress Urinary Incontinence in a Japan Community Health Survey in 2023 (JaCS 2023) - Differences between Males and Females -

78 - Prevalence and Risk Factors of Stress Urinary Incontinence in a Japan Community Health Survey in 2023 (JaCS 2023) - Differences between Males and Females -

7 - Advancing Urethral Bulking for Stress Urinary Incontinence in Women

7 - Advancing Urethral Bulking for Stress Urinary Incontinence in Women

136 - Long-Term Reoperation Rates Following Mid-Urethral Sling Insertion for Stress Urinary Incontinence: A Population-Based Study

136 - Long-Term Reoperation Rates Following Mid-Urethral Sling Insertion for Stress Urinary Incontinence: A Population-Based Study