Urogenital Distress Inventory Research Articles

Effects of Inspiratory Muscle Training on Stress Urinary Incontinence in North African Women: A Randomized Controlled Trial.

Pelvic floor muscles (PFMs) are involved in respiratory mechanisms. Additionally, stress urinary incontinence (SUI) can affect physical function. This randomized controlled trial was aimed at investigating the effects of inspiratory muscle training (IMT) on SUI severity, PFM function, and physical function in Tunisian women with SUI. Twenty-seven incontinent women were randomly assigned to either the experimental group or the control group. The following parameters were assessed: respiratory muscle strength (RMS; maximal inspiratory and expiratory pressures), SUI severity (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; pad test), PFM function (Modified Oxford Scale, electromyography, and endurance), and physical function (Timed Up & Go test; 6-min walk test; incremental shuttle walking test). IMT was conducted using threshold IMT. The IMT program significantly reduced the severity of SUI (p < 0.01), improved PFM function (p < 0.001), enhanced physical function (p < 0.01), and increased RMS (p < 0.001). Inspiratory muscle training could be an effective method for improving pelvic floor disorders and physical function in women with SUI.

Effects of Mindfulness Meditation on Patient Experience During Urodynamics: A Prospective Study.

Urodynamics (UDS) assesses voiding dysfunction using intravesical, vaginal, or rectal catheters, which can be distressing. This study was aimed at utilizing mindfulness to reduce anxiety and pain in patients undergoing UDS. A single-institution randomized controlled trial was conducted on 60 patients who underwent UDS. Patients were assigned to a mindfulness group (n = 30) or a control group (n = 30). Before UDS testing, all patients completed validated questionnaires assessing lower urinary tract symptoms (Urogenital Distress Inventory 6, UDI-6), anxiety (State-Trait Anxiety Inventory 6, STAI-6), and pain (Visual Analog Scale, VAS). The mindfulness group listened to a mindfulness audio prompt before UDS. All patients received standardized UDS education before UDS testing in a calm environment. After UDS testing, all patients completed validated UDS-perception questionnaires, STAI-6, Likert scale, and VAS surveys. Statistical analysis was performed using paired t tests, independent t tests, Wilcoxon, and Chi-squared tests. Both groups had similar demographics, history of prior UDS, anxiety, and baseline UDI-6 and STAI-6. Post-UDS, anxiety scores decreased in both groups, with the mindfulness group reporting significant improvement in "calmness" (mean 1.7, SD = 0.84) compared with the control group (mean 2.3, SD = 1.0, p < 0.05). The mindfulness group reported increased relaxation whereas the control group reported decreased relaxation post-UDS. Patients in both groups without a history of UDS had a significant improvement in total anxiety compared with those with a history of UDS. Mindfulness meditation may improve calmness and relaxation for patients undergoing UDS.

Efficacy and safety of intradetrusor abobotulinumtoxinA and incobotulinumtoxinA in women with overactive bladder and the value of local anesthesia: arandomized clinical study.

Anon-inferiority clinical study evaluated the efficacy and safety of abobotulinumtoxinA vs. incobotulinumtoxinA intradetrusor injections in women with overactive bladder and urge urinary incontinence. Also, the effect of local anesthesia on the pain level of the procedure was assessed. Patients were randomized to receive 20intradetrusor injections of either 300 U abobotulinumtoxinA or 100 U incobotulinumtoxinA. They were further randomized to receive either local anesthesia (40 ml 1% lidocaine solution) or placebo before botulinum toxin injection. Before the procedure and 4months after the procedure each patient reported urinary incontinence episodes, frequency, nocturia, completed the Urogenital Distress Inventory (UDI-6) score, Incontinence Impact Questionnaire (IIQ-7), and Incontinence Quality of Life (I-QOL) questionnaire. Each patient completed apatient satisfaction survey 4 months after the procedure. During the procedure, the patients graded the pain intensity of every injection on avisual analog scale (VAS). The total score of each questionnaire was considered. A total of 54patients with amean age of 66 ± 13(SD) years completed the study. Total scores of UDI‑6, IIQ‑7, I‑QOL, patient satisfaction, urinary incontinence episodes, frequency, nocturia and VAS questionnaires did not show differences between the abobotulinumtoxinA (n = 26) or incobotulinumtoxinA (n = 28) group. Urinary retention requiring catheterization was noted in five patients. The VAS and patient satisfaction questionnaire values did not show significant differences between the group receiving bladder instillation with lidocaine solution (n = 28) or the group receiving placebo (n = 26). In women with overactive bladder and urge urinary incontinence where conservative treatment failed, abobotulinumtoxinA vs. incobotulinumtoxinA intradetrusor injections showed comparable results regarding improved clinical outcome and patient satisfaction. Local anesthesia before the procedure did not reduce the pain level in comparison with the placebo.

An evaluation of lower urinary tract symptoms among patients with hypertension: A cross-sectional study.

Hypertension (HTN) is a prevalent and impactful health concern associated with cardiovascular morbidity and mortality. This research delves into the intricate relationship between HTN and lower urinary tract symptoms (LUTS), acknowledging the multifaceted nature of these conditions and their potential impact on individuals' quality of life. This cross-sectional study, conducted in Nablus, Palestine, employed convenient sampling to recruit hypertensive patients from the Ministry of Health clinics between September and December 2023. The inclusion criterion involved confirmed hypertensive patients, while the exclusion criterion included individuals with specific health conditions. The collected data included demographic, comorbidity, and lifestyle factor data. The study utilized the urogenital distress inventory 6 (UDI-6) and Incontinence Impact Questionnaire (IIQ)-7 short forms to assess urinary distress symptoms and the impact of urinary incontinence on quality of life. All the statistical analyses, including Pearson, Chi-square, Fisher's exact, Kruskal-Wallis, and Mann-Whitney tests, were performed with various tests for significance, and the significance level was set at P < 0.05. Among the 351 participants meeting the inclusion criteria, females (62.1%) and married individuals (83.5%) were the predominant participants. The majority were aged 58-67 (42.5%), had a high school education (39.0%), and had a body mass index (BMI) of 30-34.9 (30.2%). Significant correlations were found between UDI-6 scores and sex, age, marital status, education level, employment status, and comorbidities. The IIQ-7 score was significantly correlated with female sex, marital status, age, comorbidities, duration of HTN, employment status, and education level. Both the UDI-6 and IIQ-7 scores revealed considerable impacts on urinary symptoms and quality of life. A significant negative correlation (r = -0.579) between the IIQ-7 score and UDI-6 score emphasized the interconnectedness of urinary distress symptoms and their impact on quality of life (P < 0.001). These findings underscore the multifaceted nature of LUTS and their profound effects on hypertensive patients' well-being. Our study revealed a significant association between HTN and LUTS, especially among females and specific demographic groups. This emphasizes the need for comprehensive management. The observed negative impact on quality of life emphasizes the significance of adopting holistic approaches to address both conditions.

Incidence of Urinary Incontinence During the Postpartum Period in Rajavithi Hospital: A Prospective Cohort Study.

The objective was to study the incidence of urinary incontinence (UI), associated risk factors and quality of life (QOL) in postpartum women. A prospective study was conducted with 406 postpartum women at Rajavithi Hospital and followed up over the phone between June 2020 and September 2021. Inclusion criteria were singleton pregnant women aged 18-45years, and gestational age ≥ 37weeks. Baseline characteristics (age, body mass index, birthweight, gestational age, parity, delivery type, smoking, and alcohol and caffeine intake) were recorded. UI was defined as a score ≥ 16.7% using the Urogenital Distress Inventory. Incontinence-related QOL was evaluated using the Incontinence Impact Questionnaire: a score of ≥ 70 indicated poor QOL. Outcomes were assessed during the postpartum period at 2days, 6weeks, 3 months, and 6months. Multivariate logistic regression was used to analyze risk factors for UI. The incidence of self-reported UI at 2days, 6weeks, 3 months, and 6months postpartum were 39%, 3%, 1%, and 0% respectively. Caffeine consumption during pregnancy was only a risk factor for UI (adjusted RR 1.61, 95%CI 1.27-2.05, p < 0.001) after adjusting for age, BMI, birthweight, parity, delivery type, alcohol, smoking, and pelvic floor exercise. Three women with UI had poor QOL, whereas all women without UI reported a good QOL. In our study sample, urinary incontinence was found in one-third of women during the early postpartum period, but for most women symptoms improved with the first 6weeks and all resolved at 6months. In this study, caffeine consumption during pregnancy was the only risk factor for UI.

Real-World Evidence From a Digital Health Treatment Program for Female Urinary Incontinence: Observational Study of Outcomes Following User-Centered Product Design.

Urinary incontinence (UI) affects millions of women with substantial health and quality-of-life impacts. Supervised pelvic floor muscle training (PFMT) is the recommended first-line treatment. However, multiple individual and institutional barriers impede women's access to skilled care. Evidence suggests that digital health solutions are acceptable and may be effective in delivering first-line incontinence treatment, although these technologies have not yet been leveraged at scale. The primary objective is to describe the effectiveness and safety of a prescribed digital health treatment program to guide PFMT for UI treatment among real-world users. The secondary objectives are to evaluate patient engagement following an updated user platform and identify the factors predictive of success. This retrospective cohort study of women who initiated device use between January 1, 2022, and June 30, 2023, included users aged ≥18 years old with a diagnosis of stress, urgency, or mixed incontinence or a score of >33.3 points on the Urogenital Distress Inventory Short Form (UDI-6). Users are prescribed a 2.5-minute, twice-daily, training program guided by an intravaginal, motion-based device that pairs with a smartphone app. Data collected by the device or app include patient-reported demographics and outcomes, adherence to the twice-daily regimen, and pelvic floor muscle performance parameters, including angle change and hold time. Symptom improvement was assessed by the UDI-6 score change from baseline to the most recent score using paired 2-tailed t tests. Factors associated with meeting the UDI-6 minimum clinically important difference were evaluated by regression analysis. Of 1419 users, 947 met inclusion criteria and provided data for analysis. The mean baseline UDI-6 score was 46.8 (SD 19.3), and the mean UDI-6 score change was 11.3 (SD 19.9; P<.001). Improvement was reported by 74% (697/947) and was similar across age, BMI, and incontinence subtype. Mean adherence was 89% (mean 12.5, SD 2.1 of 14 possible weekly uses) over 12 weeks. Those who used the device ≥10 times per week were more likely to achieve symptom improvement. In multivariate logistic regression analysis, baseline incontinence symptom severity and maximum angle change during pelvic floor muscle contraction were significantly associated with meeting the UDI-6 minimum clinically important difference. Age, BMI, and UI subtype were not associated. This study provides real-world evidence to support the effectiveness and safety of a prescribed digital health treatment program for female UI. A digital PFMT program completed with visual guidance from a motion-based device yields significant results when executed ≥10 times per week over a period of 12 weeks. The program demonstrates high user engagement, with 92.9% (880/947) of users adhering to the prescribed training regimen. First-line incontinence treatment, when implemented using this digital program, leads to statistically and clinically substantial symptom improvements across age and BMI categories and incontinence subtypes.

Correlation of Self-Efficacy for Pelvic Floor Muscle Exercise with Symptoms of Stress Urinary Incontinence in Women.

Self-efficacy for pelvic floor exercises, i.e. confidence in achieving pelvic floor contractions, may predict adherence to treatment. However, there is a paucity of literature investigating the clinical relevance of this outcome. The aim was to determine the relationship between self-efficacy for pelvic floor exercise and symptom severity, pelvic floor distress and impact on quality of life, as well as sociodemographic characteristics and pelvic floor muscle strength in women with stress urinary incontinence (SUI). A cross-sectional study was conducted in women with SUI. The Spanish version of the Broome Pelvic Muscle Self-Efficacy Scale was used to assess self-efficacy for pelvic floor exercise. The dependent variables were: urinary incontinence symptoms using the International Consultation on Incontinence Questionnaire, short form (ICIQ-SF), pelvic floor distress symptoms using the Urogenital Distress Inventory-6, impact on quality of life using the Incontinence Impact Questionnaire (IIQ-7), leakage using the 1-h pad test, number of SUI episodes per week and pelvic floor muscle strength. A total of 56 women with a median age of 44.5years were included. Self-efficacy for pelvic floor exercise correlated negatively and moderately with the ICIQ-SF (r = -0.529; p < 0.001), IIQ-7 (r = -0.442; p = 0.001), 1-h pad test (rs = -0.467; p < 0.001); and number of SUI episodes/week (rs = -0.489; p < 0.001). Correlation with the other outcomes was weak or non-existent. Linear regression with forward selection showed that the ICIQ-SF was the variable most related to self-efficacy (β: -3.01, 95% CI: -4.03 to -1.69). These findings highlight the importance of assessing self-efficacy for pelvic floor exercise in the treatment of women with SUI. Future prospective studies are needed to confirm these findings.

Impact of pelvic floor muscle training on sexual function in women affected by stress urinary incontinence.

Pelvic floor muscle training can effectively improve pelvic floor muscle strength and activities; however, its impact on sexual function in women with stress urinary incontinence remains unclear. The study sought to investigate the impact of pelvic floor muscle training on pelvic floor muscle and sexual function in women with stress urinary incontinence. This was a retrospective observational study involving women who visited a urogynecologic clinic at a tertiary medical center. Patients with stress urinary incontinence without pelvic organ prolapse underwent pelvic floor muscle training programs that included biofeedback and intravaginal electrostimulation. Other evaluations included pelvic floor manometry, electromyography, and quality-of-life questionnaires, including the short forms of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Clinical characteristics, vaginal squeezing and resting pressure, maximal pelvic floor contraction, duration of sustained contraction, quality-of-life scores, and sexual function were compared between baseline and after the pelvic floor muscle training programs. There were 61 women included in the study. The mean number of treatment sessions was 12.9 ± 6.3, and the mean treatment duration was 66.7 ± 32.1days. The short forms of the Urogenital Distress Inventory (7.7 ± 3.8 vs 1.8 ± 2.1; P < .001) and Incontinence Impact Questionnaire (5.9 ± 4.3 vs 1.8 ± 2.0; P < .001) scores significantly improved after the pelvic floor muscle training program. In addition, all pelvic floor muscle activities significantly improved, including maximal vaginal squeezing pressure (58.7 ± 20.1 cmH2O vs 66.0 ± 24.7 cmH2O; P = .022), difference in vaginal resting and maximal squeezing pressure (25.3 ± 14.6 cmH2O vs 35.5 ± 16.0 cmH2O; P < .001), maximal pelvic muscle voluntary contraction (24.9 ± 13.8 μV vs 44.5 ± 18.9 μV; P < .001), and duration of contraction (6.2 ± 5.7 s vs 24.9 ± 14.6s; P < .001). Nevertheless, the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire score demonstrated no significant improvement (28.8 ± 9.7 vs 29.2 ± 12.3; P = .752). Pelvic floor muscle training programs may not improve sexual function in women with stress urinary incontinence. The strength of this study is that we evaluated sexual function with validated questionnaires. The small sample size and lack of long-term data are the major limitations. Pelvic floor muscle training can improve pelvic floor muscle activities and effectively treat stress urinary incontinence; however, it may not improve sexual function.

Can pelvic floor muscle function before surgery determine the outcome of surgical treatment of stress urinary incontinence in women?

The study aimed to determine whether pelvic floor muscle (PFM) function before surgery may correlate with the success of surgical interventions for treating stress urinary incontinence (SUI). Our hypothesis was that addressing identified variables in preoperative rehabilitation could potentially improve surgical outcomes. This prospective observational study was conducted at a single center and enrolled women qualified to mid-urethral tape insertion for SUI between 2020 and 2022. Digital palpation and manometry (Peritron™ 9300 V) were used to evaluate PFM function. The following parameters were acquired: vaginal resting pressure, vaginal pressure during maximal voluntary contraction (MVC), the area under the curve during a 10-second MVC, moreover the ability to perform correct PFM contraction, reflexive PFM contraction during cough and relaxation were assessed. All measurements were performed before the surgical treatment and during follow-up assessments at 1, 3, and 6 months postoperatively. The primary endpoint of the study was defined as objective cure, characterized by a negative cough stress test (CST), along with a subjective assessment based on the Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7). The study involved 57 eligible female participants, all of whom completed the 6-month follow-up. Objective cure was observed in 75.44% of cases, while subjective cure was reported in 33%. There was no association between PFM parameters and surgical outcomes. The success of surgical treatment of SUI 6 months postsurgery is not related to preoperative pelvic floor muscle function.

Resolution of Overactive Bladder Symptoms After Anterior and Apical Prolapse Repair.

Patients often present with both overactive bladder (OAB) and pelvic organ prolapse (POP) concerns. It is unknown whether treatment of POP improves OAB. This study aimed to evaluate whether OAB improves after anterior/apical POP repair for anterior wall prolapse. This was a prospective study of women with anterior/apical prolapse at or beyond the hymen and concomitant OAB symptoms, undergoing apical repair. Overactive bladder severity was evaluated with the Urogenital Distress Inventory-6 (UDI-6) questionnaire and the Incontinence Impact Questionnaire-7 preoperatively and 2, 6, 12, and 24 weeks postoperatively. The primary outcome was a reduction of ≥11 points or greater on the UDI-6 at 6 months. Those who reported an ≥11-point reduction were termed responders. Multivariable regression analyses were performed to evaluate factors associated with reduction in OAB symptoms after POP surgery. A total of 117 patients met the criteria for analysis, with 79.5% reporting improved OAB symptoms after POP repair at 6 months. There were no preoperative differences between groups. The mean preoperative UDI-6 and Incontinence Impact Questionnaire-7 scores were higher in the responder group (51.1 ± 16.8 vs 26.4 ± 15.1 [P < 0.001] and 44.6 ± 23.8 vs 22.8 ± 21.4 [P = 0.001], respectively), and the presence of detrusor overactivity was lower (29.0% vs 54.2%, P = 0.02). After regression, a higher preoperative UDI-6 total was associated with an increased likelihood of symptom improvement at 6 months (adjusted odds ratio, 1.14 per point [1.08-1.19]), whereas detrusor overactivity on preoperative urodynamics was associated with a decreased likelihood of OAB symptom improvement (adjusted odds ratio, 0.10 [0.02-0.44]). Overactive bladder symptoms improve in the majority of patients undergoing apical repair for anterior/apical prolapse beyond the hymen.

Defining success after surgical treatment of stress urinary incontinence

BackgroundA consensus standardized definition of success after stress urinary incontinence surgical treatment is lacking, which precludes comparisons between studies and affects patient counseling. ObjectivesTo identify optimal patient-centric definition(s) of success after stress urinary incontinence surgical treatment and to compare the identified “more accurate” treatment success definitions with a commonly used composite definition of success (ie, no reported urine leakage, negative cough stress test result, and no retreatment). Study DesignWe evaluated 51 distinct treatment success definitions for participants enrolled in a previously conducted randomized trial of stress urinary incontinence treatments concomitantly performed with sacrocolpopexy (NCT00934999). For each treatment success definition, we calculated the mean (SD) of participant-assessed symptom improvement and participant-assessed surgical success scores with an 11-point Likert scale among those achieving success and failure. The “more accurate” treatment success definition(s) were identified by measuring the magnitude of the mean difference of participant assessments with Hedges g values. The treatment success definitions with the highest Hedges g values were considered “more accurate” treatment success definitions and were then compared with the composite definition of success. ResultsThe percentage of participants who had treatment success (6.4% to 97.3%) and Hedges g values (–4.85 to 1.25) varied greatly according to each treatment success definition. An International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score of 5 or less, Urogenital Distress Inventory-6 score of 33.3 or less, and a no/mild stress urinary incontinence response on Urogenital Distress Inventory-6 question 3 had the highest Hedges g values and were considered the top 3 “more accurate” treatment success definitions. Paradoxically, treatment success definitions that required a negative cough stress test result or no persistent urinary leakage greatly reduced the ability to differentiate participant-assessed symptom improvement or surgical success. When the “more accurate” treatment success definitions were compared with the composite definition, patients with failed treatment according to the composite definition had lower Urinary Impact Questionnaire-7 scores, and a higher proportion of complete/somewhat satisfaction and very good/perfect bladder condition survey responses. Additionally, the composite definition had considerably fewer favorable outcomes for participants than did the top 3 “more accurate” treatment success definitions. ConclusionsSuccessful outcomes of stress urinary incontinence surgical treatments for women undergoing concurrent sacrocolpopexy varied greatly depending on the definition used; however, stringent definitions (requiring complete dryness) and objective testing (negative cough stress test result) had decreased, rather than increased, participant-assessed symptom improvement and surgical success scores. The “more accurate” treatment success definitions better differentiated participant-assessed symptom improvement and surgical success than the composite definition. The composite definition disproportionally misidentified participants who reported minor symptoms or complete/somewhat satisfaction with their outcome as having treatment failures and yielded a considerably lower proportion of women who reported favorable outcomes than did the top 3 “more accurate” treatment success definitions.

Symptom Severity and Its Impact on Daily Life in Women with Urinary Incontinence: A Cross-sectional Study

Objective: The aim of this study is to determine the severity of symptoms, their impact on daily life, and the associated factors in women with urinary incontinence (UI). Methods: A cross-sectional, descriptive study was conducted among women with UI in the province of Istanbul, involving 161 women aged 40 years and older who had given birth at least once between June and September 2021. Data were collected using a questionnaire form, the Urogenital Distress Inventory (UDI-6), and the Incontinence Impact Questionnaire (IIQ-7). Results: The mean age of women was 57.08±9.86. Women’s mean score of the UDI-6 and mean score of the IIQ-7 were found to be 46.30±20.61 and 34.45±22.98 respectively. A significant difference was found between the women’s UDI-6 scores and IIQ-7 scores and education, having a vaginal operation, constant drug use, and the behavior at the first appearance of UI (P&lt;0.05). A positive correlation was found between the UDI-6 and the IIQ-7 (r=0.658; P=0.000). Conclusion: The daily life of women with high severity of UI symptoms was more adversely affected. As age, weight, body mass index, the number of births, the number of miscarriages, the number of pregnancies, and the duration of UI increased, the severity of symptoms also increased.

Autologous Fascial Slings for Stress Urinary Incontinence: a 17-year Follow-up of a Randomised Controlled Study.

Safety concerns with the use of mesh in vaginal surgery have been ongoing. Autologous fascial slings (AFS) avoid foreign body complications. We compared the long-term (17-year) outcomes of two AFS repair methods-the standard sling and short sling (sling-on-string), and assessed durability and patient satisfaction of these for the treatment of stress urinary incontinence (SUI). A total of 107 patients from three urogynaecology units who had participated in a randomised controlled trial assessing standard (n = 52) and short (n = 55) slings were followed up for a median period of 17 years. Primary outcomes were Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) scores to assess the impact on the quality of life and symptom distress. Logistic quantile regression was employed to compare the two methods. Secondary outcomes included long-term complications and patient satisfaction. Mean scores showed no statistically significant difference between the standard and short slings at the 17-year follow-up relating to IIQ and UDI scores, leakage or urgency (p > 0.05). Improved bladder function was observed at 17 years compared with baseline (standard sling-IIQ scores mean difference [MD] 1.22 [CI: 0.69, 1.74], UDI scores MD 0.83 [CI: 0.70, 0.97]; short sling-IIQ score MD 1.14 [CI: 0.73, 1.54], UDI scores MD 0.54 [CI: 0.40, 0.67]) with age-related deterioration over time. Re-operation rates were low and patient satisfaction rates were high (67.2%) at follow-up. Autologous fascial slings are an effective and durable option for management of SUI and the short sling procedure can be recommended owing to plausible surgical advantages.

A Motion-based Device Urinary Incontinence Treatment: A Longitudinal Analysis at 18 and 24 Months

Introduction and hypothesisThere are sparse data regarding the long-term efficacy of pelvic floor muscle training (PFMT) for the treatment of urinary incontinence (UI). The objective of this study was to evaluate the impact of an 8-week PFMT program guided by a motion-based intravaginal device versus a standard home program over 24 months.MethodsBetween October 2020 and March 2021, a total of 363 women with stress or stress-predominant mixed UI were randomized and completed an 8-week PFMT program using a motion-based intravaginal device (intervention group) or a home program following written/video instructions (control group). Participants were not asked to continue training after the 8-week program. At 18 and 24 months’ follow-up, the Urogenital Distress Inventory, short-form (UDI-6) and Patient Global Impression of Improvement (PGI-I) were collected. In the original trial, a total of 139 participants in each arm were needed to detect a 0.3 effect size (alpha = 0.05, power 0.8, one-tailed t test) in the difference in UDI-6 scores.ResultsA total of 231 participants returned 24-month data. Mean age at 24 months was 51.7 ± 14.5 years, and mean BMI was 31.8 ± 7.4 kg/m2. Mean change in UDI-6 scores from baseline to 24 months was greater in the intervention group than the control group (−21.1 ± 24.5 vs −14.8 ± 19.4, p = 0.04). Reported improvement using PGI-I was greater in the intervention group than in the control group at 24 months (35% vs 22%, p = 0.03, OR 1.95(95% CI 1.08, 3.57).ConclusionsPelvic floor muscle training guided by a motion-based prescription intravaginal device yielded durable and significantly greater UI symptom improvement than a standard home program, even in the absence of continued therapy.

Female genital mutilation and urinary incontinence: an analytical comparison with Sudan's prevalent demography.

Female genital mutilation/cutting impacts over 200 million women globally and is linked to obstetric complications as well as long-term urogynecological and psychosexual issues that are frequently overlooked and inadequately addressed. This study aimed to assess the impact of female genital mutilation/cutting on urinary incontinence. This cross-sectional study was conducted in the gynecology department of the Research Hospital located in the Nyala rural region of Sudan. The participants were interviewed to gather socio-demographic and background information. In addition, they received a thorough gynecological examination to evaluate the presence and type of female genital mutilation/cutting. The Incontinence Impact Questionnaire and the Urogenital Distress Inventory were applied to the group with female genital mutilation/cutting and the control group without female genital mutilation/cutting to evaluate urinary incontinence and related discomfort. Subsequently, the scores of both participant groups were compared. The study compared age, weight, height, BMI, gravida, parity, and sexual intercourse averages between groups. The mean Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 scores of individuals who underwent mutilation were higher than those of individuals who did not undergo mutilation (p<0.001). Notably, participants subjected to infibulation exhibited significantly higher average scores on both measures in contrast with the other groups (p<0.001). A higher proportion of mutilated participants, specifically those with infibulation, are afflicted with symptoms of incontinence.

Efficacy of Pelvic Floor and Core Stabilization Exercises on Urinary Incontinence in the PostPartum Period

Abstract Aim: This study aims to compare the effectiveness of pelvic floor exercises and core stabilization exercises in the treatment of urinary incontinence in women. Material and Methods: Forty women 1 to 6 months postpartum was recruited. The postpartum women were randomly divided into three groups: 1) pelvic floor exercises group (PFE); 2) core stabilization group (CS), 3) control group (C). Pelvic floor muscle exercises were performed 3 times a day (morning, noon, evening) in 3 different positions (lying on your back, sitting and standing) in PFE group. Participants performed core stabilization exercises 3 days a week for 6 weeks in CS group. Participants did not receive any exercise therapy and continued their routine. Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ7) and Incontinence Severity Index (ISI) were used as outcome measurements. Results: Statistically significant difference was observed in all outcome measures in the PFE and CS group (p&lt;0.05). Also, there was no statistically significant change in outcomes measures in the control group (p&gt;0.05). There was no significant difference between the outcome measures of the PFE and CS groups except for ISI values (p&gt;0.17). UDI-6 and IIQ7 results in the PFE group improved more than in the CS group. When the PFE and control groups were compared, the PFE group was found to be more effective than the control group in terms of all results (p&lt;0.017). Conclusion: Pelvic floor exercises and core stabilization exercises are effective methods for reducing incontinence symptoms in the postpartum period. Pelvic floor muscle training caused more significant changes than core stabilization exercises in postpartum women.

Evaluation of the differences in sexual functions of women who underwent transobturatuar tape surgery

Aims: The study aims to determine the changes in sexual function and life of patients with stress urinary incontinence (SUI) and mixed type urinary incontinence (MUI) with transobturator tape (TOT) operation.&#x0D; Methods: 232 urinary incontinence patients who had only TOT surgery between the dates of May 2022- May 2023 were included in the study. Participants were similar in terms of demographic parameters. Participants completed several questionnaires, such as the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), Female Sexual Function Index (FSFI), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), both before surgery and six months post-operative. &#x0D; Results: While IIQ-7 and UDI-6 values, which measure the adverse effects of urinary incontinence, were 13.06±3.74, 7.03±2.61 preoperatively, they were 2.14±2.12 and 2.92±1.77 postoperatively. The FSFI values for evaluating female sexual function were 22.58±1.91 preoperatively and 26.62±1.80 postoperatively, respectively. The total value of the PISQ-12 questionnaire, which also evaluated sexual function, was 39.77±14.19 preoperatively and 46.61±0.97 postoperatively. There was a significant difference between the results of the surveys conducted before and after the operation.(p values: 0.0001, 0.0001, 0.0001, and 0.0001, respectively).&#x0D; Conclusion: Having a TOT operation affects the sexual function and life of patients suffering from SUI positively.

The Effectiveness of Modified Pilates Program with and without Kinesiotaping on Postnatal Urinary Stress Incontinence: A Randomized Clinical Trial

Introduction: Urinary Stress Incontinence is very common condition seen in postnatal woman. Without pelvic floor strengthening this condition will lead to social inhibition. The rate of urinary stress incontinence is more in normal vaginal delivery compared to C-Section. Few authors have demonstrated the effectiveness of Kegal exercise and Pilates on such woman with urinary stress incontinence. There is dirth in the literature related to effect of Kinesiotaping in reduction of urinary stress incontinence.&#x0D; Research Objective: The objective of the research was to find out the effect of Kinesiotape along with the Modified Pilates program on subjects with postnatal urinary incontinence.&#x0D; Methodology: This is an experimental study with randomised clinical trial design and the study setting was Bruhat Bangalore Mahanagar Palike, and the included 50 postnatal women who underwent vaginal delivery. The sample was divided into two groups: Group A (25) were subjected to Modified Pilates Program with Kinesiotaping and Group B (25) were subjected to Modified Pilates Program alone. The intervention was conducted for 6 weeks. The outcome measures like: PERFECT Scheme, Questionnaire for Urinary Incontinence Diagnosis and Urogenital Distress Inventory were assessed both pre and post therapy at 6th week.&#x0D; Results: Pre therapy both groups showed no statistical significance. Post therapy; Group A showed significant result with respect to all three outcome measures PERFECT (&lt;0.0001), QUID (&lt;0.001) and UDI (&lt;0.001) and Group B showed significance only with respect to PERFECT Scheme (&lt;0.05).&#x0D; Conclusion: The study concluded that Modified Pilates will no doubt strengthen the pelvic floor muscle; but Kinesiotape addition to it will improve the strength by maintaining it and thus increasing the quality of life of the patient. Thus, using kinesiotape during the pelvic floor rehabilitation of Postnatal women with stress incontinence will provide benefit to the patient.&#x0D; Summary: The current article concludes that Modified Pilates will strengthen the pelvic floor because of the abdominal cylinder involved along with Kinesiotape will add on to reduction in urinary incontinence because of the stimulation of sacral plexus.

Comparing the Efficacy of Dynamic Neuromuscular Stabilization Exercises and Kegel Exercises on Stress Urinary Incontinence in Women: A Pilot Study.

Background and objective Stress urinary incontinence (SUI) is a prevalent condition affecting women of various age groups, significantly impacting their quality of life. To address this multifaceted issue, a comprehensive approach that goes beyond traditional pelvic floor exercises is needed. Dynamic neuromuscular stabilization (DNS) exercises, targeting the integrated spinal stabilization system, offera promising alternative. Thus, this study aimed to compare the effectiveness of DNS exercises and Kegel exercises in managing SUI among women. Methods This single-blinded, pilot study involved 24 women aged 18-40 years with mild to moderate SUI. Participants were divided into DNS and Kegel exercise groups. Outcome measures included perineometer readings, electromyography (EMG) data, and the Urogenital Distress Inventory-6 (UDI-6). Statistical analysis compared baseline and 12-week data within and between groups, and rank-biserial correlation coefficient (r) as a measure of effect size in our study wascalculated. Results At 12 weeks, the DNS group showed significant improvement in pelvic floor muscle strength compared to Kegel exercises (p = 0.005). Both groups had significantly enhanced pelvic floor muscle strength (p < 0.05). A significant change occurred for EMG average, EMG peak, and EMG maximum voluntary contraction (MVC) at 12 weeks (average p = 0.005; peak p = 0.001; MVC p = 0.009), with significant improvements in both groups (p < 0.05). For UDI-6, a significant difference emerged between the two groups at 12 weeks (p < 0.05), with significant improvements in both groups individually from baseline to 12 weeks (p < 0.05). The effect size "r" for all variables indicated a medium to large effect size, underscoring the substantial and significant impact of DNS exercises in managing SUI among women compared to Kegel exercises. Conclusion This study suggests that DNS exercises, emphasizing the coordinated activation of the diaphragm, abdominals, multifidus, and pelvic floor, may provide a more effective approach for managing SUI in women compared to traditional Kegel exercises.

The relationship between low back pain, pelvic tilt, and lumbar lordosis with urinary incontinence using the DIERS formetric 4D motion imaging system.

Urinary incontinence (UI) is a common public health problem and postural changes may be crucial in women presenting with UI. This study was aimed at evaluating the relationship between low back pain (LBP), pelvic tilt (PT), and lumbar lordosis (LL) in women with and without UI using the DIERS formetric 4D motion imaging system. To date no study has to our knowledge compared postural changes and LBP in women with UI using the DIERS 4D formetric system. This was a case-control study. We included 33 women with UI and 33 without incontinence. The severity of urogenital symptoms was assessed by the IIQ-7 (Incontinence Impact Score) and UDI-6 (Urogenital Distress Inventory), and disability owing to LBP was evaluated using the Oswestry Disability Index (ODI). Posture and movement assessment, LL angle, thoracic kyphosis, and PT assessment were performed with the DIERS Formetric 4D motion imaging system. The LL angle and pelvic torsion degree were higher in the incontinence group than in the control group (53.9 ± 9.5° vs 48.18 ± 8.3°; p= 0.012, 3.9 ± 4.1 vs 2.03 ± 1.8 mm; p= 0.018 respectively). The LBP visual analog scale value was also significantly higher in the incontinence group (5.09 ± 2.3 vs 1.7 ± 1.8 respectively, p< 0.0001). The LL angle showed a positive correlation with pelvic obliquity, (r = 0.321, p< 0.01) and fleche lombaire (r = 0.472, p< 0.01) and a negative correlation with lumbar range of motion measurements. Pelvic obliquity correlated positively with pelvic torsion (r = 0.649, p< 0.01), LBP (r = 0.369, p< 0.01), and fleche lombaire (r = 0.269, p< 0.01). Women with UI were more likely to have lumbopelvic sagittal alignment changes and a higher visual analog scale for LBP. These findings show the need for assessment of lumbopelvic posture in women with UI.