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Sample records for imaging fecal incontinence

  1. Fecal Incontinence

    MedlinePlus

    ... control than formed stool, it is an added stress that can lead to fecal incontinence. Diagnosis & Tests How will my doctor diagnose the cause of fecal incontinence? Along with a physical exam, your doctor may want to do other tests ...

  2. [Update on fecal incontinence].

    PubMed

    Buhmann, Helena; Nocito, Antonio

    2014-10-29

    Fecal incontinence is defined as an accidental loss of stool or the inability to control defecation. There are three subtypes of fecal incontinence: passive incontinence, urge incontinence and soiling. About 8% of the adult population suffer from fecal incontinence, but only 1/3 consults a doctor. Beside the individual handicap, fecal incontinence has a huge socio-economic impact. Causes of fecal incontinence are changes in the quantity or quality of the stool and structural or functional disorders. Diagnostics encompass the medical history, clinical examination including the digital rectal examination, imaging (particularly endoanal ultrasound) as well as functional diagnostics (anal manometry and defecography). Nowadays, the most promising conservative treatment option consists of loperamide and biofeedback therapy. The most successful invasive method is the sacral neuromodulation. PMID:25351694

  3. Fecal Incontinence

    MedlinePlus

    ... Adults Making Your Wishes Known Home & Community Home › Aging & Health A to Z › Fecal Incontinence Font size A A A Print Share Glossary Basic Facts & Information Causes & Symptoms Diagnosis & Tests Care & Treatment Lifestyle & Management Other Resources Caregiving How ...

  4. Fecal Incontinence in Children

    MedlinePlus

    Donate Find a Doctor Join eNewsletter Sidebar × MOBILE MENU About Us What is Incontinence? Prevalence Causes of Incontinence Fecal Incontinence in Children Reporter's Guide to Bowel Incontinence Signs & Symptoms Symptoms of ...

  5. Surgical Management for Fecal Incontinence

    PubMed Central

    Anandam, Joselin L.

    2014-01-01

    Fecal incontinence is a socially debilitating condition that can lead to social isolation, loss of self-esteem and self-confidence, and depression in an otherwise healthy person. After the appropriate clinical evaluation and diagnostic testing, medical management is initially instituted to treat fecal incontinence. Once medical management fails, there are a few surgical procedures that can be considered. This article is devoted to the various surgical options for fecal incontinence including the history, technical details, and studies demonstrating the complication and success rate. PMID:25320569

  6. Recent concepts in fecal incontinence.

    PubMed

    Douglas, J M; Smith, L E

    2001-08-01

    Fecal incontinence is an inability to defer release of gas or stool from the anus and rectum by mechanisms of voluntary control. It is an important medical disorder affecting the quality of life of more than 2% of the US population. The most common contributing factors include previous vaginal deliveries, pelvic or perineal trauma, previous anorectal surgery, and rectal prolapse. Many physicians lack experience and knowledge related to pelvic floor incontinence disorders, but advancing technology has improved this knowledge. Increased experience with endoanal ultrasound and endoanal magnetic resonance imaging have given us better understanding of the anatomy of the anal canal, and new techniques with muscle translocation and artificial neosphincters and neuromodulation have expanded our armamentarium of options for restoring continence. PMID:12112954

  7. Obstetrics and Fecal Incontinence

    PubMed Central

    Chin, Kathleen

    2014-01-01

    Anal incontinence (AI) can be a debilitating condition for women following vaginal delivery. Operative vaginal delivery and anal sphincter laceration are important risk factors for the development of postpartum AI. Obtaining a comprehensive delivery history, along with a thorough physical examination of the perineum, vagina and rectum may aid the clinician in the diagnosis of an anal sphincter defect. Sonographic imaging can also assist in identifying sphincter defects. The treatment of AI may include a combination of dietary modification, medications that promote constipation, pelvic floor physical therapy, biofeedback, anal sphincteroplasty, and/or sacral neuromodulation. PMID:25320570

  8. Obstetrics and fecal incontinence.

    PubMed

    Chin, Kathleen

    2014-09-01

    Anal incontinence (AI) can be a debilitating condition for women following vaginal delivery. Operative vaginal delivery and anal sphincter laceration are important risk factors for the development of postpartum AI. Obtaining a comprehensive delivery history, along with a thorough physical examination of the perineum, vagina and rectum may aid the clinician in the diagnosis of an anal sphincter defect. Sonographic imaging can also assist in identifying sphincter defects. The treatment of AI may include a combination of dietary modification, medications that promote constipation, pelvic floor physical therapy, biofeedback, anal sphincteroplasty, and/or sacral neuromodulation. PMID:25320570

  9. Current Management of Fecal Incontinence

    PubMed Central

    Wang, Jennifer Y; Abbas, Maher A

    2013-01-01

    Objective: To review the management of fecal incontinence, which affects more than 1 in 10 people and can have a substantial negative impact on quality of life. Methods: The medical literature between 1980 and April 2012 was reviewed for the evaluation and management of fecal incontinence. Results: A comprehensive history and physical examination are required to help understand the severity and type of symptoms and the cause of incontinence. Treatment options range from medical therapy and minimally invasive interventions to more invasive procedures with varying degrees of morbidity. The treatment approach must be tailored to each patient. Many patients can have substantial improvement in symptoms with dietary management and biofeedback therapy. For younger patients with large sphincter defects, sphincter repair can be helpful. For patients in whom biofeedback has failed, other options include injectable medications, radiofrequency ablation, or sacral nerve stimulation. Patients with postdefecation fecal incontinence and a rectocele can benefit from rectocele repair. An artificial bowel sphincter is reserved for patients with more severe fecal incontinence. Conclusion: The treatment algorithm for fecal incontinence will continue to evolve as additional data become available on newer technologies. PMID:24355892

  10. Surgical management of fecal incontinence.

    PubMed

    Bleier, Joshua I S; Kann, Brian R

    2013-12-01

    The surgical approach to treating fecal incontinence is complex. After optimal medical management has failed, surgery remains the best option for restoring function. Patient factors, such as prior surgery, anatomic derangements, and degree of incontinence, help inform the astute surgeon regarding the most appropriate option. Many varied approaches to surgical management are available, ranging from more conservative approaches, such as anal canal bulking agents and neuromodulation, to more aggressive approaches, including sphincter repair, anal cerclage techniques, and muscle transposition. Efficacy and morbidity of these approaches also range widely, and this article presents the data and operative considerations for these approaches. PMID:24280402

  11. Diagnostic Testing for Fecal Incontinence

    PubMed Central

    Olson, Craig H.

    2014-01-01

    Many tests are available to assist in the diagnosis and management of fecal incontinence. Imaging studies such as endoanal ultrasonography and defecography provide an anatomic and functional picture of the anal canal which can be useful, especially in the setting of planned sphincter repair. Physiologic tests including anal manometry and anal acoustic reflexometry provide objective data regarding functional values of the anal canal. The value of this information is of some debate; however, as we learn more about these methods, they may prove useful in the future. Finally, nerve studies, such as pudendal motor nerve terminal latency, evaluate the function of the innervation of the anal canal. This has been shown to have significant prognostic value and can help guide clinical decision making. Significant advances have also happened in the field, with the relatively recent advent of magnetic resonance defecography and high-resolution anal manometry, which provide even greater objective anatomic and physiologic information about the anal canal and its function. PMID:25320566

  12. Fecal Incontinence: Etiology, Evaluation, and Treatment

    PubMed Central

    Hayden, Dana M.; Weiss, Eric G.

    2011-01-01

    Fecal incontinence is a debilitating problem facing ~2.2% of the U.S. general population over 65 years of age. Etiologic factors include traumatic, neurologic, congenital, and iatrogenic. Most commonly, obstetric trauma causes fecal incontinence as well as poorly performed anorectal surgery or pelvic radiation. Several severity scores and quality of life indexes have been developed to quantify incontinent symptoms. There are several nonsurgical and surgical options for the treatment of fecal incontinence. Biofeedback is among the most successful nonoperative strategies. Depending on the cause, anal sphincter repair, artificial bowel sphincter, and sacral nerve stimulation are used to treat fecal incontinence with some success. Unfortunately, fecal incontinence is an extremely difficult problem to manage: there has not been one, single treatment option that has proven to be both safe and effective in long-term studies. PMID:22379407

  13. Endoanal ultrasonography in fecal incontinence: Current and future perspectives.

    PubMed

    Albuquerque, Andreia

    2015-06-10

    Fecal incontinence has a profound impact in a patient's life, impairing quality of life and carrying a substantial economic burden due to health costs. It is an underdiagnosed condition because many affected patients are reluctant to report it and also clinicians are usually not alert to it. Patient evaluation with a detailed clinical history and examination is very important to indicate the type of injury that is present. Endoanal ultrasonography is currently the gold standard for sphincter evaluation in fecal incontinence and is a simple, well-tolerated and non-expensive technique. Most studies revealed 100% sensitivity in identifying sphincter defect. It is better than endoanal magnetic resonance imaging for internal anal sphincter defects, equivalent for the diagnosis of external anal sphincter defects, but with a lower capacity for assessment of atrophy of this sphincter. The most common cause of fecal incontinence is anal sphincter injury related to obstetric trauma. Only a small percentage of women are diagnosed with sphincter tears immediately after vaginal delivery, but endoanal ultrasonography shows that one third of these women have occult sphincter defects. Furthermore, in patients submitted to primary repair of these tears, ultrasound revealed a high frequency of persistent sphincter defects after surgery. Three-dimensional endoanal ultrasonography is currently largely used and accepted for sphincter evaluation in fecal incontinence, improving diagnostic accuracy and our knowledge of physiologic and pathological sphincters alterations. Conversely, there is currently no evidence to support the use of elastography in fecal incontinence evaluation. PMID:26078826

  14. Endoanal ultrasonography in fecal incontinence: Current and future perspectives

    PubMed Central

    Albuquerque, Andreia

    2015-01-01

    Fecal incontinence has a profound impact in a patient’s life, impairing quality of life and carrying a substantial economic burden due to health costs. It is an underdiagnosed condition because many affected patients are reluctant to report it and also clinicians are usually not alert to it. Patient evaluation with a detailed clinical history and examination is very important to indicate the type of injury that is present. Endoanal ultrasonography is currently the gold standard for sphincter evaluation in fecal incontinence and is a simple, well-tolerated and non-expensive technique. Most studies revealed 100% sensitivity in identifying sphincter defect. It is better than endoanal magnetic resonance imaging for internal anal sphincter defects, equivalent for the diagnosis of external anal sphincter defects, but with a lower capacity for assessment of atrophy of this sphincter. The most common cause of fecal incontinence is anal sphincter injury related to obstetric trauma. Only a small percentage of women are diagnosed with sphincter tears immediately after vaginal delivery, but endoanal ultrasonography shows that one third of these women have occult sphincter defects. Furthermore, in patients submitted to primary repair of these tears, ultrasound revealed a high frequency of persistent sphincter defects after surgery. Three-dimensional endoanal ultrasonography is currently largely used and accepted for sphincter evaluation in fecal incontinence, improving diagnostic accuracy and our knowledge of physiologic and pathological sphincters alterations. Conversely, there is currently no evidence to support the use of elastography in fecal incontinence evaluation. PMID:26078826

  15. Ischemic fecal incontinence and rectal angina.

    PubMed

    Devroede, G; Vobecky, S; Massé, S; Arhan, P; Léger, C; Duguay, C; Hémond, M

    1982-11-01

    In 36 patients who consulted for fecal incontinence or rectal pain, or both, there was grossly visible scarring of the rectum and biopsy revealed mucosal atrophy and fibrosis. A steal from the hemorrhoidal arteries to the iliac vessels was demonstrated in 3 subjects. Maximum tolerable volumes within a rectal balloon were smaller than in control subjects, both in men (192 vs. 273 ml) and in women (142 vs. 217 ml) (p less than 0.01). The rectoanal inhibitory reflex was abnormal in all but 1 patient. Specific abnormalities were a decreased amplitude or a prolonged duration of the reflex. It was totally absent in 2 patients. This study is compatible with the hypothesis that chronic ischemia of the rectum may cause fecal incontinence or rectal pain. PMID:7117809

  16. Fecal Incontinence: Epidemiology, Impact, and Treatment.

    PubMed

    Bochenska, Katarzyna; Boller, Anne-Marie

    2016-09-01

    Fecal incontinence (FI) is a chronic and debilitating condition that carries a significant health, economic, and social burden. FI has a considerable psychosocial and financial impact on patients and their families. A variety of treatment modalities are available for FI including behavioral and dietary modifications, pharmacotherapy, pelvic floor physical therapy, bulking agents, anal sphincteroplasty, sacral nerve stimulation, artificial sphincters, magnetic sphincters, posterior anal sling, and colostomy. PMID:27582653

  17. Office-Based Management of Fecal Incontinence

    PubMed Central

    Costilla, Vanessa C.; Mayer, Anita P.; Crowell, Michael D.

    2013-01-01

    Fecal incontinence (FI) is a devastating disorder that is more prevalent than previously realized. FI is the involuntary loss of stool. Many factors contribute to the pathophysiology of FI, including advanced age, bowel irregularity, parity, and obesity. A detailed history and focused rectal examination are important to making the diagnosis and determining contributing causes. Although multiple diagnostic studies are available to assess the cause of FI, specific guidelines that delineate when testing should be done do not exist. Clinicians must weigh the risk, benefit, and burden of testing against the need for empiric treatment. All types of FI are initially managed in the same way, which includes lifestyle modification to reduce bowel derangements, improved access to toileting, and initiation of a bulking regimen to improve stool consistency. If initial conservative management fails, pharmaco-logic agents, biofeedback, or surgery may be indicated. PMID:23935551

  18. Fecal incontinence in men: Causes and clinical and manometric features

    PubMed Central

    Muñoz-Yagüe, Teresa; Solís-Muñoz, Pablo; Ciriza de los Ríos, Constanza; Muñoz-Garrido, Francisco; Vara, Jesús; Solís-Herruzo, José Antonio

    2014-01-01

    AIM: To determine the causes and characteristics of fecal incontinence in men and to compare these features with those presented by a group of women with the same problem. METHODS: We analyzed the medical history, clinical and manometric data from 119 men with fecal incontinence studied in our unit and compared these data with those obtained from 645 women studied for the same problem. Response to treatment was evaluated after 6 mo of follow-up. RESULTS: Fifteen percent of patients studied in our unit for fecal incontinence were male. Men took longer than women before asking for medical help. Ano-rectal surgery was the most common risk factor for men related to fecal incontinence. Chronic diarrhea was present in more than 40% of patients in both groups. Decreased resting and external anal sphincter pressures were more frequent in women. No significant differences existed between the sexes regarding rectal sensitivity and recto-anal inhibitory reflex. In 17.8% of men, all presenting soiling, manometric findings did not justify fecal incontinence. Response to treatment was good in both groups, as 80.4% of patients improved and fecal incontinence disappeared in 13.2% of them. CONCLUSION: In our series, it was common that men waited longer in seeking medical help for fecal incontinence. Ano-rectal surgery was the major cause of this problem. Chronic diarrhea was a predisposing factor in both sexes. Manometric differences between groups were limited to an increased frequency of hypotony of the external anal sphincter in women. Fecal incontinence was controllable in most patients. PMID:24976729

  19. Update on the Management of Fecal Incontinence for the Gastroenterologist.

    PubMed

    Wald, Arnold

    2016-03-01

    Many patients with fecal incontinence respond to conservative measures based upon a careful assessment and a multimodality approach that Is within the expertise of the practicing gastroenterologist. However, there Is a need for new and effective strategies when conservative therapy fails. This article reviews established therapies for fecal incontinence, such as biofeedback, as well as new therapies that have been approved by the US Food and Drug Administration (FDA), such as sacral neuromodulation and an injectable bulking agent. Also reviewed are some of the newer approaches that have not yet been approved by the FDA or that have uncertain efficacy. PMID:27231444

  20. Pregnancy and postpartum bowel changes: constipation and fecal incontinence.

    PubMed

    Shin, Grace Hewon; Toto, Erin Lucinda; Schey, Ron

    2015-04-01

    Pregnancy and the postpartum period are often associated with many gastrointestinal complaints, including nausea, vomiting, and heartburn; however, the most troublesome complaints in some women are defecatory disorders such as constipation and fecal incontinence, especially postpartum. These disorders are often multifactorial in etiology, and many studies have looked to see what risk factors lead to these complications. This review discusses the current knowledge of pelvic floor and anorectal physiology, especially during pregnancy, and reviews the current literature on causes and treatments of postpartum bowel symptoms of constipation and fecal incontinence. PMID:25803402

  1. Update on the Management of Fecal Incontinence for the Gastroenterologist

    PubMed Central

    2016-01-01

    Many patients with fecal incontinence respond to conservative measures based upon a careful assessment and a multimodality approach that Is within the expertise of the practicing gastroenterologist. However, there Is a need for new and effective strategies when conservative therapy fails. This article reviews established therapies for fecal incontinence, such as biofeedback, as well as new therapies that have been approved by the US Food and Drug Administration (FDA), such as sacral neuromodulation and an injectable bulking agent. Also reviewed are some of the newer approaches that have not yet been approved by the FDA or that have uncertain efficacy. PMID:27231444

  2. Transient bladder and fecal incontinence following epidural blood patch

    PubMed Central

    Palomero-Rodríguez, Miguel Angel; Palacio-Abinzada, Francisco J.; Campollo, Sara Chacón; Laporta-Báez, Yolanda; Mendez Cendón, Jose Carlos; López-García, Andres

    2015-01-01

    Epidural blood patch (EBP) is the currently accepted treatment of choice for postdural puncture headache because of its high initial success rates and infrequent complications. Many authors recommended a small volume (10-20 mL) of blood to be delivered for an effective EBP. Here, we report an obstetric patient who developed a transient bladder and fecal incontinence after 19 mL of blood EBP at L1 -L2 level. Since the magnetic resonance image did not demonstrate any definitive spinal cord lesion, the exact mechanism remains unclear. We suggest that accumulation of blood performed at L1 to L2 level in a closed relationship with the sacral cord, may have trigger a significant pressure elevation of the epidural space at this level, resulting in a temporal spinal cord-related injury in the sacral cord. PMID:26543470

  3. Fecal Incontinence and Pelvic Floor Dysfunction in Women: A Review.

    PubMed

    Freeman, Alison; Menees, Stacy

    2016-06-01

    Pelvic floor dysfunction and fecal incontinence is a common and debilitating condition in women, particularly as women age, and often goes under-reported to health care providers. It is important for providers to ask patients about possible symptoms. An algorithm for evaluation and treatment is presented. Current and future therapies are described and discussed. PMID:27261895

  4. Review of the diagnosis, management and treatment of fecal incontinence.

    PubMed

    Rezvan, Azadeh; Jakus-Waldman, Sharon; Abbas, Maher A; Yazdany, Tajnoos; Nguyen, John

    2015-01-01

    Fecal incontinence is a common problem affecting women but is underreported because of patients' reluctance to discuss their symptoms and an inconsistent use of screening tools by physicians. Obstetric injury from vaginal delivery is the principal cause of fecal incontinence among young women. Prevalence rates are highest in the elderly, especially those with declining cognitive function. There are multiple diagnostic tests including anal manometry, endosonography, defecography, and pudendal nerve latency testing to assist physicians in the workup of patients and aid in the selection of appropriate treatment options. After patient identification and workup, most patients can be offered conservative measures including dietary measures and biofeedback. Surgery is indicated for specific abnormalities such as rectal prolapse, fistula, and recent obstetrical sphincter injury repair. Management of refractory cases may include sacral nerve stimulation and percutaneous tibial nerve stimulation. Fecal diversion or an artificial bowel sphincter may be considered when all else has failed. Primary care physicians, gynecologists, and specialists in female pelvic medicine should screen women for fecal incontinence. Initial conservative therapy may be directed by the primary health provider, and those resistant to this approach should be referred to specialist care. PMID:25185605

  5. Sacral Nerve Stimulation For Urinary Urge Incontinence, Urgency-Frequency, Urinary Retention, and Fecal Incontinence

    PubMed Central

    2005-01-01

    Executive Summary Objective The aim of this review was to assess the effectiveness, safety, and cost of sacral nerve stimulation (SNS) to treat urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence. Background: Condition and Target Population Urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence are prevalent, yet rarely discussed, conditions. They are rarely discussed because patients may be uncomfortable disclosing their symptoms to a health professional or may be unaware that there are treatment options for these conditions. Briefly, urge incontinence is an involuntary loss of urine upon a sudden urge. Urgency-frequency is an uncontrollable urge to void, which results in frequent, small-volume voids. People with urgency-frequency may or may not also experience chronic pelvic pain. Urinary retention refers to the inability to void despite having the urge to void. It can be caused by a hypocontractile detrusor (weak or no bladder muscle contraction) or obstruction due to urethral overactivity. Fecal incontinence is a loss of voluntary bowel control. The prevalence of urge incontinence, urgency-frequency, and urinary retention in the general population is 3.3% to 8.2%, and the prevalence of fecal incontinence is 1.4% to 1.9%. About three-quarters of these people will be successfully treated by behaviour and/or drug therapy. For those who do not respond to these therapies, the options for treatment are management with diapers or pads, or surgery. The surgical procedures are generally quite invasive, permanent, and are associated with complications. Pads and/or diapers are used throughout the course of treatment as different therapies are tried. Patients who respond successfully to treatment may still require pads or diapers, but to a lesser extent. The Technology Being Reviewed: Sacral Nerve Stimulation Sacral nerve stimulation is a procedure where a small device attached to an electrode is

  6. Neuromodulation for fecal incontinence: an effective surgical intervention.

    PubMed

    Chiarioni, Giuseppe; Palsson, Olafur S; Asteria, Corrado R; Whitehead, William E

    2013-11-01

    Fecal incontinence is a disabling symptom with medical and social implications, including fear, embarrassment, isolation and even depression. Most patients live in seclusion and have to plan their life around the symptom, with secondary impairment of their quality of life. Conservative management and biofeedback therapy are reported to benefit a good percentage of those affected. However, surgery must be considered in the non-responder population. Recently, sacral nerve electrostimulation, lately named neuromodulation, has been reported to benefit patients with fecal incontinence in randomized controlled trials more than placebo stimulation and conservative management, by some unknown mechanism. Neuromodulation is a minimally invasive procedure with a low rate of adverse events and apparently favorable cost-efficacy profile. This review is intended to expand knowledge about this effective intervention among the non-surgically skilled community who deals with this disabled group of patients. PMID:24222947

  7. Treatment strategies in obstructed defecation and fecal incontinence

    PubMed Central

    Khaikin, Marat; Wexner, Steven D

    2006-01-01

    Obstructed defecation (OD) and fecal incontinence (FI) are challenging clinical problems, which are commonly encountered in the practice of colorectal surgeons and gastroenterologists. These disorders socially and psychologically distress patients and greatly impair their quality of life. The underlying anatomical and pathophysiological changes are complex, often incompletely understood and cannot always be determined. As a consequence, many medical, surgical, and behavioral approaches have been described, with no panacea. Over the past decade, advances in an understanding of these disorders together with rational and similar methods of evaluation in anorectal physiology laboratories (ARP), radiology studies, and new surgical techniques have led to promising results. In this brief review, we discuss treatment strategies and recent updates on clinical and therapeutic aspects of obstructed defecation and fecal incontinence. PMID:16718835

  8. Fecal incontinence: A review of current treatment options.

    PubMed

    Fejka, Michael David

    2016-09-01

    Fecal incontinence affects patients of all sexes, races, and ethnicities; however, those affected often are afraid or too embarrassed to ask for help. Attention to risk factors and directed physical examinations can help healthcare providers diagnose and formulate treatment plans. Numerous diagnostic tests are available. Diligent follow-up is needed to direct patients to second-line therapies such as sacral nerve stimulation or surgical procedures. PMID:27580000

  9. Artificial Muscle Devices: Innovations and Prospects for Fecal Incontinence Treatment.

    PubMed

    Fattorini, Elisa; Brusa, Tobia; Gingert, Christian; Hieber, Simone E; Leung, Vanessa; Osmani, Bekim; Dominietto, Marco D; Büchler, Philippe; Hetzer, Franc; Müller, Bert

    2016-05-01

    Fecal incontinence describes the involuntary loss of bowel content, which is responsible for stigmatization and social exclusion. It affects about 45% of retirement home residents and overall more than 12% of the adult population. Severe fecal incontinence can be treated by the implantation of an artificial sphincter. Currently available implants, however, are not part of everyday surgery due to long-term re-operation rates of 95% and definitive explantation rates of 40%. Such figures suggest that the implants fail to reproduce the capabilities of the natural sphincter. This article reviews the artificial sphincters on the market and under development, presents their physical principles of operation and critically analyzes their performance. We highlight the geometrical and mechanical parameters crucial for the design of an artificial fecal sphincter and propose more advanced mechanisms of action for a biomimetic device with sensory feedback. Dielectric electro-active polymer actuators are especially attractive because of their versatility, response time, reaction forces, and energy consumption. The availability of such technology will enable fast pressure adaption comparable to the natural feedback mechanism, so that tissue atrophy and erosion can be avoided while maintaining continence during daily activities. PMID:26926695

  10. The Differential Impact of Flatal Incontinence in Women With Anal Versus Fecal Incontinence

    PubMed Central

    Meyer, Isuzu; Tang, Ying; Szychowski, Jeff M; Richter, Holly E

    2015-01-01

    Objectives The differential impact on quality of life (QOL) that leakage of both stool and flatus confers on women compared to stool only is unclear. Our aim was to characterize differences in symptom distress, impact on QOL, and anorectal testing among women with leakage of stool and flatus, stool only, and flatus only. Methods A retrospective review was conducted of women undergoing evaluation of at least monthly bowel incontinence symptoms. Subjects were divided into 3 groups: liquid/solid stool and flatus (anal incontinence, AI); liquid/solid stool only (fecal incontinence, FI); and flatal only (FL). Baseline assessment included the Modified Manchester Health Questionnaire (MMHQ) including the Fecal Incontinence Severity Index (FISI), Short Form-12 (SF-12), as well as anorectal manometry and endoanal ultrasound evaluations. Results Of 436 subjects, 381 had AI, 45 FI, and 10 FL. Significant between-group differences were noted in MMHQ (p=0.0002) and FISI total scores (p<0.0001) where women with AI reflected greater negative impact than women with FI. The SF-12 (PCS, MCS) scores were similar in all three groups (p=0.22, 0.08). Resting/squeeze pressures were significantly lower in AI and FI groups compared to FL (p=0.0004), whereas rectal capacity was similar in all three groups. Although exploratory, MMHQ scores were similar between FI and FL groups, although FISI scores were higher in the FI group (p<0.0001). Conclusions Women with AI have higher symptom specific distress and greater negative impact on QOL compared to women with FI. Treatment of all bowel incontinence symptoms is important to improve symptom-specific and general QOL. PMID:26506162

  11. Current management of fecal incontinence: Choosing amongst treatment options to optimize outcomes

    PubMed Central

    Van Koughnett, Julie Ann M; Wexner, Steven D

    2013-01-01

    The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life. Fecal incontinence is common, though it is often under-reported by patients. In addition to standard treatment options, new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity. Non-operative treatments include dietary modifications, medications, and biofeedback therapy. Currently used surgical treatments include repair (sphincteroplasty), stimulation (sacral nerve stimulation or posterior tibial nerve stimulation), replacement (artificial bowel sphincter or muscle transposition) and diversion (stoma formation). Newer augmentation treatments such as radiofrequency energy delivery and injectable materials, are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence. In general, more invasive surgical treatments are now reserved for moderate to severe fecal incontinence. Functional and quality of life related outcomes, as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient. General indications, techniques, and outcomes profiles for the various treatments of fecal incontinence are discussed in detail. Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence. PMID:24409050

  12. Factors that Affect Consultation and Screening for Fecal Incontinence

    PubMed Central

    Kunduru, Lalitha; Kim, Sung Min; Heymen, Steve; Whitehead, William E.

    2016-01-01

    Background & Aims Fecal incontinence (FI) affects 15% of people age 70 years and older, but only 10%–30% discuss FI with their physicians. We aimed to identify barriers that prevent people from consulting with their physicians, and physicians from screening for FI. Methods We performed structured interviews of 124 individuals with FI (mean 56 years old, 87.9% women) recruited from 6 medical offices at the University of North Carolina Hospitals from June 2012 through March 2013. The subjects completed the Fecal Incontinence Severity Index and Fecal Incontinence Quality of Life Scale questionnaires. Interview questions aimed to determine which patients had consulted physicians for FI. Eleven of the 56 physicians with patients included in the study responded to the survey. Results Eighty-eight of the 124 participants consulted with their physicians about FI (consulters). These individuals had a higher incidence of depression than the 36 subjects who did not consult with their physicians about FI (non-consulters; P=.04), but similar Fecal Incontinence Severity Index scores. A smaller proportion of non-consulters were aware of available treatments than consulters (P<.01). Fifty-six percent of non-consulters said their FI was not serious enough to consult a physician. There was no difference between consulters and non-consulters in embarrassment in talking about FI. Among consulters, 88% initiated the conversation about FI with their physician. Seven of the 11 responding physicians screened for FI, and only screened high-risk patients. The 4 physicians who did not screen for FI were unaware of its prevalence, viewed FI as a low priority, or stated that patients were responsible for reporting their own symptoms. Conclusions Based on surveys of physicians and patients, many patients have insufficient knowledge about the availability and effectiveness of treatments for FI. Some people with FI do not discuss it with their physician because their symptoms are mild, and most

  13. Patients’ experience compared to physicians’ recommendations for the treatment of fecal incontinence: A qualitative approach

    PubMed Central

    Cichowski, Sara B; Dunivan, Gena C; Rogers, Rebecca G; Komesu, Yuko M

    2015-01-01

    Introduction To compare physician-recommended treatment options for fecal incontinence to patients’ knowledge of treatment options using qualitative methods. Our hypothesis was that physician recommendations were not being communicated well to patients’ and that this impaired patients’ ability to cope with fecal incontinence. Methods Cognitive interviews were conducted with physicians who routinely care for women with fecal incontinence. Physicians were asked to describe their typical non-surgical treatment recommendations and counseling for fecal incontinence. Women with bothersome fecal incontinence were recruited to participate in focus groups and asked about personal experience with fecal incontinence symptoms and treatments. For both the physician interviews and patient focus groups, qualitative data analysis was performed using grounded theory methodology. Results Physicians identified several barriers patients face when seeking treatment: lack of physician interest towards fecal incontinence and patients’ embarrassment in discussing fecal incontinence. Physicians universally recommended fiber and pelvic floor exercise; they felt the majority (approximately 70–80%) of patients will improve with these therapies. Collectively, patients were able to identify all treatment recommendations given by physicians although many had discovered these treatments through personal experience. Three concepts emerged regarding treatment options that physicians did not identify but that patients felt were important in their treatment: hope for improvement, personal effort to control symptoms and encouragement to go on living life. Conclusions While physicians had treatment to offer women with fecal incontinence, women with fecal incontinence had found the best treatments through personal research and effort. Women want to hear a message of hope, encouragement and personal effort from providers. PMID:24573357

  14. Current and Emerging Treatment Options for Fecal Incontinence

    PubMed Central

    2014-01-01

    Fecal incontinence (FI) is a multifactorial disorder that imposes considerable social and economic burdens. The aim of this article is to provide an overview of current and emerging treatment options for FI. A MEDLINE search was conducted for English-language articles related to FI prevalence, etiology, diagnosis, and treatment published from January 1, 1990 through June 1, 2013. The search was extended to unpublished trials on ClinicalTrials.gov and relevant publications cited in included articles. Conservative approaches, including dietary modifications, medications, muscle-strengthening exercises, and biofeedback, have been shown to provide short-term benefits. Transcutaneous electrical stimulation was considered ineffective in a randomized clinical trial. Unlike initial studies, sacral nerve stimulation has shown reasonable short-term effectiveness and some complications. Dynamic graciloplasty and artificial sphincter and bowel devices lack randomized controlled trials and have shown inconsistent results and high rates of explantation. Of injectable bulking agents, dextranomer microspheres in non-animal stabilized hyaluronic acid (NASHA Dx) has shown significant improvement in incontinence scores and frequency of incontinence episodes, with generally mild adverse effects. For the treatment of FI, conservative measures and biofeedback therapy are modestly effective. When conservative therapies are ineffective, invasive procedures, including sacral nerve stimulation, may be considered, but they are associated with complications and lack randomized, controlled trials. Bulking agents may be an appropriate alternative therapy to consider before more aggressive therapies in patients who fail conservative therapies. PMID:25014235

  15. Anatomical Disruption & Length-Tension Dysfunction of Anal Sphincter Complex Muscles in Women with Fecal Incontinence

    PubMed Central

    Kim, Young Sun; Weinstein, Milena; Raizada, Varuna; Jiang, Yanfen; Bhargava, Valmik; Rajasekaran, M. Raj; Mittal, Ravinder K.

    2013-01-01

    BACKGROUND Anal sphincter complex muscles; internal anal sphincter, external anal sphincter and puborectalis muscles, play important role in the anal continence mechanism. Patients with symptoms of fecal incontinence have weak anal sphincter complex muscles; however, their length-tension properties and relationship to anatomical disruption have never been studied. OBJECTIVE To assess the anatomy of anal sphincter complex muscles using 3D-ultrasound imaging system and determine the relationship between anatomical defects and length-tension property of external anal sphincter and puborectalis muscles in women with incontinence symptoms and control subjects. DESIGN Severity of anal sphincter muscle damage was determined by static and dynamic 3Dimensional-ultrasound imaging. Length-tension property was determined by anal and vaginal pressure respectively using custom designed probes. PATIENTS 44 asymptomatic controls and 24 incontinent patients participated in this study. MAIN OUTCOME MEAUSURES Anatomical defects and length-tension dysfunction of anal sphincter complex muscles in FI patients were evaluated. RESULT Prevalence of injury to sphincter muscles are significantly higher in the incontinent patients compared to controls. 85% of patients but only 9% controls reveal damage to ≥2 of the 3 muscles of anal sphincter complex. Anal and vaginal squeeze pressure increased with increase in the probe size (length-tension curve) in majority of controls. In patients, the increase in anal and vaginal squeeze pressures was either significantly smaller than controls or it decreased with the increasing probe size (abnormal length-tension). CONCLUSIONS Length-tension property of the external anal sphincter and puborectalis muscles is significantly impaired in incontinent patients. Our findings have therapeutic implication in the treatment of anal incontinence. PMID:24105004

  16. Psychosocial co-morbidity affects treatment outcome in children with fecal incontinence.

    PubMed

    van Everdingen-Faasen, Els Q; Gerritsen, Bert J; Mulder, Paul G H; Fliers, Ellen A; Groeneweg, Michael

    2008-09-01

    Fecal incontinence is a common disorder in children. Many children with fecal incontinence have psychosocial co-morbidity. In this study, the effect of psychosocial co-morbidity on the treatment outcome of children with fecal incontinence was evaluated. One hundred and fifty children with fecal incontinence were treated in a multidisciplinary program. All children had been treated unsuccessfully for at least one year before entering the program. The treatment consisted of laxative treatment, psychosocial interventions, and biofeedback training. Psychosocial co-morbidity was classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). One hundred and forty-one children were completely analyzed (102 boys, mean age 9.6 (range 6.5-16.5) years). Of these, 31 (22%) children had fecal incontinence without constipation and 110 (78%) children had fecal incontinence associated with constipation. In 95% of children, at least one psychosocial co-morbidity was present. Treatment was successful at 12 months in 69% of patients. Treatment was less successful in children with attention deficit hyperactivity disorder (ADHD), in children with parent-child relational problems, and in mentally retarded children. The results indicate that the early assessment and treatment of psychosocial co-morbidity might improve treatment response in children with fecal incontinence. Children with fecal incontinence are treated less successfully in the first year if they have ADHD, parent-child relational problems, or mental retardation. Psychosocial evaluation and the early assessment and treatment of psychosocial co-morbidity is indicated in order to improve response rate. Family counseling--aimed at improving parent-child relations--should be an integral part of a multidisciplinary treatment program for fecal incontinence. PMID:17952465

  17. Pelvic Floor Rehabilitation in the Treatment of Fecal Incontinence

    PubMed Central

    Scott, Kelly M.

    2014-01-01

    Fecal incontinence (FI) is a prevalent problem that can drastically affect quality of life. Pelvic floor rehabilitation is an important first-line treatment for patients with FI, and many published case reports and a small number of randomized controlled trials (RCTs) provide limited evidence for its efficacy. Pelvic floor rehabilitation approaches to the treatment of FI include pelvic floor muscle training, biofeedback, and volumetric training with rectal balloon catheters. Various forms of external electrical stimulation have also been described and may be of added benefit. Behavioral bowel retraining is an important part of a good rehabilitative approach as well. Pelvic floor rehabilitation treatment for FI is thought to be effective and safe, with reported success rates in a majority of studies at 50 to 80%. Many more high-quality RCTs are needed to define optimal treatment protocols. PMID:25320568

  18. Dietary Fiber Supplementation for Fecal Incontinence: A Randomized Clinical Trial

    PubMed Central

    Bliss, Donna Z.; Savik, Kay; Jung, Hans-Joachim G.; Whitebird, Robin; Lowry, Ann; Sheng, Xioayan

    2014-01-01

    Dietary fiber supplements are used to manage fecal incontinence (FI), but little is known about the fiber type to recommend or the level of effectiveness of such supplements, which appear related to the fermentability of the fiber. The aim of this single-blind, randomized controlled trial was to compare the effects of three dietary fiber supplements (carboxymethylcellulose [CMC], gum arabic [GA], or psyllium) with differing levels of fermentability to a placebo in community-living individuals incontinent of loose/liquid feces. The primary outcome was FI frequency; secondary outcomes included FI amount and consistency, supplement intolerance, and quality of life (QoL). Possible mechanisms underlying supplement effects were also examined. After a 14-day baseline, 189 subjects consumed a placebo or 16g total fiber/day of one of the fiber supplements for 32 days. FI frequency significantly decreased after psyllium supplementation versus placebo, in both intent-to-treat and per-protocol mixed model analyses. CMC increased FI frequency. In intent-to-treat analysis, the number of FI episodes/week after supplementation was estimated to be 5.5 for Placebo, 2.5 for Psyllium, 4.3 for GA, and 6.2 for CMC. Only psyllium consumption resulted in a gel in feces. Supplement intolerance was low. QoL scores did not differ among groups. Patients with FI may experience a reduction in FI frequency after psyllium supplementation, and decreased FI frequency has been shown to be an important personal goal of treatment for patients with FI. Formation of a gel in feces appears to be a mechanism by which residual psyllium improved FI. PMID:25155992

  19. A Controlled Trial of An Intervention to Improve Urinary/Fecal Incontinence and Constipation

    PubMed Central

    Schnelle, John F.; Leung, Felix W.; Rao, Satish SC; Beuscher, Linda; Keeler, Emmett; Clift, Jack W.; Simmons, Sandra

    2010-01-01

    Objectives Evaluate effects of a multi component intervention on fecal (FI) and urinary incontinence (UI) outcomes Design Randomized controlled trial Setting Six nursing homes Participants One hundred and twelve Nursing Home (NH) residents Intervention Intervention subjects offered toileting assistance, exercise, and choice of food /fluid snacks every 2 hours for 8 hours per day over 3 months. Measurements Frequency of UI and FI and rate of appropriate toileting as determined by direct checks from research staff. Anorectal assessments were completed on subset of 29 residents. Results Intervention significantly increased physical activity, frequency of toileting and food/ fluid intake Urinary incontinence improved (p<.05) as did frequency of bowel movements (p<.01) and percent of bowel movements (p <.01) in toilet. The frequency of fecal incontinence did not change. Most subjects (89%) who underwent anorectal testing showed a dyssynergic voiding pattern which could explain the lack of efficacy of this intervention program alone on fecal incontinence. Conclusion The multi-component intervention significantly changed multiple risk factors associated with fecal incontinence and increased bowel movements without decreasing fecal incontinence. The dyssynergic voiding pattern and rectal hyposensitivity suggest that future interventions may have to be supplemented with bulking agents (fiber) and/or biofeedback therapy to improve bowel function. PMID:20653804

  20. Standard Compared With Mnemonic Counseling for Fecal Incontinence: A Randomized Controlled Trial

    PubMed Central

    Cichowski, Sara B; Dunivan, Gena C; Rogers, Rebecca G; Murrietta, Ambroshia M; Komesu, Yuko M

    2015-01-01

    Objective To estimate whether women who underwent mnemonic counseling had better recall of fecal incontinence therapies at 2 months and if mnemonic counseling resulted in greater satisfaction with physician counseling and improvement in quality of life when compared to a group who underwent standard counseling. Methods Counseling naive women with fecal incontinence were recruited from an academic Urogynecology clinic. Women underwent physical examinations, completed the Quality of the Physician-Patient Interaction, recorded fecal incontinence treatment options they recalled, and completed the Fecal Incontinence Severity Index and Manchester Health Questionnaire immediately after counseling and again at 2 months. Results Ninety women consented to participate, were randomized and completed baseline questionnaires. At baseline women did not differ in age, ethnicity, education, fecal incontinence severity index or Manchester Health Questionnaire scores. After counseling the mnemonic group reported higher satisfaction on Quality of the Physician-Patient Interaction (66.4± 6.5 vs 62.2 ± 10.7, p=0.03). Ninety percent (81/90) of women followed-up at 2 months. Our primary endpoint, two month recall of fecal incontinence treatments was not different between groups (2.3 ± 1.6 mnemonic counseling vs 1.8 ± 1.0 standard counseling; p=0.08). Secondary endpoints the mnemonic group reported greater improvement on total Manchester Health Questionnaire (p=0.02), emotional (p=0.03), sleep (0.045), role limitations (<0.01), and physical limitations (p=0.04) when compared to the standard group. Conclusions Fecal incontinence counseling with a mnemonic aid did not improve recall at 2 months but improved patient satisfaction and quality of life at 2 months. PMID:25932833

  1. What's New in the Toolbox for Constipation and Fecal Incontinence?

    PubMed

    Lee, Yeong Yeh

    2014-01-01

    Constipation and fecal incontinence (FI) are common complaints predominantly affecting the elderly and women. They are associated with significant morbidity and high healthcare costs. The causes are often multi-factorial and overlapping. With the advent of new technologies, we have a better understanding of their underlying pathophysiology which may involve disruption at any levels along the gut-brain-microbiota axis. Initial approach to management should always be the exclusion of secondary causes. Mild symptoms can be approached with conservative measures that may include dietary modifications, exercise, and medications. New prokinetics (e.g., prucalopride) and secretagogues (e.g., lubiprostone and linaclotide) are effective and safe in constipation. Biofeedback is the treatment of choice for dyssynergic defecation. Refractory constipation may respond to neuromodulation therapy with colectomy as the last resort especially for slow-transit constipation of neuropathic origin. Likewise, in refractory FI, less invasive approach can be tried first before progressing to more invasive surgical approach. Injectable bulking agents, sacral nerve stimulation, and SECCA procedure have modest efficacy but safe and less invasive. Surgery has equivocal efficacy but there are promising new techniques including dynamic graciloplasty, artificial bowel sphincter, and magnetic anal sphincter. Despite being challenging, there are no short of alternatives in our toolbox for the management of constipation and FI. PMID:25705618

  2. Symptoms associated with dietary fiber supplementation over time in individuals with fecal incontinence

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to compare the severity of adverse gastrointestinal (GI) symptoms during supplementation with dietary fiber or placebo over time in adults with fecal incontinence. Secondary aims were to determine the relationship between symptom severity and upset and their association...

  3. Incontinence - resources

    MedlinePlus

    Resources - incontinence ... The following organizations are good resources for information on incontinence. Fecal incontinence : The American Congress of Obstetricians and Gynecologists -- www.acog.org/~/media/for%20patients/faq139.ashx ...

  4. Bowel incontinence

    MedlinePlus

    Uncontrollable passage of feces; Loss of bowel control; Fecal incontinence; Incontinence - bowel ... and weaken, leading to diarrhea and stool leakage. Fecal impaction . It is usually caused by chronic constipation. ...

  5. Fecal incontinence: a review of prevalence and obstetric risk factors.

    PubMed

    Wang, Andrea; Guess, Marsha; Connell, Kathleen; Powers, Kenneth; Lazarou, George; Mikhail, Magdy

    2006-05-01

    Anal incontinence (AI) is a significant problem that causes social and hygienic inconvenience. The true prevalence of AI is difficult to estimate due to inconsistencies in research methods, but larger studies suggest a rate of 2-6% for incontinence to stool. There is a significant association between sonographically detected anal sphincter defects and symptoms of AI. The intrapartum factors most consistently associated with a higher risk of AI include: forceps delivery, third or fourth degree tears, and length of the second stage of labor. Fetal weight of > 4,000 g is also associated with AI. Repair of the sphincter can be performed in either an overlapping or an end-to-end fashion, with similar results for both methods. The role of cesarean delivery for the prevention of AI remains unclear, and further study should be devoted to this question. PMID:15973465

  6. Validation of questionnaires to assess quality of life related to fecal incontinence in children with anorectal malformations and Hirschsprung's disease

    PubMed Central

    Mathias, Arthur Loguetti; Tannuri, Ana Cristina Aoun; Ferreira, Mariana Aparecida Elisei; Santos, Maria Mercês; Tannuri, Uenis

    2016-01-01

    Abstract Objective: Surgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease (HD) leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life. Methods: The questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal children was used as control. Results: At two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (p<0.05, Student's t-test). There were also significant differences between the results of children with ARMs and children with HD. Conclusions: QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment. PMID:26522822

  7. Urinary incontinence, fecal incontinence and pelvic organ prolapse in a population-based, racially diverse cohort. Prevalence and risk factors

    PubMed Central

    RORTVEIT, Guri; SUBAK, Leslee L.; THOM, David H.; CREASMAN, Jennifer M.; VITTINGHOFF, Eric; VAN DEN EEDEN, Stephen K.; BROWN, Jeanette S.

    2016-01-01

    Objectives We investigated the prevalence of and risk factors for combinations of urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) in racially diverse women over age 40. Methods The Reproductive Risks for Incontinence Study at Kaiser (RRISK) is a population-based study with data from 2106 women > 40 years. Pelvic floor conditions were determined by self-report. Risk factors were assessed by self-report, interview and record review. Independent risk factors were identified by multinomial logistic regression analysis. Results At least one pelvic floor condition was reported by 714 (34%) women. Of these, 494 (69%) had UI only, 60 (8%) POP only, and 46 (6%) had FI only. Both UI and FI were reported by 64 (9%), both UI and POP by 51 (7%). Among women with FI, 60% reported more than one condition. Corresponding figures for POP and UI were 49% and 18%. Estrogen use and constipation were shared risk factors for UI, FI and POP. BMI was a unique risk factor for UI only, diabetes for FI only and parity for POP only. No clear pattern could be found to support the hypothesis that risk factors for single conditions are more strongly associated with combined conditions. Conclusions Patients with FI or POP often have concomitant UI. These diseases both share and have unique risk factors in a complex pattern. PMID:22453506

  8. The magnetic anal sphincter: a new device in the management of severe fecal incontinence.

    PubMed

    Mantoo, Surendra; Meurette, Guillaume; Podevin, Juliette; Lehur, Paul-Antoine

    2012-09-01

    The authors aim to report the concept and technique of implantation and the first results of the clinical use of the magnetic anal sphincter (MAS) in the management of fecal incontinence (FI). The MAS device is designed to augment the native anal sphincter. The implant is a series of titanium beads with magnetic cores linked together with independent titanium wires. To defecate, the force generated by straining separates the beads to open up the anal canal. The technique of implantation is simple with no requirement of adjustments. The MAS has a role in the management of severe FI. The device has acceptable and comparable adverse effects to other therapies. FI and Fecal Incontinence Quality of Life scores are significantly improved in the short term. The MAS offers a simple and less invasive option of anal reinforcement. It is one step further in the quest for an ideal artificial anal sphincter device. PMID:23116075

  9. Rectal tone and compliance affected in patients with fecal incontinence after fistulotomy

    PubMed Central

    Awad, Richard Alexander; Camacho, Santiago; Flores, Francisco; Altamirano, Evelyn; García, Mario Antonio

    2015-01-01

    AIM: To investigate the anal sphincter and rectal factors that may be involved in fecal incontinence that develops following fistulotomy (FIAF). METHODS: Eleven patients with FIAF were compared with 11 patients with idiopathic fecal incontinence and with 11 asymptomatic healthy subjects (HS). All of the study participants underwent anorectal manometry and a barostat study (rectal sensitivity, tone, compliance and capacity). The mean time since surgery was 28 ± 26 mo. The postoperative continence score was 14 ± 2.5 (95%CI: 12.4-15.5, St Mark’s fecal incontinence grading system). RESULTS: Compared with the HS, the FIAF patients showed increased rectal tone (42.63 ± 27.69 vs 103.5 ± 51.13, P = 0.002) and less rectal compliance (4.95 ± 3.43 vs 11.77 ± 6.9, P = 0.009). No significant differences were found between the FIAF patients and the HS with respect to the rectal capacity; thresholds for the non-noxious stimuli of first sensation, gas sensation and urge-to-defecate sensation or the noxious stimulus of pain; anal resting pressure or squeeze pressure; or the frequency or percentage of relaxation of the rectoanal inhibitory reflex. No significant differences were found between the FIAF patients and the patients with idiopathic fecal incontinence. CONCLUSION: In patients with FIAF, normal motor anal sphincter function and rectal sensitivity are preserved, but rectal tone and compliance are impaired. The results suggest that FIAF is not due to alterations in rectal sensitivity and that the rectum is more involved than the anal sphincters in the genesis of FIAF. PMID:25852287

  10. Quality of Life Differences in Female and Male Patients with Fecal Incontinence

    PubMed Central

    Mundet, Lluís; Ribas, Yolanda; Arco, Sandra; Clavé, Pere

    2016-01-01

    Background/Aims To explore and compare quality of life (QoL) differences in female and male patients with fecal incontinence. Methods Ninety-one patients with fecal incontinence (60 women, mean (SD) age 64.13 (9.72) years; 31 men, mean (SD) age 63.61 (13.33) years) were assessed for pathophysiology (anorectal manometry and ultrasound), clinical severity (Wexner and Vaizey scales), QoL (Fecal Incontinence Quality of Life Score [FIQL]) and health status (EQ-5D). Results External and internal anal sphincter impairment rates were 96.5% and 70.2%, respectively, in women, compared to 30% and 43.3% respectively in men (P < 0.05). Clinical severity was similar in both sexes, with mean (SD) Wexner scores of 10.95 (4.35) for women and 9.81 (4.30) for men, and mean (SD) Vaizey scores of 13.27 (4.66) for women and 11.90 (5.22) for men. Scores for women were significantly lower for all FIQL depression and coping subscales (P < 0.001) and the EQ-5D depression subscale (P < 0.01). EQ-5D index was 0.687 (0.20) for women and 0.835 (0.15) for men (P < 0.001). QoL was negatively affected by female gender (−1.336), anxiety/depression (−1.324) and clinical severity (−0.302), whereas age had a positive impact (0.055 per year) (P < 0.01). Conclusions The pathophysiology of fecal incontinence differed between the sexes. For similar severity scores, impact on QoL was higher in women. Gender had the highest impact on QoL compared to other factors. QoL measurements should be part of assessment and treatment protocols. PMID:26486375

  11. Injection of porous polycaprolactone beads containing autologous myoblasts in a dog model of fecal incontinence

    PubMed Central

    Kang, Sung-Bum; Lee, Hye Seung; Lim, Jae-Young; Oh, Se Heang; Kim, Sang Joon; Hong, Sa-Min; Jang, Je-Ho; Cho, Jeong-Eun; Lee, Sung-Min

    2013-01-01

    Purpose Few studies have examined whether bioengineering can improve fecal incontinence. This study designed to determine whether injection of porous polycaprolactone beads containing autologous myoblasts improves sphincter function in a dog model of fecal incontinence. Methods The anal sphincter of dogs was injured and the dogs were observed without and with (n = 5) the injection of porous polycaprolactone beads containing autologous myoblasts into the site of injury. Autologous myoblasts purified from the gastrocnemius muscles were transferred to the beads. Compound muscle action potentials (CMAP) of the pudendal nerve, anal sphincter pressure, and histopathology were determined 3 months after treatment. Results The amplitudes of the CMAP in the injured sphincter were significantly lower than those measured before injury (1.22 mV vs. 3.00 mV, P = 0.04). The amplitudes were not different between dogs with and without the injection of autologous myoblast beads (P = 0.49). Resting and squeezing pressures were higher in dogs treated with autologous myoblast beads (2.00 mmHg vs. 1.80 mmHg; 6.13 mmHg vs. 4.02 mmHg), although these differences were not significant in analyses of covariance adjusted for baseline values. The injection site was stained for smooth muscle actin, but showed evidence of foreign body inflammatory reactions. Conclusion This was the first study to examine whether bioengineering could improve fecal incontinence. Although the results did not show definite evidence that injection of autologous myoblast beads improves sphincter function, we found that the dog model was suitable and reliable for studying the effects of a potential treatment modality for fecal incontinence. PMID:23577316

  12. Management of fecal incontinence - focus on a vaginal insert for bowel control.

    PubMed

    Sokol, Eric R

    2016-01-01

    Fecal incontinence, also referred to as accidental bowel leakage, is a debilitating condition that impacts quality of life in a significant number of women. Current treatments for fecal incontinence include behavioral modification, biofeedback, drug therapy, and invasive surgical procedures. However, these treatments have suboptimal efficacy due to patient adherence, variability of presentation across patients, cost, and additional health risks. A vaginal bowel control system (Eclipse™ System) was developed to offer a low-risk, effective, and patient-managed approach to treating accidental bowel leakage. The vaginal bowel control system consists of a vaginal insert and user-controlled, pressure-regulated pump. Once inflated, the balloon of the vaginal insert is directed posteriorly to occlude the rectum, allowing the woman to immediately regain control of bowel function. This article will introduce the design evolution and feasibility studies of the Eclipse System. In addition, this review will discuss the results from a recent clinical trial that demonstrated the safety and efficacy of the vaginal bowel control system in managing fecal incontinence and other symptoms of bowel dysfunction. PMID:27274318

  13. Management of fecal incontinence – focus on a vaginal insert for bowel control

    PubMed Central

    Sokol, Eric R

    2016-01-01

    Fecal incontinence, also referred to as accidental bowel leakage, is a debilitating condition that impacts quality of life in a significant number of women. Current treatments for fecal incontinence include behavioral modification, biofeedback, drug therapy, and invasive surgical procedures. However, these treatments have suboptimal efficacy due to patient adherence, variability of presentation across patients, cost, and additional health risks. A vaginal bowel control system (Eclipse™ System) was developed to offer a low-risk, effective, and patient-managed approach to treating accidental bowel leakage. The vaginal bowel control system consists of a vaginal insert and user-controlled, pressure-regulated pump. Once inflated, the balloon of the vaginal insert is directed posteriorly to occlude the rectum, allowing the woman to immediately regain control of bowel function. This article will introduce the design evolution and feasibility studies of the Eclipse System. In addition, this review will discuss the results from a recent clinical trial that demonstrated the safety and efficacy of the vaginal bowel control system in managing fecal incontinence and other symptoms of bowel dysfunction. PMID:27274318

  14. Efficacy of Biofeedback Therapy before and after Sphincteroplasty for Fecal Incontinence because of Obstetric Injury: A Randomized Controlled Trial

    PubMed Central

    Ghahramani, Leila; Mohammadipour, Mastoureh; Roshanravan, Reza; Hajihosseini, Fahimeh; Bananzadeh, Alimohammad; Izadpanah, Ahmad; Hosseini, Seyed Vahid

    2016-01-01

    Fecal incontinence is a challenging condition in that it exerts various psychosocial impacts on daily life. Different treatment modalities have been suggested for fecal incontinence. The present study aimed to evaluate the efficacy of biofeedback therapy in combination with surgery in the management of fecal incontinence. The present randomized controlled trial was performed on 27 women with a complaint of fecal incontinence because of delivery trauma. The patients underwent sphincteroplasty and levatorplasty via the same method by 2 colorectal surgeons. In Group I, biofeedback therapy was performed 3 months before and 6 months after the surgery; in Group II, biofeedback therapy was applied only 6 months after the surgery; and in Group III, only surgical management was performed. The results revealed a significant difference between the preoperative and postoperative Wexner scores of incontinence in all the 3 groups. Additionally, the difference between the preoperative and postoperative scores was significant only in Group I and Group III, but not in Group II. The reduction in the Wexner score was significantly less in Group III. However, no significant difference was observed between the 3 groups concerning the mean difference of preoperative and postoperative manometry. The present study revealed no significant role for biofeedback therapy alone in the improvement of manometric evaluation. However, the Wexner score, which is an indicator of patient satisfaction, increased with biofeedback therapy following sphincteroplasty. In general, surgical treatment is now reserved for selected patients with fecal incontinence and has recently been developed with biofeedback therapy. Trial Registration Number: IRCT201206039936N1 PMID:26989283

  15. Late Fecal Incontinence After High-Dose Radiotherapy for Prostate Cancer: Better Prediction Using Longitudinal Definitions

    SciTech Connect

    Fiorino, Claudio; Rancati, Tiziana; Fellin, Gianni; Vavassori, Vittorio; Cagna, Emanuela; Casanova Borca, Valeria; Girelli, Giuseppe; Menegotti, Loris; Monti, Angelo Filippo; Tortoreto, Francesca; Delle Canne, Stefania; Valdagni, Riccardo

    2012-05-01

    Purpose: To model late fecal incontinence after high-dose prostate cancer radiotherapy (RT) in patients accrued in the AIROPROS (prostate working group of the Italian Association of Radiation Oncology) 0102 trial using different endpoint definitions. Methods and Materials: The self-reported questionnaires (before RT, 1 month after RT, and every 6 months for {<=}3 years after RT) of 586 patients were available. The peak incontinence (P{sub I}NC) and two longitudinal definitions (chronic incontinence [C{sub I}NC], defined as the persistence of Grade 1 or greater incontinence after any Grade 2-3 event; and mean incontinence score [M{sub I}NC], defined as the average score during the 3-year period after RT) were considered. The correlation between the clinical/dosimetric parameters (including rectal dose-volume histograms) and P{sub I}NC (Grade 2 or greater), C{sub I}NC, and M{sub I}NC of {>=}1 were investigated using multivariate logistic analyses. Receiver operating characteristic curves and the area under the curve were used to assess the predictive value of the different multivariate models. Results: Of the 586 patients, 36 with a Grade 1 or greater incontinence score before RT were not included in the present analysis. Of the 550 included patients, 197 (35.8%) had at least one control with a Grade 1 or greater incontinence score (M{sub I}NC >0). Of these 197 patients, 37 (6.7%), 22 (4.0%), and 17 (3.1%) were scored as having P{sub I}NC, M{sub I}NC {>=}1, and C{sub I}NC, respectively. On multivariate analysis, Grade 2 or greater acute incontinence was the only predictor of P{sub I}NC (odds ratio [OR], 5.9; p = .0009). Grade 3 acute incontinence was predictive of C{sub I}NC (OR, 9.4; p = .02), and percentage of the rectal volume receiving >40 Gy of {>=}80% was predictive of a M{sub I}NC of {>=}1 (OR, 3.8; p = .008) and of C{sub I}NC (OR, 3.6; p = .03). Previous bowel disease, previous abdominal/pelvic surgery, and the use of antihypertensive (protective factor

  16. Prospective study on Incontinence-Associated Dermatitis and its Severity instrument for verifying its ability to predict the development of pressure ulcers in patients with fecal incontinence.

    PubMed

    Park, Kyung Hee; Choi, Heejung

    2016-03-01

    Fecal incontinence with loose stools is a risk factor for skin damage that may develop into a pressure ulcer (PU). The aim of this study was to determine the feasibility of applying the Incontinence-Associated Dermatitis and its Severity (IADS) instrument to patients with fecal incontinence as a tool to predict PU development. This prospective study enrolled 120 intensive care unit patients with bowel incontinence of Bristol Stool type 5, 6, and 7. Trained nurses evaluated IADS scores and the occurrence of PUs daily for 7 days. Patients with higher IADS scores were significantly more likely to develop a PU (odds ratio = 1·22, 95% confidence interval = 1·12-1·33). The receiver operating characteristic curve analysis revealed the area under curve to be 0·790, suggesting that higher IADS scores are associated with an increased likelihood of developing a PU (sensitivity 72·5%, specificity 71·2%, using a cut-off value of 8/9). Our results suggest that the IADS instrument can serve as a tool for predicting the occurrence of PUs in patients with fecal incontinence. Patients with IADS scores that exceed eight points should be classified as being at risk of developing a PU, and placed under intensive care as a proactive measure to prevent PU development. PMID:26847935

  17. Incontinence Treatment: Biofeedback

    MedlinePlus

    Donate Find a Doctor Join eNewsletter Sidebar × MOBILE MENU About Us What is Incontinence? Prevalence Causes of Incontinence Fecal Incontinence in Children Reporter's Guide to Bowel Incontinence Signs & Symptoms Symptoms of ...

  18. A 10-Year Follow-Up of Urinary and Fecal Incontinence among the Oldest Old in the Community: The Canadian Study of Health and Aging

    ERIC Educational Resources Information Center

    Ostbye,Truls; Seim, Arnfinn; Krause, Katrina M.; Feightner, John; Hachinski, Vladimir; Sykes, Elizabeth; Hunskaar, Steinar

    2004-01-01

    Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991-1992, 1996, and 2001. Using data from the CSHA, we report the…

  19. Symptoms Associated with Dietary Fiber Supplementation over Time in Individuals with Fecal Incontinence

    PubMed Central

    Bliss, Donna Z.; Savik, Kay; Jung, Hans-Joachim G.; Whitebird, Robin; Lowry, Ann

    2011-01-01

    Background Knowledge about adverse symptoms over time from fiber supplementation is lacking. Purpose To compare the severity of adverse gastrointestinal (GI) symptoms during supplementation with dietary fiber or placebo over time in adults with fecal incontinence. Secondary aims were to determine the relationship between symptom severity and emotional upset and their association with study attrition and reducing fiber dose. Methods Subjects (N=189, 77% female, 92% white, (age = 58 years, SD = 14) with fecal incontinence were randomly assigned to placebo or a supplement of 16g total dietary fiber/day from one of three sources: gum arabic, psyllium, or carboxymethylcellulose. They reported GI symptoms daily during baseline (14 days), incremental fiber dosing (6 days), and two segments of steady full fiber dose (32 days total). Results Severity of symptoms in all groups was minimal. Adjusting for study segment and day, a greater feeling of fullness in the psyllium group was the only symptom that differed from symptoms in the placebo group. Odds of having greater severity of flatus, belching, fullness, and bloating were 1.2–2.0 times greater in the steady dose segment compared to baseline. There was a positive association between symptom severity and emotional upset. Subjects with a greater feeling of fullness or bloating or higher scores for total symptom severity or emotional upset were more likely to withdraw from the study sooner or reduce fiber dose. Conclusions Persons with fecal incontinence experience a variety of GI symptoms over time. Symptom severity and emotional upset appear to influence fiber tolerance and study attrition. Supplements seemed well tolerated. PMID:21543963

  20. Executive summary: A Quick Reference Guide for Managing Fecal Incontinence (FI).

    PubMed

    Willson, Margaret M; Angyus, Melissa; Beals, Dawn; Callan, Laurie; Francis, Kathleen; Kingan, Michael J; Porras, Opal Kathleen

    2014-01-01

    This article is an executive summary of A Quick Reference Guide for Managing Fecal Incontinence (FI), which was published September 2013 by the WOCN Society's Continence Committee. The quick reference guide provides an overview of fecal incontinence and how it is commonly managed. The information has been compiled so that nurses can quickly access a wide array of information in a single resource to facilitate patient care and patient/staff education. The topics include a definition of FI, epidemiologic data, psychosocial impact, costs, a brief description of bowel physiology, causes of FI, skin complications, assessment, management, patient education, and recommendations for future research. The complete quick reference guide also includes 5 appendices. The appendices provide additional information about predisposing factors for FI, assessment tools, medications and foods that affect gastric or colonic motility, and examples of FI management systems/collectors. The complete quick reference guide is available in the Members-Only library at the WOCN Society's Web site (http://www.wocn.org), and it can also be purchased from the online bookstore at the Society's Web site. This article provides a synopsis of the key features contained in the complete quick reference guide. PMID:24378693

  1. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy

    PubMed Central

    Mandaliya, Rohan; DiMarino, Anthony J.; Moleski, Stephanie; Rattan, Satish; Cohen, Sidney

    2015-01-01

    Background Despite the surge of new medical and surgical approaches to treat fecal incontinence, the types of sphincter abnormalities in patients with incontinence have not been well characterized. We aimed to categorize anal sphincter dysfunction using anorectal manometry in patients with fecal incontinence as a potential guide for improved treatment. Methods A retrospective review of 162 consecutive patients with fecal incontinence referred for anorectal manometry was performed. Resting anal pressure and maximal squeeze pressure were considered as measures of internal anal sphincter and external anal sphincter function respectively. Results Mean age of the patients was 63 years (13-89); females (81.5%) and males (18.5%). 74% of the patients had sphincter dysfunction on anorectal manometry. Internal anal sphincter dysfunction was present in 62% patients vs. external anal sphincter dysfunction present in 44% patients. 80% females had abnormal manometry vs. 44% in males (P<0.0001). Internal anal sphincter dysfunction was present in 68% females vs. 37% in males (P=0.0026). Conclusions Overall, abnormal anorectal manometry studies revealed that internal anal sphincter dysfunction is the most common finding, alone or in combination with external anal sphincter dysfunction. We suggest that anorectal manometry may be important to delineate anal sphincter function prior to using newer therapeutic mechanical devices. Future studies using pharmacological agents to increase internal anal sphincter tone may be of clinical importance. Finally, the classification of fecal incontinence based on the type of sphincter dysfunction may be an improved guide in the selection of newer agents in treating fecal incontinence. PMID:26423466

  2. Rectal bleeding, fecal incontinence, and high stool frequency after conformal radiotherapy for prostate cancer: Normal tissue complication probability modeling

    SciTech Connect

    Peeters, Stephanie; Hoogeman, Mischa S.; Heemsbergen, Wilma D.; Hart, Augustinus; Koper, Peter C.M.; Lebesque, Joos V. . E-mail: j.lebesque@nki.nl

    2006-09-01

    Purpose: To analyze whether inclusion of predisposing clinical features in the Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) model improves the estimation of late gastrointestinal toxicity. Methods and Materials: This study includes 468 prostate cancer patients participating in a randomized trial comparing 68 with 78 Gy. We fitted the probability of developing late toxicity within 3 years (rectal bleeding, high stool frequency, and fecal incontinence) with the original, and a modified LKB model, in which a clinical feature (e.g., history of abdominal surgery) was taken into account by fitting subset specific TD50s. The ratio of these TD50s is the dose-modifying factor for that clinical feature. Dose distributions of anorectal (bleeding and frequency) and anal wall (fecal incontinence) were used. Results: The modified LKB model gave significantly better fits than the original LKB model. Patients with a history of abdominal surgery had a lower tolerance to radiation than did patients without previous surgery, with a dose-modifying factor of 1.1 for bleeding and of 2.5 for fecal incontinence. The dose-response curve for bleeding was approximately two times steeper than that for frequency and three times steeper than that for fecal incontinence. Conclusions: Inclusion of predisposing clinical features significantly improved the estimation of the NTCP. For patients with a history of abdominal surgery, more severe dose constraints should therefore be used during treatment plan optimization.

  3. Comparing community and specialty provider-based recruitment in a randomized clinical trial: clinical trial in fecal incontinence

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recruitment of participants to clinical trials remains a significant challenge, especially for research addressing topics of a sensitive nature such as fecal incontinence (FI). The Fiber Study, a randomized controlled trial on symptom management for FI, successfully enrolled 189 community-living adu...

  4. Fecal Incontinence

    MedlinePlus

    ... anus, the opening through which stool leaves the body. [ Top ] How does bowel control work? Bowel control relies on muscles and nerves ... such as after every meal. Over time, the body becomes used to a regular ... regular bowel control pattern can take weeks to months. Pelvic Floor ...

  5. Fecal Incontinence

    MedlinePlus

    ... stool leaves the body. [ Top ] How does bowel control work? Bowel control relies on muscles and nerves ... Current Funding Opportunities Funded Grants & Grant History Funding Process Research Programs & Contacts Research Training & Career Development Research ...

  6. Use of hollow microneedles for targeted delivery of phenylephrine to treat fecal incontinence.

    PubMed

    Jun, Hyesun; Han, Mee-Ree; Kang, Nae-Gyu; Park, Jung-Hwan; Park, Jung Ho

    2015-06-10

    A hollow microneedle (HM) was prepared to deliver a phenylephrine (PE) solution into the anal sphincter muscle as a method for treating fecal incontinence. The goal of this study was the local targeted delivery of PE into the sphincter muscle through the perianal skin with minimal pain using hollow microneedles, resulting in the increase of resting anal sphincter pressure. PE was administered on the left and the right sides of the anus of a rat through the perianal skin using 1.5mm long HM. An in vivo imaging system study was conducted after injection of Rhodamine B, and a histological study was performed after injection of gentian violet. The resting anal sphincter pressure in response to various drug doses was measured by using an air-charged catheter. Anal pressure change produced by HM administration was compared with change produced by intravenous injection (IV), subcutaneous (SC) injection and intramuscular (IM) injection. The change in mean blood pressure produced by HM administration as a function of PE dose was compared with change produced by PBS injection. A pharmacokinetic study of the new HM administration method was performed. A model drug solution was localized in the muscle layer under the perianal skin at the injection site and then diffused out over time. HM administration of PE induced significant contraction of internal anal sphincter pressure over 12h after injection, and the maximum anal pressure was obtained between 5 and 6h. Compared to IV, SC and IM treatments, HM treatment produced greater anal pressure. There was no increase in blood pressure after HM administration of PE within the range of predetermined concentration. Administration of 800μg/kg of PE using HM produced 0.81±0.38h of tmax. Our study suggests that HM administration enables local delivery of a therapeutic dose of PE to the anal sphincter muscle layer with less pain. This new treatment has great potential as a clinical application because of the ease of the procedure

  7. Impact of Fecal Incontinence and Its Treatment on Quality of Life in Women

    PubMed Central

    Richter, Holly E.

    2015-01-01

    Fecal incontinence (FI) is a physically and psychosocially debilitating disorder which negatively impacts quality of life (QOL). It bears a significant burden not only on patients but also on their families, caretakers, as well as society as a whole. Even though it is considered a somewhat common condition, especially as women age, the prevalence is often underestimated due to patients’ reluctance to report symptoms or seek care. The evaluation and treatment of FI can be also hindered by lack of understanding of the current management options among healthcare providers and how they impact on QOL. This article provides a comprehensive review on the impact of FI and its treatment on QOL in women. PMID:25776296

  8. Safety and Efficacy of Permacol Injection in the Treatment of Fecal Incontinence

    PubMed Central

    Ayers, Jennifer; Ayantunde, Abraham; Praveen, Bandipalyam V

    2016-01-01

    Purpose Permacol has been gaining popularity in recent times for the treatment of fecal incontinence (FI). This study aims to evaluate the safety and efficacy of anal submucosal Permacol injection in the treatment of FI. Methods All consecutive patients who underwent Permacol injection for FI over a 3-year period were included. Patients' data relating to obstetric history, anorectal/pelvic operations, type of FI, preoperative anorectal physiology results and follow-up details for outcome measures were collected. Preoperative and postoperative Cleveland Clinic Florida Incontinence Scores (CCFISs) were noted. Patients were surveyed by using a telephone questionnaire to assess the quality of life and other outcome measures. Data were analysed using SPSS ver.19.0. Results Thirty patients (28 females and 2 males) with a median age of 67 years were included in the study. Of those patients, 37%, 50%, and 13% were noted to have passive, mixed and urge FI, respectively. Six of the patients (20%) had repeat Permacol injections, 5 of whom had sustained responses to the first Permacol injection for a mean of 11 months. There was a significant improvement in the CCFIS from a baseline median of 12.5, mean 12.8 interquartile range [IQR], 6–20), to a median of 3.5, mean 4.8 (IQR, 0–20), P < 0.001. Of the patients surveyed by telephone 89% were satisfied with their overall experience and the improvement in their symptoms following Permacol injections. Conclusion This study has demonstrated that Permacol injection for the treatment of FI is safe and effective and has no associated major complications. However, the results are not permanent; consequently, a significant proportion of the patients with an initial response may require repeat injections. PMID:27218098

  9. Obstetric Sphincter Injury Interacts with Diarrhea and Urgency to Increase the Risk of Fecal Incontinence in Women with IBS

    PubMed Central

    Robinson, Barbara L.; Matthews, Catherine A.; Palsson, Olafur S; Geller, Elizabeth; Turner, Marsha; Parnell, Brent; Crane, Andrea; Jannelli, Mary; Wells, Ellen; Connolly, AnnaMarie; Lin, Feng-Chang; Whitehead, William E.

    2014-01-01

    Objectives To confirm that fecal urgency and diarrhea are independent risk factors for fecal incontinence (FI), to identify obstetrical risk factors associated with FI in women with IBS (irritable bowel syndrome), and to determine whether obstetric anal sphincter injuries interact with diarrhea or urgency to explain the occurrence of FI. Methods The study is a supplement to a diary study of bowel symptoms in 164 female patients with IBS. Subjects completed daily bowel symptom diaries for 90 consecutive days and rated each bowel movement (BM) for stool consistency and presence of urgency, pain, and FI. All female participants from the parent study were invited to complete a telephone-administered 33-item bowel symptom and obstetric history questionnaire which included the Fecal Incontinence Severity Index (FISI). Results Out of 164 women in the parent study, 115 (70.1%) completed the interview. Seventy-four (45.1%) reported FI on their diary including 34 (29.6%) who reported at least one episode per month, 112 (97.4%) reported episodes of urgency, and 106 (92.2%) reported episodes of diarrhea. The mean FISI score was 13.9±9.7. Upon multivariable analysis, FI was significantly associated with parity (p=0.007), operative vaginal delivery (p=0.049), obstetrical sphincter lacerations (p=0.007), fecal urgency (p=0.005), diarrhea (p=0.008), and hysterectomy (p=0.004), but was not associated with episiotomy, pelvic organ prolapse, or urinary incontinence. The synergistic interactions of obstetric anal sphincter laceration with urgency (p=0.002) and diarrhea (p=0.004) were significant risk factors for FI. Conclusion Fecal urgency and diarrhea are independent risk factors for FI, and they interact with obstetric anal sphincter laceration to amplify the risk of FI. PMID:23321658

  10. Malone antegrade continence enema (MACE) for fecal incontinence in imperforate anus improves quality of life.

    PubMed

    Mattix, Kelly D; Novotny, Nathan M; Shelley, Anita A; Rescorla, Frederick J

    2007-12-01

    The MACE procedure has been used in patients with imperforate anus (IA) to improve fecal continence. Our aim was to assess the impact of the MACE on the quality of life (QOL) in children with IA and fecal incontinence. A retrospective review was performed of children with IA that underwent the MACE procedure between 1997 and 2004. Patients and their parents were contacted by telephone survey regarding continence and its psychosocial effects before and after MACE. The same survey was given to the patients' teachers. Responses to 15 questions were compiled and a QOL score calculated and significance evaluated by t-test (P < or = 0.05). IRB approval was obtained. Thirty-two patients were identified with a mean age at operation of 9 years (4-19 years) and mean follow-up of 3.8 years (7 months to 8 years). Four patients had a low malformation, 8 were intermediate, 15 were high, and 5 had a cloacal anomaly. Twenty patients had documented sacral/spinal anomalies, including five with tethered cord. Post-MACE complications included stenosis in 16 (50%), with 11 requiring an operative revision at a mean of 21.7 months (2 months to 6 years), takedown in one at 4 years and volvulus in one at 18 months. Prior to the MACE, 18/25 (72%) had poor QOL scores. Post-MACE QOL results were similar between patients, parents and teachers. Patients' mean QOL score improved from 59.9 to 26.3% (P < 0.001), with parents from 59.7 to 26.4% (P < 0.001). QOL score improved >50% in nine families, 25-50% in ten and <25% in six. All patients and parents interviewed reported an improvement in their QOL following the MACE. This procedure should be offered to children with IA with the expectation of significant improvement in QOL. PMID:17938937

  11. Eliciting Help-Seeking Behaviors in Patients With Fecal Incontinence: Supporting Timely Access to Treatment.

    PubMed

    Timmermans, S Lana

    2016-09-01

    People with fecal incontinence (FI) symptoms often do not report their symptoms to their care providers, which may adversely impact their quality of life. Although the differential diagnosis for the cause of an individual's FI symptoms can be done by a family doctor, nurse practitioner, or a specialist, many other healthcare professionals have the training and education to competently screen patients for FI risk factors. Those individuals identified with FI symptoms can be supported to disclose this information to their healthcare professional in a timely manner. Healthcare professionals have a responsibility to encourage patients to seek medical treatment in order to ensure an accurate diagnosis for their FI symptoms, and to support clients through the process of managing symptoms including adhering to care plans to mitigate modifiable causes of FI. When clients actively seek medical help, it is referred to as help-seeking behavior. Given the sensitive nature of FI, with the associated stigma and taboo surrounding the topic, healthcare providers must conscientiously work to support each client with sensitivity and self-awareness. PMID:27580281

  12. Incontinence and incontinence-associated dermatitis.

    PubMed

    Langemo, Diane; Hanson, Darlene; Hunter, Susan; Thompson, Patricia; Oh, In Eui

    2011-03-01

    Incontinence is a prevalent problem and can lead to many complications. Both urinary and fecal incontinence can result in tissue breakdown, now commonly referred to as incontinence-associated dermatitis. This article addresses the types of incontinence, its etiology and pathophysiology, assessment, prevention and treatment, and the latest research. PMID:21326024

  13. HealthLines: Incontinent? You're Not Alone

    MedlinePlus

    ... or are injured. The three main disorders are urinary incontinence, fecal incontinence, and pelvic organ prolapse, which happens ... least one pelvic disorder; nearly 16 percent reported urinary incontinence; 9 percent had fecal incontinence; and nearly 3 ...

  14. Urinary, Fecal, and Dual Incontinence in Older U.S. Adults

    PubMed Central

    Wu, Jennifer M.; Matthews, Catherine A.; Vaughan, Camille P.; Markland, Alayne D.

    2015-01-01

    OBJECTIVES To estimate the prevalence of urinary (UI), fecal (FI), and dual incontinence (DI) and to identify shared factors associated with each type of incontinence in older U.S. women and men. DESIGN Population-based cross-sectional study. SETTING National Health and Nutrition Examination Survey (NHANES, 2005–2010). PARTICIPANTS Women and men aged 50 and older. MEASUREMENTS UI was defined as moderate to severe (≥3 on a validated UI severity index, range 0–12); FI was at least monthly loss of solid, liquid, or mucus stool; and DI was the presence of UI and FI. RESULTS Women were more likely than men to report UI only and DI but not FI only (UI only, women 19.8%, men 6.4%; FI only, women 8.2%, men 8.4%; DI women, 6.0%, men 1.9%). In both sexes, prevalence increased with age. In regression models adjusted for parity and hysterectomy, DI in women was associated with non-Hispanic white race (odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.5–3.4), depression (OR = 4.7, 95% CI = 2.0–11.1), comorbidities (OR = 4.3, 95% CI = 1.9–9.6 for ≥3 comorbidities vs none), hysterectomy (OR = 1.8, 95% CI = 1.2–2.7), and diarrhea (OR = 2.8, 95% CI = 1.5–5.0). In men, ADL impairment (OR = 2.4, 95% CI = 1.2–4.9) and poorer self-rated health (OR = 2.8, 95% CI = 1.5–5.30) were associated with DI. CONCLUSION UI, FI, and DI are common in older women and men. Factors associated with DI were distinct from those associated with UI and FI. There were also differences according to sex, with DI associated with depression and comorbid diseases in women and lack of functional ability and poorer self-rated health in men. PMID:25940401

  15. Free Antropyloric Valve Flap for End-Stage Fecal Incontinence as a Substitute to Permanent Colostomy.

    PubMed

    Mishra, Brijesh; Chandra, Abhijeet; Gejje, Somashekar; Noushif, M; Upadhyay, Divya N; Mishra, Nalini

    2016-03-01

    Background Surgical removal of the anal canal and sphincter for carcinoma results in end-stage fecal incontinence (ESFI) and requires a permanent colostomy resulting in significant impact on quality of life. Presently, there are limited options for EFSI. The successful use of pedicled antropyloric valve (APV) based on left gastroepiploic artery as an alternative to permanent colostomy has previously been described. It is based on a long omental pedicle which at times is risky and is difficult to perform. A free APV flap could be the only solution in such cases. We assessed the vascular anatomy for the technical feasibility of a free APV flap, and report the first ever clinical application of free APV flap. Methods Bench dissection of 10 pancreaticoduodenectomy specimens was done to delineate the vessels of APV flap. It showed the consistent presence of right gastroepiploic and infrapyloric vessels in all specimens with sufficient diameters. After the technical feasibility, a free APV Flap transposition to perineum was done in a patient, where pedicled transposition was not feasible. Results The free APV flap with vagus nerve branch was harvested without extensive dissection along the greater curvature of stomach. A tension free anastomosis was achieved between the epiploic and left colic vessels. The flap survived well and had a definite tone on digital examination. It was evaluated by radiological and manometric methods. Conclusions APV flap for EFSI can be done as a free flap with distinct advantages and it has the potential of becoming popular options for EFSI. PMID:26473796

  16. An Evidence-Based Approach to the Evaluation, Diagnostic Assessment and Treatment of Fecal Incontinence in Women

    PubMed Central

    Richter, Holly E.

    2014-01-01

    Fecal incontinence (FI) is a debilitating disorder which negatively impacts quality of life. The etiology is often multifactorial and although most women with FI are able to be treated, many remain untreated because a significant proportion of women do not report their symptoms and seek care. The evaluation and treatment of FI can be also hindered by a lack of understanding of the mechanisms and current options. This article provides a review on the evidence-based evaluation and management for FI. PMID:25505643

  17. Adverse events of sacral neuromodulation for fecal incontinence reported to the federal drug administration

    PubMed Central

    Bielefeldt, Klaus

    2016-01-01

    AIM: To investigate the nature and severity of AE related to sacral neurostimulation (SNS). METHODS: Based on Pubmed and Embase searches, we identified published trials and case series of SNS for fecal incontinence (FI) and extracted data on adverse events, requiring an active intervention. Those problems were operationally defined as infection, device removal explant or need for lead and/or generator replacement. In addition, we analyzed the Manufacturer and User Device Experience registry of the Federal Drug Administration for the months of August - October of 2015. Events were included if the report specifically mentioned gastrointestinal (GI), bowel and FI as indication and if the narrative did not focus on bladder symptoms. The classification, reporter, the date of the recorded complaint, time between initial implant and report, the type of AE, steps taken and outcome were extracted from the report. In cases of device removal or replacement, we looked for confirmatory comments by healthcare providers or the manufacturer. RESULTS: Published studies reported adverse events and reoperation rates for 1954 patients, followed for 27 (1-117) mo. Reoperation rates were 18.6% (14.2-23.9) with device explants accounting for 10.0% (7.8-12.7) of secondary surgeries; rates of device replacement or explant or pocket site and electrode revisions increased with longer follow up. During the period examined, the FDA received 1684 reports of AE related to SNS with FI or GI listed as indication. A total of 652 reports met the inclusion criteria, with 52.7% specifically listing FI. Lack or loss of benefit (48.9%), pain or dysesthesia (27.8%) and complication at the generator implantation site (8.7%) were most commonly listed. Complaints led to secondary surgeries in 29.7% of the AE. Reoperations were performed to explant (38.2%) or replace (46.5%) the device or a lead, or revise the generator pocket (14.6%). Conservative management changes mostly involved changes in stimulation

  18. A prospective, randomized, controlled study of a suspension positioning system used with elderly bedridden patients with neurogenic fecal incontinence.

    PubMed

    Su, Mei-Yin; Lin, Shi-Quan; zhou, Ye-Wen; Zhou, Ye-Wen; Liu, Si-Ya; Lin, Ai; Lin, Xi-Rong

    2015-01-01

    Elderly patients with acute neurological impairment are prone to severe disability, fecal incontinence (FI), and resultant complications. A suspension positioning system (SPS), based on the orthopedic suspension traction system commonly used for conservative treatment of pediatric femoral fracture and uncomplicated adult pelvic fracture, was developed to facilitate FI management in patients immobilized secondary to an acute neurological condition. To evaluate the effectiveness and safety of the system, a prospective, randomized, controlled study was conducted between October 2009 and July 2012. Two hundred (200) elderly, bedridden, hospitalized patients with acute, nonchronic neurological impairment were randomly assigned to receive routine FI nursing care (ie, individualized dietary modification, psychological support, health education, and social support for caregivers and family members [control group]) or routine incontinence care plus the SPS (experimental group) during the day. Rates of perianal fecal contamination, skin breakdown, incontinence associated dermatitis, pressure ulcer development, and lower urinary tract infection (LUTI) were significantly lower in the SPS than in the control group (P <0.05). Length of hospitalization and costs of care were also lower in the SPS group (P <0.05). Patient quality-of-life (QoL) and FI QoL scores were similar at baseline but significantly higher (better) at the 6-month follow-up interview in the SPS than in the control group (P <0.05). In this study, the rate of FI-associated morbidities was lower and 6-month patient QoL scores were higher in the SPS than in the control group. No adverse events were observed, and all patients completed the study. Further clinical studies are needed to examine the long-term effects of SPS use among neurologically impaired FI patients. PMID:25581605

  19. The Relationship of 3D Translabial Ultrasound Anal Sphincter Complex Measurements to Postpartum Anal and Fecal Incontinence

    PubMed Central

    MERIWETHER, Kate V.; HALL, Rebecca J.; LEEMAN, Lawrence M.; MIGLIACCIO, Laura; QUALLS, Clifford; ROGERS, Rebecca G.

    2015-01-01

    Objective We aimed to determine whether ASC measurements on translabial ultrasound (TL-US) were related to anal incontinence (AI) or fecal incontinence (FI) symptoms six months postpartum. Methods A prospective cohort of primiparous women underwent TL-US six months after a vaginal birth (VB) or Cesarean delivery (CD). Muscle thickness was measured at 3, 6, 9, and 12 o’clock positions of the external sphincter (EAS), the same four quadrants of the internal sphincter (IAS) at proximal, mid, and distal levels, and at the bilateral pubovisceralis muscle (PVM). Measurements were correlated to AI and FI on the Wexner Fecal Incontinence Scale, with sub-analyses by mode of delivery. The odds ratio (OR) of symptoms was calculated for every one millimeter increase in muscle thickness (E1MIT). Results 423 women (299 VB, 124 CD) had TL-US six months postpartum. Decreased AI risk was associated with thicker measurements at the 6 o’clock (OR 0.74 E1MIT) and 9 o’clock proximal IAS (OR 0.71 E1MIT) in the entire cohort. For CD women, thicker measurements of the 9 o’clock proximal IAS were associated with decreased risk of AI (OR 0.56 E1MIT) and thicker distal 6 o’clock IAS measurements were related to a decreased risk of FI (OR 0.37 E1MIT). For VB women, no sphincter measurements were significantly related to symptoms, but thicker PVM measurements were associated with increased risk of AI (right side OR 1.32 E1MIT; left side OR 1.21 E1MIT). Conclusions ASC anatomy is associated with AI and FI in certain locations; these locations varybased on the patient’s mode of delivery. PMID:26085463

  20. Identifying factors associated with clinical success in patients treated with NASHA®/Dx injection for fecal incontinence

    PubMed Central

    Franklin, Howard; Barrett, Andrew C; Wolf, Ray

    2016-01-01

    Purpose Injection with the bulking agent consisting of non-animal stabilized hyaluronic acid/dextranomer (NASHA®/Dx) is well tolerated and efficacious for the treatment of fecal incontinence (FI); however, the patient population that may derive maximum benefit has not been established. This post hoc responder analysis assessed demographic and baseline characteristics predictive of responsiveness to NASHA/Dx treatment. Methods Adults with a Cleveland Clinic Florida fecal incontinence score (CCFIS) ≥10 were randomized to receive NASHA/Dx or sham treatment. The primary end point was response to treatment (ie, decrease from baseline of ≥50% in number of FI episodes) at 6 months; a prespecified secondary end point was change in fecal incontinence quality of life (FIQL) score at 6 months. Post hoc subgroup analyses were performed for baseline and demographic characteristics and prior FI treatments. Results Overall, response to treatment was significantly greater with NASHA/Dx versus sham injection (52.7% vs 32.1%; P=0.0089). All subgroups analyzed demonstrated evidence of improvement, favoring NASHA/Dx versus sham treatment for both response to treatment and change in the FIQL coping/behavior subscale score. For the primary end point, a significantly greater percentage of patients with CCFIS ≤15, FI symptoms ≤5 years’ duration, or obstetric causes of FI responded to NASHA/Dx treatment versus patients receiving sham treatment (51.1% vs 28.3%, P=0.0169; 55.4% vs 25.7%, P=0.0026; and 53.6% vs 23.1%, P=0.0191, respectively). The mean change in the FIQL coping/behavior score significantly favored NASHA/Dx versus sham treatment for patients with CCFIS ≤15 (P=0.0371), FI symptoms ≤5 years’ duration (P=0.0289), or obstetric causes of FI (P=0.0384). Patients without a history of specific FI treatments (eg, antidiarrheal medications, biofeedback, surgery) were more likely to respond to NASHA/Dx versus sham treatment for both end points. Conclusion Although all

  1. Treatment of fecal incontinence - review of observational studies (OS) and randomized controlled trials (RCT) related to injection of bulking agent into peri-anal tissue.

    PubMed

    Leung, Felix W

    2011-10-01

    PURPOSE: Novel treatments are needed to augment medical therapy for fecal incontinence. METHODS: Medline and Google search (fecal incontinence and injection treatment), English publications. RESULTS: Twenty-two observational studies and 4 randomized controlled trials were identified. OS mostly with limited sample sizes reported promising results. Repeated injection was necessary in some patients. Effect on anal sphincter pressures was highly variable. Significant improvements in the length of anal high-pressure zone, asymmetry index and maximum tolerable rectal volume were suggested. Four randomized controlled trials (n=176) revealed: 1. Short-term benefits from injection of Bioplastique under ultrasound guidance compared with digital guidance; 2. Silicone biomaterial (PTQ) provided some advantages and was safer than carbon-coated beads (Durasphere); 3. PTQ did not demonstrate clinical benefit compared to control injection of saline; 4. There was significant improvement at 6 weeks post injection, but no difference between Bulkamid and Permacol. A 2010 Cochrane review, however, noted that these data were inconclusive due to limited number and methodological weaknesses. CONCLUSION: Further studies are warranted to assess patient-centered outcomes (e.g. adequate relief) in addition to the attenuation of severity of incontinence symptoms in ambulatory patients. In nursing home residents, cost-effectiveness studies combining injection treatment and prompted voiding (to mitigate constraints of immobility and dementia) in preventing peri-anal skin complications deserves to be considered. PMID:22586538

  2. Treatment of fecal incontinence - review of observational studies (OS) and randomized controlled trials (RCT) related to injection of bulking agent into peri-anal tissue

    PubMed Central

    2011-01-01

    Purpose Novel treatments are needed to augment medical therapy for fecal incontinence. Methods Medline and Google search (fecal incontinence and injection treatment), English publications. Results Twenty-two observational studies and 4 randomized controlled trials were identified. OS mostly with limited sample sizes reported promising results. Repeated injection was necessary in some patients. Effect on anal sphincter pressures was highly variable. Significant improvements in the length of anal high-pressure zone, asymmetry index and maximum tolerable rectal volume were suggested. Four randomized controlled trials (n=176) revealed: 1. Short-term benefits from injection of Bioplastique under ultrasound guidance compared with digital guidance; 2. Silicone biomaterial (PTQ) provided some advantages and was safer than carbon-coated beads (Durasphere); 3. PTQ did not demonstrate clinical benefit compared to control injection of saline; 4. There was significant improvement at 6 weeks post injection, but no difference between Bulkamid and Permacol. A 2010 Cochrane review, however, noted that these data were inconclusive due to limited number and methodological weaknesses. Conclusion Further studies are warranted to assess patient-centered outcomes (e.g. adequate relief) in addition to the attenuation of severity of incontinence symptoms in ambulatory patients. In nursing home residents, cost-effectiveness studies combining injection treatment and prompted voiding (to mitigate constraints of immobility and dementia) in preventing peri-anal skin complications deserves to be considered. PMID:22586538

  3. Hyperspectral Imaging of fecal contamination on chickens

    NASA Technical Reports Server (NTRS)

    2003-01-01

    ProVision Technologies, a NASA research partnership center at Sternis Space Center in Mississippi, has developed a new hyperspectral imaging (HSI) system that is much smaller than the original large units used aboard remote sensing aircraft and satellites. The new apparatus is about the size of a breadbox. Health-related applications of HSI include scanning chickens during processing to help prevent contaminated food from getting to the table. ProVision is working with Sanderson Farms of Mississippi and the U.S. Department of Agriculture. ProVision has a record in its spectral library of the unique spectral signature of fecal contamination, so chickens can be scanned and those with a positive reading can be separated. HSI sensors can also determine the quantity of surface contamination. Research in this application is quite advanced, and ProVision is working on a licensing agreement for the technology. The potential for future use of this equipment in food processing and food safety is enormous.

  4. Dynamic versus Adynamic Graciloplasty in Treatment of End-Stage Fecal Incontinence: Is the Implantation of the Pacemaker Really Necessary? 12-Month Follow-Up in a Clinical, Physiological, and Functional Study

    PubMed Central

    Walega, Piotr; Romaniszyn, Michal; Siarkiewicz, Benita; Zelazny, Dorota

    2015-01-01

    Purpose. The aim of the study is to compare functional results of end-stage fecal incontinence treatment with dynamic graciloplasty and adynamic graciloplasty augmented with transanal conditioning of the transposed muscle. Methods. A total of 20 patients were qualified for graciloplasty procedure due to end-stage fecal incontinence. 7 patients underwent dynamic graciloplasty (DGP), whereas 13 patients were treated with adynamic graciloplasty, with transanal stimulation in the postoperative period (AGP). Clinical, functional, and quality of life assessments were performed 3, 6, and 12 months after the procedures. Results. There were no intraoperative or early postoperative complications. The detachment of gracilis muscle tendon was observed in one patient in DGP group and two in AGP group. There was a significant improvement of Fecal Incontinence Quality of Life (FIQL) and Fecal Incontinence Severity Index (FISI) scores in both groups 12 months after procedure. Anorectal manometry showed improvement regarding basal and squeeze pressures in both groups, with significantly better squeeze pressures in AGP group. Conclusions. The functional effects in the DGP and AGP groups were similar. Significantly lower price of the procedure and avoidance of implant-related complication risk suggest the attractiveness of the AGP method augmented by transanal stimulation. PMID:25861261

  5. Inspection of fecal contamination on strawberries using fluorescence imaging

    NASA Astrophysics Data System (ADS)

    Chuang, Yung-Kun; Yang, Chun-Chieh; Kim, Moon S.; Delwiche, Stephen R.; Lo, Y. Martin; Chen, Suming; Chan, Diane E.

    2013-05-01

    Fecal contamination of produce is a food safety issue associated with pathogens such as Escherichia coli that can easily pollute agricultural products via animal and human fecal matters. Outbreaks of foodborne illnesses associated with consuming raw fruits and vegetables have occurred more frequently in recent years in the United States. Among fruits, strawberry is one high-potential vector of fecal contamination and foodborne illnesses since the fruit is often consumed raw and with minimal processing. In the present study, line-scan LED-induced fluorescence imaging techniques were applied for inspection of fecal material on strawberries, and the spectral characteristics and specific wavebands of strawberries were determined by detection algorithms. The results would improve the safety and quality of produce consumed by the public.

  6. Improved hyperspectral imaging system for fecal detection on poultry carcasses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Agricultural Research Service (ARS) has developed imaging technology to detect fecal contaminants on poultry carcasses. The hyperspectral imaging system operates from about 400 to 1000 nm, but only a few wavelengths are used in a real-time multispectral system. Recently, the upgraded system, inc...

  7. Urinary Incontinence

    MedlinePlus

    ... of this page please turn Javascript on. Urinary Incontinence What Is Urinary Incontinence? Urinary incontinence means a person leaks urine by ... about what you can do. Types of Urinary Incontinence There are different types of urinary incontinence. Stress ...

  8. Classification of fecal contamination on leafy greens by hyperspectral imaging

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A hyperspectral fluorescence imaging system was developed and used to obtain several two-waveband spectral ratios on leafy green vegetables, represented by romaine lettuce and baby spinach in this study. The ratios were analyzed to determine the proper one for detecting bovine fecal contamination on...

  9. Classification of Fecal Contamination on Leafy Greens by Hyperspectral Imaging

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A hyperspectral fluorescence imaging system was developed and used to obtain several two-waveband spectral ratios on leafy green vegetables, represented by romaine lettuce and baby spinach in this study. The ratios were analyzed to determine the proper one for detecting bovine fecal contamination on...

  10. Classification of fecal contamination on leafy greens by hyperspectral imaging

    NASA Astrophysics Data System (ADS)

    Yang, Chun-Chieh; Jun, Won; Kim, Moon S.; Chao, Kaunglin; Kang, Sukwon; Chan, Diane E.; Lefcourt, Alan

    2010-04-01

    This paper reported the development of hyperspectral fluorescence imaging system using ultraviolet-A excitation (320-400 nm) for detection of bovine fecal contaminants on the abaxial and adaxial surfaces of romaine lettuce and baby spinach leaves. Six spots of fecal contamination were applied to each of 40 lettuce and 40 spinach leaves. In this study, the wavebands at 666 nm and 680 nm were selected by the correlation analysis. The two-band ratio, 666 nm / 680 nm, of fluorescence intensity was used to differentiate the contaminated spots from uncontaminated leaf area. The proposed method could accurately detect all of the contaminated spots.

  11. [Incontinence - Etiology, diagnostics and Therapy].

    PubMed

    Frieling, Thomas

    2016-08-01

    Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available. Anal-fecal continence is maintained by anatomical factors, rectoanal sensation, and rectal compliance. The diagnostic approach comprises muscle and nerve injuries by iatrogenic, obstetric or surgical trauma, descending pelvic floor or associated diseases. A basic diagnostic workup is sufficient to characterize the different manifestations of fecal incontinence in most of the cases. This includes patient history with a daily stool protocol and digital rectal investigation. Additional investigations may include anorectal manometry, anal sphincter EMG, conduction velocity of the pudendal nerve, needle EMG, barostat investigation, defecography and the dynamic MRI. Therapeutic interventions are focused on the individual symptoms and should be provided in close cooperation with gastroenterologists, surgeons, gynecologists, urologists, physiotherapeutics and psychologists (nutritional-training, food fibre content, pharmacological treatment of diarrhea/constipation, toilet training, pelvic floor gymnastic, anal sphincter training, biofeedback). Surgical therapy includes the STARR operation for rectoanal prolapse and sacral nerve stimulation for chronic constipation and anal-fecal incontinence. Surgery should not be applied unless the diagnostic work-up is complete and all conservative treatment options failed. PMID:27557074

  12. Automatic identification of fungi under complex microscopic fecal images

    NASA Astrophysics Data System (ADS)

    Liu, Lin; Yuan, Yang; Zhang, Jing; Lei, Haoting; Wang, Qiang; Liu, Juanxiu; Du, Xiaohui; Ni, Guangming; Liu, Yong

    2015-07-01

    Automatic identification of fungi in microscopic fecal images provides important information for evaluating digestive diseases. To date, disease diagnosis is primarily performed by manual techniques. However, the accuracy of this approach depends on the operator's expertise and subjective factors. The proposed system automatically identifies fungi in microscopic fecal images that contain other cells and impurities under complex environments. We segment images twice to obtain the correct area of interest, and select ten features, including the circle number, concavity point, and other basic features, to filter fungi. An artificial neural network (ANN) system is used to identify the fungi. The first stage (ANN-1) processes features from five images in differing focal lengths; the second stage (ANN-2) identifies the fungi using the ANN-1 output values. Images in differing focal lengths can be used to improve the identification result. The system output accurately detects the image, whether or not it has fungi. If the image does have fungi, the system output counts the number of different fungi types.

  13. Management of Loose, Frequent Stools and Fecal Incontinence in a Chronic Mesenteric Ischemia Patient with Oral Serum-derived Bovine Immunoglobulin

    PubMed Central

    Good, Larry; Burnett, Bruce P

    2015-01-01

    AIM Chronic diarrhea with fecal incontinence (FI) is a severe, underreported, and intractable problem in many patients for which limited pharmaceutical options exist. METHODS A retrospective case history was collected after the administration of a prescription medical food composed of serum-derived bovine immunoglobulin/protein isolate (SBI) at 5 g once daily in a patient with chronic mesenteric ischemia (CMI) for chronic loose, frequent, and urgent stools. The patient was an 84-year-old white male with a 20-year history of progressively worsening chronic diarrhea with six to eight watery stools per day (Bristol Stool Form Scale, Type 7), urgency, nocturnal diarrhea, FI, and postprandial abdominal discomfort before administration of SBI. RESULTS After four weeks of SBI administration, the patient had two to three soft, semi-formed stools (Bristol Stool Form Scale, Types 4 and 5) per day with no nocturnal diarrhea, urgency, or FI, as well as full resolution of abdominal discomfort. In addition, the patient expressed an enhanced quality of life (QoL): able to travel, attend social events, and perform tasks not possible before therapy. CONCLUSION This case underscores how a safe, nutritional therapy may offer a new modality for physicians to address chronic loose, frequent stools with FI in patients with CMI in this difficult to manage gastrointestinal population. PMID:25674029

  14. Epidemiology, pathophysiology, and classification of fecal incontinence: State of the Science Summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Workshop

    PubMed Central

    Bharucha, Adil E.; Dunivan, Gena; Goode, Patricia S.; Lukacz, Emily S.; Markland, Alayne D.; Matthews, Catherine A.; Mott, Louise; Rogers, Rebecca G.; Zinsmeister, Alan R.; Whitehead, William E.; Rao, Satish S.C.; Hamilton, Frank A.

    2015-01-01

    In August 2013, the National Institutes of Health sponsored a conference to address major gaps in our understanding of the epidemiology, pathophysiology, and management of fecal incontinence (FI) and to identify topics for future clinical research. This article is the first of a two-part summary of those proceedings. FI is a common symptom, with a prevalence that ranges from 7 to 15% in community-dwelling men and women, but is often underreported as providers seldom screen for FI and patients do not volunteer the symptom, even though the symptoms can have a devastating impact on quality of life. Rough estimates suggest that FI is associated with a substantial economic burden, particularly in patients who require surgical therapy. Bowel disturbances, particularly diarrhea, the symptom of rectal urgency, and burden of chronic illness are the strongest independent risk factors for FI in the community. Smoking, obesity, and inappropriate cholecystectomy are emerging, potentially modifiable risk factors. Other risk factors for FI include advanced age, female gender, disease burden (co-morbidity count, diabetes), anal sphincter trauma (obstetrical injury, prior surgery), and decreased physical activity. Neurological disorders, inflammatory bowel disease, pelvic floor anatomical disturbances (rectal prolapse) are also associated with FI. The pathophysiological mechanisms responsible for FI include diarrhea, anal and pelvic floor weakness, reduced rectal compliance, and reduced or increased rectal sensation; many patients have multi-faceted anorectal dysfunctions. The type (urge, passive or combined); etiology (anorectal disturbance, bowel symptoms or both); and severity of FI provide the basis for classifying FI; these domains can be integrated to comprehensively characterize the symptom. Several validated scales for classifying symptom severity and its impact on quality of life are available. Symptom severity scales should incorporate the frequency, volume, consistency

  15. Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop.

    PubMed

    Bharucha, Adil E; Dunivan, Gena; Goode, Patricia S; Lukacz, Emily S; Markland, Alayne D; Matthews, Catherine A; Mott, Louise; Rogers, Rebecca G; Zinsmeister, Alan R; Whitehead, William E; Rao, Satish S C; Hamilton, Frank A

    2015-01-01

    In August 2013, the National Institutes of Health sponsored a conference to address major gaps in our understanding of the epidemiology, pathophysiology, and management of fecal incontinence (FI) and to identify topics for future clinical research. This article is the first of a two-part summary of those proceedings. FI is a common symptom, with a prevalence that ranges from 7 to 15% in community-dwelling men and women, but it is often underreported, as providers seldom screen for FI and patients do not volunteer the symptom, even though the symptoms can have a devastating impact on the quality of life. Rough estimates suggest that FI is associated with a substantial economic burden, particularly in patients who require surgical therapy. Bowel disturbances, particularly diarrhea, the symptom of rectal urgency, and burden of chronic illness are the strongest independent risk factors for FI in the community. Smoking, obesity, and inappropriate cholecystectomy are emerging, potentially modifiable risk factors. Other risk factors for FI include advanced age, female gender, disease burden (comorbidity count, diabetes), anal sphincter trauma (obstetrical injury, prior surgery), and decreased physical activity. Neurological disorders, inflammatory bowel disease, and pelvic floor anatomical disturbances (rectal prolapse) are also associated with FI. The pathophysiological mechanisms responsible for FI include diarrhea, anal and pelvic floor weakness, reduced rectal compliance, and reduced or increased rectal sensation; many patients have multifaceted anorectal dysfunctions. The type (urge, passive or combined), etiology (anorectal disturbance, bowel symptoms, or both), and severity of FI provide the basis for classifying FI; these domains can be integrated to comprehensively characterize the symptom. Several validated scales for classifying symptom severity and its impact on the quality of life are available. Symptom severity scales should incorporate the frequency, volume

  16. Length Tension Function of Puborectalis Muscle: Implications for the Treatment of Fecal Incontinence and Pelvic Floor Disorders

    PubMed Central

    Mittal, Ravinder K; Sheean, Geoff; Padda, Bikram S; Rajasekaran, Mahadevan R

    2014-01-01

    Background/Aims External anal sphincter (EAS) and puborectalis muscle (PRM) play important role in anal continence function. Based on length-tension measurement, we recently reported that the human EAS muscle operates at short sarcomere length under physiological conditions. Goal of our study was to determine if PRM also operates at the short sarcomere length. Methods Length-tension relationship of the PRM muscle was studied in vivo in 10 healthy nullipara women. Length was altered by vaginal distension using custom-designed probes of 5, 10, 15, 20, 25 and 30 mm diameters as well as by distending a polyethylene bag with different volumes of water. Probes were equipped with a reverse perfuse sleeve sensor to measure vaginal pressure (surrogate of PRM tension). PRM electromyogram (EMG) was recorded using wire electrodes. Three-dimensional ultra-sound images were obtained to determine effect of vaginal distension on PRM length. Results Ultrasound images demonstrate distension volume dependent increase in PRM length. Rest and squeeze pressures of vaginal bag increased with the increase in bag volume. Similarly, the change in vaginal pressure, which represents the PRM contraction increased with the increase in the probe size. Increase in probe size was not associated with an increase in EMG activity (a marker of neural drive) of the PRM. Conclusions Probe size dependent increase in PRM contraction pressure, in the presence of constant EMG (neural input) proves that the human PRM operates at short sarcomere length. Surgically adjusting the PRM length may represent a novel strategy to improve treat anal continence and possibly other pelvic floor disorders. PMID:25273124

  17. Identifying fecal matter contamination in produce fields using multispectral reflectance imaging under ambient solar illumination

    NASA Astrophysics Data System (ADS)

    Everard, Colm D.; Kim, Moon S.; Lee, Hoonsoo; O'Donnell, Colm P.

    2016-05-01

    An imaging device to detect fecal contamination in fresh produce fields could allow the producer avoid harvesting fecal contaminated produce. E.coli O157:H7 outbreaks have been associated with fecal contaminated leafy greens. In this study, in-field spectral profiles of bovine fecal matter, soil, and spinach leaves are compared. A common aperture imager designed with two identical monochromatic cameras, a beam splitter, and optical filters was used to simultaneously capture two-spectral images of leaves contaminated with both fecal matter and soil. The optical filters where 10 nm full width half maximum bandpass filters, one at 690 nm and the second at 710 nm. These were mounted in front of the object lenses. New images were created using the ratio of these two spectral images on a pixel by pixel basis. Image analysis results showed that the fecal matter contamination could be distinguished from soil and leaf on the ratio images. The use of this technology has potential to allow detection of fecal contamination in produce fields which can be a source of foodbourne illnesses. It has the added benefit of mitigating cross-contamination during harvesting and processing.

  18. [Postpartum incontinence. Narrative review].

    PubMed

    Rodríguez, Rodolfo; Alós, Rafael; Carceller, M Soledad; Solana, Amparo; Frangi, Andrés; Ruiz, M Dolores; Lozoya, Roberto

    2015-01-01

    The development of fecal incontinence after childbirth is a common event. This incontinence responds to a multifactorial etiology in which the most common element is external anal sphincter injury. There are several risk factors, and it is very important to know and avoid them. Sphincter injury may result from perineal tear or sometimes by incorrectly performing an episiotomy. It is very important to recognize the injury when it occurs and repair it properly. Pudendal nerve trauma may contribute to the effect of direct sphincter injury. Persistence of incontinence is common, even after sphincter repair. Surgical sphincteroplasty is the standard treatment of obstetric sphincter injuries, however, sacral or tibial electric stimulation therapies are being applied in patients with sphincter injuries not repaired with promising results. PMID:25467972

  19. Cross-sectional imaging following surgical interventions for stress urinary incontinence in females.

    PubMed

    Jung, Brian C; Tran, Ngoc-Anh; Verma, Sadhna; Dutta, Rahul; Tung, Paul; Mousa, Michael; Hernandez-Rangel, Eduardo; Nayyar, Megha; Lall, Chandana

    2016-06-01

    Stress urinary incontinence (SUI) is a condition in which the weakness of the pelvic floor muscles causes unintentional loss of urine. For patients who are unable to achieve symptomatic improvement from lifestyle modification and pharmacotherapy, surgical placement of the pelvic slings or the use of urethral bulking agents has been shown to provide tremendous symptomatic improvement. Learning to recognize the pelvic slings and to identify their complications on imaging is invaluable; however, this is challenging because of the change in the local anatomy after surgical placement of the sling. In this paper, we present CT and MR imaging to demonstrate the surgical and non-surgical treatments of female SUI and their complications. Through this pictorial essay, our goal is to familiarize radiologists with recognizing the various forms of treatment for SUIs, the relevant pelvic anatomy, and complications that may occur secondary to the surgical placement of the pelvic slings. PMID:26934892

  20. Urinary incontinence

    MedlinePlus

    Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary ... Causes of urinary incontinence include: Blockage in the urinary system Brain or nerve problems Dementia or other mental health problems that make ...

  1. Effect of broiler carcass washing on fecal contaminant imaging

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The USDA Food Safety and Inspection Service has mandated that there be no fecal contaminants on poultry carcasses when the carcasses enter the chiller tank because of a risk of cross-contamination of pathogens. Since the inception of the hazard analysis and critical control point (HACCP) mandate, th...

  2. Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series (image)

    MedlinePlus

    ... or rectocele. This is occasionally performed to treat stress incontinence in women by supporting the bladder and urethra in its ... straining with bowel movements since this can cause stress on the incision.

  3. Red to far-red multispectral fluorescence image fusion for detection of fecal contamination on apples

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This research developed a multispectral algorithm derived from hyperspectral line-scan fluorescence imaging under violet/blue LED excitation for detection of fecal contamination on Golden Delicious apples. Using a hyperspectral line-scan imaging system consisting of an EMCCD camera, spectrograph, an...

  4. Detection of fecal residue on poultry carcasses by laser induced fluorescence imaging

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Feasibility of fluorescence imaging technique for the detection of diluted fecal matters from various parts of the digestive tract, including colon, ceca, small intestine, and duodenum, on chicken carcasses was investigated. One of the challenges for using fluorescence imaging for inspection of agri...

  5. Line-scan hyperspectral imaging for real-time on-line poultry fecal detection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The preliminary results demonstrated that high speed line-scan hyperspectral imaging system has a potential for real-time online fecal detection during poultry processing. To improve detection accuracy, fully calibrated images both spatially and spectrally were acquired for further processing. In ad...

  6. Line-scan hyperspectral imaging for real-time poultry fecal detection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The preliminary results demonstrated that high speed line-scan hyperspectral imaging system has a potential for real-time online fecal detection during poultry processing. To improve detection accuracy, fully calibrated images both spatially and spectrally were acquired for further processing. In ad...

  7. Detection of fecal residue on poultry carcasses by laser induced fluorescence imaging techniques

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The potential use of laser-induced fluorescence imaging techniques was investigated for the detection of diluted fecal matters from various parts of the digestive tract, including colon, ceca, small intestine, and duodenum, on poultry carcasses. One of the challenges for using fluorescence imaging f...

  8. Analysis of reflectance spectra from hyperspectral images of poultry carcasses for fecal and ingesta detection

    NASA Astrophysics Data System (ADS)

    Windham, William R.; Lawrence, Kurt C.; Park, Bosoon; Smith, Doug P.; Poole, Gavin

    2002-11-01

    Identification and separation of poultry carcasses contaminated by feces and/or crop ingesta are very important to protect the consumer from a potential source of food poisoning. A transportable hyperspectral imaging system was developed to detect fecal and ingesta contamination on the surface of poultry carcasses. Detection algorithms used with the imaging system were developed from visible/near infrared monochromator spectra and with contaminates from birds fed a corn/soybean meal diet. The objectives of this study were to investigate using regions of interest reflectance spectra from hyperspectral images to determine optimal wavelengths for fecal detection algorithms from images of birds fed corn, wheat and milo diets. Spectral and spatial data between 400 and 900 nm with a 1.0 nm spectral resolution were acquired from uncontaminated and fecal and ingesta contaminated poultry carcasses. Regions of interest (ROIs) were defined for fecal and ingesta contaminated and uncontaminated skin (i.e. breast, thigh, and wing). Average reflectance spectra of the ROIs were extracted for analysis. Reflectance spectra of contaminants and uncontaminated skin differed. Spectral data pre-processing treatments with a single-term, linear regression program to select wavelengths for optimum calibration coefficients to detect contamination were developed. Fecal and ingesta detection models, specifically a quotient of 2 and/or 3-wavelengths was 100% successful in classification of contaminates.

  9. Hyperspectral imaging technique for detection of poultry fecal residues on food processing equipments

    NASA Astrophysics Data System (ADS)

    Cho, Byoung-Kwan; Kim, Moon S.; Chen, Yud-Ren

    2005-11-01

    Emerging concerns about safety and security in current mass production of food products necessitate rapid and reliable inspection for contaminant-free products. Diluted fecal residues on poultry processing plant equipment surface, not easily discernable from water by human eye, are contamination sources for poultry carcasses. Development of sensitive detection methods for fecal residues is essential to ensure safe production of poultry carcasses. Hyperspectral imaging techniques have shown good potential for detecting of the presence of fecal and other biological substances on food and processing equipment surfaces. In this study, use of high spatial resolution hyperspectral reflectance and fluorescence imaging (with UV-A excitation) is presented as a tool for selecting a few multispectral bands to detect diluted fecal and ingesta residues on materials used for manufacturing processing equipment. Reflectance and fluorescence imaging methods were compared for potential detection of a range of diluted fecal residues on the surfaces of processing plant equipment. Results showed that low concentrations of poultry feces and ingesta, diluted up to 1:100 by weight with double distilled water, could be detected using hyperspectral fluorescence images with an accuracy of 97.2%. Spectral bands determined in this study could be used for developing a real-time multispectral inspection device for detection of harmful organic residues on processing plant equipment.

  10. [Anal incontinence].

    PubMed

    Signorelli, I; Andreoni, G M; Capelli, G; Gozzini, P A

    1983-06-01

    The Authors describe the clinical rectal incontinence according to etiology, physiology and pathologic anatomy. They report a case of such rectal incontinence followed to hemorroidectom and treated by transplantation of gracilis muscle according to Pikrell technique, comparing this approach with other current surgical procedures. PMID:6680848

  11. Incontinence Treatment: Surgical Treatments

    MedlinePlus

    ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ...

  12. Symptoms of Incontinence

    MedlinePlus

    ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ...

  13. Incontinence Treatment: Medication

    MedlinePlus

    ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ...

  14. Urinary Incontinence

    MedlinePlus

    ... you risk getting rashes, sores, skin infections and urinary tract infections. Also, you may find yourself avoiding friends and ... elderly and may be a sign of a urinary tract infection or an overactive bladder. Overflow incontinence This type ...

  15. Urinary Incontinence

    MedlinePlus

    Urinary incontinence (UI) is loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age. Women experience ...

  16. Urinary Incontinence

    MedlinePlus

    ... injury, birth defects, stroke, diabetes, multiple sclerosis, and physical changes associated with aging. Pregnancy — Unborn babies push down ... incontinence in women. It is often caused by physical changes from pregnancy, childbirth, and menopause. It can be ...

  17. ANALYSIS OF REFLECTANCE SPECTRA FROM HYPERSPECTRAL IMAGES OF POULTRY CARCASSES FOR FECAL AND INGESTA DETECTION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Identification and separation of poultry carcasses contaminated by feces and/or crop ingesta are very important to protect the consumer from a potential source of food poisoning. A transportable hyperspectral imaging system was developed to detect fecal and ingesta contamination on the surface of p...

  18. Real-time multispectral imaging system for online poultry fecal inspection using UML

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A prototype real-time multispectral imaging system for fecal and ingesta contaminant detection on broiler carcasses was developed and tested. The prototype system includes a common aperture camera with three optical trim filters (517, 565 and 802-nm wavelength), which were selected and validated by...

  19. Real-Time Multispectral Imaging System for Online Poultry Fecal Inspection using Unified Modeling Language.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A prototype real-time multispectral imaging system for fecal detection on broiler carcasses has been developed. The prototype system included a common aperture camera with three optical trim filters (517, 565 and 802-nm wavelength), which were selected by visible/NIR spectroscopy and validated by a...

  20. An Overview of Bowel Incontinence: What Can Go Wrong?

    ERIC Educational Resources Information Center

    Norton, William F.

    2008-01-01

    Bowel incontinence, also called fecal incontinence, is the loss of control over liquid or solid stools. It can occur at any age--as a child, teenager, or adult. Severity can range from infrequent leakage of a small amount of stool to total loss of bowel control. Some persons might feel the urge to have a bowel movement but be unable to control it…

  1. Vesicorectal fistula detected on direct radionuclide cystography--importance of fecal matter imaging.

    PubMed

    Aghaei, Atena; Sadeghi, Ramin; Saeedi, Parisa

    2014-01-01

    We report an 11 year old male patient with the history of imperforate anus, which was repaired surgically 4 years ago. He has been complaining of intermittent passing of urine into the rectum recently. The vesicorectal fistula in this patient was proven by imaging of the fecal matter post direct radionuclide cystography study. Our case showed that nuclear medicine imaging can be extended to unanimated objects such as patients' excrements or fluids with important diagnostic yields. PMID:24610652

  2. Bladder and rectal incontinence without paraplegia or paraparesis after endovascular aneurysm repair.

    PubMed

    Nishioka, Naritomo; Kurimoto, Yoshihiko; Maruyama, Ryushi; Ujihira, Kosuke; Iba, Yutaka; Hatta, Eiichiro; Yamada, Akira; Nakanishi, Katsuhiko

    2016-12-01

    Spinal cord ischemia is a well-known potential complication of endovascular aneurysm repair (EVAR), and it is usually manifested by paraplegia or paraparesis. We describe a case in which spinal cord ischemia after EVAR presented by isolated bladder and rectal incontinence without other neurological deficits. A 63-year-old woman presented with intermittent claudication secondary to an infrarenal abdominal aortic aneurysm (AAA), and a left common iliac artery obstruction, for which she underwent EVAR using an aorto-uniiliac (AUI) device and ilio-femoral artery bypass. On postoperative day 3, she developed urinary and fecal incontinence without signs of paraplegia or paraparesis. Magnetic resonance imaging (MRI) showed a hyper-intense signal in the spinal cord. She received hyperbaric oxygen (HBO) therapy and was discharged after 18 days when her urinary and fecal incontinence were almost resolved. This report suggests that spinal cord ischemia after EVAR for aortoiliac occlusive disease might present as bladder and rectal incontinence without other neurological manifestations. PMID:26943687

  3. Line-scan hyperspectral imaging for real-time poultry fecal detection

    NASA Astrophysics Data System (ADS)

    Park, Bosoon; Yoon, Seung-Chul; Windham, William R.; Lawrence, Kurt C.; Heitschmidt, G. W.; Kim, Moon S.; Chao, Kaunglin

    2010-04-01

    The ARS multispectral imaging system with three-band common aperture camera was able to inspect fecal contaminants in real-time mode during poultry processing. Recent study has demonstrated several image processing methods including binning, cuticle removal filter, median filter, and morphological analysis in real-time mode could remove false positive errors. The ARS research groups and their industry partner are now merging the fecal detection and systemically disease detection systems onto a common platform using line-scan hyperspectral imaging system. This system will aid in commercialization by creating one hyperspectral imaging system with user-defined wavelengths that can be installed in different locations of the processing line to solve significant food safety problems. Therefore, this research demonstrated the feasibility of line-scan hyperspectral imaging system in terms of processing speed and detection accuracy for a real-time, on-line fecal detection at current processing speed (140 birds per minute) of commercial poultry plant. The newly developed line-scan hyperspectral imaging system could improve Food Safety Inspection Service (FSIS)'s poultry safety inspection program significantly.

  4. Steinert's syndrome presenting as anal incontinence: a case report

    PubMed Central

    2011-01-01

    Introduction Myotonic dystrophy (MD) or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. Case Presentation We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45. Conclusions In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. PMID:21838873

  5. The use of magnetic resonance imaging in the differential diagnosis between starch and fecal peritonitis.

    PubMed

    Winkler, E; Ravid-Megido, M; Rosin, D; Kuriansky, J; Yuditz, A; Horowitz, A; Orenstein, A; Shabtai, M; Ayalon, A

    2001-01-01

    Granulomatous peritonitis, caused by the starch from the surgeons' gloves, is a hypersensitivity reaction that can complicate abdominal surgery and mimic other causes of peritonitis. The diagnosis of this entity is difficult to make, and relies on a high index of suspicion. We suggest the use of magnetic resonance imaging to facilitate the diagnosis of this condition, based on an experimental animal model. 84 rats were subjected to laparotomy, and the abdominal cavity was exposed to either saline solution, talc solution, starch solution or fecal material by creating a cecal perforation. TI-weighted magnetic resonance images, with and without gadolinum enhancement, were taken after 3, 5 and 10 days. The animals were then sacrificed and the abdominal contents were evaluated both macroscopically and microscopically. Both talc and starch caused gross adhesions involving the entire abdominal viscera, and microscopy revealed signs of inflammation and fibrosis. Starch induced reactive granulomas. The adhesions in the cases of fecal peritonitis were confined to the area of the perforation. MR images of the starch peritonitis group was remarkable for a diffuse pathological process with enhancement of the omentum and the peritoneum after gadolinum injection. The MR readings of the fecal peritonitis group showed a localized process with no diffuse enhancement of the peritoneum. The striking differences between the magnetic resonance images of starch and fecal peritonitis in rats suggest that this modality is both sensitive and specific in diagnosing starch peritonitis in a rat model. Early non-invasive diagnosis of these separate entities would ease the establishment of the appropriate treatment. We are currently investigating the use of MRI imaging in suspected starch peritonitis in humans. PMID:12678128

  6. Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence

    PubMed Central

    Kupec, Tomas; Stickeler, Elmar

    2016-01-01

    Purpose. The objective was to evaluate, by means of tomographic ultrasound imaging (TUI), the reliability of a novel approach for determining the position of the implanted tension-free transobturator tape (TOT). Furthermore, we analyzed the association between the position of the tape at rest and the subjective cure in stress incontinent women. Methods. This retrospective pilot study consists of 32 stress incontinent women, who underwent TOT procedure and routine sonographic control at day 1 postoperatively and at follow-up visit. TUI was applied on the resulting 4D volumes, thereby delivering 9 axial slices with a 4 mm interslice distance starting at the meatus urethrae internus in caudal direction. The reliability of the approach was tested by two examiners. Postoperative and follow-up ultrasound parameters of uncured and cured patients were analyzed. Results. Measurements of the position of the TOT demonstrated high intraclass correlation coefficients. We found minor differences between sonographic parameters at day 1 postoperatively and at follow-up after a median period of 321 days. In cured patients, the position of the tape was measured in a more caudal position than in uncured patients. Conclusions. TUI can be a reliable method for determining the position of the tape. Further studies are needed to evaluate whether the postoperatively determined position can be used as an indicator of future subjective cure. PMID:27610378

  7. Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence.

    PubMed

    Gräf, Charlotte M; Kupec, Tomas; Stickeler, Elmar; Goecke, Tamme W; Meinhold-Heerlein, Ivo; Najjari, Laila

    2016-01-01

    Purpose. The objective was to evaluate, by means of tomographic ultrasound imaging (TUI), the reliability of a novel approach for determining the position of the implanted tension-free transobturator tape (TOT). Furthermore, we analyzed the association between the position of the tape at rest and the subjective cure in stress incontinent women. Methods. This retrospective pilot study consists of 32 stress incontinent women, who underwent TOT procedure and routine sonographic control at day 1 postoperatively and at follow-up visit. TUI was applied on the resulting 4D volumes, thereby delivering 9 axial slices with a 4 mm interslice distance starting at the meatus urethrae internus in caudal direction. The reliability of the approach was tested by two examiners. Postoperative and follow-up ultrasound parameters of uncured and cured patients were analyzed. Results. Measurements of the position of the TOT demonstrated high intraclass correlation coefficients. We found minor differences between sonographic parameters at day 1 postoperatively and at follow-up after a median period of 321 days. In cured patients, the position of the tape was measured in a more caudal position than in uncured patients. Conclusions. TUI can be a reliable method for determining the position of the tape. Further studies are needed to evaluate whether the postoperatively determined position can be used as an indicator of future subjective cure. PMID:27610378

  8. Urinary Incontinence

    MedlinePlus

    ... Adults Making Your Wishes Known Home & Community Home › Aging & Health A to Z › Urinary Incontinence Font size A A A Print Share Glossary Basic Facts & Information Causes & Symptoms Diagnosis & Tests Care & Treatment Lifestyle & Management Other Resources Caregiving How ...

  9. MedlinePlus: Urinary Incontinence

    MedlinePlus

    ... Also in Spanish Stress incontinence Also in Spanish Suprapubic catheter care Also in Spanish Urge incontinence Also in ... catheterization - male Skin care and incontinence Stress incontinence Suprapubic catheter care Urge incontinence Urinary catheters Urinary catheters - what ...

  10. Stress urinary incontinence

    MedlinePlus

    Incontinence - stress ... over 2 cups of urine in their bladder. Stress incontinence occurs when the muscles that control your ... area or the prostate (in men) Unknown causes Stress incontinence is the most common type in women. ...

  11. Urinary incontinence - injectable implant

    MedlinePlus

    ... repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

  12. Real-time multispectral imaging system for online poultry fecal inspection using UML

    NASA Astrophysics Data System (ADS)

    Park, Bosoon; Kise, Michio; Lawrence, Kurt C.; Windham, William R.; Smith, Douglas P.; Thai, Chi N.

    2006-10-01

    A prototype real-time multispectral imaging system for fecal and ingesta contaminant detection on broiler carcasses has been developed. The prototype system includes a common aperture camera with three optical trim filters (517, 565 and 802-nm wavelength), which were selected by visible/NIR spectroscopy and validated by a hyperspectral imaging system with decision tree algorithm. The on-line testing results showed that the multispectral imaging technique can be used effectively for detecting feces (from duodenum, ceca, and colon) and ingesta on the surface of poultry carcasses with a processing speed of 140 birds per minute. This paper demonstrated both multispectral imaging hardware and real-time image processing software. For the software development, the Unified Modeling Language (UML) design approach was used for on-line application. The UML models included class, object, activity, sequence, and collaboration diagram. User interface model included seventeen inputs and six outputs. A window based real-time image processing software composed of eleven components, which represented class, architecture, and activity. Both hardware and software for a real-time fecal detection were tested at the pilot-scale poultry processing plant. The run-time of the software including online calibration was fast enough to inspect carcasses on-line with an industry requirement. Based on the preliminary test at the pilot-scale processing line, the system was able to acquire poultry images in real-time. According to the test results, the imaging system is reliable for the harsh environments and UML based image processing software is flexible and easy to be updated when additional parameters are needed for in-plant trials.

  13. Detection of fecal contamination on beef meat surfaces using handheld fluorescence imaging device (HFID)

    NASA Astrophysics Data System (ADS)

    Oh, Mirae; Lee, Hoonsoo; Cho, Hyunjeong; Moon, Sang-Ho; Kim, Eun-Kyung; Kim, Moon S.

    2016-05-01

    Current meat inspection in slaughter plants, for food safety and quality attributes including potential fecal contamination, is conducted through by visual examination human inspectors. A handheld fluorescence-based imaging device (HFID) was developed to be an assistive tool for human inspectors by highlighting contaminated food and food contact surfaces on a display monitor. It can be used under ambient lighting conditions in food processing plants. Critical components of the imaging device includes four 405-nm 10-W LEDs for fluorescence excitation, a charge-coupled device (CCD) camera, optical filter (670 nm used for this study), and Wi-Fi transmitter for broadcasting real-time video/images to monitoring devices such as smartphone and tablet. This study aimed to investigate the effectiveness of HFID in enhancing visual detection of fecal contamination on red meat, fat, and bone surfaces of beef under varying ambient luminous intensities (0, 10, 30, 50 and 70 foot-candles). Overall, diluted feces on fat, red meat and bone areas of beef surfaces were detectable in the 670-nm single-band fluorescence images when using the HFID under 0 to 50 foot-candle ambient lighting.

  14. Hyperspectral fluorescence imaging using violet LEDs as excitation sources for fecal matter contaminate identification on spinach leaves

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Food safety in the production of fresh produce for human consumption is a worldwide issue and needs to be addressed to decrease foodborne illnesses and resulting costs. Hyperspectral fluorescence imaging coupled with multivariate image analysis techniques for detection of fecal contaminates on spina...

  15. Incontinence Treatment: Newer Treatment Options

    MedlinePlus

    ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ... Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories Contact Us ...

  16. Digital bowel cleansing free detection method of colonic polyp from fecal tagging CT images

    NASA Astrophysics Data System (ADS)

    Oda, Masahiro; Kitasaka, Takayuki; Mori, Kensaku; Suenaga, Yasuhito; Takayama, Tetsuji; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Nawano, Shigeru

    2008-03-01

    This paper presents a digital bowel cleansing (DBC) free detection method of colonic polyp from fecal tagging CT images. Virtual colonoscopy (VC) or CT colonography is a new colon diagnostic method to examine the inside of the colon. However, since the colon has many haustra and its shape is long and convoluted, there is a risk of overlooking of lesions existing in blinded areas caused by haustra. Automated polyp detection from colonic CT images will reduce the risk of overlooking. Although many methods for polyp detection have been proposed, these methods needed DBC to detect polyps surrounded by tagged fecal material (TFM). However, DBC may changes shapes of polyps or haustra while removing TFM and it adversely affect polyp detection. We propose a colonic polyp detection method that enables us to detect polyps surrounded by either the air or the TFM simultaneously without any DBC processes. CT values inside polyps surrounded by the air and polyps surrounded by the TFM regions tend to gradually increase (blob structure) and decrease (inverse-blob structure) from outward to inward, respectively. We thus employ blob and inverse-blob structure enhancement filters based on the eigenvalues of the Hessian matrix to detect polyps using intensity characteristic of polyps. False positive elimination is performed using three feature values: the volume, maximum value of the filter outputs, and the standard deviation of CT values inside polyp candidate regions. We applied the proposed method to 104 cases of abdominal CT images. Sensitivity for polyps >= 6 mm was 91.2% with 7.8 FPs/case.

  17. Urinary incontinence in women.

    PubMed

    Wood, Lauren N; Anger, Jennifer T

    2014-01-01

    Urinary incontinence affects women of all ages. History, physical examination, and certain tests can guide specialists in diagnosing stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence. First line management includes lifestyle and behavior modification, as well as pelvic floor strength and bladder training. Drug therapy is helpful in the treatment of urgency incontinence that does not respond to conservative measures. In addition, sacral neuromodulation, intravesical onabotulinumtoxinA injections, and posterior tibial nerve stimulation can be used in select patient populations with drug refractory urgency incontinence. Midurethral synthetic slings, including retropubic and transobturator approaches, are safe and efficacious surgical options for stress urinary incontinence and have replaced more invasive bladder neck slings that use autologous or cadaveric fascia. Despite controversy surrounding vaginal mesh for prolapse, synthetic slings for the treatment of stress urinary incontinence are considered safe and minimally invasive. PMID:25225003

  18. Urinary incontinence - retropubic suspension

    MedlinePlus

    Retropubic suspension is surgery to help control stress incontinence . This is urine leakage that happens when you ... This procedure is done to treat stress incontinence . Before discussing ... medicines, or other options. If you tried these and are ...

  19. External incontinence devices

    MedlinePlus

    ... of products that are available in your area. URINARY INCONTINENCE DEVICES Urine collection devices are mainly used by ... urinary system References Payne CK. Conservative management of urinary incontinence: Behavioral and pelvic floor therapy, urethral and pelvic ...

  20. Urinary incontinence - retropubic suspension

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007374.htm Urinary incontinence - retropubic suspension To use the sharing features on ... may be because other problems are causing your urinary incontinence. Over time, some or all of the leakage ...

  1. Adaptive remapping procedure for electronic cleansing of fecal tagging CT colonography images

    NASA Astrophysics Data System (ADS)

    Morra, Lia; Delsanto, Silvia; Campanella, Delia; Regge, Daniele; Bert, Alberto

    2009-02-01

    Fecal tagging preparations are attracting notable interest as a way to increase patients' compliance to virtual colonoscopy. Patient-friendly preparations, however, often result in less homogeneous tagging. Electronic cleansing algorithms should be capable of dealing with such preparations and yield good quality 2D and 3D images; moreover, successful electronic cleansing lays the basis for the application of Computer Aided Detection schemes. In this work, we present a cleansing algorithm based on an adaptive remapping procedure, which is based on a model of how partial volume affects both the air-tissue and the soft-tissue interfaces. Partial volume at the stool-soft tissue interface is characterized in terms of the local characteristics of tagged regions, in order to account for variations in tagging intensity throughout the colon. The two models are then combined in order to obtain a remapping equation relating the observed intensity to the that of the cleansed colon. The electronic cleansed datasets were then processed by a CAD scheme composed of three main steps: colon surface extraction, polyp candidate segmentation through curvature-based features, and linear classifier-based discrimination between true polyps and false alarms. Results obtained were compared with a previous version of the cleansing algorithm, in which a simpler remapping procedure was used. Performances are increased both in terms of the visual quality of the 2D cleansed images and 3D rendered volumes, and of CAD performances on a sameday FT virtual colonoscopy dataset.

  2. Indium-111-labeled autologous leukocyte imaging and fecal excretion. Comparison with conventional methods of assessment of inflammatory bowel disease

    SciTech Connect

    Leddin, D.J.; Paterson, W.G.; DaCosta, L.R.; Dinda, P.K.; Depew, W.T.; Markotich, J.; McKaigney, J.P.; Groll, A.; Beck, I.T.

    1987-04-01

    This study was designed to evaluate the role of /sup 111/In-labeled leukocyte imaging and fecal excretion in the assessment of inflammatory bowel disease. We compared these tests to various indices of disease activity in Crohn's disease, to Truelove's grading in ulcerative colitis, and to endoscopy, x-ray, and pathology in both diseases. Eleven controls, 16 patients with Crohn's disease, 13 with ulcerative colitis, and 3 with other types of acute bowel inflammation were studied (positive controls). Indium scanning was performed at 1, 4, and 24 hr. Fourteen of 16 patients with active Crohn's disease had positive scans but in only five was localization accurate. One patient had inactive ulcerative colitis, and the scan was negative. Of 12 patients with active ulcerative colitis, 10 had positive scans but disease localization was accurate in only four. Disease extent was correctly defined in 1 of the 3 Positive Controls. There was no significant difference in the accuracy of scanning at 1, 4, or 24 hr. /sup 111/In fecal excretion was significantly higher in patients with inflammatory bowel disease than in controls, and there was correlation between /sup 111/In fecal excretion and most of the indices of disease activity in Crohn's disease. In ulcerative colitis, /sup 111/In fecal excretion did not correlate with Truelove's grading but reflected colonoscopic assessment of severity. In conclusion, /sup 111/In-labeled leukocyte scanning lacks sensitivity with respect to disease extent, but fecal excretion of /sup 111/In correlates well with disease severity as determined by other methods.

  3. Racial and Ethnic Disparities in Time to Cure of Incontinence Present at Nursing Home Admission

    PubMed Central

    Bliss, Donna Z.; Gurvich, Olga; Savik, Kay; Eberly, Lynn E.; Harms, Susan; Wyman, Jean F.

    2015-01-01

    As many as half of older people that are admitted to nursing homes (NHs) are incontinent of urine and/or feces. Not much is known about the rate of cure of incontinence present at NH admission, but available reports suggest the rate is low. There have been racial and ethnic disparities in incontinence treatment, but the role of disparities in the cure of incontinence is understudied. Using the Peters-Belson method and multilevel predictors, our findings showed that there were disparities in the time to cure of incontinence for Hispanic NH admissions. A significantly smaller proportion of older Hispanic admissions were observed to have their incontinence cured and cured later than expected had they been White. Reducing disparities in incontinence cure will improve health outcomes of Hispanic NH admissions. Significant predictors in our model suggest strategies to reduce the disparity including attention to managing fecal incontinence and incontinence in those with cognitive impairment, improving residents’ functional status, and increasing resources to NHs admitting older Hispanics with incontinence to develop innovative and cost effective ways to provide equitable quality care. PMID:26295010

  4. Stress urinary incontinence.

    PubMed

    Nygaard, Ingrid E; Heit, Michael

    2004-09-01

    Stress urinary incontinence, the complaint of involuntary leakage during effort or exertion, occurs at least weekly in one third of adult women. The basic evaluation of women with stress urinary incontinence includes a history, physical examination, cough stress test, voiding diary, postvoid residual urine volume, and urinalysis. Formal urodynamics testing may help guide clinical care, but whether urodynamics improves or predicts the outcome of incontinence treatment is not yet clear. The distinction between urodynamic stress incontinence associated with hypermobility and urodynamic stress incontinence associated with intrinsic sphincter deficiency should be viewed as a continuum, rather than a dichotomy, of urethral function. Initial treatment should include behavioral changes and pelvic floor muscle training. Estrogen is not indicated to treat stress urinary incontinence. Bladder training, vaginal devices, and urethral inserts also may reduce stress incontinence. Bulking agents reduce leakage, but effectiveness generally decreases after 1-2 years. Surgical procedures are more likely to cure stress urinary incontinence than nonsurgical procedures but are associated with more adverse events. Based on available evidence at this time, colposuspension (such as Burch) and pubovaginal sling (including the newer midurethral synthetic slings) are the most effective surgical treatments. PMID:15339776

  5. The development of a line-scan imaging algorithm for the detection of fecal contamination on leafy geens

    NASA Astrophysics Data System (ADS)

    Yang, Chun-Chieh; Kim, Moon S.; Chuang, Yung-Kun; Lee, Hoyoung

    2013-05-01

    This paper reports the development of a multispectral algorithm, using the line-scan hyperspectral imaging system, to detect fecal contamination on leafy greens. Fresh bovine feces were applied to the surfaces of washed loose baby spinach leaves. A hyperspectral line-scan imaging system was used to acquire hyperspectral fluorescence images of the contaminated leaves. Hyperspectral image analysis resulted in the selection of the 666 nm and 688 nm wavebands for a multispectral algorithm to rapidly detect feces on leafy greens, by use of the ratio of fluorescence intensities measured at those two wavebands (666 nm over 688 nm). The algorithm successfully distinguished most of the lowly diluted fecal spots (0.05 g feces/ml water and 0.025 g feces/ml water) and some of the highly diluted spots (0.0125 g feces/ml water and 0.00625 g feces/ml water) from the clean spinach leaves. The results showed the potential of the multispectral algorithm with line-scan imaging system for application to automated food processing lines for food safety inspection of leafy green vegetables.

  6. Hyperspectral reflectance and fluorescence line-scan imaging system for online detection of fecal contamination on apples

    NASA Astrophysics Data System (ADS)

    Kim, Moon S.; Cho, Byoung-Kwan; Yang, Chun-Chieh; Chao, Kaunglin; Lefcourt, Alan M.; Chen, Yud-Ren

    2006-10-01

    We have developed nondestructive opto-electronic imaging techniques for rapid assessment of safety and wholesomeness of foods. A recently developed fast hyperspectral line-scan imaging system integrated with a commercial apple-sorting machine was evaluated for rapid detection of animal feces matter on apples. Apples obtained from a local orchard were artificially contaminated with cow feces. For the online trial, hyperspectral images with 60 spectral channels, reflectance in the visible to near infrared regions and fluorescence emissions with UV-A excitation, were acquired from apples moving at a processing sorting-line speed of three apples per second. Reflectance and fluorescence imaging required a passive light source, and each method used independent continuous wave (CW) light sources. In this paper, integration of the hyperspectral imaging system with the commercial applesorting machine and preliminary results for detection of fecal contamination on apples, mainly based on the fluorescence method, are presented.

  7. Urinary incontinence - injectable implant

    MedlinePlus

    Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

  8. Skin care and incontinence

    MedlinePlus

    Incontinence - skin care ... in a wheelchair, regular chair, or bed TAKING CARE OF THE SKIN Using diapers and other products ... skin. Over time, the skin breaks down. Special care must be taken to keep the skin clean ...

  9. Urinary Incontinence: Bladder Training

    MedlinePlus

    ... following ways: Lengthen the amount of time between bathroom trips. Increase the amount of urine your bladder ... Kegel exercises may also help control urges. Scheduled bathroom trips: Some people control their incontinence by going ...

  10. Prevalence of Bowel Incontinence

    MedlinePlus

    ... and how improve living with these conditions . Publication Library Books of Interest Medical Definitions About IFFGD About us Our Mission Awareness Activities Advocacy Activities Research Leadership IFFGD Symposium Report Industry Council Contact Us Living with Incontinence A Personal ...

  11. Anal encirclement with polypropylene mesh for rectal prolapse and incontinence.

    PubMed

    Sainio, A P; Halme, L E; Husa, A I

    1991-10-01

    Seventeen selected patients (mean age, 74 years)--14 with rectal prolapse and 3 with persisting anal incontinence after previous operations--underwent high anal encirclement with polypropylene mesh. There was no operative mortality. Prolapse recurred in 2 (15 percent) of the 13 patients followed up for 6 months or more (mean, 3.5 years). Three (27 percent) of the 11 patients with associated anal incontinence improved functionally, as did the three operated on for persisting incontinence, but only one patient regained normal continence. No breakage, cutting out, or infection related to the mesh was observed. Because of the risk of fecal impaction encountered in three of our patients, the procedure is not advocated for severely constipated patients. Despite the somewhat disappointing results regarding restoration of continence, we find this method useful in patients with rectal prolapse who are unfit for more extensive surgery, in controlling the prolapse to an acceptable degree. PMID:1914725

  12. Comorbidity of ADHD and incontinence in children.

    PubMed

    von Gontard, Alexander; Equit, Monika

    2015-02-01

    ADHD and incontinence are common childhood disorders which co-occur at much higher rates than expected by chance. The aim of this review was to provide an overview both of the comorbidity of nocturnal enuresis (NE), daytime urinary incontinence (DUI) and faecal incontinence (FI) in children with ADHD; and, vice versa, of the co-occurrence of ADHD in children with NE, DUI and FI. Most clinical studies have focussed on the association of ADHD and NE. Population-based studies have shown that children with DUI have an even greater risk for ADHD than those with NE. While children with FI have the highest overall comorbidity rates of psychological disorders, these are heterogeneous with a wide range of internalising and externalising disorders--not necessarily of ADHD. Genetic studies indicate that ADHD and NE, DUI and FI do not share the same genetic basis. The comorbidity is conferred by non-genetic factors. Possible aetiological and pathogenetic links between ADHD and incontinence are provided by neurophysiological, imaging and pharmacological studies. The co-occurrence has clinical implications: children with ADHD and NE, DUI and FI are more difficult to treat, show lower compliance and have less favourable treatment outcomes for incontinence. Therefore, both groups of disorders have to be assessed and treated specifically. PMID:24980793

  13. [Pharmacotherapy of stress incontinence].

    PubMed

    Jost, W H; Marsalek, P; Michel, M C

    2005-10-14

    Female urinary incontinence is a medical and social problem with a large prevalence. Stress urinary incontinence (SUI) is the most common form of urinary incontinence and is responsible for 49 % of all incontinence, if mixed forms are included even for 78 %. As of yet, apart from "off-label" treatment, there is no pharmacological treatment available for stress urinary incontinence. For instance, estrogens are used in menopausal patients but a substantial effect in the treatment of SUI has not been demonstrated. a-Adrenergics, such as phenylpropanolamine and midodrine, and b-adrenergics, such as clenbuterol, are also used in "off-label" therapy. A recently conducted meta-analysis of 15 randomised studies with female patients who received a- und b-adrenergics as part of their therapy, failed to detect efficacy compared to placebo. Tricyclic antidepressives, such as imipramine and doxepine, which are used for the treatment of urge incontinence, are also used "off-label" in the treatment of SUI. However, no placebo-controlled studies have been conducted so far. The serotonin-norepinephrine reuptake inhibitor duloxetine represents a new therapeutic approach in the treatment of SUI. It has shown positive effects on bladder and urethra in animal experiments, most likely through an effect on the Onuf's nucleus in the spinal cord. In randomised, placebo-controlled studies (phase II and III) in women with SUI, a significant and clinically relevant reduction in urinary incontinence episodes as well as an improvement in the quality of life compared to placebo was shown. PMID:16231235

  14. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ... sling procedures are done to treat stress urinary incontinence. Before discussing surgery, your doctor will have you ...

  15. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007376.htm Urinary incontinence - vaginal sling procedures To use the sharing features ... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ...

  16. Urinary incontinence surgery - female - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000134.htm Urinary incontinence surgery - female - discharge To use the sharing features ... Blaivas JM, Gormley EA, et al; Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

  17. Surgery for Stress Urinary Incontinence

    MedlinePlus

    ... Education FAQs Surgery for Stress Urinary Incontinence Patient Education Pamphlets - Spanish Surgery for Stress Urinary Incontinence FAQ166, July 2014 ... Your Practice Patient Safety & Quality Payment Reform (MACRA) Education & Events Annual ... Pamphlets Teen Health About ACOG About Us Leadership & ...

  18. Incontinence: The Potential Budget Buster

    ERIC Educational Resources Information Center

    Gardner, Sharon

    2009-01-01

    Someone who lives with incontinence, whether bowel, bladder, or both, knows the social stigma and personal toll on his life. Incontinence is the ever-present shadowy silhouette lurking over almost every decision, sometimes requiring complex preplanning. In this article, the author describes the challenges of incontinence and discusses how she…

  19. Fecal culture

    MedlinePlus

    Stool culture; Culture - stool ... stool tests are done in addition to the culture, such as: Gram stain of stool Fecal smear ... Giannella RA. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt LJ, ...

  20. Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

    SciTech Connect

    Geinitz, Hans; Thamm, Reinhard; Keller, Monika; Astner, Sabrina T.; Heinrich, Christine; Scholz, Christian; Pehl, Christian; Kerndl, Simone; Prause, Nina; Busch, Raymonde; Molls, Michael; Zimmermann, Frank B.

    2011-04-01

    Purpose: To prospectively assess the intestinal symptoms and fecal continence in patients who had undergone conformal radiotherapy (CRT) for prostate cancer. Methods and Materials: A total of 78 men who had undergone definitive CRT for prostate cancer were evaluated. The patients were assessed before, during (treatment Weeks 4 and 6), and 2, 12, and 24 months after CRT completion. The intestinal symptoms and fecal continence were evaluated with comprehensive standardized questionnaires. Results: The intestinal symptoms were mostly intermittent, with only a small minority of patients affected daily. Defecation pain, fecal urge, and rectal mucous discharge increased significantly during therapy. Defecation pain and rectal mucous discharge had returned to baseline levels within 8 weeks and 1 year after CRT, respectively. However, fecal urge remained significantly elevated for {<=}1 year and then returned toward the pretreatment values. The prevalence of rectal bleeding was significantly elevated 2 years after CRT. Fecal continence deteriorated during CRT and remained impaired at 1 year after treatment. Incontinence was mostly minor, occurring less than once per week and predominantly affecting incontinence for gas. Conclusion: Intestinal symptoms and fecal incontinence increased during prostate CRT. Except for rectal bleeding, the intestinal symptoms, including fecal incontinence, returned to baseline levels within 1-2 years after CRT. Thus, the rate of long-term late radiation-related intestinal toxicity was low.

  1. Faecal incontinence in the elderly : epidemiology and management.

    PubMed

    Wald, Arnold

    2005-01-01

    Faecal incontinence occurs in up to 10% of community dwelling persons > or = 65 years of age and approximately 50% of nursing home residents. It is a vastly under-reported problem that has a devastating effect on those who experience it as well as their spouses and caregivers. There are three broad categories of faecal incontinence among the elderly: (i) overflow incontinence; (ii) reservoir incontinence; and (iii) rectosphincteric incontinence. The first two can be diagnosed based upon the patient's history and physical examination and the response to dietary and pharmacological interventions. The third is assessed by careful physical examination supplemented by diagnostic tests directed towards evaluation of anorectal continence mechanisms. The most important of these is anorectal manometry, which can be supplemented by studies of structure (anal ultrasonography or pelvic floor magnetic resonance imaging) and neuromuscular function (electromyogram). A variety of therapeutic interventions are employed in patients with rectosphincteric incontinence; these include dietary, behavioural, pharmacological and surgical modalities chosen on the basis of the results of diagnostic testing. For isolated internal anal sphincter weakness, a cotton barrier in the anal canal is often effective. Acute sphincter injury is best treated with sphincteroplasty but, otherwise, surgical procedures are of uncertain benefit. Peripheral neurogenic incontinence may be treated with antidiarrhoeal agents, biofeedback techniques and dietary manipulations. Sacral spinal nerve stimulation is a promising new technique for selected patients with neurogenic faecal incontinence and is currently undergoing testing in the US and Europe. Significant improvement in quality of life can be achieved in most elderly persons with faecal incontinence. PMID:15733020

  2. MULTISPECTRAL IMAGING SYSTEM FOR FECAL AND INGESTA DETECTION ON POULTRY CARCASSES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A multispectral imaging system including a common aperture camera with three optical trim filters (515.4, 566.4 and 631 nm), which were selected by visible/NIR spectroscopy and validated by a hyperspectral imaging system, was developed for a real-time, on-line poultry inspection application. The al...

  3. A Qualitative Study of Family Caregiver Experiences of Managing Incontinence in Stroke Survivors

    PubMed Central

    Tseng, Chien-Ning; Huang, Guey-Shiun; Yu, Po-Jui; Lou, Meei-Fang

    2015-01-01

    Background Incontinence is a common problem faced by family caregivers that is recognized as a major burden and predictor of institutionalization. However, few studies have evaluated the experiences of family caregivers caring for stroke survivors with incontinence. Purpose To describe experiences of caregivers managing incontinence in stroke survivors. Design This qualitative descriptive study employed a grounded-theory approach. Methods Semi-structured in-depth interviews with ten family caregivers of stroke survivors with incontinence were conducted during 2011. Audiotaped interviews were transcribed and analyzed using content analysis. Findings Data analysis identified four themes: chaos, hypervigilance, exhaustion, and creating a new life. There were nine related subcategories: fluster, dirtiness, urgency, fear of potential health-hazard, physically demanding and time-consuming, mentally draining, financial burden, learning by doing, and attitude adjustment. Together, these described a process of struggling to cope with the care of stroke survivors with urinary/fecal incontinence. Of the four categories, “creating a new life” developed gradually over time to orient caregivers to their new life, while the other three categories occurred in a chronological order. Conclusion The research highlighted unique caring experiences of family caregivers of stroke patients, which focused solely on the ‘incontinence issue’. Understanding these experiences may help nurses provide better support and resources for family caregivers when caring for stroke survivors with incontinence. PMID:26066345

  4. Incontinence in Elderly Cared for by Family.

    ERIC Educational Resources Information Center

    Noelker, Linda S.

    1987-01-01

    Analyzed the consequences of incontinence for both the family members caring for the incontinent elderly and for the elderly. Found that incontinence was related to perceived negative affect in family relations and to considering an alternative care arrangement. Suggests that interventions directed to the management of incontinence may help to…

  5. Urogynecologic conditions: urinary incontinence.

    PubMed

    Kelley, Robert; Garely, Alan D

    2015-03-01

    Urinary incontinence (UI), the leakage of urine, is a condition that frequently goes untreated. There are many different types of UI, including stress and urge UI, and the etiology is multifactorial. Diagnosis can be made with a pertinent history, including use of a questionnaire; a pelvic examination; and direct observation. Additional testing can include physical maneuvers to elicit stress leakage and urodynamic studies. Treatment ranges from pelvic floor exercise to surgical support of the pelvic floor for stress UI and, typically, behavioral therapy and/or pharmacotherapy, starting with antimuscarinic drugs, for urge UI. PMID:25756372

  6. Sphincteroplasty for anal incontinence

    PubMed Central

    Pescatori, Lorenzo Carlo; Pescatori, Mario

    2014-01-01

    Sphincteroplasty (SP) is the operation most frequently performed in patients suffering from moderate-to-severe anal incontinence (AI) who do not respond to conservative treatment. Other costly surgeries, such as artificial bowel sphincter (ABS) and electro-stimulated graciloplasty, have been more or less abandoned due to their high morbidity rate. Minimally invasive procedures are widely used, such as sacral neuromodulation and injection of bulking agents, but both are costly and the latter may cure only mild incontinence. The early outcome of SP is usually good if the sphincters are not markedly denervated, but its effect diminishes over time. SP is more often performed for post-traumatic than for idiopathic AI. It may also be associated to the Altemeier procedure, aimed at reducing the recurrence rate of rectal prolapse, and may be useful when AI is due either to injury to the sphincter, or to a narrowed rectum following the procedure for prolapse and haemorrhoids (PPH) and stapled transanal rectal resection (STARR). The outcome of SP is likely to be improved with biological meshes and post-operative pelvic floor rehabilitation. SP is more effective in males than in multiparous women, whose sphincters are often denervated, and its post-operative morbidity is low. In conclusion, SP, being both low-cost and safe, remains a good option in the treatment of selected patients with AI. PMID:24759337

  7. Line-scan hyperspectral imaging system for real-time inspection of poultry carcasses with fecal material and ingesta

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In poultry processing plants, fecal material and ingesta are the primary source of carcass contamination with microbial pathogens. The current practice of the poultry inspection in the United States is primarily human visual observations. Since the visual inspection is becoming more challenging in p...

  8. When you have urinary incontinence

    MedlinePlus

    ... rub baking soda into the stain, and then vacuum off the baking powder. You can also use ... management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Wein AJ, ed. ...

  9. Managing incontinence: women's normalizing strategies.

    PubMed

    Skoner, M M; Haylor, M J

    1993-01-01

    Women's strategies for managing urinary incontinence were examined in a grounded-theory study. The women's basic social concern was dealing with incontinence in a manner that enabled them to feel normal. Feeling normal meant being able to do what they wanted to do and needed to do to have a normal life-style as they perceived it. This goal was accomplished by normalizing incontinence and its management. Normalization was achieved by directing its course through self-management, accounting for it in terms of personal history and life experiences, and delaying medical counsel. These strategies are described. The findings provide fresh insights about women's response to incontinence and their practice of self-managing its consequences. PMID:8138472

  10. Urge incontinence: the patient's perspective.

    PubMed

    Brown, J S; Subak, L L; Gras, J; Brown, B A; Kuppermann, M; Posner, S F

    1998-12-01

    Urge incontinence has a profound effect on the day-to-day lives of women. The purpose of this study was to identify specific aspects of functioning and well-being affected by urge incontinence or mixed incontinence with a primary urge component. We conducted six focus groups of 65 racially and age diverse, community-dwelling women with urge incontinence. Transcripts of the focus groups were quantitatively analyzed for word use frequency with QSR NUD*IST software. Demographics, symptomatology, and the impact of incontinence on daily activities and feelings were assessed by questionnaire. Participants in the focus groups were on average 62 years of age; 52% were nonwhite, and 26% had a high school or less education. In the three identified broad domains, 52% of domain-related words were associated with feelings, 40% with activities, and 8% with relationships. Frequently identified references were bathroom availability (24%), loss of control (14%), anxiety (11%), and sleep disturbance (10%). Women under the age of 70 compared with older women more commonly identified feeling unattractive and low self-esteem (12% versus 2%, p < 0.007) and adverse effects on dating and sexual activity (45% versus 0%, p < 0.02). The effect of incontinence on quality of life correlated with frequency, nocturia, and pad use (Kendall's tau beta 0.02-0.32, p < 0.05). Urge incontinence affects many quality of life issues and contributes to limitation of activities, loss of control, and negative self-perception. Focus groups of diverse women with urge incontinence symptomatology are useful in understanding these effects. PMID:9929859

  11. Intractable incontinence in the elderly.

    PubMed

    Ouslander, J G

    2000-05-01

    The number of people living into extreme old age is rising exponentially in the USA, Europe and other developed countries. Urinary incontinence is prevalent in this population. While many very old (age > 75 years) incontinent individuals are relatively healthy and respond well to various treatments, a substantial proportion has impaired cognitive function and impaired mobility. These impairments make urinary incontinence much more difficult to assess, manage and cure than in younger populations. Irrespective of age and disability, a basic assessment of incontinence should be carried out to identify potentially reversible causes and indications for further evaluation. The outcome of such an assessment may not be cure or improvement of incontinence, but better quality of life and the prevention of morbid and expensive medical conditions that may result from poorly managed incontinence. Incontinence in this population should generally not be considered 'intractable' until a trial of noninvasive therapy (i.e. behavioural and/or pharmacological) has been undertaken. Some very frail elderly respond well to a toileting programme such as prompted voiding, and a small but significant proportion benefit from the careful addition of a bladder relaxant drug to the toileting programme. Others, depending on their ability and willingness to toilet and their preferences for further treatment, may be candidates for surgical intervention. Pads and garments should not be used so that they foster dependency, or as a primary treatment until other specific interventions have been tried. Indwelling catheters should be used only for specific and well-documented indications, because of the risks of urinary tract infection and sepsis associated with their long-term use. The dictionary defines 'intractable' as 'not easily relieved or cured'. In the elderly, cure for incontinence, and most other chronic conditions, is the exception rather than rule. Relief (or amelioration), improvement in

  12. Optimal management of incontinence-associated dermatitis in the elderly.

    PubMed

    Gray, Mikel

    2010-01-01

    Incontinence-associated dermatitis (IAD), sometimes referred to as perineal dermatitis, is an inflammation of the skin associated with exposure to urine or stool. Elderly adults, and especially those in long-term care facilities, are at risk for urinary or fecal incontinence and IAD. Traditionally, IAD has received little attention as a distinct disorder, and it is sometimes confused with stage I or II pressure ulcers. However, a modest but growing body of research is beginning to provide insights into the epidemiology, etiology, and pathophysiology of IAD. In addition, recent changes in reimbursement policies from the US Center for Medicare and Medicaid Services regarding pressure ulcer prevention has focused attention on the differential diagnosis of IAD versus pressure ulcer, and its influence on pressure ulcer risk. Color, location, depth, and the presence or absence of necrotic tissue are visual indicators used to differentiate IAD from pressure-related skin damage. Prevention is based on avoiding or minimizing exposure to stool or urine combined with a structured skin-care program based on principles of gentle cleansing, moisturization, preferably with an emollient, and application of a skin protectant. Treatment of IAD focuses on three main goals: (i) removal of irritants from the affected skin; (ii) eradication of cutaneous infections such as candidiasis; and (iii) containment or diversion of incontinent urine or stool. PMID:20131923

  13. [Conservative treatment in male urinary incontinence].

    PubMed

    Kirschner-Hermanns, R; Anding, R

    2014-03-01

    Prevalence, pathophysiology, diagnostic and therapeutic approaches of urinary incontinence are well studied in women; however, studies on male urinary incontinence focus on incontinence following surgery of the bladder or prostate, predominantly incontinence after radical prostatectomy. Aging men suffer from incontinence, most frequently urge incontinence (overactive bladder, OAB), nearly as often as women do.The domain of conservative therapy of urinary stress incontinence in men is pelvic floor training. It remains unclear whether biofeedback procedures, electrostimulation therapy, or magnetic stimulation therapy can enhance pelvic floor training. There are data suggesting that an off-label therapy with Duloxetin®, a selective serotonin-noradrenaline reuptake inhibitor (SSNRI), improves urinary incontinence following radical prostatectomy. Antimuscarinic agents in combination with bladder training have been proven as safe and effective treatment in men with OAB. Data, however, suggest that men with OAB are far less frequently treated than women. PMID:24585116

  14. Managing stress incontinence in postnatal women.

    PubMed

    Whitehouse, Tracy

    Urinary incontinence can have a significant impact on quality of life. This article explores the causes of stress urinary incontinence, and the impact of childbirth in particular, and discusses the importance of thorough assessment and treatment options. PMID:22708190

  15. Factors associated with urinary incontinence in women.

    PubMed Central

    Yarnell, J W; Voyle, G J; Sweetnam, P M; Milbank, J; Richards, C J; Stephenson, T P

    1982-01-01

    Possible aetiological factors for urinary incontinence were examined in a prevalence study among a random sample of 1000 women aged 18 and over. Infective factors were not markedly associated with incontinence but mechanical factors such as parity and obesity were. No association was found, however, between a history of perineal damage at childbirth and incontinence. Women with incontinence had on average a higher score for a 'neuroticism' trait elicited by questionnaire than women without the disorder. PMID:7069357

  16. Urinary Incontinence: Management and Treatment Options

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2009-01-01

    Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

  17. Fecal Fat: The Test

    MedlinePlus

    ... limited. Home Visit Global Sites Search Help? Fecal Fat Share this page: Was this page helpful? Also known as: Qualitative or Quantitative Stool Fat; Stool Lipids; 72 Hour Fecal Fat; Fat Stain ...

  18. Female urinary incontinence rehabilitation.

    PubMed

    Di Benedetto, P

    2004-08-01

    Pelvic floor rehabilitation (PFR) is an important and recommended strategy for the treatment of many urogynecological disorders including urinary incontinence (UI). The recognised pioneer of PFR is the American gynecologist Arnold Kegel who, over 50 years ago, proposed pelvic floor muscle exercises (PFME) to prevent and/or treat female UI. Kegel's techniques were successfully used by others too, but as the years passed these techniques sank into unjustified oblivion. In the 1980s in Europe the medical world's interest in PFME techniques gained ground, contemporaneously with functional electrical stimulation (FES) and biofeedback (BFB). As a general rule, the least invasive and least dangerous procedure for the patient should be the first choice, and behavioural and rehabilitative techniques should be considered as the first line of therapy for UI. The behavioural approaches in women with UI and without cognitive deficits are tailored to the patient's underlying problem, such as bladder training or retraining (BR) for urge UI. BR has many variations but generally consists of education, scheduled voiding, and positive reinforcements. The rehabilitative approaches comprise BFB, FES, PFME, and vaginal cones (VC). BFB allows the subject to modify the unconscious physiological events, while FES is aimed at strengthening perineal awareness, increasing the tone and trophism of the pelvic floor, and inhibiting detrusor overactivity. PFME play an extremely important role in the conservative treatment of UI and overactive bladder, and many studies have demonstrated their effectiveness. Many authors have used the different methods for PFR in a heterogeneous manner: the best results were obtained when protocols requiring the contemporary use of 2 or more techniques were followed. PMID:15377984

  19. [Male Urinary Incontinence--a Taboo Issue].

    PubMed

    Kozomara-Hocke, Marko; Hermanns, Thomas; Poyet, Cédric

    2016-03-01

    Male urinary incontinence is an underestimated and frequently not broached issue. The urinary incontinence is divided into stress-, urge incontinence and hybrid forms as well as overflow incontinence. The fact that there are increasingly more men over 60 means that the prevalence of the urinary incontinence is up to 40%, and urinary incontinence will increasingly gain importance in daily routine practice. Many investigations and therapies can be realized by the general practitioner. Already simple therapy approaches can lead to a considerable clinical improvement of male urinary incontinence. If the initial therapy fails or pathological results (i. e. microhaematuria, recurrent urinary tract infections, raised residual urine and so on) are found, the patient should be referred to a urologist. PMID:26934011

  20. High Costs of Urinary Incontinence Among Women Electing Surgery to Treat Stress Incontinence

    PubMed Central

    Subak, Leslee L.; Brubaker, Linda; Chai, Toby C.; Creasman, Jennifer M.; Diokno, Ananias C.; Goode, Patricia S.; Kraus, Stephen R.; Kusek, John W.; Leng, Wendy W.; Lukacz, Emily S.; Norton, Peggy; Tennstedt, Sharon

    2008-01-01

    OBJECTIVE To estimate costs for incontinence management, health-related quality of life, and willingness to pay for incontinence improvement in women electing surgery for stress urinary incontinence. METHODS A total of 655 incontinent women enrolled in the Stress Incontinence Surgical Treatment Efficacy Trial, a randomized surgical trial. Baseline out-of-pocket costs for incontinence management were calculated by multiplying self-report of resources used (supplies, laundry, dry cleaning) by national resource costs ($2006). Health-related quality of life was estimated with the Health Utilities Index Mark 3. Participants estimated willingness to pay for 100% improvement in incontinence. Potential predictors of these outcomes were examined by using multivariable linear regression. RESULTS Mean age was 52±10 years, and mean number of weekly incontinence episodes was 22±21. Mean and median (25%, 75% interquartile range) estimated personal costs for incontinence management among all women were $14±$24 and $8 (interquartile range $3, $18) per week, and 617 (94%) women reported any cost. Costs increased significantly with incontinence frequency and mixed compared with stress incontinence. The mean and median Health Utilities Index Mark 3 scores were 0.73±0.25 and 0.84 (interquartile range 0.63, 0.92). Women were willing to pay a mean of $118±$132 per month for complete resolution of incontinence, and willingness to pay increased significantly with greater expected incontinence improvement, household income, and incontinent episode frequency. CONCLUSION Urinary incontinence is associated with substantial costs. Women spent nearly $750 per year out of pocket for incontinence management, had a significant decrement in quality of life, and were willing to pay nearly $1,400 per year for cure. PMID:18378749

  1. Incontinence-associated dermatitis: a comprehensive review and update.

    PubMed

    Gray, Mikel; Beeckman, Dimitri; Bliss, Donna Z; Fader, Mandy; Logan, Susan; Junkin, Joan; Selekof, Joan; Doughty, Dorothy; Kurz, Peter

    2012-01-01

    In 2009, a multinational group of clinicians was charged with reviewing and evaluating the research base pertaining to incontinence-associated dermatitis (IAD) and synthesizing this knowledge into best practice recommendations based on existing evidence. This is the first of 2 articles focusing on IAD; it updates current research and identifies persistent gaps in our knowledge. Our literature review revealed a small but growing body of evidence that provides additional insight into the epidemiology, etiology, and pathophysiology of IAD when compared to the review generated by the first IAD consensus group convened 5 years earlier. We identified research supporting the use of a defined skin care regimen based on principles of gentle perineal cleansing, moisturization, and application of a skin protectant. Clinical experience also supports application of an antifungal powder, ointment, or cream in patients with evidence of cutaneous candidiasis, aggressive containment of urinary or fecal incontinence, and highly selective use of a mild topical anti-inflammatory product in selected cases. The panel concluded that research remains limited and additional studies are urgently needed to enhance our understanding of IAD and to establish evidence-based protocols for its prevention and treatment. PMID:22193141

  2. Female urinary incontinence: effective treatment strategies.

    PubMed

    Castro, R A; Arruda, R M; Bortolini, M A T

    2015-04-01

    Urinary incontinence is a dysfunction that tremendously affects women's quality of life, involving social, emotional and economic aspects. Although various treatments for urinary incontinence have been described, it is important to know which of them are truly effective. This review seeks to determine the current available therapies for women with stress urinary incontinence and overactive bladder syndrome, based on the best scientific evidence. PMID:25307986

  3. Psychosomatic Aspects of Urinary Incontinence in Women

    PubMed Central

    Debus, G.; Kästner, R.

    2015-01-01

    Urinary incontinence in women is a common problem. With increasing age its prevalence and severity of its manifestations increase. Among nursing home residents the frequency is between 43 and 77 %, 6 to 10 % of all admissions to nursing homes are due to urinary incontinence. The risk for urinary incontinence among women with cognitive deficits is 1.5- to 3.4-fold higher than for women without mental disorders. The most common form is stress incontinence (50 %), followed by mixed stress-urge incontinence (40 %) and purely urge incontinence (OAB = overactive bladder, 20 %). With regard to its cause, the latter remains unclarified in about 80 % of the cases. It is often difficult to treat. There are also cases in which urge incontinence is related to traumatic events. In such cases behavioural and psychotherapeutic options may be helpful. Almost inevitably every form of incontinence has psychological consequences: shame and insecurity are often results of uncontrolled loss of urine. Among others, in the long term, they lead to the avoidance of social contacts and possibly to depression and isolation. Consideration of the psychosomatics is important in the therapy for female urinary incontinence from three points of view: 1) the efficacy of treatment is better suited to the patient, 2) the treatment costs are lower, 3) the professional satisfaction of the responsible physician increases. PMID:25797959

  4. Conservative treatment for anal incontinence

    PubMed Central

    Carter, Dan

    2014-01-01

    Anal incontinence (AI) in adults is a troublesome condition that negatively impacts upon quality of life and results in significant embarrassment and social isolation. The conservative management of AI is the first step and targets symptomatic relief. The reported significant improvement with conservative treatments for AI is close to 25% and involves prescribed changes in lifestyle habits, a reduced intake of foods that may cause or aggravate diarrhea or rectal urgency, and the use of specific anti-diarrheal agents. The use of a mechanical barrier in the form of an anal plug and the outcomes and principles of pelvic kinesitherapies and biofeedback options are outlined. This review discusses a gastroenterologist's approach towards conservative therapy in patients referred with anal incontinence. PMID:24759347

  5. HYPERSPECTRAL REFLECTANCE AND FLUORESCENCE LINE-SCAN IMAGING SYSTEM FOR ONLINE DETECTION OF FECAL CONTAMINATION ON APPLES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Scientists at the Instrumentation and Sensing Lab, USDA have developed nondestructive opto-electronic imaging techniques for rapid assessment of safety and wholesomeness of foods. A recently developed fast hyperspectral line-scan imaging system integrated with a commercial apple-sorting machine was...

  6. Fecal Pollution of Water.

    EPA Science Inventory

    Fecal pollution of water from a health point of view is the contamination of water with disease-causing organisms (pathogens) that may inhabit the gastrointestinal tract of mammals, but with particular attention to human fecal sources as the most relevant source of human illnesse...

  7. Fecal Pollution of Water

    EPA Science Inventory

    Fecal pollution of water from a health point of view is the contamination of water with disease-causing organisms (pathogens) that may inhabit the gastrointestinal tract of mammals, but with particular attention to human fecal sources as the most relevant source of human illnesse...

  8. Incontinent Children Discover Hope at Camp Oakhurst.

    ERIC Educational Resources Information Center

    Raps, Marvin A.

    1991-01-01

    Describes summer-camp experiences of young people who are incontinent because of spina bifida. Focuses on residential camp program as encouragement for youth to learn independent incontinence management. Describes self-catheterization program and process as minor inconvenience and positive alternative to soiled clothing and accompanying…

  9. Urinary Incontinence: Causes and Methods of Evaluation

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2008-01-01

    This article presents the third of a multi-part series offering the most timely educational information, innovative approaches, products and technology solutions as well as coping and stigma-fighting approaches available on the subject of incontinence. Here, the author introduces the types and physiology of urinary incontinence. The author also…

  10. Incidence and Predictors of Anal Incontinence after Obstetric Anal Sphincter Injury in Primiparous Women

    PubMed Central

    Richter, Holly E; Nager, Charles W; Burgio, Kathryn L; Whitworth, Ryan; Weidner, Alison C; Schaffer, Joseph; Zyczynski, Halina M; Norton, Peggy; Jelovsek, J Eric; Meikle, Susan F; Spino, Cathie; Gantz, Marie; Graziano, Scott; Brubaker, Linda

    2014-01-01

    Objective To describe the incidence of fecal incontinence (FI) at 6, 12 and 24 weeks postpartum, anal incontinence (AI) and fecal urgency at 24 weeks and identify predictors of AI in women with obstetric anal sphincter injury (OASI). Methods Primiparous women sustaining OASIs were identified at 8 clinical sites. Third degree OASIs were characterized using World Health Organization (WHO) criteria, 3a (<50%) or 3b (>50%) tear through the sphincter. FI was defined as leakage of liquid/solid stool and/or mucus in the past month; AI was defined as leakage of liquid/solid stool and/or mucus and/or gas in the past month and was assessed at 6, 12 and 24 weeks postpartum using the Fecal Incontinence Severity Index. Logistic regression identified variables associated with AI. Results 343 women participated: 297 subjects sustained a third degree OASI, 168 type 3a, 98 type 3b and 31 indeterminant; 45 had a fourth degree OASI. Overall FI incidence at 6, 12 and 24 weeks was 7% (23/326, 95% CI: 4%,10%), 4% (6/145, 95% CI: 2%,9%) and 9% (13/138, 95% CI: 5%,16%), respectively. At 24 weeks AI incidence was 24% (95% CI: 17%,32%) and fecal urgency 21% (95% CI: 15%,29%). No significant differences in FI and AI rates were noted by 3rd degree type or between groups with 3rd and 4th OASI. Flatal incontinence was greater in women sustaining a 4th degree tear (35% vs 16%, p=0.04). Caucasian race (AOR 4.64, 95% CI: 1.35-16.02) and shorter duration of second stage (AOR 1.47 per 30 minute decrease, 95% CI: 1.12-1.92) were associated with AI at 24 weeks. Conclusions Overall 24-week incidence of FI is 9% (95% CI: 5%,16%) and AI is 24% (95% CI: 17%,32%). In women with OASI, Caucasian race and shorter second stage labor were associated with postpartum AI. PMID:25679358

  11. Constipation and Fecal Soiling

    MedlinePlus

    ... Increase fluids in the diet, especially water and water rich foods (which usually are fiber-rich). (continued on next page) Fecal Soiling continued 5. Increase physical activity. Exercise helps the colon move. 6. It is ...

  12. [Decubitus or incontinence-associated dermatitis?].

    PubMed

    Houwing, Ronald H; Koopman, Eddy S M

    2014-01-01

    A lack of understanding about the distinction between incontinence-associated dermatitis and pressure sores leads to inadequate treatment and therefore a higher incidence of pressure sores. Pressure relief may not be adequately carried out due to concentration exclusively on treatment of incontinence. In this article we will discuss the multifactorial approach, based on 2 patient cases. In order to prevent pressure sores, the cause of incontinence has to be investigated and treated if possible. Appropriate pressure relief must be carried out, in addition to adequate skin care. PMID:25159696

  13. A budget impact analysis comparing use of a modern fecal management system to traditional fecal management methods in two canadian hospitals.

    PubMed

    Langill, Mike; Yan, Songkai; Kommala, Dheerendra; Michenko, Michael

    2012-12-01

    Research suggests that fecal management systems (FMS) offer advantages, including potential cost savings, over traditional methods of caring for patients with little or no bowel control and liquid or semi-liquid stool. A budget impact model accounting for material costs of managing fecal incontinence was developed, and 1 year of experiential data from two hospitals' ICUs were applied to it. Material costs were estimated for traditional methods (ie, use of absorbent briefs/pads, skin cleansers, moisturizers) and compared with material costs of using a modern FMS for both average (normal-range weight) and complex (bariatric with wounds) ICU patients at hospital 1 and any ICU patient at hospital 2. Reductions in daily material costs per ICU patient using FMS versus traditional methods were reported by hospital 1 ($93.74 versus $143.89, average patient; $150.55 versus $476.41, complex patient) and by hospital 2 ($61.15 versus $104.85 per patient). When extrapolated to the total number of patients expected to use FMS at each institution, substantial annual cost savings were projected (hospital 1: $57,216; hospital 2: $627,095). In addition, total nursing time per day for managing fecal incontinence (ie, changing, cleaning, repositioning patients, changing pads, linens, and the like) was estimated at hospital 1, showing substantial reductions with FMS (120 minutes versus 348 minutes for average patients; 240 minutes versus 760 minutes for complex). Nursing time was not included in cost calculations to keep the analysis conservative. Results of this study suggest the materials cost of using the FMS in ICU patients was substantially lower than the cost of traditional fecal incontinence management protocols of care in both hospitals. Comparative studies using patient level data, materials, and nursing time costs, as well as complication rates, are warranted. PMID:23221016

  14. Urinary incontinence - what to ask your doctor

    MedlinePlus

    ... I use to clean a mattress? How much water or liquids should I drink every day? Which foods or liquids can make my urinary incontinence worse? Are there activities I should avoid that may cause problems with ...

  15. Management of urinary incontinence in women.

    PubMed Central

    O'Dowd, T C

    1993-01-01

    Control of micturition is a complex physiological and anatomical process which often fails in women. The sequelae of urinary incontinence in women range from inconvenience to social and psychological stigmatization. Surprisingly, many women are tolerant of often quite severe sequelae, despite a range of management techniques that exist to alleviate or cure incontinence. Some of the more successful techniques are well suited to general practice management and can be carried out by the patient under the supervision of her doctor, district nurse, practice nurse or midwife. This paper reviews the physiology of micturition, stress urinary incontinence and incontinence caused by detrusor instability, and the management techniques available to alleviate or cure the problem. PMID:8260222

  16. The fecal bacteria

    USGS Publications Warehouse

    Sadowsky, Michael J., (Edited By); Whitman, Richard L.

    2011-01-01

    The Fecal Bacteria offers a balanced, integrated discussion of fecal bacteria and their presence and ecology in the intestinal tract of mammals, in the environment, and in the food supply. This volume covers their use in examining and assessing water quality in order to offer protection from illnesses related to swimming in or ingesting contaminated water, in addition to discussing their use in engineering considerations of water quality, modeling, monitoring, and regulations. Fecal bacteria are additionally used as indicators of contamination of ready-to-eat foods and fresh produce. The intestinal environment, the microbial community structure of the gut microbiota, and the physiology and genomics of this broad group of microorganisms are explored in the book. With contributions from an internationally recognized group of experts, the book integrates medicine, public health, environmental, and microbiological topics in order to provide a unique, holistic understanding of fecal bacteria. Moreover, it shows how the latest basic science and applied research findings are helping to solve problems and develop effective management strategies. For example, readers will discover how the latest tools and molecular approaches have led to our current understanding of fecal bacteria and enabled us to improve human health and water quality. The Fecal Bacteria is recommended for microbiologists, clinicians, animal scientists, engineers, environmental scientists, food safety experts, water quality managers, and students. It will help them better understand fecal bacteria and use their knowledge to protect human and environmental health. They can also apply many of the techniques and molecular tools discussed in this book to the study of a broad range of microorganisms in a variety of habitats.

  17. Factors influencing intact skin in women with incontinence using absorbent products: results of a cross-sectional, comparative study.

    PubMed

    Shigeta, Yoshie; Nakagami, Gojiro; Sanada, Hiromi; Konya, Chizuko; Sugama, Junko

    2010-12-01

    Incontinence-associated dermatitis (IAD) is a common problem in elderly incontinent people. A comparative cross-sectional study was conducted to examine and compare properties of intact skin on the buttocks and subumbilicus area in elderly people wearing absorbent products and to identify pad environment factors that affect skin properties. Study participants included 45 elderly (age range: 68 to 103 years) female residents of one nursing home who were incontinent of feces and urine (dual incontinence group--DIG, n = 35) or feces only (fecal incontinence group--FIG, n= 10). Skin pH and hydration were measured and factors believed to affect the perineal environment and contribute to the development of IAD were assessed. In both DIG and FIG, skin hydration levels and pH were higher in the coccygeal than in the subumbilical area. Skin hydration of the sacral region in the DIG was significantly higher than in the FIG (P = 0.019) and skin pH on the coccygeal region and sacral region in the DIG was significantly higher than in the FIG (coccygeal region, P = 0.013; sacral region, P = 0.023). Absorbent pad surface pH (P &0.01) and excessive sweating (P = 0.006) were significantly related to skin pH. Results show that properties of perineal skin in elderly women with incontinence are affected by occlusion with pads, increasing the risk of IAD. Studies comparing the effect of various types of pads and pad-change frequencies on skin properties are needed. PMID:21205991

  18. General practitioners and women with urinary incontinence.

    PubMed Central

    Grealish, M; O'Dowd, T C

    1998-01-01

    BACKGROUND: Urinary incontinence is a common problem for adult women. It results in a large financial and psychosocial cost. Much urinary incontinence goes unreported. Women with urinary incontinence can be successfully assessed and treated in general practice but studies have shown that many GPs manage the condition inadequately. AIM: This study aims to examine GPs' awareness of urinary incontinence in women and their management of, and attitudes to, female urinary incontinence. METHOD: A qualitative study was conducted with 21 GPs responding to semi-structured interviews. Thematic analysis was carried out on these interviews, with recurrent views and experiences being identified and grouped. RESULTS: The interviews of 11 male and nine female GPs were suitable for analysis. GPs were aware of the prevalence and under-reporting of urinary incontinence in women. Many were unhappy with their own management of the condition and with the management options available to them. Male GPs in particular were reluctant to carry out gynaecological examinations, and few GPs expressed enthusiasm for teaching pelvic floor exercises or bladder drills. Medications were frequently used but generally considered ineffective or intolerable. The services of both public health nurses and practice nurses were under-used, largely because of lack of training in this area. Although incontinence nurses were employed in the area, many GPs did not know of their availability and, of those who did, few referred to them more than infrequently. CONCLUSION: This study demonstrates that many GPs avoid dealing with the problem of urinary incontinence in women and that they find it to be a difficult, chronic problem to treat. Specialist options seem not to be useful in general practice. The findings need to be explored in other GP settings. PMID:9624768

  19. The management of urinary incontinence.

    PubMed

    Barnard, R J

    1982-01-01

    Urinary incontinence is defined as the involuntary loss of urine which is a social or hygienic problem and is objectively demonstrable. It is common in the general population and not all patients will report the presence of the problem because of, among other things, embarrassment. Assessment is important and should be multi-disciplinary. It includes a history, physical examination and some simple tests. A bladder chart kept by the patient aids assessment. Most patients can then be categorized and further testing planned. These tests are usually invasive and include urodynamic tests and electromyographic studies. With their conclusion treatment can be instituted, such as bladder training, drugs and various aids and appliances. PMID:7095985

  20. [Faecal incontinence - serious medical and social issue].

    PubMed

    Ihnát, Peter; Kozáková, Radka; Vávra, Petr; Pelikán, Anton; Zonča, Pavel

    2016-01-01

    Faecal incontinence presents gastrointestinal disorder with high prevalence (more than 2% of population) and serious impact on the quality of life. General practitioners, gastroenterologists and colorectal surgeons play the principal role in screening, diagnostics and providing health care to patients who suffer from faecal incontinence. Insufficient knowledge about faecal incontinence and minimal training aimed at its diagnostics and therapy lead to the low quality of provided health care.Authors offer comprehensive up-to-date review focused on faecal incontinence - its definition, prevalence, seriousness, consequences, pathophysiology, diagnostics and management. Detailed anatomical and physiological assessment of each patient is fundamental in determining correct cause of faecal incontinence and consequent selection of the most appropriate therapeutic modality.Broad spectrum of available therapeutic options comprises conservative management (lifestyle modification, diet, medications, and absorbent tools), biofeedback and surgical interventions (sphincter augmentation, sphincter reconstruction, sacral nerve stimulation, sphincter substitution and stools diversion). Application of the most appropriate treatment can lead in majority of patients to significant improvement in faecal incontinence and quality of life. Early diagnosis prevents possible complications, which would possibly deteriorate patients quality of life. PMID:27256145

  1. Pad testing in incontinent women: a review.

    PubMed

    Ryhammer, A M; Djurhuus, J C; Laurberg, S

    1999-01-01

    This article reviews the literature on pad-weighing tests used for objectifying and quantifying incontinence in urinary incontinent women. The patients wear pads weighed before and after the test period. A weight gain is taken as a measure of the amount of urine loss. The tests are in principle of two different types: short-term office tests and long-term home tests, and measure different aspects of urinary control and dysfunction. Both have an inherent large intra- and interindividual variability. Pad weight gains obtained from patients referred for incontinence and those from self-reported continent controls overlap to a certain degree, and it is not possible to identify distinct numerical cut-off values separating continence from incontinence. This suggests that incontinence is a complex condition in which the amount of leakage, other sources of weight gain, and differences in the individual patients' personal characteristics influence the identification and quantification of the problem. In spite of the shortcomings the pad tests remain a valuable tool for both the clinician and the researcher. The home pad tests are superior to the office tests in terms of authenticity, and should be performed with a concomitant systematic registration of the participant's voidings, fluid intake and episodes of incontinence. PMID:10384973

  2. Fecal Occult Blood Test and Fecal Immunochemical Test

    MedlinePlus

    ... Visit Global Sites Search Help? Fecal Occult Blood Test and Fecal Immunochemical Test Share this page: Was this page helpful? Also ... Test Common Questions Ask Us Related Pages The Test How is it used? When is it ordered? ...

  3. Urinary Incontinence Treatments for Women (Beyond the Basics)

    MedlinePlus

    ... neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study. J Urol 2005; ... treatment of urge incontinence in older women: a randomized controlled trial. JAMA 2002; 288:2293. Herbison P, ...

  4. Urinary Incontinence Could Be Controlled by an Inflatable Penile Prosthesis

    PubMed Central

    Choi, Hyung Ki; Lee, Hye-Yeon

    2016-01-01

    Purpose Due to the increasing numbers of radical prostatectomies (RP) performed for prostate cancer, a substantial and increasing number of patients suffer from postoperative urinary incontinence and erectile dysfunction (ED). The objective of our study was to see whether an inflatable penile prosthesis implantation could control urinary incontinence for patients with the dual problems of ED and incontinence. Materials and Methods From March 2010 through May 2015, 25 post-RP patients were referred to our clinic with ED or incontinence. The degree of incontinence was classified according to the International Consultation on Incontinence Questionnaire-Short Form. Inflatable penile prostheses were implanted in all 25 patients. Results For one month after implantation, partial or full inflation was performed progressively to control urine leakage. Of 18 patients, 13 patients were categorized with mild or moderate stress incontinence. All 13 patients obtained control of incontinence with partial inflation (30% to 60%) and all reported satisfactory outcomes. Five out of the 18 patients were categorized with severe total incontinence. Three of the 5 patients could tolerate incontinence with full inflation on and off. Thirteen patients out of the total of 18 (72.2%) had their incontinence controlled by an inflating penile prosthesis. Conclusions An inflatable penile prosthesis is highly recommended as an initial procedure, especially in patients with the dual problems of ED and incontinence. PMID:27169127

  5. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Protective garment for incontinence. 876.5920... garment for incontinence. (a) Identification. A protective garment for incontinence is a device that... garment from the patient's excreta. This generic type of device does not include diapers for infants....

  6. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Protective garment for incontinence. 876.5920... garment for incontinence. (a) Identification. A protective garment for incontinence is a device that... garment from the patient's excreta. This generic type of device does not include diapers for infants....

  7. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Protective garment for incontinence. 876.5920... garment for incontinence. (a) Identification. A protective garment for incontinence is a device that... garment from the patient's excreta. This generic type of device does not include diapers for infants....

  8. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Protective garment for incontinence. 876.5920... garment for incontinence. (a) Identification. A protective garment for incontinence is a device that... garment from the patient's excreta. This generic type of device does not include diapers for infants....

  9. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Protective garment for incontinence. 876.5920... garment for incontinence. (a) Identification. A protective garment for incontinence is a device that... garment from the patient's excreta. This generic type of device does not include diapers for infants....

  10. Prevention and management of incontinence-associated dermatitis.

    PubMed

    Bardsley, Alison

    Maintaining skin integrity in people with incontinence is challenging. Incontinence is common in older people and those compromised by medical or surgical comorbidities. Urinary and faecal incontinence can result in skin breakdown, which is characterised by erosion of the epidermis, creating a moist, macerated appearance to the skin. Incontinence and associated skin breakdown can have a considerable effect on an individual's physical and psychological wellbeing. This article discusses the aetiology of incontinence-associated dermatitis and considers the best options for the prevention, management and treatment of this condition. PMID:23940938

  11. Prevalence and Risk Indicators for Anal Incontinence among Pregnant Women

    PubMed Central

    Skjeldestad, Finn Egil; Sandvik, Leiv

    2013-01-01

    The aim of this study was to assess the prevalence and risk factors of anal incontinence in an unselected pregnant population at second trimester. A survey of pregnant women attending a routine ultrasound examination was conducted in a university hospital in Oslo, Norway. A questionnaire consisting of 105 items concerning anal incontinence (including St. Mark's score), urinary incontinence, medication use, and comorbidity was posted to women when invited to the ultrasound examination. Results. Prevalence of self-reported anal incontinence (St. Mark's score ≥ 3) was the lowest in the group of women with a previous cesarean section only (6.4%) and the highest among women with a previous delivery complicated by obstetric anal sphincter injury (24.4%). Among nulliparous women the prevalence of anal incontinence was 7.7% and was associated to low educational level and comorbidity. Prevalence of anal incontinence increased with increasing parity. Urinary incontinence was associated with anal incontinence in all parity groups. Conclusions. Anal incontinence was most frequent among women with a history of obstetric anal sphincter injury. Other obstetrical events had a minor effect on prevalence of anal incontinence among parous women. Prevention of obstetrical sphincter injury is likely the most important factor for reducing bothersome anal incontinence among fertile women. PMID:23819058

  12. Electrokinetic properties of incontinence nonwoven devices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An understanding of the water transport properties of nonwoven incontinence devices is a prerequisite to the design of cotton-based nonwovens. A complete understanding of the interfacial moisture movement which occurs between the layers of coverstock, acquisition layer, distribution layer, absorbent...

  13. Management of patients with faecal incontinence.

    PubMed

    Duelund-Jakobsen, Jakob; Worsoe, Jonas; Lundby, Lilli; Christensen, Peter; Krogh, Klaus

    2016-01-01

    Faecal incontinence, defined as the involuntary loss of solid or liquid stool, is a common problem affecting 0.8-8.3% of the adult population. Individuals suffering from faecal incontinence often live a restricted life with reduced quality of life. The present paper is a clinically oriented review of the pathophysiology, evaluation and treatment of faecal incontinence. First-line therapy should be conservative and usually include dietary adjustments, fibre supplement, constipating agents or mini enemas. Biofeedback therapy to improve external anal sphincter function can be offered but the evidence for long-term effect is poor. There is good evidence that colonic irrigation can reduce symptoms and improve quality of life, especially in patients with neurogenic faecal incontinence. Surgical interventions should only be considered if conservative measures fail. Sacral nerve stimulation is a minimally invasive procedure with high rate of success. Advanced surgical procedures should be restricted to highly selected patients and only performed at specialist centres. A stoma should be considered if other treatment modalities fail. PMID:26770270

  14. [Rare differential diagnosis of urinary incontinence].

    PubMed

    Coutty, Nadège; Dubreucq, Sylvie; Delahousse, Guy; Cosson, Michel

    2003-04-01

    The authors report the case of a 55-year-old woman with prolapse presenting a differential diagnosis of urinary incontinence: a peritoneo-vaginal fistula with serous discharge in a patient with ascites and a history of hysterectomy. The only cases of peritoneo-vaginal fistula reported in the literature were discovered during extra-uterine pregnancy after hysterectomy. PMID:12765075

  15. Coping with the Impact of Incontinence

    ERIC Educational Resources Information Center

    Gartley, Cheryle

    2008-01-01

    This article presents Part 2 of a multi-part series offering the most timely educational information, innovative approaches, products and technology solutions as well as coping and stigma-fighting approaches available on the subject of incontinence. In this article, the author contends that it is extremely important to teach children coping skills…

  16. Management of patients with faecal incontinence

    PubMed Central

    Duelund-Jakobsen, Jakob; Worsoe, Jonas; Lundby, Lilli; Christensen, Peter; Krogh, Klaus

    2016-01-01

    Faecal incontinence, defined as the involuntary loss of solid or liquid stool, is a common problem affecting 0.8–8.3% of the adult population. Individuals suffering from faecal incontinence often live a restricted life with reduced quality of life. The present paper is a clinically oriented review of the pathophysiology, evaluation and treatment of faecal incontinence. First-line therapy should be conservative and usually include dietary adjustments, fibre supplement, constipating agents or mini enemas. Biofeedback therapy to improve external anal sphincter function can be offered but the evidence for long-term effect is poor. There is good evidence that colonic irrigation can reduce symptoms and improve quality of life, especially in patients with neurogenic faecal incontinence. Surgical interventions should only be considered if conservative measures fail. Sacral nerve stimulation is a minimally invasive procedure with high rate of success. Advanced surgical procedures should be restricted to highly selected patients and only performed at specialist centres. A stoma should be considered if other treatment modalities fail. PMID:26770270

  17. [Fecal microbiota transplantation: review].

    PubMed

    Barbut, F; Collignon, A; Butel, M-J; Bourlioux, P

    2015-01-01

    Fecal microbiota transplantation (FMT) has gained an increasing medical interest, since the recognition of the role of disturbed microbiota in the development of various diseases. To date, FMT is an established treatment modality for multiple recurrent Clostridium difficile infection (RCDI), despite lack of standardization of the procedure. Persisting normalization of the disturbed colonic microbiota associated with RCDI seems to be responsible for the therapeutic effect of FMT. For other diseases, FMT should be considered strictly experimental, only offered to patients in an investigational clinical setting. Although the concept of FMT is appealing, current expectations should be damped until future evidence arises. PMID:25577013

  18. Fecal calprotectin in inflammatory bowel disease.

    PubMed

    Walsham, Natalie E; Sherwood, Roy A

    2016-01-01

    Inflammatory bowel disease (IBD) and irritable bowel syndrome share many symptoms. While irritable bowel syndrome is a functional bowel disorder for which no specific treatment is available, the range of effective therapies for IBD is evolving rapidly. Accurate diagnosis of IBD is therefore essential. Clinical assessment, together with various imaging modalities and endoscopy, has been the mainstay of diagnosis for many years. Fecal biomarkers of gastrointestinal inflammation have appeared in the past decade, of which calprotectin, a neutrophil cytosolic protein, has been studied the most. Crohn's disease and ulcerative colitis are chronic remitting and relapsing diseases, and objective assessment of disease activity and response to treatment are important. This review focuses on the use of fecal calprotectin measurements in the diagnosis and monitoring of patients with IBD. PMID:26869808

  19. Fecal calprotectin in inflammatory bowel disease

    PubMed Central

    Walsham, Natalie E; Sherwood, Roy A

    2016-01-01

    Inflammatory bowel disease (IBD) and irritable bowel syndrome share many symptoms. While irritable bowel syndrome is a functional bowel disorder for which no specific treatment is available, the range of effective therapies for IBD is evolving rapidly. Accurate diagnosis of IBD is therefore essential. Clinical assessment, together with various imaging modalities and endoscopy, has been the mainstay of diagnosis for many years. Fecal biomarkers of gastrointestinal inflammation have appeared in the past decade, of which calprotectin, a neutrophil cytosolic protein, has been studied the most. Crohn’s disease and ulcerative colitis are chronic remitting and relapsing diseases, and objective assessment of disease activity and response to treatment are important. This review focuses on the use of fecal calprotectin measurements in the diagnosis and monitoring of patients with IBD. PMID:26869808

  20. Fecal Pellet Flux in the Mesopelagic Sargasso Sea

    NASA Astrophysics Data System (ADS)

    Koweek, D.; Shatova, O.; Conte, M. H.; Weber, J. C.

    2010-12-01

    The Oceanic Flux Program (OFP), located 75km SE of Bermuda, is the longest running sediment trap time-series of its kind, continually collecting deep sea particle flux since 1978. Recent application of digital microphotography to the size-fractionated OFP sediment trap material has generated a wealth of new quantitative visual information on particle flux composition, its changes with depth, and its temporal variability. We examined the fecal pellet flux at 1500m depth using image analysis of digital archives, in conjunction with data on the overlying surface ocean from the Bermuda Testbed Mooring (BTM) and the Bermuda Atlantic Time Series (BATS) programs, to investigate the role of mesoscale physical forcing on mesopelagic particle flux variability. During 2007, a productive cyclonic eddy, a mode water eddy and an anticyclonic eddy passed over the OFP site. Fecal pellet flux was enhanced during passage of both the cyclonic and mode water eddies. Total mass flux (TMF) was also enhanced during the productive cyclonic eddy, but was not influenced by the passage of the mode water eddy. No increase in fecal pellet flux or TMF was apparent during passage of the anticyclonic eddy despite indications of increased zooplankton abundance from ADCP backscatter intensity. Fecal pellet size frequency distributions indicate the presence of two, and sometimes three, distinct size classes. No seasonal trend in mean size of fecal pellets was observed for any size class, implying that the size distribution of the zooplankton populations producing the pellets is relatively constant throughout the year. We also investigated fecal pellet flux changes with depth at 500, 1500 and 3200m. Fecal pellet flux, and the fecal pellet contribution to TMF, were greatest at 500m and decreased with depth. The use of quantitative image analysis holds great potential as a powerful analytical tool in studies of marine particulate flux.

  1. A modified inflammatory bowel disease questionnaire and the Vaizey Incontinence questionnaire are more sensitive measures of acute gastrointestinal toxicity during pelvic radiotherapy than RTOG grading

    SciTech Connect

    Khalid, Usman; McGough, Camilla; Hackett, Claire; Blake, Peter; Harrington, Kevin J.; Khoo, Vincent S.; Tait, Diana; Norman, Andrew R.; Andreyev, H. Jervoise N. . E-mail: j@andreyev.demon.co.uk

    2006-04-01

    Purpose: Simple scales with greater sensitivity than Radiation Therapy Oncology Group (RTOG) grading to detect acute gastrointestinal toxicity during pelvic radiotherapy, could be clinically useful. Methods and Materials: Do questionnaires used in benign gastrointestinal diseases detect toxicity in patients undergoing radiotherapy? The patient-completed Inflammatory Bowel Disease (IBDQ) and Vaizey Incontinence questionnaires were compared prospectively at baseline and at Week 5 to physician-completed RTOG grading. Results: A total of 107 patients, median age 63 years, were recruited. After 5 weeks of treatment, patients with gynecologic and gastrointestinal cancer were more symptomatic than urologic patients (p 0.012; p = 0.014). Overall, 94% had altered bowel habits, 80% loose stool, 74% frequency, 65% difficult gas, 60% pain, >48% distress, 44% tenesmus, >40% restrictions in daily activity, 39% urgency, 37% fecal incontinence, and 40% required antidiarrheal medication. The median RTOG score was 1 (range, 0-2), median IBDQ score 204.5 (range, 74-224), and median Vaizey score 5 (range, 0-20). Chemotherapy preceding radiotherapy increased fecal incontinence (p 0.002). RTOG scores stabilized after 3 weeks, IBDQ scores peaked at Week 4, and Vaizey scores worsened throughout treatment. IBDQ and Vaizey scores distinguished between groups with different RTOG scores. Conclusion: The IBDQ and Vaizey questionnaires are reliable and sensitive, offering greater insight into the severity and range of symptoms compared with RTOG grading.

  2. MASD part 2: incontinence-associated dermatitis and intertriginous dermatitis: a consensus.

    PubMed

    Black, Joyce M; Gray, Mikel; Bliss, Donna Z; Kennedy-Evans, Karen L; Logan, Susan; Baharestani, Mona M; Colwell, Janice C; Goldberg, Margaret; Ratliff, Catherine R

    2011-01-01

    A consensus panel was convened to review current knowledge of moisture-associated skin damage (MASD) and to provide recommendations for prevention and management. This article provides a summary of the discussion and the recommendations in regards to 2 types of MASD: incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD). A focused history and physical assessment are essential for diagnosing IAD or ITD and distinguishing these forms of skin damage from other types of skin damage. Panel members recommend cleansing, moisturizing, and applying a skin protectant to skin affected by IAD and to the perineal skin of persons with urinary or fecal incontinence deemed at risk for IAD. Prevention and treatment of ITD includes measures to ensure that skin folds are dry and free from friction; however, panel members do not recommend use of bed linens, paper towels, or dressings for separating skin folds. Individuals with ITD are at risk for fungal and bacterial infections and these infections should be treated appropriately; for example, candidal infections should be treated with antifungal therapies. PMID:21747256

  3. Prevalence and risk factors of urinary incontinence in Chinese women: a population-based study.

    PubMed

    Ge, Jing; Yang, Peng; Zhang, Yi; Li, Xinyu; Wang, Quanyi; Lu, Yongxian

    2015-03-01

    To estimate the current prevalence rate of urinary incontinence (UI) and to identify risk factors in Chinese women, we conducted a population-based survey in 3058 women in Beijing, China, in 2009. The prevalence rate of UI was estimated to be 22.1%, with stress UI (12.9%) being more prevalent than urgency UI (1.7%) and mixed UI (7.5%). The prevalence rates of UI, urgency UI, and mixed UI increased with age, with the highest recorded in participants aged ≥70 years. However, stress UI was most commonly seen in participants aged 50 to 69 years. Risk factors for UI included aging, lower education background, older age of menarche, menstrual disorder, pregnancy history, episiotomy, chronic pelvic pain, gynecological disease, other chronic diseases, constipation, fecal incontinence, lower daily water intake, and frequency of high protein intake. UI is a common disorder in Chinese women, and many risk factors are able to affect the development of UI. PMID:22186396

  4. Midurethral slings for stress urinary incontinence: a urogynecology perspective.

    PubMed

    Ridgeway, Beri; Barber, Matthew D

    2012-08-01

    Stress urinary incontinence (SUI), the involuntary leakage of urine associated with an increase in intraabdominal pressure (coughing, laughing, and sneezing), affects 12.8% to 46.0% of women. SUI is the most common type of urinary incontinence in women younger than 60 years and accounts for at least half of incontinence in all women. Retropubic and transobturator midurethral sling procedures are safe and effective treatments for stress urinary incontinence but have different complication profiles. History, examination, and additional testing may assist in choosing the correct sling type. Appropriate counseling and managing patient expectation are necessary to optimize patient satisfaction. PMID:22877711

  5. Risk Factors for Urinary Incontinence among Middle-aged Women

    PubMed Central

    DANFORTH, Kim N.; TOWNSEND, Mary K.; LIFFORD, Karen; CURHAN, Gary C.; RESNICK, Neil M.; GRODSTEIN, Francine

    2005-01-01

    Objective: Identify risk factors for urinary incontinence in middle-aged women. Study Design: Cross-sectional analysis of 83,355 Nurses' Health Study II participants. Since 1989, women have provided health information on mailed questionnaires; in 2001, at age 37-54 years, information on urinary incontinence was requested. We examined adjusted odds ratios of incontinence using logistic regression. Results: 43% of women reported incontinence. After adjustment, African-American (OR=0.49, 95% CI 0.40-0.60) and Asian-American women (OR=0.57, 95% CI 0.46-0.72) were at reduced odds of severe incontinence compared to Caucasians. Increased age, body mass index, and parity were all positively associated with incontinence, as were current smoking, type 2 diabetes, and hysterectomy. Women aged 50-54 years had 1.81 times the odds of severe incontinence compared to women <40 years (95% CI 1.66-1.97); women with BMI ≥ 30 kg/m2 had 3.10 times the odds of severe incontinence compared to BMI 22-24 kg/m2 (95% CI 2.91-3.30). Conclusions: Urinary incontinence is highly prevalent among these middle-aged women. Potential risk factors include age, race/ethnicity, body mass index, parity, smoking, diabetes, and hysterectomy. PMID:16458626

  6. Male urinary incontinence and the urinary sheath.

    PubMed

    Smart, Clare

    This article addresses the assessment and management of male incontinence with a specific focus on the use of the male external catheter (MEC) or urinary sheath. Education and expertise when dealing with a man with urinary incontinence, as well as a tactful and sensitive attitude towards this embarrassing problem, are essential for a successful outcome. The urinary sheath is often perceived by nurses and patients as a difficult product to master and is prone to failure owing to incorrect fitting and management. With correct usage it can make a great difference to a patient's quality of life and avoid problems often associated with urinary catheters and pads such as urinary infection and skin excoriation. Detailed assessment of the patient as well as his suitability for the MEC is essential for a successful outcome. PMID:24820510

  7. [Diagnosis of urinary stress incontinence in men].

    PubMed

    Goepel, M

    2014-03-01

    Male lower urinary tract symptoms (LUTS) occur more frequently with increasing age. LUTS can either be caused by benign prostatic syndrome (BPS) and consecutive subvesical obstruction as well as detrusor hyperactivity. On the other hand, stress urinary incontinence is mostly seen after surgical intervention in the pelvis like radical prostatectomy. Also high volume centers report persisting incontinence rates of 2-4 % after radical prostatectomy.The diagnostic procedure in men with LUTS is divided in two steps: basic diagnostics, followed by a conservative treatment option, and extended diagnostic procedures including measurement of bladder pressure during filling and voiding. In addition, radiologic examinations, including voiding cystouretherogram, retrograde cystogram, CT scan, MRI scan, are added according to the severity of the symptoms and the scheduled surgical procedure. According to the guidelines of the DGU, EAU, AUA, and ICS, this extended examination is also mandatory prior to any surgical procedure like suburethral tapes, artificial sphincters, and sacral foramen neuronal stimulators. PMID:24615463

  8. [Treatment of cystoceles with urinary stress incontinence].

    PubMed

    Sarf, I; Aboutaieb, R; Dakir, M; el Moussaoui, A; Rabii, R; Hafiani, M; Bennani, S; el Mrini, M; Meziane, F; Benjelloun, S

    1998-01-01

    Thirteen women were operated for cystocele associated with urinary stress incontinence. Cystoceles were grade I in 6 cases, grade II in 6 cases and grade III in 1 case. Five patients underwent retropubic colposuspension according to Burch (3 cases) and M.M.K. (2 cases). Eight patients were treated by RAZ's technique associated with anterior colporaphy in order to reduce the cystocele. In this latter group, only one recurrence was observed and was treated by repeat colporaphy with good results. Colposuspension associated with anterior colporaphy is a reliable method for the treatment of cystocele with urinary stress incontinence, associated with low morbidity and short hospitalization. Its results are probably comparable to those of retropubic colposuspension, at least for a 6 months follow-up. PMID:9827204

  9. Slings in iatrogenic male incontinence: Current status

    PubMed Central

    Gallo, Fabrizio; Schenone, M.; Giberti, C.

    2010-01-01

    Objectives: The increasing number of prostatectomies entails an increasing number of patients suffering from iatrogenic incontinence despite improved surgical techniques. The severity of this problem often requires invasive treatments such as periurethral injection of bulking agents, artificial urinary sphincter (AUS) implantation, and sub-urethral sling positioning. The artificial urethral sphincter has represented, until today, the gold standard but, in the recent years, sling systems have been investigated as minimally invasive alternative options. Today, three different sling procedures are commonly performed: bone-anchored, readjustable, and trans-obturator slings systems. The aim of this review is to critically report the current status of sling systems in the treatment of iatrogenic male incontinence. Materials and Methods: MEDLINE and PubMed databases were searched and all articles between 1974 and 2009 were evaluated. Results: With regard to bone-anchored, readjustable, and trans-obturator slings systems, cure rates ranged between 58.0% and 86.0%, 55.5% and 73.0%, and 40.0% and 63.0%, respectively, while major complication rates ranged between 0 and 14.5%, 10.0 and 22.2%, and 0 and 10.0%, respectively. Conclusions: Suburethral slings are the only alternative techniques which can be favorably compared with the AUS, showing more advantages with respect to AUS implantations which are mainly represented by a quick and less invasive approach, low morbidity, and low costs. In spite of the difficulty in identifying the most effective sling procedure, overall, sling systems can be recommended for patients with persistent mild or moderate incontinence. However, the indication can also be extended to patients with severe incontinence, after appropriate counseling, allowing AUS implantation in the event of sling failure. PMID:20877609

  10. A Curious Case of Continuous Incontinence.

    PubMed

    Saltzman, Amanda; Roth, Christopher C

    2016-06-01

    Obstructed hemivagina, ipsilateral renal anomaly (OHVIRA) is a rare Müllerian duct abnormality with renal manifestations. Classical presentation is an adolescent female with abdominal pain following menarche. Because of its rarity, diagnosis is often delayed. There have been <20 reported cases of prepubertal OHVIRA. We present a case of missed OHVIRA diagnosis that presented with continuous incontinence following incision of the obstructed hemivagina and discuss the current medical literature on this subject. PMID:26898899

  11. Emerging surgical therapies for faecal incontinence.

    PubMed

    Mitchell, Peter J; Sagar, Peter M

    2014-05-01

    Faecal incontinence is a common condition and is associated with considerable morbidity and economic cost. The majority of patients are managed with conservative interventions. However, for those patients with severe or refractory incontinence, surgical treatment might be required. Over the past 20 years, numerous developments have been made in the surgical therapies available to treat such patients. These surgical therapies can be classified as techniques of neuromodulation, neosphincter creation (muscle or artificial) and injection therapy. Techniques of neuromodulation, particularly sacral nerve stimulation, have transformed the management of these patients with a minimally invasive procedure that offers good results and low morbidity. By contrast, neosphincter procedures are characterized by being more invasive and associated with considerable morbidity, although some patients will experience substantial improvements in their continence. Injection of bulking agents into the anal canal can improve symptoms and quality of life in patients with mild-to-moderate incontinence, and the use of autologous myoblasts might be a future therapy. Further research and development is required not only in terms of the devices and procedures, but also to identify which patients are likely to benefit most from such interventions. PMID:24275793

  12. FECAL COLIFORM INCREASE AFTER CENTRIFUGATION

    EPA Science Inventory

    The Water Environment Research Foundation (WERF) recently published a report titled Examination of Reactivation and Regrowth of Fecal Coliforms in Anaerobically Digested Sludges. Seven full-scale publicly owned treatment facilities were sampled several times to determine if bacte...

  13. School Experiences of an Adolescent with Medical Complexities Involving Incontinence

    ERIC Educational Resources Information Center

    Filce, Hollie Gabler; Bishop, John B.

    2014-01-01

    The educational implications of chronic illnesses which involve incontinence are not well represented in the literature. The experiences of an adolescent with multiple complex illnesses, including incontinence, were explored via an intrinsic case study. Data were gathered from the adolescent, her mother, and teachers through interviews, email…

  14. The Management of Urinary Incontinence by Community-Living Elderly.

    ERIC Educational Resources Information Center

    Mitteness, Linda S.

    1987-01-01

    Explored ways elderly people (N=30) manage urinary incontinence. Subjects tended to dismiss their urinary incontinence as a normal part of aging and used various behavioral and psychological strategies to maintain their independence, usually without any assistance from the health professions. Management strategies commonly involved some degree of…

  15. [Conservative therapy of female urinary incontinence--potential and effect].

    PubMed

    Horcicka, L; Chmel, R; Novácková, M

    2005-01-01

    Non-surgical treatment of female stress urinary incontinence is not as effective as surgical methods but it is very successful in indicated cases. Rehabilitation of the pelvic floor muscles (Kegel exercises, vaginal cones, and electrostimulation of the pelvic floor muscles), drug treatment (alfa-mimetics, tricyclic antidepressives, estrogens, duloxetin), pessarotherapy and uretral obturator devices represent possibilities of conservative therapy of the stress incontinence. Conservative therapy is the method of choice in the treatment of urge incontinence. The most successful are anticholinergic drugs but they have very frequent serious side effects (dryness of the mucous membranes, accommodation disorders, constipation). Spasmolytics, estrogens and tricyclic antidepressives are the other popular used drugs. Life style modification, bladder training and electrostimulation represent very important parts of the conservative treatment. Effectiveness of the non-surgical treatment of both urge and stress urinary incontinence can not reach 100 percent but it helps very much in the quality of life improvement of incontinent women. PMID:15887395

  16. Office management of urinary incontinence among older patients

    PubMed Central

    Frank, Christopher; Szlanta, Agata

    2010-01-01

    OBJECTIVE To provide family physicians with a guide to office management of urinary incontinence (UI) among older patients. SOURCES OF INFORMATION Ovid MEDLINE and the Cochrane database were searched using the terms urinary incontinence, stress incontinence, overactive bladder, urge incontinence, elderly, and geriatrics. MAIN MESSAGE A variety of conditions affecting the nervous system and the lower urinary tract can affect bladder function and UI. Among older patients the effects of decreased cognition and impaired mobility can be substantial, and environmental barriers can play a role. When managing older patients with UI, emphasis on treating concurrent conditions, optimizing medications, and working on lifestyle and behavioural factors is at least as important as pharmacologic treatment. Medications are relevant, but the potential for adverse effects increases among older patients. CONCLUSION Various resources are available to support family physicians in office management of UI, and family physicians can improve symptoms and the quality of patients’ lives by screening for and helping patients to manage incontinence. PMID:21075990

  17. Urinary incontinence in the bitch: an update.

    PubMed

    Reichler, I M; Hubler, M

    2014-06-01

    Urinary incontinence (UI), defined as the involuntary loss of urine during the filling phase of the bladder (Abrams et al. 2002), is a commonly seen problem in veterinary practice. Urinary sphincter mechanism incompetence (USMI) after spaying is the most common micturition disorder, and its medical treatment is normally successful, even though the underlying pathophysiological mechanism is not fully understood. Hormonal changes inducing structural and functional alterations in the bladder, as well as in the urethra composition, are discussed. To manage incontinent patients successfully, possible underlying abnormalities besides USMI should be ruled out. In the majority of cases, history, physical examination and simple tests including urinalysis and urine bacterial culture lead to a presumed aetiology. If USMI is the most likely cause, then the advantage of further diagnostic tests should be discussed with the owner before starting a trial therapy with alpha-adrenergic drugs. Potential side effects of this therapy have to be mentioned even though they rarely occur. It is important to thoroughly evaluate the success of the initial treatment. Its failure should lead to further diagnostic testing. Specialized clinical assessments may provide an aetiological diagnosis, and this could serve as a basis for discussing further treatment options. Surgical procedures, which may in rare cases cause irreversible side effects, may be instituted. If incontinence reoccurs after initial treatment was successfully performed, the diagnostic work-up including urinalysis should always be repeated. As results of urinalysis did not correlate well with results of bacterial culture, a urine culture is recommended (Comer and Ling 1981). Cystocentesis is the preferred method of urine collection (Bartges 2004). Equivocal results of quantitative cultures of urine samples obtained during midstream voiding or by catheterization require repeat collection by cystocentesis (Comer and Ling 1981

  18. [Significance of conservative treatment for faecal incontinence].

    PubMed

    Schwandner, O

    2012-08-01

    Based on a variety of aetiological factors and combined disorders in faecal incontinence, a conservative treatment option as the primary treatment can be recommended. Conservative treatment includes medical therapy influencing stool consistency and stool passage, pelvic floor exercises and biofeedback as well as local treatment options. However, defining the role of conservative treatment concepts related to success or failure remains a challenging task. The lack of evidence derived from studies is related to a variety of reasons including inclusion criteria, patient selection, treatment standardisation, and the principal difficulty to objectively define functional success. PMID:22933004

  19. Stress Urinary Incontinence: Comparative Efficacy Trials.

    PubMed

    Lavelle, Erin Seifert; Zyczynski, Halina M

    2016-03-01

    Women seeking relief from symptoms of stress urinary incontinence (SUI) may choose from a broad array of treatment options. Therapies range from lifestyle/behavioral modification to surgical interventions, and differ in terms of both effectiveness and risk. Individualized treatment plans can be developed to address a patient's expectations and goals for treatment, as well as her tolerance for potential adverse events. This article reviews the highest-quality clinical trials comparing contemporary treatment options for women with SUI. Clinicians and patients can use this compendium to inform their treatment selection. PMID:26880507

  20. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report.

    PubMed

    Karslıoǧlu, Ersin Hatice; Özalp, Elvan; Çayköylü, Ali

    2016-02-29

    Urinary incontinence, although rarely reported, is one of the most important adverse effects of antipsychotic medication. It can be an embarrassing, distressing, and potentially treatment-limiting. Several antipsychotics, including both typical and atypical varieties, are known to induce urinary incontinence. Many antipsychotic drugs target the neural pathways controlling continence by binding to receptors of some neurotransmitters such as serotonin, dopamine, acetylcholine, and adrenaline. Pharmacological management of incontinence should be considered if there is a risk of cessation of the antipsychotic therapy or any decline in patients' compliance. Amitriptyline, desmopressin, ephedrine, and anticholinergics such as oxybutynin and trihexyphenidyl are the most frequently used agents to treat incontinence. We think that the frequency of incontinence is higher than reported in the literature, and that follow-up routines should include a form of standardized screening for all possible adverse effects, including incontinence, of any given antipsychotic. In this article, we report a case of urinary incontinence as an adverse effect of paliperidone palmitate use during maintenance therapy in a patient with schizophrenia. PMID:26792046

  1. Screening for incontinence in a secure psychiatric service for women.

    PubMed

    Long, Clive G; West, Rachel; Siddique, Rizwana; Rigg, Samantha; Banyard, Ellen; Stillman, Swee-Kit; Butler, Sarah; Dolley, Olga

    2015-12-01

    Incontinence is associated with mental illness and neuroleptic medications but diagnosis and treatment is often poor or non-existent. Problems of incontinence are compounded in secure psychiatric services for women by poor health, obesity, and a sedentary lifestyle. Addressing the physical health of this group necessitates a more accurate picture of the nature, incidence, and management of incontinence. A point-in-time survey of 108 women who agreed to be interviewed (93%) covered presence, frequency, and nature of incontinence, and information on management case note data was used to gather demographic and previous medical history, comparisons were made between patients with and without problems of incontinence. Findings indicate a problem of incontinence in 48% of women with a dominance of problems of stress and urge enuresis. Of modifiable factors that contribute to enuresis, the current study highlighted the contribution of obesity, smoking and clozapine medication. A further finding was the preference for managing rather than treating problems of incontinence. Actions to improve the detection and treatment of this problem are described. PMID:26146962

  2. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report

    PubMed Central

    Karslıoǧlu, Ersin Hatice; Özalp, Elvan; Çayköylü, Ali

    2016-01-01

    Urinary incontinence, although rarely reported, is one of the most important adverse effects of antipsychotic medication. It can be an embarrassing, distressing, and potentially treatment-limiting. Several antipsychotics, including both typical and atypical varieties, are known to induce urinary incontinence. Many antipsychotic drugs target the neural pathways controlling continence by binding to receptors of some neurotransmitters such as serotonin, dopamine, acetylcholine, and adrenaline. Pharmacological management of incontinence should be considered if there is a risk of cessation of the antipsychotic therapy or any decline in patients’ compliance. Amitriptyline, desmopressin, ephedrine, and anticholinergics such as oxybutynin and trihexyphenidyl are the most frequently used agents to treat incontinence. We think that the frequency of incontinence is higher than reported in the literature, and that follow-up routines should include a form of standardized screening for all possible adverse effects, including incontinence, of any given antipsychotic. In this article, we report a case of urinary incontinence as an adverse effect of paliperidone palmitate use during maintenance therapy in a patient with schizophrenia. PMID:26792046

  3. Utilization of incontinence clinical practice guidelines.

    PubMed

    Roe, B; Moore, K N

    2001-11-01

    Clinical practice guidelines (CPGs) are evidence-based recommendations for best practice and have been developed with the assumption they will be embraced by practitioners; a further assumption is that clinical practice guidelines will improve the delivery of care. In this article, we provide a working definition of evidence-based practice, discuss the strengths and limitations of CPGs, describe the implementation of CPGs in the context of urinary incontinence, and consider the steps that the WOCN has taken to initiate evidence-based practice. Current issues are presented along with initiatives that have resulted in clinical practice guidelines on incontinence from the United States, United Kingdom, and Canada. On the basis of the current literature, it is concluded that clinical practice guidelines can play an important role in WOCN practice and that the implementation of guidelines may improve clinical practice. However, guidelines are only as valid as the evidence on which they are based and may not take into account gender or cultural differences or the effect that comorbid conditions can have on treatment outcomes. Finally, guidelines must follow a comprehensive approach that involves management and staff and includes education, facilitation, evaluation, feedback, and an understanding of change strategies. PMID:11707762

  4. Diagnosis, Evaluation, and Treatment of Mixed Urinary Incontinence in Women

    PubMed Central

    Chughtai, Bilal; Laor, Leanna; Dunphy, Claire; Lee, Richard; Te, Alexis; Kaplan, Steven

    2015-01-01

    Mixed urinary incontinence (MUI) is a common clinical problem in the community and hospital setting. The broad definition of the term makes it difficult to diagnose, as well as determine effective treatment strategies. There are no current guidelines recommended for physicians. The estimated prevalence of this condition is approximately 30% in all women with incontinence. It has also been suggested that patients with MUI report more bothersome symptoms than either stress or urge incontinence; approximately 32% of 40- to 64-year-olds with MUI report symptoms of depression. The authors examine the diagnosis, evaluation, and treatment of patients with MUI. PMID:27222643

  5. Development of a Simple Multispectral Algorithm Using a Hyperspectral Line-Scan Imaging System for Detection of Fecal Contamination on Apples

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne diseases are of serious concern for public health. It is necessary to develop fast and reliable non-destructive detection methods to improve food product monitoring for the food industry. This research was conducted to investigate hyperspectral fluorescence imaging using violet/blue LED ex...

  6. Fecal microbiota transplantation: in perspective

    PubMed Central

    Gupta, Shaan; Allen-Vercoe, Emma; Petrof, Elaine O.

    2016-01-01

    There has been increasing interest in understanding the role of the human gut microbiome to elucidate the therapeutic potential of its manipulation. Fecal microbiota transplantation (FMT) is the administration of a solution of fecal matter from a donor into the intestinal tract of a recipient in order to directly change the recipient’s gut microbial composition and confer a health benefit. FMT has been used to successfully treat recurrent Clostridium difficile infection. There are preliminary indications to suggest that it may also carry therapeutic potential for other conditions such as inflammatory bowel disease, obesity, metabolic syndrome, and functional gastrointestinal disorders. PMID:26929784

  7. Fecal microbiota transplantation: in perspective.

    PubMed

    Gupta, Shaan; Allen-Vercoe, Emma; Petrof, Elaine O

    2016-03-01

    There has been increasing interest in understanding the role of the human gut microbiome to elucidate the therapeutic potential of its manipulation. Fecal microbiota transplantation (FMT) is the administration of a solution of fecal matter from a donor into the intestinal tract of a recipient in order to directly change the recipient's gut microbial composition and confer a health benefit. FMT has been used to successfully treat recurrent Clostridium difficile infection. There are preliminary indications to suggest that it may also carry therapeutic potential for other conditions such as inflammatory bowel disease, obesity, metabolic syndrome, and functional gastrointestinal disorders. PMID:26929784

  8. CDC Study Finds Fecal Contamination in Pools

    MedlinePlus

    ... Communication (404) 639-3286 CDC study finds fecal contamination in pools A study of public pools done ... The E. coli is a marker for fecal contamination. Finding a high percentage of E. coli-positive ...

  9. Home Use Tests: Fecal Occult Blood

    MedlinePlus

    ... Procedures In Vitro Diagnostics Home Use Tests Fecal Occult Blood Share Tweet Linkedin Pin it More sharing ... test kit to measure the presence of hidden (occult) blood in your stool (feces). What is fecal ...

  10. Informatics in Radiology: Dual-Energy Electronic Cleansing for Fecal-Tagging CT Colonography

    PubMed Central

    Kim, Se Hyung; Lee, June-Goo; Yoshida, Hiroyuki

    2013-01-01

    Electronic cleansing (EC) is an emerging technique for the removal of tagged fecal materials at fecal-tagging computed tomographic (CT) colonography. However, existing EC methods may generate various types of artifacts that severely impair the quality of the cleansed CT colonographic images. Dual-energy fecal-tagging CT colonography is regarded as a next-generation imaging modality. EC that makes use of dual-energy fecal-tagging CT colonographic images promises to be effective in reducing cleansing artifacts by means of applying the material decomposition capability of dual-energy CT. The dual-energy index (DEI), which is calculated from the relative change in the attenuation values of a material at two different photon energies, is a reliable and effective indicator for differentiating tagged fecal materials from various types of tissues on fecal-tagging CT colonographic images. A DEI-based dual-energy EC scheme uses the DEI to help differentiate the colonic lumen—including the luminal air, tagged fecal materials, and air-tagging mixture—from the colonic soft-tissue structures, and then segments the entire colonic lumen for cleansing of the tagged fecal materials. As a result, dual-energy EC can help identify partial-volume effects in the air-tagging mixture and inhomogeneous tagging in residual fecal materials, the major causes of EC artifacts. This technique has the potential to significantly improve the quality of EC and promises to provide images of a cleansed colon that are free of the artifacts commonly observed with conventional single-energy EC methods. © RSNA, 2013 PMID:23479680

  11. Anterior vaginal wall repair (surgical treatment of urinary incontinence) - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100110.htm Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series ... 4 out of 4 Normal anatomy Overview The vaginal opening lies just below the urethral opening, and ...

  12. [Urinary incontinence caused by urocolpos. Report of a new case].

    PubMed

    Ortega Mariscal, J; Congregado Ruiz, B; Campoy Martínez, P; Pérez Pérez, M; Rodríguez Pérez, A; Soltero González, A

    2001-06-01

    We present a new case of urocolpos that appeared as urinary incontinence. We discuss the etiology and the available therapeutic choices, emphasizing on the value of the clinical history and physical exploration showed data. PMID:11512514

  13. [Health care of geriatric patients with urinary incontinence].

    PubMed

    Mueller, Edgar A; Kirch, Wilhelm

    2015-04-01

    Urinary incontinence occurs frequently in geriatric patients. In the doctor's practice, the symptoms are often not mentioned by the patients; this may lead to loss of autonomy and social isolation. A screening for urinary incontinence should therefore be part of each geriatric assessment. In the presence of urinary incontinence, several treatment options are available, which need to be tailored according to the individual capabilities (mobility, motivation and cognitive performance) of the patient. Non-pharmacological treatment options, such as behavior modification, toilet training and pelvic floor training, should be exploited before any pharmacotherapy commences. If the pharmacological treatment involves the use of anticholinergic agents, the cognitive performance should be monitored. An interdisciplinary collaboration is a prerequisite for the optimized treatment and adequate health care of geriatric patients with urinary incontinence. PMID:25826038

  14. Pelvic floor muscle training for urinary incontinence postpartum.

    PubMed

    Hall, Bethany; Woodward, Sue

    The offering of pelvic floor muscle exercises to all women during their first pregnancy is recommended by National Institute for Health and Care Excellence (NICE) guidelines. Pelvic floor muscles suffer significant trauma throughout pregnancy and childbirth, which may sometimes lead to urinary incontinence postpartum. However, it is uncertain how effective pelvic floor muscle exercises are in treating this incontinence. Several trials have been analysed to try to understand this question. Issues such as when the exercises were undertaken, how often they were performed and in what circumstances they were carried out, have all been considered. While it is still uncertain whether they are effective in reducing urinary incontinence postpartum, as they are non-invasive and fairly simple to carry out, they are still the first-line management for urinary incontinence postpartum with other treatments being considered if this is ineffective. PMID:26067791

  15. Incontinence-associated dermatitis: a consensus.

    PubMed

    Gray, Mikel; Bliss, Donna Z; Doughty, Dorothy B; Ermer-Seltun, JoAnn; Kennedy-Evans, Karen L; Palmer, Mary H

    2007-01-01

    Incontinence-associated dermatitis (IAD) is an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin. Little research has focused on IAD, resulting in significant gaps in our understanding of its epidemiology, natural history, etiology, and pathophysiology. A growing number of studies have examined clinical and economic outcomes associated with prevention strategies, but less research exists concerning the efficacy of various treatments. In the clinical and research settings, IAD is often combined with skin damage caused by pressure and shear or related factors, sometimes leading to confusion among clinicians concerning its etiology and diagnosis. This article reviews existing literature related to IAD, outlines strategies for assessing, preventing, and treating IAD, and provides suggestions for additional research needed to enhance our understanding and management of this common but under-reported and understudied skin disorder. PMID:17228207

  16. Animal Models of Stress Urinary Incontinence

    PubMed Central

    Jiang, Hai-Hong

    2011-01-01

    Stress urinary incontinence (SUI) is a common health problem significantly affecting the quality of life of women worldwide. Animal models that simulate SUI enable the assessment of the mechanism of risk factors for SUI in a controlled fashion, including childbirth injuries, and enable preclinical testing of new treatments and therapies for SUI. Animal models that simulate childbirth are presently being utilized to determine the mechanisms of the maternal injuries of childbirth that lead to SUI with the goal of developing prophylactic treatments. Methods of assessing SUI in animals that mimic diagnostic methods used clinically have been developed to evaluate the animal models. Use of these animal models to test innovative treatment strategies has the potential to improve clinical management of SUI. This chapter provides a review of the available animal models of SUI, as well as a review of the methods of assessing SUI in animal models, and potential treatments that have been tested on these models. PMID:21290221

  17. Efficacy of Physiotherapy for Urinary Incontinence following Prostate Cancer Surgery

    PubMed Central

    Bakuła, Stanisław

    2014-01-01

    The study enrolled 81 with urinary incontinence following radical prostate-only prostatectomy for prostatic carcinoma. The patients were divided into two groups. The patients in Group I were additionally subdivided into two subgroups with respect to the physiotherapeutic method used. The patients of subgroup IA received a rehabilitation program consisting of three parts. The patients of subgroup IB rehabilitation program consist of two parts. Group II, a control group, had reported for therapy for persistent urinary incontinence following radical prostatectomy but had not entered therapy for personal reasons. For estimating the level of incontinence, a 1-hour and 24-hour urinary pad tests, the miction diary, and incontinence questionnaire were used, and for recording the measurements of pelvic floor muscles tension, the sEMG (surface electromyography) was applied. The therapy duration depended on the level of incontinence and it continued for not longer than 12 months. Superior continence outcomes were obtained in Group I versus Group II and the difference was statistically significant. The odds ratio for regaining continence was greater in the rehabilitated Group I and smaller in the group II without the rehabilitation. A comparison of continence outcomes revealed a statistically significant difference between Subgroups IA versus IB. The physiotherapeutic procedures applied on patients with urine incontinence after prostatectomy, for most of them, proved to be an effective way of acting, which is supported by the obtained results. PMID:24868546

  18. Incontinence in Intellectual Disability: An Under Recognized Cause.

    PubMed

    Nair, Lal Devayanivasudevan; Sagayaraj, Benjamin; V T T, Rajan; Kumar, Radha

    2015-09-01

    Many children with Down syndrome may develop urinary incontinence during adolescence or nearing adulthood. Most often low mental ability, behavioural issues, urinary tract infection, hypothyroidism, atlanto-axial subluxation or sexual abuse may be suspected to be the reason. We report a case of Down syndrome with tethered cord syndrome (TCS) and Lipoma of Filum terminale with Cauda equina in normal position, as a cause of bowel and bladder incontinence. The need for operating with Cauda Equina in normal position is debated. But a conscious decision was taken to operate and the incontinence improved markedly which was documented by using a standardized questionnaire (King's questionnaire) and thereby making a difference in the child's life. A literature search did not result in any case of Down syndrome with tethered cord syndrome and secondary incontinence as presentation. Considering the possibility of TCS as a cause of incontinence, often neglected even in normal children, careful evaluation and correction of such problems will make a difference in the life of many intellectually disabled children. Incontinence should not be casually attributed to intellectual disability without ruling out other causes. PMID:26500975

  19. [Urinary incontinence in the elderly can be treated].

    PubMed

    van Houten, Paul

    2015-01-01

    A recent survey on the use of drugs for incontinence in the elderly stated that only anticholinergic drugs used for urge incontinence have a slight positive effect on incontinence episodes. However, this does not mean that there are no potential treatments for incontinence in the frail elderly. The Dutch surveillance on problems in the care sector, the 'National prevalence survey of care problems' ('Landelijke prevalentiemeting zorgproblemen'), shows that between 2004 and 2014 the prevalence of urinary incontinence dropped from 76% to 49%. This fall in prevalence is due to the policies developed by institutions, and by training for nurses and physicians. Successful treatment begins with assessment of functionality (mobility and cognition), assessment of relevant multimorbidity and reconsideration of the use of drugs with an impact on continence. As a next step, bladder retraining and pelvic floor exercises may be used if the elderly person is able to perform these exercises independently. An anticholinergic drug can be tried as a last resort if there is urge incontinence and there are no contraindications. PMID:26732219

  20. Football practice and urinary incontinence: Relation between morphology, function and biomechanics.

    PubMed

    Roza, Thuane Da; Brandão, Sofia; Oliveira, Dulce; Mascarenhas, Teresa; Parente, Marco; Duarte, José Alberto; Jorge, Renato Natal

    2015-06-25

    Current evidence points to a high prevalence of urinary incontinence among female athletes. In this context, this study aims to assess if structural and biomechanical characteristics of the pubovisceral muscles may lead to urine leakage. Clinical and demographic data were collected, as well as pelvic Magnetic Resonance Imaging. Furthermore, computational models were built to verify if they were able to reproduce similar biomechanical muscle response as the one measured by dynamic imaging during active contraction by means of the percent error. Compared to the continent ones (n=7), incontinent athletes (n=5) evidenced thicker pubovisceral muscles at the level of the midvagina (p=0.019 and p=0.028 for the right and left sides, respectively). However, there were no differences neither in the strength of contraction in the Oxford Scale or in the displacement of the pelvic floor muscles during simulation of voluntary contraction, which suggests that urine leakage may be related with alterations in the intrafusal fibers than just the result of thicker muscles. Additionally, we found similar values of displacement retrieved from dynamic images and numerical models (6.42 ± 0.36 mm vs. 6.10 ± 0.47 mm; p=0.130), with a percent error ranging from 1.47% to 17.20%. However, further refinements in the mechanical properties of the striated skeletal fibers of the pelvic floor muscles and the inclusion of pelvic organs, fascia and ligaments would reproduce more realistically the pelvic cavity. PMID:25835786

  1. The relationship of urinary incontinence to early spaying in bitches.

    PubMed

    Stöcklin-Gautschi, N M; Hässig, M; Reichler, I M; Hubler, M; Arnold, S

    2001-01-01

    It is still controversial whether a bitch should be spayed before or after the first oestrus. It would be desirable to spay bitches at an age that would minimize the side effects of neutering. With regard to the risk of mammary tumours, early spaying must be recommended because the incidence of tumours is reduced considerably. The aim of the present study was to determine whether early spaying also reduces the risk of urinary incontinence. The owners of 206 bitches that had been spayed before their first oestrus and for at least 3 years were questioned on the occurrence of urinary incontinence as a result of spaying. At the time of the enquiry the average age of the bitches was 6.5 years, and the average age at the time of surgery was 7.1 months. Urinary incontinence after spaying occurred in 9.7% of bitches. This incidence is approximately half that of spaying after the first oestrus. Urinary incontinence affected 12.5% of bitches that were of a large body weight (> 20 kg body weight) and 5.1% of bitches that were of a small body weight (< 20 kg body weight). The surgical procedure (ovariectomy versus ovariohysterectomy) had no influence on the incidence, or on the period between spaying and the occurrence of urinary incontinence. Urinary incontinence occurred on average at 2 years and 10 months after surgery and occurred each day, while the animals were awake or during sleep. However, compared with late spaying the clinical signs of urinary incontinence were more distinct after early spaying. PMID:11787155

  2. Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice Guideline

    MedlinePlus

    Annals of Internal Medicine Summaries for Patients Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice ... of Physicians The full report is titled “Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice ...

  3. Taking Control: Non-Surgical Treatment Options for Urinary Incontinence in Women

    MedlinePlus

    ... UI? Taking Control: Non-surgical Treatment Options for Urinary Incontinence in Women What is UI? “Taking Control” (5- ... own home. Page 0 Page 2 What is urinary incontinence (UI)? Taking Control (5-minute video) Click on ...

  4. Novel bulking agent for faecal incontinence

    PubMed Central

    Ratto, C; Parello, A; Donisi, L; Litta, F; De Simone, V; Spazzafumo, L; Giordano, P

    2011-01-01

    Background Various injectable bulking agents have been used for the treatment of faecal incontinence (FI). However, encouraging early results are not maintained over time. This study aimed to assess short- and medium-term results of a new bulking agent for the treatment of FI. Methods The Gatekeeper™ prosthesis comprises a thin solid polyacrylonitrile cylinder that becomes thicker, shorter and softer within 24 h after implantation. Fourteen patients with FI underwent treatment with Gatekeeper™ under local anaesthesia. Four prostheses were implanted in the intersphincteric space in each patient, under endoanal ultrasound guidance. Number of episodes of major FI, Cleveland Clinic FI score (CCFIS), Vaizey score, anorectal manometry, endoanal ultrasonography (EUS), health status and quality of life (Short Form 36 and Faecal Incontinence Quality of Life questionnaires) were assessed before and after treatment. Results Mean(s.d.) follow-up was 33·5(12·4) months. There were no complications. There was a significant decrease in major FI episodes from 7·1(7·4) per week at baseline to 1·4(4·0), 1·0(3·2) and 0·4(0·6) per week respectively at 1-month, 3-month and last follow-up (P = 0·002). CCFIS improved significantly from 12·7(3·3) to 4·1(3·0), 3·9(2·6) and 5·1(3·0) respectively (P < 0·001), and Vaizey score from 15·4(3·3) to 7·1(3·9), 4·7(3·0) and 6·9(5·0) respectively (P = 0·010). Soiling and ability to postpone defaecation improved significantly, and patients reported significant improvement in health status and quality of life. At follow-up, manometric parameters had not changed and EUS did not demonstrate any prosthesis dislocation. Conclusion The Gatekeeper™ anal implant seemed safe, reliable and effective. Initial clinical improvement was maintained over time, and follow-up data were encouraging. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID:21928378

  5. Fecal transplant policy and legislation

    PubMed Central

    Vyas, Dinesh; Aekka, Apoorva; Vyas, Arpita

    2015-01-01

    Fecal microbiota transplantation (FMT) has garnered significant attention in recent years in the face of a reemerging Clostridium difficile (C. difficile) epidemic. Positive results from the first randomized control trial evaluating FMT have encouraged the medical community to explore the process further and expand its application beyond C. difficile infections and even the gastrointestinal domain. However promising and numerous the prospects of FMT appear, the method remains limited in scope today due to several important barriers, most notably a poorly defined federal regulatory policy. The Food and Drug Administration has found it difficult to standardize and regulate the administration of inherently variable, metabolically active, and ubiquitously available fecal material. The current cumbersome policy, which classifies human feces as a drug, has prevented physicians from providing FMT and deserving patients from accessing FMT in a timely fashion, and subsequent modifications seem only to be temporary. The argument for reclassifying fecal material as human tissue is well supported. Essentially, this would allow for a regulatory framework that is sufficiently flexible to expand access to care and facilitate research, but also appropriately restrictive and centralized to ensure patient safety. Such an approach can facilitate the advancement of FMT to a more refined, controlled, and aesthetic process, perhaps in the form of a customized and well-characterized stool substitute therapy. PMID:25574076

  6. Fecal transplant policy and legislation.

    PubMed

    Vyas, Dinesh; Aekka, Apoorva; Vyas, Arpita

    2015-01-01

    Fecal microbiota transplantation (FMT) has garnered significant attention in recent years in the face of a reemerging Clostridium difficile (C. difficile) epidemic. Positive results from the first randomized control trial evaluating FMT have encouraged the medical community to explore the process further and expand its application beyond C. difficile infections and even the gastrointestinal domain. However promising and numerous the prospects of FMT appear, the method remains limited in scope today due to several important barriers, most notably a poorly defined federal regulatory policy. The Food and Drug Administration has found it difficult to standardize and regulate the administration of inherently variable, metabolically active, and ubiquitously available fecal material. The current cumbersome policy, which classifies human feces as a drug, has prevented physicians from providing FMT and deserving patients from accessing FMT in a timely fashion, and subsequent modifications seem only to be temporary. The argument for reclassifying fecal material as human tissue is well supported. Essentially, this would allow for a regulatory framework that is sufficiently flexible to expand access to care and facilitate research, but also appropriately restrictive and centralized to ensure patient safety. Such an approach can facilitate the advancement of FMT to a more refined, controlled, and aesthetic process, perhaps in the form of a customized and well-characterized stool substitute therapy. PMID:25574076

  7. Anticholinergic Therapy vs. OnabotulinumtoxinA for Urgency Urinary Incontinence

    PubMed Central

    Visco, Anthony G.; Brubaker, Linda; Richter, Holly E.; Nygaard, Ingrid; Paraiso, Marie Fidela R.; Menefee, Shawn A.; Schaffer, Joseph; Lowder, Jerry; Khandwala, Salil; Sirls, Larry; Spino, Cathie; Nolen, Tracy L.; Wallace, Dennis; Meikle, Susan F.

    2012-01-01

    BACKGROUND Anticholinergic medications and onabotulinumtoxinA are used to treat urgency urinary incontinence, but data directly comparing the two types of therapy are needed. METHODS We performed a double-blind, double-placebo–controlled, randomized trial involving women with idiopathic urgency urinary incontinence who had five or more episodes of urgency urinary incontinence per 3-day period, as recorded in a diary. For a 6-month period, participants were randomly assigned to daily oral anticholinergic medication (solifenacin, 5 mg initially, with possible escalation to 10 mg and, if necessary, subsequent switch to trospium XR, 60 mg) plus one intradetrusor injection of saline or one intradetrusor injection of 100 U of onabotulinumtoxinA plus daily oral placebo. The primary outcome was the reduction from baseline in mean episodes of urgency urinary incontinence per day over the 6-month period, as recorded in 3-day diaries submitted monthly. Secondary outcomes included complete resolution of urgency urinary incontinence, quality of life, use of catheters, and adverse events. RESULTS Of 249 women who underwent randomization, 247 were treated, and 241 had data available for the primary outcome analyses. The mean reduction in episodes of urgency urinary incontinence per day over the course of 6 months, from a baseline average of 5.0 per day, was 3.4 in the anticholinergic group and 3.3 in the onabotulinumtoxinA group (P = 0.81). Complete resolution of urgency urinary incontinence was reported by 13% and 27% of the women, respectively (P = 0.003). Quality of life improved in both groups, without significant between-group differences. The anticholinergic group had a higher rate of dry mouth (46% vs. 31%, P = 0.02) but lower rates of catheter use at 2 months (0% vs. 5%, P = 0.01) and urinary tract infections (13% vs. 33%, P<0.001). CONCLUSIONS Oral anticholinergic therapy and onabotulinumtoxinA by injection were associated with similar reductions in the frequency of

  8. Anti-diuresis in the management of daytime urinary incontinence

    PubMed Central

    Robinson, D.; Cardozo, L.

    2009-01-01

    Urinary incontinence and lower urinary tract dysfunction, whilst not life threatening conditions, remain an important cause of morbidity in women and are responsible for significant impairment of quality of life. Drug therapy is often used to treat women who complain of urgency and urge incontinence and has an emerging role in the management of stress urinary incontinence. However, bothersome side effects are known to affect compliance and therefore compromise efficacy, making longterm drug therapy unpopular. The principle aim of this thesis is to assess the role of antidiuresis in women complaining of daytime urinary incontinence and also to examine its role as a ‘designer therapy’ which women can choose to use as, or when, required. In addition both the patients’ and clinicians’ attitudes towards treatment have been studied to clarify the meaning of ‘cure’, and to determine treatment acceptability, overall outcome and patient satisfaction. In the first study the patients’ concept of cure is explored as well as their expectations regarding treatment and outcome. The second study examines cure from the clinician’s perspective in addition to reviewing outcome measures in the clinical and research settings. Finally in the third study the use of desmopressin in women complaining of daytime urinary incontinence is reported. PMID:25478070

  9. Faecal incontinence: Current knowledges and perspectives

    PubMed Central

    Benezech, Alban; Bouvier, Michel; Vitton, Véronique

    2016-01-01

    Faecal incontinence (FI) is a disabling and frequent symptom since its prevalence can vary between 5% and 15% of the general population. It has a particular negative impact on quality of life. Many tools are currently available for the treatment of FI, from conservative measures to invasive surgical treatments. The conservative treatment may be dietetic measures, various pharmacological agents, anorectal rehabilitation, posterior tibial nerve stimulation, and transanal irrigation. If needed, patients may have miniinvasive approaches such as sacral nerve modulation or antegrade irrigation. In some cases, a surgical treatment is proposed, mainly external anal sphincter repair. Although these different therapeutic options are available, new techniques are arriving allowing new hopes for the patients. Moreover, most of them are non-invasive such as local application of an α1-adrenoceptor agonist, stem cell injections, rectal injection of botulinum toxin, acupuncture. New more invasive techniques with promising results are also coming such as anal magnetic sphincter and antropylorus transposition. This review reports the main current available treatments of FI and the developing therapeutics tools. PMID:26909229

  10. [Translabial ultrasonography in pelvic floor prolapse and urinary incontinence diagnostics].

    PubMed

    Pietrus, Miłosz; Pityński, Kazimierz; Bałajewicz-Nowak, Marta; Wiecheć, Marcin; Knafel, Anna; Ludwin, Artur; Dziechciowski, Marek; Nocuń, Agnieszka

    2012-09-01

    Technological advances in the construction of sonographic devices and increasingly universal access to such tests considerably widens the range of diagnostic application of the sonographic examination. This situation also refers to pelvic organs prolapse. At present, sonographic sets used in everyday obstetrical-gynecological practice allow for insight into the structures forming the female pelvic floor, and the obtained images constitute a valuable addition to the physical examination. Positioning the sonographic transducer on a the perineum enables to visualize the three compartments of the female pelvis minor. After freezing the image, it is possible to assess the position of anatomical structures in relation to bones and designated surfaces, establish mutual distances and measure appropriate angles. Most information can be obtained in this manner within the range of the frontal compartment, whose damage is often linked with urinary incontinence. The examination standards developed so far, including the analysis of the quantitative parameters, greatly minimize the potential subjectivity of the assessment of the existing disorders. Apart from its low costs, the main value of the sonographic examination of the pelvic floor is the possibility to dynamically assess the changes in statics which take place during functional testing. Not only does it have a cognitive significance, but also it allows to adjust the scope of the surgical correction to the existing damages. Thus, indirectly it can contribute to the reduction of a number of subsequent remedial surgeries. Three-dimensional sonography allows to thoroughly examine the construction and functioning of the anal levators and to detect their possible damage. It is the trauma to these muscles--occurring, among others, during childbirth--that is one of the major causes of pelvic organs descent and prolapse in women. Sonographic examination also enables to visualize the artificial material, the use of which is

  11. Development of a wearable microwave bladder monitor for the management and treatment of urinary incontinence

    NASA Astrophysics Data System (ADS)

    Krewer, F.; Morgan, F.; Jones, E.; Glavin, M.; O'Halloran, M.

    2014-05-01

    Urinary incontinence is defined as the inability to stop the flow of urine from the bladder. In the US alone, the annual societal cost of incontinence-related care is estimated at 12.6 billion dollars. Clinicians agree that those suffering from urinary incontinence would greatly benefit from a wearable system that could continually monitor the bladder, providing continuous feedback to the patient. While existing ultrasound-based solutions are highly accurate, they are severely limited by form-factor, battery size, cost and ease of use. In this study the authors propose an alternative bladder-state sensing system, based on Ultra Wideband (UWB) Radar. As part of an initial proof-of-concept, the authors developed one of the first dielectrically and anatomically-representative Finite Difference Time Domain models of the pelvis. These models (one male and one female) are derived from Magnetic Resonance images provided by the IT'IS Foundation. These IT'IS models provide the foundation upon which an anatomically-plausible bladder growth model was constructed. The authors employed accurate multi-pole Debye models to simulate the dielectric properties of each of the pelvic tissues. Two-dimensional Finite Difference Time Domain (FDTD) simulations were completed for a range of bladder volumes. Relevant features were extracted from the FDTD-derived signals using Principle Component Analysis (PCA) and then classified using a k-Nearest-Neighbour and Support Vector Machine algorithms (incorporating the Leave-one-out cross-validation approach). Additionally the authors investigated the effects of signal fidelity, noise and antenna movement relative to the target as potential sources of error. The results of this initial study provide strong motivation for further research into this timely application, particularly in the context of an ageing population.

  12. Adipose-Derived Regenerative Cell Injection Therapy for Postprostatectomy Incontinence: A Phase I Clinical Study

    PubMed Central

    Choi, Jae Young; Kim, Tae-Hwan; Yang, Jung Dug; Suh, Jang Soo

    2016-01-01

    Purpose We report our initial experience with transurethral injection of autologous adipose-derived regenerative cells (ADRCs) for the treatment of urinary incontinence after radical prostatectomy. Materials and Methods After providing written informed consent, six men with persistent urinary incontinence after radical prostatectomy were enrolled in the study. Under general anesthesia, about 50 mL of adipose tissue was obtained from the patients by liposuction. ADRCs were obtained by separation with centrifugation using the Celution cell-processing device. A mixture of ADRCs and adipose tissue were transurethrally injected into the submucosal space of the membranous urethra. Functional and anatomical improvement was assessed using a 24-h pad test, validated patient questionnaire, urethral pressure profile, and magnetic resonance imaging (MRI) during 12-week follow-up. Results Urine leakage volume was improved with time in all patients in the 24-h pad test, with the exemption of temporal deterioration at the first 2 weeks post-injection in 2 patients. Subjective symptoms and quality of life assessed on the basis of questionnaire results showed similar improvement. The mean maximum urethral closing pressure increased from 44.0 to 63.5 cm H2O at 12 weeks after injection. MRI showed an increase in functional urethral length (from 6.1 to 8.3 mm) between the lower rim of the pubic bone and the bladder neck. Adverse events, such as pelvic pain, inflammation, or de novo urgency, were not observed in any case during follow-up. Conclusion This study demonstrated that transurethral injection of autologous ADRCs can be a safe and effective treatment modality for postprostatectomy incontinence. PMID:27401646

  13. Clinical challenges of preventing incontinence-associated dermatitis.

    PubMed

    Beeckman, Dimitri; Woodward, Sue; Rajpaul, Kumal; Vanderwee, Katrien

    Incontinence-associated dermatitis (IAD) is a common skin disorder in patients with faecal and/or urinary incontinence. The past decade has seen a huge growth in publications focusing on the complexity and inconsistency of the clinical observation of IAD and the differentiation between IAD and pressure ulcers. IAD and superficial pressure ulcers cause confusion in clinical practice when trying to determine the true nature and underlying pathology of the lesion. It is a daily challenge for health professionals in hospitals, nursing homes and community care to maintain a healthy skin in patients with incontinence. The aim of this article is to provide a brief update on recent developments regarding the differentiation between pressure ulcers and IAD and the prevention of IAD. Recommendations for clinical practice and research are provided. PMID:21841685

  14. Vaginal diaphragm rings in the treatment of stress urinary incontinence.

    PubMed

    Realini, J P; Walters, M D

    1990-01-01

    To assess the effectiveness of wearing vaginal diaphragm rings in the treatment of stress urinary incontinence, 10 women with genuine stress incontinence were studied. Patients underwent urodynamic evaluation and perineal pad testing before and after fitted diaphragm rings were in place. Patients kept symptom diaries for 1 week without the ring and then for 1 week with the ring. They also gave an overall subjective evaluation of their experience. Urodynamic findings were essentially unchanged by wearing diaphragm rings. Trends toward improvement were observed in the results of pad tests and symptom diaries. Four of the 10 women experienced clinically significant improvement in amount of urine lost during pad tests, number of leaks per week, and overall assessment of response. Vaginal diaphragm rings may be an effective treatment for some women with stress urinary incontinence. PMID:2333769

  15. Diagnostic evaluation of urinary incontinence in geriatric patients.

    PubMed

    Weiss, B D

    1998-06-01

    In most cases, the evaluation of urinary incontinence requires only a history, a physical examination, urinalysis and measurement of postvoid residual urine volume. The initial purposes of the evaluation are to identify conditions requiring referral or specialized work-up and to detect and treat reversible causes that may be present. If the patient does not appear to require referral and a reversible cause is not identified, the next step is to categorize the patient's symptoms as typical of either urge or stress incontinence and treat the patient accordingly. If treatment fails or a presumptive diagnosis of urge or stress incontinence cannot be reached, the final step would be to perform more sophisticated tests or refer the patient for testing to define the cause and determine the best treatment. PMID:9636332

  16. The Artificial Urinary Sphincter in the Management of Incontinence.

    PubMed

    Suarez, Oscar A; McCammon, Kurt A

    2016-06-01

    Despite the emergence of different devices in the treatment of postprostatectomy urinary incontinence, the AMS 800 (American Medical Systems, Minnetonka, MN) remains the gold standard for the treatment of stress urinary incontinence in men. We reviewed the current literature regarding the indications, surgical principles, outcomes, and complications of artificial urinary sphincter placement for stress urinary incontinence after prostatectomy. Despite all the available information, heterogeneous data, different success definitions, and the lack of high-quality prospective studies with long-term follow-up, it is difficult to compare outcomes between studies. In spite of these, the perineal implantation of a single cuff artificial urinary sphincter has withstood the test of time. PMID:26845050

  17. Pathophysiology of Overactive Bladder and Urge Urinary Incontinence

    PubMed Central

    Steers, William D

    2002-01-01

    Storage symptoms such as urgency, frequency, and nocturia, with or without urge incontinence, are characterized as overactive bladder (OAB). OAB can lead to urge incontinence. Disturbances in nerves, smooth muscle, and urothelium can cause this condition. In some respects the division between peripheral and central causes of OAB is artificial, but it remains a useful paradigm for appreciating the interactions between different tissues. Models have been developed to mimic the OAB associated with bladder instability, lower urinary tract obstruction, neuropathic disorders, diabetes, and interstitial cystitis. These models share the common features of increased connectivity and excitability of both detrusor smooth muscle and nerves. Increased excitability and connectivity of nerves involved in micturition rely on growth factors that orchestrate neural plasticity. Neurotransmitters, prostaglandins, and growth factors, such as nerve growth factor, provide mechanisms for bidirectional communication between muscle or urothelium and nerve, leading to OAB with or without urge incontinence. PMID:16986023

  18. Evaluation of a behavioral treatment for female urinary incontinence

    PubMed Central

    Santacreu, Marta; Fernández-Ballesteros, Rocío

    2011-01-01

    Urinary incontinence is a medical, psychological, social, economic, and hygienic problem. Although it is difficult to state its prevalence, all authors agree that it is related to age and gender. This study aimed to carry out a urinary incontinence behavioral treatment in order to reduce urine leakages in 14 participants recruited from a senior center. The program consists of daily training of the pelvic floor muscles with a weekly control by a supervisor during a 2-month period and follow-up of results 2 months after the last control session. Urinary incontinence episodes were reduced by 75.67% after program completion. It appears that pelvic floor muscles training, carried out under controlled and constant supervision, significantly reduces urinary leakage. Moreover, maintaining this improvement after treatment depends on the continuation of the exercises as well as on the urinary leakage frequency baseline and the urinary leakage frequency during the last treatment session. PMID:21753868

  19. Post-stroke emotional incontinence or bipolar disorder?

    PubMed Central

    Mnif, Leila; Sellami, Rim; Masmoudi, Jawaher

    2016-01-01

    Introduction Post-stroke emotional incontinence and bipolar disorder are two disorders that involve the dysfunction of brain structures responsible for emotional regulation. The objective of this work is to study the links between these disorders through a clinical case. Case report We present the case of a 43-year-old man without previous psychiatric history who experienced emotional incontinence after cerebrovascular events. He reacted promptly to selective serotonin reuptake inhibitor treatment. However, he experienced his first episode of hypomania after 6 months of antidepressant therapy. Adjunctive therapy with valproic acid and low-dose paroxetine was eventually added, resulting in complete improvement of both emotional incontinence and hypomania after 4 additional months of treatment. Conclusion The clinician should carefully explore any history of premorbid bipolar disorder, personality disorder characterized by mood instability, and family history of bipolar disorder. PMID:27536109

  20. Stress incontinence and pelvic floor exercises in pregnancy.

    PubMed

    Sahakian, Josine

    This literature review is a critique of the research looking at the impact of pelvic floor exercises during pregnancy on urinary stress incontinence in postnatal women. Seven studies were selected for review following a database search on the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline and the British Nursing Index (BNI). The research produced mixed findings. Four of the seven studies demonstrated a significant improvement in urinary stress incontinence in postnatal women following pelvic floor muscle exercise during pregnancy. However, the studies that spanned a longer time period found no long-term effectiveness. More research is needed for a more conclusive picture as to whether antenatal pelvic floor exercises can improve stress incontinence in the postpartum period. PMID:23123811

  1. THERMOTOLERANT NON-FECAL SOURCE 'KLEBSIELLA PNEUMONIAE': VALIDITY OF THE FECAL COLIFORM TEST IN RECREATIONAL WATERS

    EPA Science Inventory

    Wisconsin pulp and paper mill processing plants were evaluated for fecal coliform and total Klebsiella (i.e., thermotolerant and thermointolerant) bacterial concentrations. Using the standard fecal coliform test, up to 90 per cent of non-fecal source thermo-tolerant K. pneumoniae...

  2. Prevention and management of incontinence-associated dermatitis.

    PubMed

    Nix, Denise; Haugen, Vicki

    2010-06-01

    Perineal dermatitis, recently relabelled 'incontinence-associated dermatitis' (IAD), is an inflammation of the skin that occurs when urine and/or stool comes into contact with the skin. It can range in severity from erythema with or without loss of skin integrity to infection. IAD affects as many as 41% of adults in long-term care; it is costly, painful and, for the most part, preventable. An effective plan of care for individuals with IAD must include assessment and management of incontinence aetiology, perineal skin and risk assessment, gentle cleansing and moisturization, application of skin barriers and treatment of secondary infection, and the use of containment devices if indicated. PMID:20524708

  3. Non-surgical management of urinary incontinence in children.

    PubMed

    Duel, Barry

    2009-01-01

    Urinary incontinence and neurogenic bladder are common in children, and can be difficult to treat. This themed issue includes contributions by experts in the management of these disorders. Dr. John Kryger discusses the nonsurgical management of neurogenic bladder in children with spina bifida. Drs. Lori Dyer and Israel Franco summarize the literature and their experience with the use of botulinum toxin in neurogenic and non-neurogenic incontinence in children. Dr. Paul Austin summarizes the use of alpha-adrenergic blockers. These drugs are primarily used to treat bladder outlet obstruction due to prostatic hyperplasia, but show great promise in the treatment of dysfunctional voiding in children. PMID:19936567

  4. [Duloxetine. A new preparation for patients with urinary incontinence].

    PubMed

    Walter, Steen

    2005-11-28

    Stress Urinary Incontinence is a common symptom among women. The urethral closure is insufficient. Pelvic floor exercise can minish the symptoms, but many women need an operation. Duloxetine, a new drug, is believed to strengthen the contraction of the external urethral sphincter through central neuromodulation, resulting in enhanced urethral closure during the urine storage phase. In controlled studies a significant effect are found in women suffer from Stress Urinary Incontinence. Discontinuate rates for adverse events were high especially nausea and fatigue. The adverse event deminish after 4 weeks. PMID:16324435

  5. CHRONIC FECAL IMPACTION IN CHILDREN

    PubMed Central

    Feigen, Gerald Mason

    1957-01-01

    In seventeen cases of chronic fecal impaction in children the main symptoms were severe constipation, pain and bleeding on defecation, soiling of the underpants, and anxiety. The main findings were large impactions in the rectum, minor injuries of the anal canal, some degree of patulous anus and soiling of the perianal skin. Good results were obtained in all cases with treatment that included giving dioctyl sodium sulfosuccinate and flavored petrolatum, attention to diet, encouragement of the patient and advice to the parents. PMID:13383391

  6. DYNAMICS OF AQUATIC FECAL CONTAMINATION, FECAL SOURCE IDENTIFICATION, AND CORRELATION OF BACTEROIDALES HOST-SPECIFIC MARKERS DETECTION WITH FECAL PATHOGENS

    EPA Science Inventory

    Fecal pollution impairs the health and productivity of coastal waters and causes human disease. PCR of host-specific 16S rDNA sequences from anaerobic Bacteroidales bacteria offers a promising method of tracking fecal contamination and identifying its source(s). Before Bacteroida...

  7. Fecal Source Identification with Real-Time Quantitative PCR

    EPA Science Inventory

    Waterborne diseases that originate from fecal pollution remain a significant public health issue. Current fecal indicator technologies recommended by the U.S. Environmental Protection Agency for water quality testing do not discriminate between different animal sources of fecal ...

  8. [Urinary incontinence - what can be done by the family doctor and when is the urologist needed?].

    PubMed

    Keller, Isabelle Sonja; Brachlow, Jan Frederic; Padevit, Christian; Kurz, Michael; John, Hubert

    2014-10-01

    About 15% of the women and 10% of the men past the age of 65 years suffer from urinary incontinence. In most cases, accurate history taking can help differentiate between urge incontinence, stress incontinence and overflow incontinence, and is essential in choosing the appropriate treatment. Initial diagnostic testing can be conducted by the general practitioner, especially tests to exclude urinary tract infections or to rule out an overactive bladder. Patient education on changes to fluid intake and voiding habits as well as advice on suitable incontinence products are important first steps in the management of urinary continence. Also, drug treatment can be initiated in general practice. Patients with refractory urinary incontinence, particularly those who did not respond to anticholinergic medication, should be referred to a urologist for further evaluation since there may be an underlying tumour or other disorder of the bladder that is causing the incontinence. PMID:25270747

  9. Diagnosis and office-based treatment of urinary incontinence in adults. Part two: treatment

    PubMed Central

    Jimbo, Masahito; Heidelbaugh, Joel J.

    2013-01-01

    Urinary incontinence is a common problem in both men and women. In this review article we address treatment of the various forms of incontinence with conservative treatments, medical therapy, devices and surgery. The US Preventive Services Task Force, The Cochrane Database of Systematic Reviews, and PubMed were reviewed for articles focusing on urinary incontinence. Conservative therapy with education, fluid and food management, weight loss, timed voiding and pelvic floor physical therapy are all simple office-based treatments for incontinence. Medical therapy for incontinence currently is only available for urgency incontinence in the form of anticholinergic medication. Condom catheters, penile clamps, urethral inserts and pessaries can be helpful in specific situations. Surgical therapies vary depending on the type of incontinence, but are typically offered if conservative measures fail. PMID:23904858

  10. Optimum Membrane Structures for Growth of Coliform and Fecal Coliform Organisms

    PubMed Central

    Sladek, K. J.; Suslavich, R. V.; Sohn, B. I.; Dawson, F. W.

    1975-01-01

    The purpose of this study was to determine the optimum membrane filter structure and characteristics for recovery of coliform organisms. Additionally, other factors such as sterilization method and membrane composition were examined. Fecal coliform growth tests with varied samples indicated that the most critical factor in recovery was surface pore morphology and not other factors previously suspected. Fecal coliform counts showed a dramatic increase, with increasing surface opening sizes. Membrane structures with surface openings large enough to surround the entrapped bacteria are required for optimum growth of fecal coliform organisms. Maximum fecal coliform recoveries are obtained using membranes composed of mixed esters of cellulose exhibiting a surface opening diameter of 2.4 μm and a retention pore size of 0.7 μm. Images PMID:1103734

  11. Prevalence and risk factors of urinary incontinence in Indian women: A hospital-based survey

    PubMed Central

    Singh, Uma; Agarwal, Pragati; Verma, Manju Lata; Dalela, Diwakar; Singh, Nisha; Shankhwar, Pushplata

    2013-01-01

    Background and Objectives: Urinary incontinence is a problem that creates both physical and psychological nuisance to a woman. This problem needs to be studied in detail in Indian population because of lack of precise data. The objectives of this study were to study the prevalence and risk factors of urinary incontinence in Indian women. Materials and Methods: This hospital-based cross-sectional study conducted from August 2005 to June 2007 included women attending gynecology OPD (consulters) and hospital employees (nonconsulters). Subjects who were incontinent were asked a standard set of questions. Incontinence was classified as urge, stress, or mixed based on symptoms. A univariate followed by multivariate analysis was done to look for risk factors. Results: Of 3000 women enrolled, 21.8% (656/3000) women were incontinent. There was no significant difference in incontinence rate between consulters and nonconsulters [618/2804 (22.1%) vs. 38/196 (19.4%); P value = 0.6). Of the total women having incontinence, highest numbers were found to have stress incontinence [73.8% (484/656)] followed by mixed [16.8% (110/656)] and urge incontinence [9.5% (62/656)]. Age more than 40 years; multiparity; postmenopausal status; body mass index more than 25; history of diabetes and asthma; and habit of taking tea, tobacco, pan, and betel are risk factors found to be associated with increased prevalence of urinary incontinence in univariate analysis. On multivariate analysis, age more than 40 years, multiparity, vaginal delivery, hysterectomy, menopause, tea and tobacco intake, and asthma were found to be significantly associated with overall incontinence. Stress incontinence was separately not associated with menopause. Urge incontinence was not associated with vaginal delivery. Conclusion: Urinary incontinence is a bothersome problem for women. Simple questionnaire can help to detect this problem and diagnose associated risk factors, so that necessary steps can be taken in its

  12. TRACKING FECAL CONTAMINATION WITH BACTEROIDALES MOLECULAR MARKERS: AN ANALYSIS OF THE DYNAMICS OF FECAL CONTAMINATION IN THE TILLAMOOK BASIN, OREGON

    EPA Science Inventory

    Although amplification of source-specific molecular markers from Bacteroidales fecal bacteria can identify several different kinds of fecal contamination in water, it remains unclear how this technique relates to fecal indicator measurements in natural waters. The objectives of t...

  13. CHEMICAL INDICATORS OF HUMAN FECAL CONTAMINATION

    EPA Science Inventory

    Currently, the quality of drinking and recreational waters is estimated through the measurement of fecal bacteria such as Escherichia coli and Enterococci. However, since it takes time for the microorganisms to grow and be detected, their utility as indicators of human fecal co...

  14. Management of faecal incontinence in graft-versus-host disease.

    PubMed

    Woodward, Sue

    Graft-versus-host disease (GvHD), a common yet serious complication of allogeneic haemopoietic stem cell transplantation, can cause significant morbidity and negatively impact on patients' quality of life. The gastrointestinal tract is frequently affected resulting in nausea and vomiting, abdominal pain and profuse diarrhoea (Washington and Jagasia, 2009) which can be both distressing and humiliating for patients. The volume of watery, green diarrhoea produced can be greater than 2 litres per day (Ferrara et al, 2009) and is one indicator of the severity of GvHD. It may, in some cases, lead to faecal incontinence. Management of GvHD-associated diarrhoea involves the use of high-dose steroids to control the exaggerated immune response, anti-diarrhoeal medication, management of fluid and electrolytes, and nutritional management. It may also require management of faecal incontinence and prevention of incontinence-associated dermatitis. This paper describes the pathology of GvHD, the management of GvHD-associated diarrhoea and faecal incontinence and discusses the potential use of a faecal management system inappropriately selected individuals with uncontrolled diarrhoea and limited mobility. PMID:22306636

  15. Electrokinetic profiles of nonowoven cotton for absorbent incontinence material

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper discusses recent work on cotton/synthetic nonwovens, their electrokinetic analysis, and their potential use in incontinence materials. Electrokinetic analysis is useful in exploring fiber surface polarity properties, and it is a useful tool to render a snap shot of the role of fiber char...

  16. Quality of life in women with urinary incontinence.

    PubMed

    Senra, Cláudia; Pereira, M Graça

    2015-01-01

    The aim of this study is to examine the relationship among psychological, clinical and sociodemographic variables, and quality of life in women with urinary incontinence. The sample consisted of 80 women diagnosed with urinary incontinence (UI) followed in a Northern Central Hospital in Portugal. Participants answered the Incontinence Quality of Life (I-QOL); Satisfaction with Sexual Relationship Questionnaire (SSRQ); Hospital Anxiety and Depression Scales (HADS) and the Brief Cope. The results revealed that women with higher quality of life considered their symptoms of urine loss as mild or moderated compared to those with severe urine loss. The less severe urine loss was associated with greater sexual satisfaction and less use of religion and self-blame as coping strategies. In terms of coping, women who considered the loss of urine as severe expressed more feelings regarding UI. Stress urinary incontinence, high sexual satisfaction, and less use of denial, distraction, and religion as coping strategies, predicted higher quality of life. According to the results, UI has an impact on women's sexual satisfaction and quality of life. Therefore, intervention programs should target these women, including their partners, helping them to adjust to their condition and teaching effective coping strategies in order to improve their sexual satisfaction and quality of life. PMID:26107369

  17. [Urinary incontinence in castrated bitches. 2. Diagnosis and treatment].

    PubMed

    Arnold, S

    1997-01-01

    Urinary incontinence due to spaying is caused by a sphincter incompetence of the urethra. In practice the diagnosis is established by ruling out other causes of incontinence such as neurological disease, bacterial cystitis, urinary tract malformation, iatrogenic ureterovaginal fistula and neoplasia of the urinary tract. An accurate diagnosis of urethral sphincter incompetence is made by urethral pressure profilometry. A urethral closure pressure of 7.4 cm H2O allowed the differentiation of bitches with urinary incontinence, due to spaying, from healthy control dogs with a diagnostic accuracy of 91%. For therapy alpha-adrenergic drugs (Ephedrine or Phenylpropanolamine) are recommended, which result in continence in 74% and improvement in 24% of incontinent patients. In the absence of response estrogens may be used. If the medical therapy fails to achieve urinary continence, the endoscopic injection of collagen into the submucosa of the proximal urethra can be performed. This is a simple and minimally invasive procedure. It rarely leads to complications and may be repeated when necessary. The method is successful in 75% of cases. PMID:9281063

  18. [The anal incontinence-- study on 20 operated cases].

    PubMed

    Iusuf, T; Sârbu, V; Grasa, C; Cristache, C; Botea, F

    2001-01-01

    The authors present 20 cases operated for anal incontinence. Two techniques were performed: direct repair (18 cases) and Musset-Cottrell procedure (2 cases). The results were excellent in 12 cases, good in 5 cases and satisfactory in 3 cases. The method of choice seems to be the direct repair of the anal sphincter after a proper local and general preparation. PMID:12731180

  19. Severe rectal haemorrhage after treatment for faecal incontinence

    PubMed Central

    Taggarshe, Deepa; Visco, Jeffrey J.

    2014-01-01

    Bulking agent injected submucosally is an alternative effective treatment for faecal incontinence in elderly patients who fail conservative measures. Since most elderly patients are on antiplatelet therapy and are sometimes unaware of their medication, this can lead to serious complications. PMID:25180215

  20. Urinary incontinence, pelvic floor dysfunction, exercise and sport.

    PubMed

    Bø, Kari

    2004-01-01

    Urinary incontinence is defined as "the complaint of any involuntary leakage of urine" and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as "involuntary leakage on effort or exertion, or on sneezing or coughing". The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women's participation in sport and fitness activities and, therefore, it may be a threat to women's health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A 'stiff' and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes

  1. The development of national quality performance standards for disposable absorbent products for adult incontinence.

    PubMed

    Muller, Nancy; McInnis, Elaine

    2013-09-01

    Disposable absorbent products are widely used in inpatient care settings and in the community to manage adult urinary and fecal incontinence, but few product standards exist to help guide their production or optimal use. Increasing costs and reduced revenues have caused a number of states to evaluate absorbent product use among persons who receive care at home with the assistance of the Medicaid Waiver Program, further increasing concerns about the lack of product performance standards. To address these issues, the National Association For Continence (NAFC) formed a council of experts and key stakeholders with the objective of establishing national, independent quality performance standards for disposable absorbent products provided by states to Waiver Program recipients. The Council consisted of representatives from five purposefully selected states, technical directors from six nonwoven product manufacturers, an officer of the nonwoven manufactures trade association, a delegate from an academic nursing program and professional societies, a family caregiver, and a patient representative. Following a consensus method and guidelines for use, nine specific recommendations were developed, posted for public comment, and further refined. Final recommendations for product performance assessment include: rewet rate (a measure of a product's ability to withstand multiple incontinent episodes between changes), rate of acquisition (a measure of the speed at which urine is drawn away from the skin by a product, product retention capacity (a measure of a product's capacity to hold fluid without rewetting the skin), sizing options, absorbency levels, product safety, closure technology, breathable zones (a measure of the air permeability across a textile-like fabric at a controlled differential pressure), and elasticity. The Council also set values for and recommended four quantifiable parameters, and the testing methodology associated with each, to help consumers and states

  2. Beyond incontinence: The stigma of other urinary symptoms

    PubMed Central

    Elstad, Emily A.; Taubenberger, Simone P.; Botelho, Elizabeth M.; Tennstedt, Sharon L.

    2010-01-01

    Aim This paper is a report of a study conducted to characterize the stigma of urinary frequency and urgency and differentiate it from the stigma of incontinence and to describe race/ethnic and gender differences in the experience of stigma among a diverse sample of individuals. Background Lower urinary tract symptoms, including frequency, urgency and incontinence, are susceptible to stigma, but previous stigma research has focused almost exclusively on incontinence. Method The Boston Area Community Health Survey is a population-based, random sample epidemiological survey of urologic symptoms (N=5503). Qualitative data for this study came from in-depth interviews conducted between 2007 and 2008 with a random subsample of 151 black, white and Hispanic men and women with urinary symptoms. Findings Respondents reported stigma associated with frequency and urgency – not just incontinence. The stigma of frequency/urgency is rooted in social interruption, loss of control of the body, and speculation as to the nature of a non-specific “problem.” Overall, the stigma of urinary symptoms hinged upon whether or not the problem was “perceptible.” Men felt stigmatized for making frequent trips to the bathroom and feared being seen as impotent. Women feared having an unclean body or compromised social identity. Hispanic people in particular voiced a desire to keep their urinary symptoms a secret. Conclusion The stigma of urinary symptoms goes beyond incontinence to include behaviors associated with frequency and urgency. Healthcare practitioners should assess for stigma sequelae (e.g. anxiety, depression) in individuals with frequency and urgency, and stress treatment options to circumvent stigmatization. PMID:20735505

  3. Midurethral Slings for Women with Stress Urinary Incontinence

    PubMed Central

    2006-01-01

    Executive Summary Objective The objective of the current review was to evaluate the safety, efficacy, and cost-effectiveness of midurethral slings compared with traditional surgery. Background This assessment was undertaken in order to update and expand upon the health technology & policy assessment of tension-free vaginal tape (TVT, Gynecare Worldwide, a division of Ethicon Inc, a Johnson & Johnson company, Somerville, New Jersey) sling procedure for stress urinary incontinence published by the Medical Advisory Secretariat in February 2004. Since the publication of the 2004 assessment, a number of TVT-like sling alternatives have become available which employ the same basic principles as TVT slings: minimally invasive, midurethral placement, self-fixing, and tension-free. This update will evaluate the efficacy and safety of midurethral slings. Clinical Need Normal continence is controlled by the nervous system and involves co-ordination between bladder, urethra, urethral sphincter, and pelvic floor. Incontinence occurs when the relationship among the above components is compromised, either due to physical damage or nerve dysfunction. (1) Stress urinary incontinence is the most common form of urinary incontinence in women. It is characterized by the “complaint of involuntary leakage on effort or exertion, or on sneezing or coughing” when there is increased abdominal pressure without detrusor (bladder wall) contraction. (2) There are 2 factors which define stress urinary incontinence: a weakening in the support of the proximal urethra, causing urethral hyper-mobility and deficiency in the sphincter, causing urethral leakage. Both factors are thought to coexist. (1) Accurate tests are not available to distinguish these 2 types of stress urinary incontinence. Urinary incontinence is estimated to affect about 250,000 Canadian women and 8 million American women aged 65 and over. (3;4) The prevalence of stress urinary incontinence is very difficult to measure because

  4. Stress Urinary Incontinence in Women with a History of Gestational Diabetes Mellitus

    PubMed Central

    McEwen, Laura N.; Sarma, Aruna V.; Piette, John D.; Herman, William H.

    2008-01-01

    Abstract Objective Stress urinary incontinence may serve as a barrier to lifestyle modification among women at high risk for diabetes, but the prevalence of stress urinary incontinence among women with histories of gestational diabetes mellitus (hGDM) is unknown. The purpose of this study was to examine the prevalence of stress incontinence among women with hGDM and to examine its association with their current physical activity. Methods We surveyed women with hGDM within the past 5 years who were currently enrolled in a managed care plan (n = 228). In a cross-sectional analysis, self-reported weekly or more frequent stress incontinence was the primary independent variable and measures of physical activity and body mass index (BMI) were the outcomes of interest. We constructed multivariable models that adjusted for participant characteristics associated with the measure of incontinence or outcomes in bivariate analyses. Results Of the 228 women with hGDM, 49% reported weekly or more frequent incontinence during pregnancy, and 28% reported that incontinence affected their activities during pregnancy. Fifty percent reported weekly or more frequent incontinence after delivery, with 27% reporting interference of incontinence with activity. Less than a third of women reported optimal physical activity, and 42% were obese. After adjustment for characteristics associated with measures of activity and incontinence, there was minimal association between levels of activity and stress urinary incontinence; similarly, there was no association between BMI and measures of stress incontinence. Conclusions Stress urinary incontinence is common among women with hGDM but does not appear to be associated with physical activity levels or BMI. PMID:18537481

  5. Fecal calprotectin concentration in neonatal necrotizing enterocolitis

    PubMed Central

    Park, Ju Yi; Ko, Kyung Ok; Lim, Jae Woo; Cheon, Eun Jeong; Kim, Hyo Jeong

    2014-01-01

    Purpose Among the many factors associated with acute intestinal mucosal infection, numerous studies have proposed the usefulness of fecal calprotectin. The aim of this study was to evaluate the usefulness of fecal calprotectin in the diagnosis of necrotizing enterocolitis (NEC). Methods We collected 154 stool samples from 16 very low birth weight and premature newborns at the Konyang University Hospital neonatal intensive care unit or neonatal nursery. The stool samples were collected using the Calprest device, and the fecal calprotectin level was measured with the BÜHLMANN Calprotectin enzyme-linked immunosorbent assay kit. Results Fecal calprotectin levels were significantly higher in the NEC group than in the non-NEC group (P=0.02). There was a significant positive linear relationship between the fecal calprotectin level and number of days after birth (P=0.00) in the gestational age <26 weeks group. There was a significant negative linear relationship between the calprotectin level and number of days after birth (P=0.03) in the gestational age ≥26 weeks and <30 weeks group. There was no difference in the calprotectin levels according to the type and method of feeding between the NEC and non-NEC groups. Conclusion Fecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a noninvasive, easy, and useful tool for the diagnosis of NEC. PMID:25210522

  6. Primary Prevention of Urinary Incontinence: A Case Study of Prenatal and Intrapartum Interventions.

    PubMed

    Kissler, Katherine; Yount, Susan M; Rendeiro, Melissa; Zeidenstein, Laura

    2016-07-01

    A wealth of information is available regarding the diagnosis and treatment of urinary incontinence. However, there is a dearth of quality information and clinical practice guidelines regarding the primary prevention of urinary incontinence. Given the high prevalence of this concern and the often cited correlation between pregnancy, childbirth, and urinary incontinence, women's health care providers should be aware of risk factors and primary prevention strategies for stress urinary incontinence (SUI) in order to reduce associated physical and emotional suffering. This case report describes several common risk factors for SUI and missed opportunities for primary prevention of postpartum urinary incontinence. The most effective methods for preventing urinary incontinence include correct teaching of pelvic floor muscle training (PFMT; specifically Kegel exercises), moderate combined physical exercise regimens, counseling and support for weight loss, counseling against smoking, appropriate treatment for asthma and constipation, and appropriate labor management to prevent pelvic organ prolapse, urethral injury, and pelvic floor muscle damage. PMID:26971402

  7. Fecal Microbiota Transplantation: Just a Fancy Trend?

    PubMed

    Vandenplas, Yvan; Pierard, Denis; De Greef, Elisabeth

    2015-07-01

    The risks and advantages of the administration of fecal material of healthy people to patients are heavily debated. In adults, recurrent Clostridium difficile has become an accepted indication. In addition to all of the possible indications, many other questions need to be answered before pediatric indications and recommendations can be established. Optimal donor selection, fresh versus frozen stools versus capsules containing only microbiota, volume, and route of administration are just a few examples of the areas with missing data to allow in formulating recommendations for fecal microbiota or fecal material administration in children. A careful but not-too-complex regulation is the first priority in order to minimize the risk of administration of fecal slurry from unselected donors at home without medical supervision. PMID:25905546

  8. Measurement of fecal /sup 14/C excretion

    SciTech Connect

    Kumaran, K.A.; Wiener, N.S.; Katz, J.B.

    1982-11-01

    Simultaneous measurements of fecal /sup 14/C and expired /sup 14/CO/sub 2/ in the breath are necessary to evaluate patients with various ileal abnormalities and bile salt malabsorption. Following the oral ingestion of the labeled bile acid, glycine-(I-/sup 14/C)cholic acid, detection of increased fecal /sup 14/C without abnormal expiration of /sup 14/CO/sub 2/ identifies patients with ileal resection. This contrasts with the normal fecal /sup 14/C content and abnormal expired /sup 14/CO/sub 2/ found in patients with bacterial overgrowth. Fecal /sup 14/C content was determined by utilizing Van Slyke combustion of the specimen and trapping the liberated /sup 14/CO/sub 2/ with Scintisorb C. The method is simple, rapid, and accurate, and expands the diagnostic usefulness of the bile salt absorption test.

  9. FECAL COLIFORM INCREASE AFTER CENTRIFUGATION: EPA PERSPECTIVE

    EPA Science Inventory

    The Water Environment Research Foundation (WERF) recently published a report titled Examination of Reactivation and Regrowth of Fecal Coliforms in Anaerobically Digested Sludges. Seven full-scale publicly owned treatment facilities were sampled several times to determine if bacte...

  10. Urinary incontinence in women: its prevalence and its management in a health promotion clinic.

    PubMed Central

    Harrison, G L; Memel, D S

    1994-01-01

    BACKGROUND. It has been suggested that regular clinics might improve the management of urinary incontinence in general practice. AIM. A study was undertaken to determine the prevalence of urinary incontinence among women in one general practice and the feasibility of using a health promotion clinic in its management. METHOD. Questionnaires were sent to a 10% sample of women aged 20 years and over on the practice register. Pregnant women were excluded. RESULTS. Of 384 questionnaires sent to eligible women, 314 were completed correctly (82%). The overall reported prevalence of urinary incontinence was 53%; 8% of these women had urge incontinence, 46% had stress incontinence and 43% had mixed incontinence. Incontinence was positively correlated with parity and with gynaecological operation other than hysterectomy and repair of prolapse but not with perineal suturing after childbirth, delivery of a baby weighing 9 lb (4.1 kg) or more or mode of delivery. Twenty seven out of 78 incontinent women (35%) who completed a second questionnaire admitted to worrying about their incontinence but only 10 (13%) had consulted their doctor about the problem. The main reason given for not consulting was that incontinence was a minor inconvenience only. The 167 incontinent women were offered an appointment at a women's clinic but only 13 attended. Of these, 10 were entered into a 12 week treatment trial. Various treatments were offered, such as the women being taught bladder training and pelvic floor exercises. One woman was lost to follow up, and for eight out of nine women their continence had improved, both subjectively and objectively. CONCLUSION. Urinary incontinence in women is a common problem. It can be successfully diagnosed and treated in general practice but low attendance makes the health promotion clinic setting an inefficient means of achieving this. PMID:8185987

  11. Post-Radical-Prostatectomy Urinary Incontinence: The Management of Concomitant Bladder Neck Contracture

    PubMed Central

    King, Thomas; Almallah, Y. Zaki

    2012-01-01

    Urinary incontinence postradical prostatectomy is a common problem which adversely affects quality of life. Concomitant bladder neck contracture in the setting of postprostatectomy incontinence represents a challenging clinical problem. Postprostatectomy bladder neck contracture is frequently recurrent and makes surgical management of incontinence difficult. The aetiology of bladder neck contracture and what constitutes the optimum management strategy are controversial. Here we review the literature and also present our approach. PMID:22611382

  12. Radiation therapy in carcinoma of the prostate: a contributing cause of urinary incontinence

    SciTech Connect

    Kaufman, J.J.; Smith, R.B.; Raz, S.

    1984-11-01

    The authors believe that radiation therapy as a postoperative adjuvant or preceding salvage prostatectomy for carcinoma is particularly conducive to the complication of urinary incontinence by virtue of its sclerosing effect on residual sphincter mechanisms. Obviously, such dual therapy will continue to prevail in the foreseeable future but patients should be notified of the added risk and be prepared for further treatment of the incontinence. Unfortunately, these patients have an extra risk of complications and failure from anti-incontinence operations.

  13. Fecal Coliform Removal by River Networks

    NASA Astrophysics Data System (ADS)

    Huang, T.; Wollheim, W. M.; Stewart, R. J.

    2015-12-01

    Bacterial pathogens are a major cause of water quality impairment in the United States. Freshwater ecosystems provide the ecosystem service of reducing pathogen levels by diluting and removing pathogens as water flows from source areas through the river network. However, the integration of field-scale monitoring data and watershed-scale hydrologic models to estimate pathogen loads and removal in varied aquatic ecosystems is still limited. In this study we applied a biogeochemical river network model (the Framework for Aquatic Modeling in the Earth System or FrAMES) and utilized available field data the Oyster R. watershed, a small (51.7 km2) draining coastal New Hampshire (NH, USA), to quantify pathogen removal at the river network scale, using fecal coliform as an indicator. The Oyster R. Watershed is comprised of various land use types, and has had its water quality monitored for fecal coliform, dissolved oxygen, and turbidity since 2001. Water samples were also collected during storm events to account for storm responses. FrAMES was updated to incorporate the dominant processes controlling fecal coliform concentrations in aquatic ecosystems: spatially distributed terrestrial loading, in-stream removal, dilution, and downstream transport. We applied an empirical loading function to estimate the terrestrial loading of fecal coliform across flow conditions. Data was collected from various land use types across a range of hydrologic conditions. The loading relationship includes total daily precipitation, antecedent 24-hour rainfall, air temperature, and catchment impervious surface percentage. Attenuation is due to bacterial "die-off" and dilution processes. Results show that fecal coliform input loads varied among different land use types. At low flow, fecal coliform concentrations were similar among watersheds. However, at high flow the concentrations were significantly higher in urbanized watersheds than forested watersheds. The mainstem had lower fecal coliform

  14. Restoration of anal sphincter function after myoblast cell therapy in incontinent rats.

    PubMed

    Bisson, Aurélie; Fréret, Manuel; Drouot, Laurent; Jean, Laetitia; Le Corre, Stéphanie; Gourcerol, Guillaume; Doucet, Christelle; Michot, Francis; Boyer, Olivier; Lamacz, Marek

    2015-01-01

    Fecal incontinence (FI) remains a socially isolating condition with profound impact on quality of life for which autologous myoblast cell therapy represents an attractive treatment option. We developed an animal model of FI and investigated the possibility of improving sphincter function by intrasphincteric injection of syngeneic myoblasts. Several types of anal cryoinjuries were evaluated on anesthetized Fischer rats receiving analgesics. The minimal lesion yielding sustainable anal sphincter deficiency was a 90° cryoinjury of the sphincter, repeated after a 24-h interval. Anal sphincter pressure was evaluated longitudinally by anorectal manometry under local electrostimulation. Myoblasts were prepared using a protocol mimicking a clinical-grade process and further transduced with a GFP-encoding lentiviral vector before intrasphincteric injection. Experimental groups were uninjured controls, cryoinjured + PBS, and cryoinjured + myoblasts (different doses or injection site). Myoblast injection was well tolerated. Transferred myoblasts expressing GFP integrated into the sphincter and differentiated in situ into dystrophin-positive mature myofibers. Posttreatment sphincter pressures increased over time. At day 60, pressures in the treated group were significantly higher than those of PBS-injected controls and not significantly different from those of normal rats. Longitudinal follow-up showed stability of the therapeutic effect on sphincter function over a period of 6 months. Intrasphincteric myoblast injections at the lesion borders were equally as effective as intralesion administration, but an injection opposite to the lesion was not. These results provide proof of principle for myoblast cell therapy to treat FI in a rat model. This strategy is currently being evaluated in humans in a randomized double-blind placebo-controlled clinical trial. PMID:24143883

  15. Urinary Incontinence in Juvenile Female Soft-Coated Wheaten Terriers: Hospital Prevalence and Anatomic Urogenital Anomalies.

    PubMed

    Callard, Jason; McLoughlin, Mary A; Byron, Julie K; Chew, Dennis J

    2016-01-01

    Urinary incontinence in juvenile female dogs is often associated with urogenital anatomic anomalies. Study objectives include: (1) determine hospital prevalence of urinary incontinence in juvenile female soft-coated wheaten terriers (SCWTs) compared to other affected dogs; (2) characterize anatomic anomalies affecting urinary incontinent juvenile female SCWTs utilizing uroendoscopy; and (3) compare incidence of ectopic ureters, paramesonephric remnants, and short urethras in juvenile female urinary incontinent SCWTs to other juvenile female dogs with urinary incontinence. We hypothesize juvenile SCWTs have an increased prevalence of urinary incontinence and an increased incidence of ectopic ureters, paramesonephric remnants, and short urethras compared to non-SCWTs with urinary incontinence within our hospital population. Medical records of female dogs 6 mo of age and younger with clinical signs of urinary incontinence and video uroendoscopic evaluation presenting to The Ohio State University Veterinary Medical Center from January 2000 to December 2011 were reviewed. Twelve juvenile SCWTs and 107 juvenile non-SCWTs met the inclusion criteria. Juvenile SCWTs were found to have an increased hospital prevalence of urinary incontinence compared to other affected breeds. Observed anomalies in SCWTs include: ectopic ureters, shortened urethras, paramesonephric remnants, and bifid vaginas. This information will help guide veterinarians in recognizing a breed-related disorder of the lower urogenital tract in SCWTs. PMID:26606208

  16. Incontinence-associated dermatitis: new insights into an old problem.

    PubMed

    Voegeli, David

    Incontinence-associated dermatitis (IAD) is a common skin disorder seen in patients with incontinence. Typically IAD presents as inflammation of the skin surface characterised by redness, and in extreme cases, swelling and blister formation. If untreated this usually rapidly leads to excoriation and skin breakdown, which may subsequently become infected by the skin flora. While this is a common condition encountered in all areas of nursing practice, gaps remain in our understanding of the many contributing factors. A lack of standardised definitions of IAD, differences in terminology, and a bewildering increase in products available to prevent and manage IAD, makes it difficult for nurses to deliver evidence-based care. However, it is an area where nursing research has made a considerable contribution over the past few years. This article explores the current thinking on IAD and the implications for nursing practice. PMID:26972998

  17. Incontinence-associated dermatitis: identification, prevention and care.

    PubMed

    Holroyd, Sharon

    Incontinence-associated dermatitis (IAD) is a common skin disorder experienced by people who suffer from faecal and/or urinary incontinence. It is painful and in some cases accompanied by significant secondary infections. The prevalence is higher in those people receiving long-term care at home. IAD is often misdiagnosed and confused with pressure ulcers. Care providers now crossover health and social care boundaries and education on continence-related issues is often not prioritised. This article looks at normal skin physiology and the aetiology of IAD versus pressure ulcers. It suggests prevention and management strategies in relation to IAD; in particular, the use of barrier creams. A selection of case studies evaluating the efficacy of using Cutimed PROTECT cream in cases of IAD are presented. PMID:25978474

  18. Barrier products in the treatment of incontinence-associated dermatitis.

    PubMed

    Lian, Yaping

    2016-07-20

    This article reviews contemporary primary research studies to establish the evidence supporting the use of barrier products and evaluate practice regarding their use in the acute hospital setting. Six primary research studies investigating the use of barrier products for preventing and managing incontinence-associated dermatitis were reviewed. The aim was to identify the most effective treatments for incontinence-associated dermatitis to enhance the quality of life of patients. The studies identified that there is no significant difference in efficacy between petrolatum, zinc oxide oil and a polymer-based barrier film, and that a polymer-based barrier film is more cost-effective than petrolatum or zinc oxide. However, further robust research studies are required to inform practice. The efficacy and cost-effectiveness of barrier products can be enhanced by providing education in clinical practice on consistent skin care regimens and effective use of barrier products. PMID:27440366

  19. Gracilis muscle as neoanal sphincter for faecal incontinence.

    PubMed

    Zailani, M H M; Azmi, M N; Deen, K I

    2010-03-01

    Faecal incontinence is a debilitating chronic clinical condition which may affect the patient and care givers. Modality of treatment is based on severity of the symptoms as well as the anatomical defect itself, availability of resources and expertise. We describe a modified technique of dynamic graciloplasty as neoanal sphincter for the treatment severe faecal incontinence who has failed previous over lapping sphincteroplasty. In our modified version, instead of using implanted intramuscular electrodes and subcutaneous neurostimulator to provide continuous stimulation, the patient will undergo an external stimulation on the nerve of transplanted gracilis periodically and concurrent biofeedback therapy. We believe the technique is relatively easy to learn and very cost effective without any electrodes or neurostimulator related complications. PMID:21265253

  20. [Incontinence in old age: a social and economic problem].

    PubMed

    Welz-Barth, A

    2007-04-01

    Being afflicted with urinary incontinence in old age represents manifold medical, social, and economic problems and restrictions. The objective loss of control and decreased self-confidence result in reduced social interactions and lead to isolation and ostracism accompanied by withdrawal and depression. Giving up leisure time activities, losing social contacts, and the increasing need for long-term care often lead inevitably to a higher degree of dependency and institutionalization. In addition, the taboo still placed on this problem by those affected as well as by the attending physicians has resulted in too few patients receiving adequate diagnosis and being offered sensible treatment options. These problems can only be solved by an interdisciplinary approach. Further information, continuing education, and sensitivity toward these aspects are needed. Only then can incontinence in old age as a social and economic problem exacerbated by the demographic changes be improved. PMID:17310392

  1. Hypnotherapy for incontinence caused by the unstable detrusor.

    PubMed Central

    Freeman, R M; Baxby, K

    1982-01-01

    Fifty incontinent women with proved detrusor instability completed 12 sessions of hypnosis (symptom removal by direct suggestion and "ego strengthening") over one month. This was continued at home with a prerecorded cassette, and all patients were followed up for at least six months. At the end of the 12 sessions 29 patients were entirely symptom free, 14 improved, and seven unchanged. Three months later cystometry in 44 of the patients showed conversion of the cystometrogram to stability in 22 and a significant improvement in a further 16; only six showed no objective improvement. Seven patients relapsed (three after bereavement). Further treatment was given and five out of six patients were rendered symptom free again. Patients with detrusor instability were not found to have a noticeably increased susceptibility to hypnosis. It is concluded that psychological factors are very important in "idiopathic" detrusor instability and that hypnotherapy is effective for incontinence due to this disorder. PMID:6805716

  2. Stem cells for stress urinary incontinence: the adipose promise

    PubMed Central

    Roche, Régis; Festy, Franck; Fritel, Xavier

    2010-01-01

    Abstract Stress urinary incontinence (SUI), the most common type of incontinence in women, is a frequent and costly ailment responsible for an alteration in the quality of life. Although medical treatment gives some rather deceiving results, surgical techniques that include colposuspension or tension-free vaginal tape, employed in cases of urethral support defect, give a 5-year cure rate of more than 80%. However, these techniques could lead to complications or recurrence of symptoms. Recently, the initiation of urethral cell therapy has been undertaken by doctors and researchers. One principal source of autologous adult stem cells is generally used: muscle precursor cells (MPCs) which are the progenitors of skeletal muscle cells. Recently, a few research groups have shown interest in the MPCs and their potential for the treatment of urinary incontinence. However, using MPCs or fibroblasts isolated from a striated muscle biopsy could be questionable on several points. One of them is the in vitro cultivation of cells, which raises issues over the potential cost of the technique. Besides, numerous studies have shown the multipotent or even the pluripotent nature of stromal vascular fraction (SVF) or adipose-derived stem cells (ASCs) from adipose tissue. These cells are capable of acquiring in vitro many different phenotypes. Furthermore, recent animal studies have highlighted the potential interest of SVF cells or ASCs in cell therapy, in particular for mesodermal tissue repair and revascularization. Moreover, the potential interest of SVF cells or ASCs for the treatment of urinary incontinence in women is supported by many other characteristics of these cells that are discussed here. Because access to these cells via lipoaspiration is simple, and because they are found in very large numbers in adipose tissue, their future potential as a stem cell reservoir for use in urethral or other types of cell therapy is enormous. PMID:19799652

  3. Regenerative medicine based applications to combat stress urinary incontinence

    PubMed Central

    Thaker, Hatim; Sharma, Arun K

    2013-01-01

    Stress urinary incontinence (SUI), as an isolated symptom, is not a life threatening condition. However, the fear of unexpected urine leakage contributes to a significant decline in quality of life parameters for afflicted patients. Compared to other forms of incontinence, SUI cannot be easily treated with pharmacotherapy since it is inherently an anatomic problem. Treatment options include the use of bio-injectable materials to enhance closing pressures, and the placement of slings to bolster fascial support to the urethra. However, histologic findings of degeneration in the incontinent urethral sphincter invite the use of tissues engineering strategies to regenerate structures that aid in promoting continence. In this review, we will assess the role of stem cells in restoring multiple anatomic and physiological aspects of the sphincter. In particular, mesenchymal stem cells and CD34+ cells have shown great promise to differentiate into muscular and vascular components, respectively. Evidence supporting the use of cytokines and growth factors such as hypoxia-inducible factor 1-alpha, vascular endothelial growth factor, basic fibroblast growth factor, hepatocyte growth factor and insulin-like growth factor further enhance the viability and direction of differentiation. Bridging the benefits of stem cells and growth factors involves the use of synthetic scaffolds like poly (1,8-octanediol-co-citrate) (POC) thin films. POC scaffolds are synthetic, elastomeric polymers that serve as substrates for cell growth, and upon degradation, release growth factors to the microenvironment in a controlled, predictable fashion. The combination of cellular, cytokine and scaffold elements aims to address the pathologic deficits to urinary incontinence, with a goal to improve patient symptoms and overall quality of life. PMID:24179600

  4. [Management of female stress urinary incontinence in a specialized unit].

    PubMed

    Medina López, R A; Campoy Martínez, P; Ramírez Mendoza, A; Soltero González, A

    1998-02-01

    Urinary exertional incontinence is a very common condition which requires a broad range of therapeutic options being available. Besides, the creation of specialised units in urology is now evident, one of the areas involved being Urogynaecology. To focus the issue of female urinary incontinence, the following should be considered: to begin with, treatment is not imperative, patients must be evaluated on a case-by-case basis, the least invasive principle must prevail, diagnosis must be early, and it should be taken into account that primary and secondary prevention is both possible and necessary. A working pattern was designed accordingly, to sustain therapeutic decisions, which consisted in a detailed anamnesis, complete examination and application of an established diagnostic-therapeutic algorithm. Even so, a therapeutic, medical or surgical decision will be chosen and patients will be monitored at one, four and sixteen months after completion of treatment. To achieve good results in the management of female urinary exertional incontinence it is essential to include a large number of patients. In fact, the key is to establish a close collaboration with the gynaecologists. PMID:9586264

  5. RNA-Based Methods Increase the Detection of Fecal Bacteria and Fecal Identifiers in Environmental Waters

    EPA Science Inventory

    We evaluated the use of qPCR RNA-based methods in the detection of fecal bacteria in environmental waters. We showed that RNA methods can increase the detection of fecal bacteria in multiple water matrices. The data suggest that this is a viable alternative for the detection of a...

  6. Prevalence of incontinence, attention deficit/hyperactivity disorder and oppositional defiant disorder in preschool children.

    PubMed

    Niemczyk, Justine; Equit, Monika; Braun-Bither, Katrin; Klein, Anna-Maria; von Gontard, Alexander

    2015-07-01

    Externalizing disorders as attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are common in children with nocturnal enuresis (NE), daytime urinary incontinence (DUI) and faecal incontinence (FI). We examined the prevalence rates of ADHD, ODD and incontinence in a defined geographical area and analysed the association between externalizing disorders and subtypes of incontinence. 1,676 parents of children who were presented at the mandatory school-entry medical examination completed a questionnaire with all DSM-IV items of ADHD, ODD and six questions regarding incontinence. 50.2% were male and mean age was 5.7 years. 9.1% had at least one subtype of incontinence (8.5% had NE, 1.9% DUI and 0.8% FI). Boys were significantly more affected by incontinence overall, NE, FI and ADHD than girls. 6.4% had ADHD, 6.2% had ODD and 2.6% were affected by ADHD and ODD. 10.3% of the children with incontinence had ADHD and 10.3% ODD. Children with FI were significantly more affected by externalizing disorders (50%) than children with isolated NE (14.5%), children with DUI (9.5%) and continent children (9.5%). Children with incontinence, especially those with FI, are at much higher risk of externalizing disorders. An additional effect of children with both ADHD and ODD having higher rates of incontinence than children with only one disorder could not be found. However, these children represent a high-risk group with lower compliance to treatment and worse outcome. Therefore, screening not only for ADHD but also for ODD should be implemented for all children with incontinence. PMID:25331539

  7. Automatic Identification of Human Erythrocytes in Microscopic Fecal Specimens.

    PubMed

    Liu, Lin; Lei, Haoting; Zhang, Jing; Yuan, Yang; Zhang, Zhenglong; Liu, Juanxiu; Xie, Yu; Ni, Guangming; Liu, Yong

    2015-11-01

    Traditional fecal erythrocyte detection is performed via a manual operation that is unsuitable because it depends significantly on the expertise of individual inspectors. To recognize human erythrocytes automatically and precisely, automatic segmentation is very important for extraction of characteristics. In addition, multiple recognition algorithms are also essential. This paper proposes an algorithm based on morphological segmentation and a fuzzy neural network. The morphological segmentation process comprises three operational steps: top-hat transformation, Otsu's method, and image binarization. Following initial screening by area and circularity, fuzzy c-means clustering and the neural network algorithms are used for secondary screening. Subsequently, the erythrocytes are screened by combining the results of five images obtained at different focal lengths. Experimental results show that even when the illumination, noise pollution, and position of the erythrocytes are different, they are all segmented and labeled accurately by the proposed method. Thus, the proposed method is robust even in images with significant amounts of noise. PMID:26349804

  8. Fecal calprotectin in coeliac disease

    PubMed Central

    Capone, Pietro; Rispo, Antonio; Imperatore, Nicola; Caporaso, Nicola; Tortora, Raffaella

    2014-01-01

    We would like to share with the readers the results of our experience in 50 celiac disease (CD) patients, enrolled between September 2012 and April 2013, who were referred to our third-level CD Unit. The fecal calprotectin (FC) concentration of 50 adults with newly diagnosed CD was compared to that of a control group of 50 healthy subjects. FC level was determined by enzyme linked immunosorbent assay with diagnostic cut-off of 75 μg/g. In addition, we tried to correlate the FC level with symptoms, histological severity of CD (Marsh grade) and level of tissue transglutaminase antibodies (aTg) in CD patients. Finally, FC level was increased in five CD patients and in four controls (10% vs 8%, P = NS); mean FC concentration of patients and controls were 57.7 (SD ± 29.1) and 45.1 (SD ± 38.4) respectively. Furthermore, no significant correlation was seen between FC levels and symptoms/Marsh grade/aTg. The five CD patients did not show inflammatory lesions (e.g., ulcers, erosions) at upper endoscopy. The four healthy controls with positive FC were followed-up for further six months; in this observational period they did not show clinical signs of any underlying disease. On these bases, we think that FC is not able to investigate the subclinical inflammatory changes of active CD and FC should be considered a useless tool in the diagnostic work-up of uncomplicated CD but it should be accompanied by aTg when ruling out organic disease in patients with irritable bowel syndrome. PMID:24574734

  9. Functional lumen imaging of the gastrointestinal tract.

    PubMed

    Lottrup, Christian; Gregersen, Hans; Liao, Donghua; Fynne, Lotte; Frøkjær, Jens Brøndum; Krogh, Klaus; Regan, Julie; Kunwald, Peter; McMahon, Barry P

    2015-10-01

    This nonsystematic review aims to describe recent developments in the use of functional lumen imaging in the gastrointestinal tract stimulated by the introduction of the functional lumen imaging probe. When ingested food in liquid and solid form is transported along the gastrointestinal tract, sphincters provide an important role in the flow and control of these contents. Inadequate function of sphincters is the basis of many gastrointestinal diseases. Despite this, traditional methods of sphincter diagnosis and measurement such as fluoroscopy, manometry, and the barostat are limited in what they can tell us. It has long been thought that measurement of sphincter function through resistance to distension is a better approach, now more commonly known as distensibility testing. The functional lumen imaging probe is the first medical measurement device that purports in a practical way to provide geometric profiling and measurement of distensibility in sphincters. With use of impedance planimetry, an axial series of cross-sectional areas and pressure in a catheter-mounted allantoid bag are used for the calculation of distensibility parameters. The technique has been trialed in many valvular areas of the gastrointestinal tract, including the upper esophageal sphincter, the esophagogastric junction, and the anorectal region. It has shown potential in the biomechanical assessment of sphincter function and characterization of swallowing disorders, gastroesophageal reflux disease, eosinophilic esophagitis, achalasia, and fecal incontinence. From this early work, the functional lumen imaging technique has the potential to contribute to a better and more physiological understanding of narrowing regions in the gastrointestinal tract in general and sphincters in particular. PMID:25980822

  10. An unusual case of urinary incontinence in an intersex West Highland white terrier

    PubMed Central

    Connery, Neil A.; Spotswood, Tim

    2012-01-01

    A 5-year-old neutered female West Highland white terrier dog was presented with a history of congenital urinary incontinence that had become refractory to medical management. Complex urogenital anomalies including urethrovestibular and vestibuloperineal fistulae with low vulvar position along with a penoclitoris were present. Vaginectomy with perineal urethral reconstruction resolved the incontinence. PMID:23633714

  11. Resident and Family Satisfaction with Incontinence and Mobility Care: Sensitivity to Intervention Effects?

    ERIC Educational Resources Information Center

    Simmons, Sandra F.; Ouslander, Joseph G.

    2005-01-01

    Purpose: This study evaluated whether the satisfaction levels of long-term-care residents and their family members concerning incontinence and mobility care were sensitive to an improvement intervention. Design and Methods: A randomized, controlled intervention trial with incontinent long-term-care residents was conducted wherein research staff…

  12. A Graduate Nursing Curriculum for the Evaluation and Management of Urinary Incontinence

    ERIC Educational Resources Information Center

    Rogalski, Nicole

    2005-01-01

    Geriatric nurse practitioners should be educated in the evaluation and treatment of common geriatric syndromes like urinary incontinence. However, many advanced-practice nursing programs do not place an educational emphasis on urinary incontinence management. The purpose of this project is to provide information that supports the need for…

  13. Digital bowel cleansing for computer-aided detection of polyps in fecal-tagging CT colonography

    NASA Astrophysics Data System (ADS)

    Cai, Wenli; Näppi, Janne; Zalis, Micheal E.; Harris, Gordon J.; Yoshida, Hiroyuki

    2006-03-01

    Digital bowel cleansing (DBC) is an emerging method for segmentation of fecal materials, which are tagged by an X-ray-opaque oral contrast agent in CT colonography (CTC) images, effectively removing them for digital cleansing of the colon. Existing DBC approaches tend to use simple thresholding-based methods for the removal of tagged fecal materials; however, because of the pseudo-enhancement of polyps caused by the surrounding tagged fecal materials, such methods tend erroneously to remove a part of or the entire polyps submerged in these materials. In this study, we developed a novel DBC method that preserves the soft-tissue structures submerged in or partially covered by tagged fecal materials. In our approach, submerged soft-tissue structures are characterized by their local shape signatures that are calculated based on the eigenvalues of a Hessian matrix. A structure-enhancement function is formulated for enhancing of the soft-tissue structures, and the values of the function are integrated into the speed function of a level set method to delineate the submerged soft-tissue structures while removing the tagged fecal materials. In an analysis of 10 submerged polyps, our new DBC method was shown to delineate polyps better than was possible with our previously reported cleansing method based on thresholding. Application of our computer-aided detection (CAD) scheme showed that the use of the new DBS method substantially reduced the number of false-positive detections compared with those of our previous, thresholding-based method.

  14. A systematic review and meta-analysis of incontinence-associated dermatitis, incontinence, and moisture as risk factors for pressure ulcer development.

    PubMed

    Beeckman, Dimitri; Van Lancker, Aurélie; Van Hecke, Ann; Verhaeghe, Sofie

    2014-06-01

    The aim of this analysis was to identify the association between incontinence-associated dermatitis (IAD), its most important etiologic factors (incontinence and moisture), and pressure ulcers (PUs). A systematic review and meta-analysis were performed. We searched Medline, Embase, CINAHL, Web of Science, and the Cochrane Library for relevant papers dating through March 15, 2013. Fifty-eight studies were included. Measures of relative effect at the univariate level were meta-analyzed. In most studies (86%), a significant association between variables of interest was found, with pooled odds ratios of PUs in univariate models between 1.92 (95% CI 1.54-2.38) for urinary incontinence and 4.99 (95% CI 2.62-9.50) for double incontinence (p < .05). This evidence indicates an association between IAD, its most important etiological factors, and PUs. Methodological issues should be considered when interpreting the results of this review. PMID:24700170

  15. An unusual cause of urinary incontinence: Urethral coitus in a case of Mayer-Rokitansky-Kuster-Hauser syndrome.

    PubMed

    Sharifiaghdas, Farzaneh; Daneshpajooh, Azar; Sohbati, Samira; Mirzaei, Mahboubeh

    2016-09-01

    Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare anomaly in women and is characterized by congenital aplasia of the uterus and vagina, with normal development of secondary sexual characteristics and a normal karyotype. We report a case of a 38-year-old women with MRKH syndrome that had experienced urethral sex for many years. She presented with urinary incontinence and dyspareunia. The patient's secondary sexual characteristics were normal, and examination revealed a widely open incompetent megalourethra and an absent vagina. Laboratory studies confirmed a 46, XX karyotype. Imaging included ultrasonography and magnetic resonance imaging, which indicated bilateral normal ovaries and a rudimental bicornuate uterus. After confirming the diagnosis of MRKH, the patient underwent urethroplasty by urethral plication, antiincontinence surgery by autologous fascial sling of the bladder neck, and the creation of a neo-vagina using a urethral flap. After 3 months, voiding cystourethrography and uroflowmetry confirmed normal voiding. There were no postoperative symptoms of urinary incontinence, and the patient was completely satisfied. PMID:27617320

  16. An unusual cause of urinary incontinence: Urethral coitus in a case of Mayer-Rokitansky-Kuster-Hauser syndrome

    PubMed Central

    Sharifiaghdas, Farzaneh; Sohbati, Samira; Mirzaei, Mahboubeh

    2016-01-01

    Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare anomaly in women and is characterized by congenital aplasia of the uterus and vagina, with normal development of secondary sexual characteristics and a normal karyotype. We report a case of a 38-year-old women with MRKH syndrome that had experienced urethral sex for many years. She presented with urinary incontinence and dyspareunia. The patient's secondary sexual characteristics were normal, and examination revealed a widely open incompetent megalourethra and an absent vagina. Laboratory studies confirmed a 46, XX karyotype. Imaging included ultrasonography and magnetic resonance imaging, which indicated bilateral normal ovaries and a rudimental bicornuate uterus. After confirming the diagnosis of MRKH, the patient underwent urethroplasty by urethral plication, antiincontinence surgery by autologous fascial sling of the bladder neck, and the creation of a neo-vagina using a urethral flap. After 3 months, voiding cystourethrography and uroflowmetry confirmed normal voiding. There were no postoperative symptoms of urinary incontinence, and the patient was completely satisfied. PMID:27617320

  17. Female stress urinary incontinence: an evidence-based, case study approach.

    PubMed

    Knarr, Jamie; Musil, Carol; Warner, Camille; Kless, Jack R; Long, Jaime

    2014-01-01

    Over half of all women are affected by urinary incontinence at some point during their lives. Due to patients' embarrassment and health care providers' reluctance to discuss this sensitive subject, many women may go untreated, and in turn, suffer with disruptive symptoms and co-morbid complications associated with urinary incontinence. This article highlights a literature review of the evaluation and management of female stress urinary incontinence using a corresponding case study example. Increasing awareness and implementing evidence-based, nonsurgical treatment options are essential components of high-quality care for women with stress urinary incontinence. Urologic nurses and other health care professionals are in an ideal position to evaluate and identify strategies for the treatment of female stress urinary incontinence. PMID:25112024

  18. Diagnosis and office-based treatment of urinary incontinence in adults. Part one: diagnosis and testing

    PubMed Central

    Heidelbaugh, Joel J.; Jimbo, Masahito

    2013-01-01

    Urinary incontinence is a common problem in both men and women. This review article addresses its prevalence, risk factors, cost, the various types of incontinence, as well as how to diagnose them. The US Preventive Services Task Force, the Cochrane Database of Systematic Reviews, and PubMed were reviewed for articles focusing on urinary incontinence. Incontinence is a common problem with a high societal cost. It is frequently underreported by patients so it is appropriate for primary-care providers to screen all women and older men during visits. A thorough history and physical examination combined with easy office-based tests can often yield a clear diagnosis and rule out other transient illnesses contributing to the incontinence. Specialist referral is occasionally needed in specific situations before embarking on a treatment plan. PMID:23904857

  19. [Practice guideline 'Urinary incontinence in women' from the Dutch College of General Practitioners].

    PubMed

    Damen-van Beek, Z; Wiersma, Tj

    2016-01-01

    - The Dutch College of General Practitioners' (NHG) practice guideline 'Urinary incontinence in women' provides guidelines for diagnosis and management of stress, urgency and mixed urinary incontinence in adult women.- General practitioners (GPs) should be alert to signals for urinary incontinence in women and offer active diagnosis and treatment if necessary.- Shared decision making is central in the guideline; the GP and the patient should discuss therapeutic options and decide on treatment policy in mutual consultation.- Women with stress urinary incontinence can choose between pelvic floor exercises or a pessary as initial treatment. Placing a midurethral sling (MUS) will be discussed if initial treatment is insufficiently effective or in the case of serious symptoms.- When bladder training is ineffective in urgency incontinence, the GP will discuss the pros and cons of adding an anticholinergic agent.- Exercise therapy can take place in the GPs practice or under supervision of a pelvic physical therapist. PMID:27484432

  20. Intermittent filtration of wastewater--removal of fecal coliforms and fecal streptococci.

    PubMed

    Ausland, G; Stevik, T K; Hanssen, J F; Køhler, J C; Jenssen, P D

    2002-08-01

    Removal of fecal coliforms and fecal streptococci was monitored over a period of 13 months in 14 buried pilot scale filters, treating septic tank effluent. The effects of grain size, hydraulic dosing rate and distribution method were investigated. Two different natural sands (sorted sand and unsorted sand) and three different types of light weight aggregates (LWA 0-4 mm, LWA 2-4 mm and crushed LWA 0-3 mm) were used. Intermittent dosing rates from 20 to 80 mm/day in 12 doses per day were applied to the filters by uniform pressure distribution or point application by gravity dosing. Removal of fecal coliforms was more than three orders of magnitude higher in the media with the finest grain sizes (unsorted sand) as compared to the coarsest media (LWA 0-4 mm and LWA 2-4 mm) operated under same conditions. Fecal streptococci were determined only in effluent from filters with LWA 0-4 mm and LWA 2-4 mm. Higher removal of fecal coliforms was observed in pressure dosed filters compared to gravity dosed filters. A lower removal was observed by increasing the hydraulic dosing rate. Minimum retention time was found to be a key parameter for predicting removal of bacteria in unsaturated, aerobic filters. At minimum retention times lower than about 50 h, there was a correlation of 0.96 between retention time and removal of fecal coliforms. Retention times longer than 50 h gave almost complete removal of fecal coliforms. PMID:12230196

  1. Quantitative PCR for Genetic Markers of Human Fecal Pollution

    EPA Science Inventory

    Assessment of health risk and fecal bacteria loads associated with human fecal pollution requires reliable host-specific analytical methods and a rapid quantificationapproach. We report the development of quantitative PCR assays for quantification of two recently described human-...

  2. Addressing Uncertainty in Fecal Indicator Bacteria Dark Inactivation Rates

    EPA Science Inventory

    Fecal contamination is a leading cause of surface water quality degradation. Roughly 20% of all total maximum daily load assessments approved by the United States Environmental Protection Agency since 1995, for example, address water bodies with unacceptably high fecal indicator...

  3. Quantitative PCR for genetic markers of human fecal pollution

    EPA Science Inventory

    Assessment of health risk and fecal bacteria loads associated with human fecal pollution requires reliable host-specific analytical methods and a rapid quantification approach. We report the development of quantitative PCR assays for enumeration of two recently described hum...

  4. Urethral hypermobility after anti-incontinence surgery - a prognostic indicator?

    PubMed

    Viereck, Volker; Pauer, Hans-Ulrich; Hesse, Oda; Bader, Werner; Tunn, Ralf; Lange, Rainer; Hilgers, Reinhard; Emons, Günter

    2006-11-01

    The aim of this study was to define the concept of hypermobility of the bladder neck and determine its effects on the cure rate and postoperative complications in patients undergoing colposuspension. In a retrospective study, 310 patients who underwent primary colposuspension for urodynamically proven genuine stress urinary incontinence were assessed by introital ultrasound before surgery and during follow-up for up to 48 months postoperatively. A total of 152 women completed 48 months of follow-up. Mobility of the bladder neck during straining was described as linear dorsocaudal movement (LDM) with LDM >15 mm being defined as hypermobility. The overall objective cure rate was 90.0% at 6-month follow-up vs 76.8% at 48-month follow-up (Kaplan-Meier estimators). Urge symptoms occurred in 12.6% (39/310) of the women and de novo urge incontinence in 2.3% (7/310). Bladder neck hypermobility was significantly reduced after anti-incontinence surgery, from 67.1% (208/310) before surgery to 5.5% (17/310) immediately after surgery (P<0.0001). Postoperative hypermobility was associated with a higher recurrence rate. In the hypermobility group, 52.9 and 34.0% of the patients were continent for up to 6 and 48 months, respectively, as opposed to 92.2 and 79.2% in the group without hypermobility (P<0.0001). Women with postoperative hypermobility had a 3.2-fold higher risk of recurrence within 48 months. Bladder neck hypermobility after surgery was also associated with postoperative voiding difficulty (P=0.0278). Patients in whom hypermobility of the bladder neck diagnosed before surgery persists after colposuspension have a higher risk of recurrence and are more likely to develop postoperative complications than those without this hypermobility. PMID:16538422

  5. Incontinence-associated dermatitis: protecting the older person.

    PubMed

    Beldon, Pauline

    As the older population in the UK continues to grow, so too will the number of people presenting with dermatological problems. Older people's skin is subject to dehydration internally and environmental factors externally. If, in addition, the individual suffers continence problems, he or she is at risk of painful incontinence-associated dermatitis, or even formation of a moisture lesion. The use of an effective barrier cream that gives protection while not interfering with continence pad efficacy can be an invaluable means of comfort to the older person. PMID:22585017

  6. Urinary incontinence and related urogenital symptoms in elderly women.

    PubMed

    Molander, U

    1993-01-01

    The aims of this study were to investigate the prevalence of urinary incontinence (UI), urinary tract infections (UTI) and related urogenital symptoms (UGS) in a representative sample of elderly women (Papers I & II), and to investigate factors (Papers II & III) influencing the prevalence of UI in these women. The effects of treatment with oral estriol and placebo on the vaginal bacterial flora, vaginal cytology and urogenital symptoms in elderly women suffering from the urogenital estrogen deficiency syndrome were compared (Paper IV). A health care programme, based on an algorithm model, for the investigation and treatment of elderly women suffering from UI and related UGS, was designed and applied to a large group of elderly women (Paper V). The prevalence of UI increased in a linear fashion from 12% in the 1940 birth cohort to 25% in the 1900 birth cohort (Papers I & II). There was similar increase in the prevalence of UTI from 14% in the 1920 birth cohort to 23% in the 1900 birth cohort. In contrast, the reported prevalence of UGS such as vaginal discomfort, discharge and pruritus did not increase with age. The prevalence of UI increased with increasing parity and after hysterectomy, but was unaffected by the duration of previous oral contraceptive usage. There was no evidence to suggest that the prevalence of UI increased at the time of the last menstrual period. Neurological illnesses were an uncommon cause of UI in women < or = to 75 years of age (Paper III). Oral estriol (3 mg/day for 4 weeks followed by 2 mg/day for a further 6 weeks) had a positive influence on vaginal pH, cytology and the vaginal bacteria flora, and on UGS in elderly women suffering from the urogenital estrogen deficiency syndrome (Paper IV). Using objective techniques of evaluation (Paper V) it was possible to demonstrate successful treatment of elderly women with urge and mixed incontinence using a simple health care programme. There was however no evidence of improvement in women

  7. Engineered structures for use in disposable incontinence products.

    PubMed

    White, C F

    2003-01-01

    The background and evolution of absorbent disposable hygiene products is discussed. The current technology used to produce disposable hygiene products such as baby diapers, feminine hygiene products and adult incontinence management products is shown to have a number of manufacturing and in-use problems. Alternative technologies, such as multilayer composite webs offer the opportunity to achieve better product weight control, and therefore better control over the other related properties, reduced raw material waste and improved functional characteristics. There are still problems to be resolved when using such composite materials, but the potential of these new technologies has now been established. PMID:12885194

  8. Pelvic floor muscle exercises in genuine urinary stress incontinence.

    PubMed

    Cammu, H; Van Nylen, M

    1997-01-01

    Pelvic floor muscle exercises, in the treatment of genuine stress incontinence, have been used successfully since 1948. One may expect a significant improvement (warranting no further therapy), or cure rate of about 50%. These exercises have a long-lasting effect. Poorly motivated women should be discouraged to follow exercise sessions. An active co-operation between urogynecologist, physiotherapist and the patient is important in order to avoid undertreated and dissatisfied women. The option to be operated upon must be easily available. PMID:9557995

  9. Current Use of Injectable Agents for Female Stress Urinary Incontinence

    PubMed Central

    Herschorn, Sender

    2005-01-01

    Injectable materials of various types have been used for decades as an alternative to surgery for the treatment of stress urinary incontinence. Their success stems from their ability to improve intrinsic sphincter function, and patients with hypermobility may benefit as well. Nevertheless, the ideal agent has yet to be discovered, and surgery still may be necessary after treatment in some patients. Results vary among the different materials used, and safety, durability, and cost-effectiveness are important areas of concern in which more research is needed. PMID:16985872

  10. Urinary Incontinence and Urosepsis due to Forgotten Ureteral Stent.

    PubMed

    Barreiro, Diego Martin; Losada, Johanna Belén; Montiel, Francisco Castro; Lafos, Norberto

    2016-09-01

    Case report of a patient who, while being under study due to total urinary incontinence and multiple urinary tract infections, interoccurs with urosepsis due to a forgotten and encrusted double-J stent. An open surgery is performed with two surgical approaches, suprapubic and minimal lumbotomy, in which a nephrectomy of the atrophic kidney, a resection of the urether with a calcified double-J in its interior and a cystolithotomy were conducted with the resulting favorable resolution of the pathology. PMID:27547734

  11. Adynamic and dynamic muscle transposition techniques for anal incontinence

    PubMed Central

    Barišić, Goran; Krivokapić, Zoran

    2014-01-01

    Gracilis muscle transposition is well established in general surgery and has been the main muscle transposition technique for anal incontinence. Dynamization, through a schedule of continuous electrical stimulation, converts the fatigue-prone muscle fibres to a tonic fatigue-resistant morphology with acceptable results in those cases where there is limited sphincter muscle mass. The differences between gluteoplasty and graciloplasty, as well as the techniques and complications of both procedures, are outlined in this review. Overall, these techniques are rarely carried out in specialized units with experience, as there is a high revision and explantation rate. PMID:24759348

  12. 78 FR 12763 - Fecal Microbiota for Transplantation; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... HUMAN SERVICES Food and Drug Administration Fecal Microbiota for Transplantation; Public Workshop AGENCY... ``Fecal Microbiota for Transplantation.'' The purpose of the public workshop is to exchange information... fecal microbiota for transplantation (FMT). ] Date and Time: The public workshop will be held on May...

  13. Lack of correlation between fecal elastase-1 levels and fecal nitrogen excretion in preterm infants.

    PubMed

    Corvaglia, Luigi; Paoletti, Vittoria; Battistini, Barbara; Simoni, Patrizia; Faldella, Giacomo

    2008-10-01

    We measured fecal elastase-1 (FE1) levels in 34 preterm newborns (15 small-for-gestational-age and 19 appropriate-for-gestational-age) during the first 2 months of life and evaluated whether they were correlated with nitrogen loss in stools. FE1 increased over time, and values were similar in both groups of newborns. Fecal nitrogen was significantly higher in small-for-gestational-age infants. There was no correlation between FE1 levels and fecal nitrogen excretion. Pancreatic proteolytic function was efficient at an early stage in enterally fed preterm newborns. Despite the similar FE1 values, fecal nitrogen loss was significantly higher in small-for-gestational-age preterm infants than in appropriate-for-gestational-age preterm infants. PMID:18852648

  14. Effect of fecal material on carcass microbiology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Broiler carcass bacterial counts are increased by visible fecal material, therefore further treatment of these carcasses is necessary. Inside-outside bird washers (IOBWs) are used by many processors to remove feces and possibly reduce bacterial counts. A series of studies have shown that IOBWs hav...

  15. Discovering new indicators of fecal pollution

    PubMed Central

    McLellan, Sandra L.; Eren, A. Murat

    2014-01-01

    Fecal pollution indicators are essential to identify and remediate contamination sources and protect public health. Historically, easily cultured facultative anaerobes such as fecal coliforms, Escherichia coli, or enterococci have been used, but these indicators generally provide no information as to their source. More recently, molecular methods have targeted fecal anaerobes, which are much more abundant in humans and other mammals and some strains appear to be associated with certain host sources. Next-generation sequencing and microbiome studies have created an unprecedented inventory of microbial communities associated with fecal sources, allowing reexamination of which taxonomic groups are best suited as informative indicators. The use of new computational methods, such as oligotyping coupled with well-established machine learning approaches, is providing new insights into patterns of host association. In this review we examine the basis for host-specificity and the rationale for using 16S rRNA gene targets for alternative indicators and highlight two taxonomic groups, Bacteroidales and Lachnospiraceae, which are rich in host-specific bacterial organisms. Finally, we discuss considerations for using alternative indicators for water quality assessments with a particular focus on detecting human sewage sources of contamination. PMID:25199597

  16. Interaction of fecal coliforms with soil aggregates

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Land-applied manures may contain various contaminants that cause water pollution and concomitant health problems. Some of these pollutants are bacteria, and fecal coliforms (FC) have been widely used as an indicator of bacterial contamination. Experiments on bacteria attachment to soil are tradition...

  17. Fecal Transplants: What Is Being Transferred?

    PubMed Central

    Bojanova, Diana P.

    2016-01-01

    Fecal transplants are increasingly utilized for treatment of recurrent infections (i.e., Clostridium difficile) in the human gut and as a general research tool for gain-of-function experiments (i.e., gavage of fecal pellets) in animal models. Changes observed in the recipient's biology are routinely attributed to bacterial cells in the donor feces (~1011 per gram of human wet stool). Here, we examine the literature and summarize findings on the composition of fecal matter in order to raise cautiously the profile of its multipart nature. In addition to viable bacteria, which may make up a small fraction of total fecal matter, other components in unprocessed human feces include colonocytes (~107 per gram of wet stool), archaea (~108 per gram of wet stool), viruses (~108 per gram of wet stool), fungi (~106 per gram of wet stool), protists, and metabolites. Thus, while speculative at this point and contingent on the transplant procedure and study system, nonbacterial matter could contribute to changes in the recipient's biology. There is a cautious need for continued reductionism to separate out the effects and interactions of each component. PMID:27404502

  18. Fecal Transplants: What Is Being Transferred?

    PubMed

    Bojanova, Diana P; Bordenstein, Seth R

    2016-07-01

    Fecal transplants are increasingly utilized for treatment of recurrent infections (i.e., Clostridium difficile) in the human gut and as a general research tool for gain-of-function experiments (i.e., gavage of fecal pellets) in animal models. Changes observed in the recipient's biology are routinely attributed to bacterial cells in the donor feces (~1011 per gram of human wet stool). Here, we examine the literature and summarize findings on the composition of fecal matter in order to raise cautiously the profile of its multipart nature. In addition to viable bacteria, which may make up a small fraction of total fecal matter, other components in unprocessed human feces include colonocytes (~107 per gram of wet stool), archaea (~108 per gram of wet stool), viruses (~108 per gram of wet stool), fungi (~106 per gram of wet stool), protists, and metabolites. Thus, while speculative at this point and contingent on the transplant procedure and study system, nonbacterial matter could contribute to changes in the recipient's biology. There is a cautious need for continued reductionism to separate out the effects and interactions of each component. PMID:27404502

  19. Classification of hyperspectral imagery for identifying fecal and ingesta contaminants

    NASA Astrophysics Data System (ADS)

    Park, Bosoon; Windham, William R.; Lawrence, Kurt C.; Smith, Douglas P.

    2004-03-01

    This paper presents the research results of the performance of classification methods for hyperspectral poultry imagery to identify fecal and ingesta contaminants on the surface of broiler carcasses. A pushbroom line-scan hyperspectral imager was used to acquire hyperspectral data with 512 narrow bands covered from 400 to 900 nm wavelengths. Three different feces from digestive tracts (duodenum, ceca, colon), and ingesta were used as contaminants. These contaminants were collected from the broiler carcasses fed by corn, milo, and wheat with soybean meals. For the selection of optimum classifier, various widely used supervised classification methods (parallelepiped, minimum distance, Mahalanobis distance, maximum likelihood, spectral angle mapper, and binary coding) were investigated. The classification accuracies ranged from 62.94% to 92.27%. The highest classification accuracy for identifying contaminants for corn fed carcasses was 92.27% with spectral angle mapper classifier. While, the classification accuracy was 82.02% with maximum likelihood method for milo fed carcasses and 91.16% accuracy was obtained for wheat fed carcasses when same classification method was used. The mean classification accuracy obtained in this study for classifying fecal and ingesta contaminants was 90.21%.

  20. The Interaction between Heterotrophic Bacteria and Coliform, Fecal Coliform, Fecal Streptococci Bacteria in the Water Supply Networks

    PubMed Central

    AMANIDAZ, Nazak; ZAFARZADEH, Ali; MAHVI, Amir Hossein

    2015-01-01

    Background: This study investigated the interaction between heterotrophic bacteria and coliform, fecal coliforms, fecal streptococci bacteria in water supply networks. Methods: This study was conducted during 2013 on water supply distribution network in Aq Qala City, Golestan Province, Northern Iran and standard methods were applied for microbiological analysis. The surface method was applied to test the heterotrophic bacteria and MPN method was used for coliform, fecal coliform and fecal streptococci bacteria measurements. Results: In 114 samples, heterotrophic bacteria count were over 500 CFU/ml, which the amount of fecal coliform, coliform, and fecal streptococci were 8, 32, and 20 CFU/100 ml, respectively. However, in the other 242 samples, with heterotrophic bacteria count being less than 500 CFU/ml, the amount of fecal coliform, coliform, and fecal streptococci was 7, 23, and 11 CFU/100ml, respectively. The relationship between heterotrophic bacteria, coliforms and fecal streptococci was highly significant (P<0.05). We observed the concentration of coliforms, fecal streptococci bacteria being high, whenever the concentration of heterotrophic bacteria in the water network systems was high. Conclusion: Interaction between heterotrophic bacteria and coliform, fecal coliforms, fecal streptococci bacteria in the Aq Qala City water supply networks was not notable. It can be due to high concentrations of organic carbon, bio-films and nutrients, which are necessary for growth, and survival of all microorganisms. PMID:26811820

  1. The Current Role of the Artificial Urinary Sphincter in Male and Female Urinary Incontinence

    PubMed Central

    Islah, MAR; Cho, Sung Yong

    2013-01-01

    The evolution of the artificial urinary sphincter has affected the current surgical options for urinary incontinence. With its unique features, the artificial urinary sphincter (AUS) has been an attractive option for the treatment of urinary incontinence regardless of gender. The current paper discusses the indications, contraindications, types of devices, surgical approaches, outcomes, and complications of the AUS in the treatment of both male and female urinary incontinence. A PubMed review of the available literature was performed and articles reporting implantation of artificial urinary sphincters for urinary incontinence in both male and female patients were evaluated. There was a comparable satisfactory continence rate after the implantation of an AUS (59~97% in males vs. 60~92% in females). In comparison, there were some differences in the indications, contraindications, surgical approaches, outcomes, and complications of the AUS implanted for urinary incontinence in male and female patients. AUS implantation is a safe and effective surgical option for the treatment of urinary incontinence of various etiologies. Continuous evolution of the device has made it an attractive option for the treatment of both male and female urinary incontinence. PMID:23658862

  2. Research on a novel artificial anal sphincter for human incontinence.

    PubMed

    Zan, P; Yang, B; Zhang, J Y; Shao, Y

    2010-01-01

    This paper discusses a novel artificial anal sphincter with sensor feedback for controlling anal incontinence. The artificial anal sphincter system is a novel hydraulic-electric muscle which mainly comprises an artificial anal sphincter, a wireless power supply subsystem, and a communication subsystem. High integration of all functional components and no wire linking to the outer device make surgical implantation easier and lower risk. The wireless power supply subsystem employs a Class-E power amplifier based on adaptive control technique, and the electromagnetic compatibility in biological tissue is analysed. With the goal of designing a reliable and safe instrument, the models of human colonic blood flow and rectum motion are developed, the biomechanical material properties of human rectum and tissue ischaemia are analysed. The results show that the deformation of the artificial anal sphincter can be controlled by the press of reservoir below the upper limit of human tissue ischaemia. In vitro experiments demonstrate the artificial anal sphincter system is a good cure for human anal incontinence problems. PMID:20653341

  3. Incontinence-associated dermatitis and pressure ulcers in geriatric patients.

    PubMed

    Kottner, J; Beeckman, D

    2015-12-01

    The key characteristics of geriatric patients are advanced age, multimorbidity, a decrease of psychical performance and care dependency. In addition, advanced age, chronic and acute diseases and treatments (e.g. polypharmacy) lead, either directly or indirectly, to a wide range of skin and tissue problems. Incontinence-associated dermatitis and pressure ulcers (PUs) belong to the most prevalent in geriatric settings. Prolonged exposure of the skin to urine and/or stool can cause an irritant contact dermatitis. Skin surface 'wetness', increased skin surface pH, digestive intestinal enzymes, repeated skin cleansing activities, and a possible occlusive environment contribute to irritation and inflammation. Prevention and treatment includes activities to maintain and to enhance continence and to limit, to reduce exposure of the skin to urine and stool, and to promote healing and reepithelialisation. In frail aged skin, it is recommended to use incontinence products with smooth and breathable materials with maximum absorption capacity. Immediate skin cleansing after soiling using mild cleansers and protective and caring leave-on products are recommended. PUs are localized injuries to the skin and/or underlying tissue caused by sustained deformations of skin and underlying soft tissues. PUs management includes risk assessment, repositioning and mobilization, and the use of appropriate support surfaces. Patients must be never positioned directly on an existing PU. Especially at end of life, the PU closure and wound healing may not be the primary therapeutic goal. PMID:26186379

  4. Major Odorants Released as Urinary Volatiles by Urinary Incontinent Patients

    PubMed Central

    Pandey, Sudhir Kumar; Kim, Ki-Hyun; Choi, Si On; Sa, In Young; Oh, Soo Yeon

    2013-01-01

    In this study, volatile urinary components were collected using three different types of samples from patients suffering from urinary incontinence (UI): (1) urine (A); (2) urine + non-used pad (B); and (3) urine + used pad (C). In addition, urine + non-used pad (D) samples from non-patients were also collected as a reference. The collection of urinary volatiles was conducted with the aid of a glass impinger-based mini-chamber method. Each of the four sample types (A through D) was placed in a glass impinger and incubated for 4 hours at 37 °C. Ultra pure air was then passed through the chamber, and volatile urine gas components were collected into Tedlar bags at the other end. These bag samples were then analyzed for a wide range of VOCs and major offensive odorants (e.g., reduced sulfur compounds (RSCs), carbonyls, trimethylamine (TMA), ammonia, etc.). Among the various odorants, sulfur compounds (methanethiol and hydrogen sulfide) and aldehydes (acetaldehyde, butylaldehyde, and isovaleraldehyde) were detected above odor threshold and predicted to contribute most effectively to odor intensity of urine incontinence. PMID:23823973

  5. Brain-derived neurotrophic factor in urinary continence and incontinence.

    PubMed

    Song, Qi-Xiang; Chermansky, Christopher J; Birder, Lori A; Li, Longkun; Damaser, Margot S

    2014-10-01

    Urinary incontinence adversely affects quality of life and results in an increased financial burden for the elderly. Accumulating evidence suggests a connection between neurotrophins, such as brain-derived neurotrophic factor (BDNF), and lower urinary tract function, particularly with regard to normal physiological function and the pathophysiological mechanisms of stress urinary incontinence (SUI) and bladder pain syndrome/interstitial cystitis (BPS/IC). The interaction between BDNF and glutamate receptors affects both bladder and external urethral sphincter function during micturition. Clinical findings indicate reduced BDNF levels in antepartum and postpartum women, potentially correlating with postpartum SUI. Experiments with animal models demonstrate that BDNF is decreased after simulated childbirth injury, thereby impeding the recovery of injured nerves and the restoration of continence. Treatment with exogenous BDNF facilitates neural recovery and the restoration of continence. Serotonin and noradrenaline reuptake inhibitors, used to treat both depression and SUI, result in enhanced BDNF levels. Understanding the neurophysiological roles of BDNF in maintaining normal urinary function and in the pathogenesis of SUI and BPS/IC could lead to future therapies based on these mechanisms. PMID:25224451

  6. A Group-Based Yoga Therapy Intervention for Urinary Incontinence in Women: A Pilot Randomized Trial

    PubMed Central

    Huang, Alison J.; Jenny, Hillary E.; Chesney, Margaret A.; Schembri, Michael; Subak, Leslee L.

    2015-01-01

    Objective To examine the feasibility, efficacy, and safety of a group-based yoga therapy intervention for middle-aged and older women with urinary incontinence. Methods We conducted a pilot randomized trial of ambulatory women aged 40 years and older with stress, urgency, or mixed-type incontinence. Women were randomized to a 6-week yoga therapy program (N=10) consisting of twice weekly group classes and once weekly home practice or a waitlist control group (N=9). All participants also received written pamphlets about standard behavioral self-management strategies for incontinence. Changes in incontinence were assessed by 7-day voiding diaries. Results Mean (±SD) age was 61.4 (±8.2) years, and mean baseline frequency of incontinence was 2.5 (±1.3) episodes/day. After 6 weeks, total incontinence frequency decreased by 66% (1.8 [±0.9] fewer episodes/day) in the yoga therapy versus 13% (0.3 [±1.7] fewer episodes/day) in the control group (P=0.049). Participants in the yoga therapy group also reported an average 85% decrease in stress incontinence frequency (0.7 [±0.8] fewer episodes/day) compared to a 25% increase in controls (0.2 [± 1.1] more episodes/day) (P=0.039). No significant differences in reduction in urgency incontinence were detected between the yoga therapy versus control groups (1.0 [±1.0] versus 0.5 [±0.5] fewer episodes/day, P=0.20). All women starting the yoga therapy program completed at least 90% of group classes and practice sessions. Two participants in each group reported adverse events unrelated to the intervention. Conclusions Findings provide preliminary evidence to support the feasibility, efficacy, and safety of a group-based yoga therapy intervention to improve urinary incontinence in women. PMID:24763156

  7. The Effect of Pelvic Muscle Exercises on Urinary Incontinency and Self-Esteem of Elderly Females With Stress Urinary Incontinency, 2013

    PubMed Central

    Jahromi, Marzieh Kargar; Talebizadeh, Malihe; Mirzaei, Maryam

    2015-01-01

    Introduction: Millions of women are afflicted with stress urinary incontinence. Urinary incontinence is mentioned as one of the geriatric syndromes, together with pressure ulcers, functional decline, falls, and low self-esteem. The aim of the present study was to determine the effect of pelvic muscle exercises on urinary incontinency and self- esteem of elderly females with stress urinary incontinency in Shiraz, Iran, 2013. Material and Method: In this interventional study, 50 old females aged 60-74 years were chosen among the members of Jahandidegan center, and they were asked to sign the informed consent form and complete the demographic questionnaire. Then, Quid questionnaire was used for choosing the type of incontinence in the elderly females. Next, the participants completed the ICIQ and self-esteem questionnaires. Then, they were randomly assigned to case and control groups. Each participant took part in 8 training classes. Finally, the subjects filled the ICIQ and self-esteem questionnaires before and 2 months after the intervention. Result: The results is shown that after the intervention, ICIQ score has a significant difference between the two groups (P=0.001). Also, after the treatment, self-esteem average scores of studied unit indicated a significant statistical difference in experimental group. In other words, the training sessions improved the score of self-esteem in the experimental group (P<0.001) versus control group (P=0.08). Conclusion: Pelvic muscle exercises were an empowerment mechanism for incontinent women in improving their quality of life and self-esteem, so recommended that such these exercising programs be used in elderly health care centers as a factor to improve health promotion of elderlies ’that are suffering from urinary incontinence. PMID:25716389

  8. Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: what are the determinants of bothersome urinary incontinence and help-seeking behavior?

    PubMed

    Cetinel, Bulent; Demirkesen, Oktay; Tarcan, Tufan; Yalcin, Onay; Kocak, Taner; Senocak, Mustafa; Itil, Ismail

    2007-06-01

    The purpose of this study was to assess the prevalence of female urinary incontinence (UI) and risk factors of bothersomeness and help-seeking behavior of hidden female UI in urology and obstetrics and gynecology outpatient clinics. This multicentric and cross-sectional study was conducted as a part of the Turkish Overactive Bladder Study. Female patients (n = 5,565) who were referred with complaints other than UI and overactive bladder symptoms were surveyed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with supplementation of five more questions. The crude prevalence of UI was found to be 35.7%. The prevalence of frequent and severe incontinence was 8.2 and 6.8%, respectively. The mean age of incontinent patients was significantly higher (p < 0.001). The prevalence of stress, urge, and mixed UI was 39.8, 24.8, and 28.9%, respectively. More than half (53%) of incontinent patients were not bothered by UI, and only 12% of incontinent patients had previously sought medical help for their problem. Frequency, severity, and type of UI were independent factors for predicting bothersome UI, while only bothersomeness increased help-seeking behavior. The ICIQ-SF score of 8 has been found to be the best cutoff value to delineate the bothersome UI. Although the crude prevalence of female UI was found to be high, bothersome UI was not so common. The majority of incontinent female patients did not seek medical help. Frequency, severity, and mixed type of UI were found to be the determinants of bothersome UI for which the ICIQ-SF cutoff score of 8 was obtained. PMID:17164988

  9. Non stress non urge female urinary incontinence--diagnosis and cure: a preliminary report.

    PubMed

    Petros, P E; Ulmsten, U I

    1990-01-01

    Six patients, average age 80 years, with no previous operations, presented with urinary incontinence. The predominant symptoms were "being wet all the time" and "sudden uncontrolled urine loss". They had no symptoms of urgency or stress incontinence, and no objective evidence of "detrusor instability" or urine loss on cough stress pad testing. All but one patients were cured by the simultaneous combined Intravaginal Sling and Tuck operation, indicating that the primary cause of the symptoms was an anatomical defect in the vagina and the ligamentous supports in the region of the bladder neck, as stated in the Integral Theory of Urinary Incontinence, this supplement, elderly. PMID:2093277

  10. Faecal incontinence as presentation of an ependymomas of the spinal cord

    PubMed Central

    Jeyarajah, Santhini; King, Andrew; Papagrigoriadis, Savvas

    2007-01-01

    Background Spinal tumours and ependymomas in particular are rare causes of cauda equina syndrome that present with faecal incontinence. Case presentation We present a case of a 45 year old gentleman who presents to a colorectal clinic with incontinence. We then present a review of ependymomas with particular reference to the symptoms they cause as well a review of the neurophysiology of faecal continence. Conclusion Suspicion for non-colonic causes for faecal incontinence should arise when there is absence of other etiologic factors. Establishment of the diagnosis of spinal tumours is with neurological examination and MRI spine. PMID:17894884

  11. Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly

    PubMed Central

    Figueiredo, Vânia F.; Amorim, Juleimar S. C.; Pereira, Aline M.; Ferreira, Paulo H.; Pereira, Leani S. M.

    2015-01-01

    Background: Low back pain (LBP) and urinary incontinence (UI) are highly prevalent among elderly individuals. In young adults, changes in trunk muscle recruitment, as assessed via ultrasound imaging, may be associated with lumbar spine stability. Objective: To assess the associations between LBP, UI, and the pattern of transversus abdominis (TrA), internal (IO), and external oblique (EO) muscle recruitment in the elderly as evaluated by ultrasound imaging. Method: Fifty-four elderly individuals (mean age: 72±5.2 years) who complained of LBP and/or UI as assessed by the McGill Pain Questionnaire, Incontinence Questionnaire-Short Form, and ultrasound imaging were included in the study. The statistical analysis comprised a multiple linear regression model, and a p-value <0.05 was considered significant. Results: The regression models for the TrA, IO, and EO muscle thickness levels explained 2.0% (R2=0.02; F=0.47; p=0.628), 10.6% (R2=0.106; F=3.03; p=0.057), and 10.1% (R2=0.101; F=2.70; p=0.077) of the variability, respectively. None of the regression models developed for the abdominal muscles exhibited statistical significance. A significant and negative association (p=0.018; β=-0.0343) was observed only between UI and IO recruitment. Conclusion: These results suggest that age-related factors may have interfered with the findings of the study, thus emphasizing the need to perform ultrasound imaging-based studies to measure abdominal muscle recruitment in the elderly. PMID:25714438

  12. Severe form of radiculo - myelo - neuropathy with meningo - encephalitis secondary to Angiostrongylus cantonensis infection: unusual corpus callosal lesions and serial magnetic resonance imaging findings.

    PubMed

    Nalini, Atchayaram; Ramakrishna, Anil; Dekumoy, Paron; Kumar, Raju Ravi; Pakdee, Wallop; Saini, Jitender; Hegde, Vinay S

    2013-01-01

    A 43-year-old man presented with the symptoms of recurrent lower abdominal pain, malaise and loss of appetite of 3-week duration, followed by acute onset of generalized paresthesias, fever and headache which progressed over few days to quadriparesis, altered sensorium, urinary and fecal incontinence. He had consumed raw tongue, liver, gall bladder and testicles of monitor lizard (Varanus bengalensis). Blood picture showed eosinophilia and cerebrospinal fluid (CSF) analysis revealed elevated protein and eosinophilia. Serum and CSF serology was positive for angiostrongyliasis. Magnetic resonance imaging showed focal hyperintense lesions in the corpus callosum and brainstem and an enhancing lesion in the cerebellum. Post-contrast T1-weighted axial images of spine showed evidence of cervical cord hyperintense lesions and root enhancement. Susceptibility weighted images/phase images showed unusual feature of multiple hemorrhagic lesions in the posterior fossa and supratentorial areas. Diffusion showed no restriction of corpus callosal lesions. Patient was treated with the high dose parenteral steroids with albendazole and at 6-month follow-up and had a remarkable recovery. PMID:24005735

  13. Impact of incontinence on the quality of life of caregivers of older persons with incontinence: A qualitative study in four European countries.

    PubMed

    Santini, Sara; Andersson, Gunnel; Lamura, Giovanni

    2016-01-01

    The aim of this study was to assess the impact of incontinence management on informal caregivers of older persons with incontinence. In order to investigate this phenomenon in different welfare systems via qualitative interviews and a content analysis methodology, the study was carried out in four European countries (Italy, the Netherlands, Slovak Republic and Sweden). To this purpose, 50 semi-structured interviews were conducted with spouses and children of older people receiving their help to manage the consequences of involuntary urinary and/or faecal leakage. Findings show that incontinence has a remarkably strong effect on caregivers' quality of life, because it results in progressive social isolation, causing them financial problems as well as psychological and physical exhaustion. The lack of appropriate support and the general silence regarding the problem, which is still considered a taboo by many, aggravate the caregivers' situation. It is therefore crucial that caregivers can count on a strong public and private support network, appropriate information and suitable incontinent products, in order to better handle incontinence and care tasks in general. PMID:26620553

  14. Prevalence of urinary incontinence in Andorra: impact on women's health.

    PubMed

    Avellanet, Mercè; Fiter, Meritxell; Cirera, Eva; Coll, Margarida

    2003-07-16

    BACKGROUND: Urinary incontinence (UI) is a frequent public health problem with negative social consequences, particularly for women. Female susceptibility is the result of anatomical, social, economic and cultural factors. The main objectives of this study are to evaluate the prevalence of UI in the female population of Andorra over the age of 15 and, specifically, to determine the influence of socio-demographic factors. A secondary aim of the study is to measure the degree of concern associated with UI and whether the involved subjects have asked for medical assistance, or not. METHODS: Women aged 15 and over, answered a self-administered questionnaire while attending professional health units in Andorra during the period November 1998 to January 2000. A preliminary study was carried out to ensure that the questionnaire was both understandable and simple. RESULTS: 863 completed questionnaires were obtained during a one year period. The breakdown of the places where the questionnaires were obtained and filled out is as follows: 32.4% - medical specialists' offices; 31.5% - outpatient centres served exclusively by nurses; 24% - primary care doctors' offices; 12% from other sources. Of the women who answered the questionnaire, 37% manifested urine losses. Of those,45.3% presented regular urinary incontinence (RUI) and 55.7% presented sporadic urinary incontinence (SporadicUI). In those women aged between 45 and 64, UI was present in 56% of the subjects. UI was more frequent among parous than non-parous women. UI was perceived as a far more bothersome and disabling condition by working, middle-class women than in other socio-economic groups. Women in this particular group are more limited by UI, less likely to seek medical advice but more likely to follow a course of treatment. From a general point of view, however, less than 50% of women suffering from UI sought medical advice. CONCLUSION: The prevalence of UI in the female population of Andorra stands at about 37

  15. New Fecal Method for Plutonium and Americium

    SciTech Connect

    Maxwell, S.L. III

    2000-06-27

    A new fecal analysis method that dissolves plutonium oxide was developed at the Westinghouse Savannah River Site. Diphonix Resin (Eichrom Industries), is used to pre-concentrate the actinides from digested fecal samples. A rapid microwave digestion technique is used to remove the actinides from the Diphonix Resin, which effectively extracts plutonium and americium from acidic solutions containing hydrofluoric acid. After resin digestion, the plutonium and americium are recovered in a small volume of nitric acid that is loaded onto small extraction chromatography columns, TEVA Resin and TRU Resin (Eichrom Industries). The method enables complete dissolution of plutonium oxide and provides high recovery of plutonium and americium with good removal of thorium isotopes such as thorium-228.

  16. [Fecal Calprotectin in Inflammatory Bowel Disease].

    PubMed

    Lee, Jun

    2016-05-25

    Inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis comprise conditions characterized by chronic, relapsing immune activation and inflammation within the gastrointestinal tract. Objective estimation of intestinal inflammation is the mainstay in the diagnosis and observation of IBD, but is primarily dependent on expensive and invasive procedures such as endoscopy. Therefore, a simple, noninvasive, inexpensive, and accurate test would be extremely important in clinical practice. Fecal calprotectin is a calcium-containing protein released into the lumen that is excreted in feces during acute and chronic inflammation. It is well-researched, noninvasive, and has high sensitivity and specificity for identification of inflammation in IBD. This review will focus on the use of fecal calprotectin to help diagnose, monitor, and determine treatment in IBD. PMID:27206433

  17. [Research progress of fecal microbiota transplantation].

    PubMed

    Dai, Ting; Tang, Tongyu

    2015-07-01

    Intestinal microbial ecosystem is the most complex and the largest micro-ecosystem of the mammals. The use of antibiotics can lead to a lot of major changes of the flora, making the intestinal flora damaged and impacted, even developing Clostridium difficile infection. Fecal microbiota transplantation (FMT) as a special organ transplant therapy, which can rebuild the intestinal flora, has raised the clinical concerns. It has been used in the refractory Clostridium difficile, inflammatory bowel disease, irritable bowel syndrome, chronic fatigue syndrome, and some non-intestinal diseases related to the metabolic disorders. But this method of treatment has not become a normal treatment, and many clinicians and patients can not accept it. This paper reviews relevant literature in terms of origin, indications, mechanism, production process, current situation and future research, and provide a reference for the clinical application of the treatment of fecal microbiota transplantation. PMID:26211780

  18. Improving Quality by Taking Aim at Incontinence-Associated Dermatitis in Hospitalized Adults.

    PubMed

    Jacobson, Therese M; Wright, Tracy

    2015-01-01

    A practice-improvement project was launched to implement an evidence-based intervention bundle for incontinence-associated dermatitis (IAD) and evaluate its impact on the identification, prevention, and management of IAD in hospitalized adults. PMID:26821450

  19. Improving Quality by Taking Aim at Incontinence-Associated Dermatitis in Hospitalized Adults.

    PubMed

    Jacobson, Therese M; Wright, Tracy

    2015-01-01

    A practice-improvement project was launched to implement an evidence-based intervention bundle for incontinence-associated dermatitis (IAD) and evaluate its impact on the identification, prevention, and management of IAD in hospitalized adults. PMID:26285369

  20. The physical finding of stress urinary incontinence among African women in Ghana.

    PubMed

    Adanu, Richard M K; De Lancey, John O L; Miller, Janis M; Asante, Abena

    2006-11-01

    The aim of this study is to determine the proportion of women with the physical sign of stress urinary incontinence in a sample of Ghanaian women. Two hundred randomly selected women from attendants at a convenience selected ultrasound clinic were interviewed about symptoms of urinary incontinence. A paper towel test was performed to objectively demonstrate the physical sign of stress urinary incontinence as leakage on coughing. Forty-two percent of the women had a positive paper towel test. The two major symptoms reported by the women with positive paper towel test were (1) loss of urine while waiting to use the toilet (48.2%) and (2) loss of urine on coughing (43.4%) in daily life. The physical sign of stress urinary incontinence could be present in up to 42% of Ghanaian women. PMID:16491324

  1. Critical evaluation of electro-stimulation for management of female urinary incontinence.

    PubMed

    Yasuda, K; Yamanishi, T

    1999-10-01

    Electro-stimulation has been reported to be effective in the relief of stress and urge urinary incontinence. The rates of cure and improvement brought about by pelvic floor electro-stimulation in patients with urinary incontinence are 30-50% and 60-90%, respectively. In clinical practice, vaginal, anal and surface electrodes are used for external, short-term stimulation, and sacral root stimulation for internal, chronic (long-term) stimulation. The effectiveness of electro-stimulation has been verified in a randomized, placebo-controlled study. However, its superiority over other conservative treatments, such as pelvic floor exercise, has not been confirmed. A long-term effect has also been reported. In conclusion, pelvic floor exercise together with electro-stimulation is the mainstay of conservative management for the treatment of stress incontinence. For urge and mixed stress plus urge incontinence, electro-stimulation may be the first choice alternative treatment to drug therapy. PMID:10526930

  2. The Fecal Microbiome in Cats with Diarrhea

    PubMed Central

    Suchodolski, Jan S.; Foster, Mary L.; Sohail, Muhammad U.; Leutenegger, Christian; Queen, Erica V.; Steiner, Jörg M.; Marks, Stanley L.

    2015-01-01

    Recent studies have revealed that microbes play an important role in the pathogenesis of gastrointestinal (GI) diseases in various animal species, but only limited data is available about the microbiome in cats with GI disease. The aim of this study was to evaluate the fecal microbiome in cats with diarrhea. Fecal samples were obtained from healthy cats (n = 21) and cats with acute (n = 19) or chronic diarrhea (n = 29) and analyzed by sequencing of 16S rRNA genes, and PICRUSt was used to predict the functional gene content of the microbiome. Linear discriminant analysis (LDA) effect size (LEfSe) revealed significant differences in bacterial groups between healthy cats and cats with diarrhea. The order Burkholderiales, the families Enterobacteriaceae, and the genera Streptococcus and Collinsella were significantly increased in diarrheic cats. In contrast the order Campylobacterales, the family Bacteroidaceae, and the genera Megamonas, Helicobacter, and Roseburia were significantly increased in healthy cats. Phylum Bacteroidetes was significantly decreased in cats with chronic diarrhea (>21 days duration), while the class Erysipelotrichi and the genus Lactobacillus were significantly decreased in cats with acute diarrhea. The observed changes in bacterial groups were accompanied by significant differences in functional gene contents: metabolism of fatty acids, biosynthesis of glycosphingolipids, metabolism of biotin, metabolism of tryptophan, and ascorbate and aldarate metabolism, were all significantly (p<0.001) altered in cats with diarrhea. In conclusion, significant differences in the fecal microbiomes between healthy cats and cats with diarrhea were identified. This dysbiosis was accompanied by changes in bacterial functional gene categories. Future studies are warranted to evaluate if these microbial changes correlate with changes in fecal concentrations of microbial metabolites in cats with diarrhea for the identification of potential diagnostic or therapeutic

  3. Method development for fecal lipidomics profiling.

    PubMed

    Gregory, Katherine E; Bird, Susan S; Gross, Vera S; Marur, Vasant R; Lazarev, Alexander V; Walker, W Allan; Kristal, Bruce S

    2013-01-15

    Robust methodologies for the analysis of fecal material will facilitate the understanding of gut (patho)physiology and its role in health and disease and will help improve care for individual patients, especially high-risk populations, such as premature infants. Because lipidomics offers a biologically and analytically attractive approach, we developed a simple, sensitive, and quantitatively precise method for profiling intact lipids in fecal material. The method utilizes two separate, complementary extraction chemistries, dichloromethane (DCM) and a methyl tert-butyl ether/hexafluoroisopropanol (MTBE) mixture, alone or with high pressure cycling. Extracts were assessed by liquid chromatography-high-resolution mass spectrometry-based profiling with all ion higher energy collisional dissociation fragmentation in both positive and negative ionization modes. This approach provides both class-specific and lipid-specific fragments, enhancing lipid characterization. Solvents preferentially extracted lipids based on hydrophobicity. More polar species preferred MTBE; more hydrophobic compounds preferred DCM. Pressure cycling differentially increased the yield of some lipids. The platform enabled analysis of >500 intact lipophilic species with over 300 lipids spanning 6 LIPID MAPS categories identified in the fecal matter from premature infants. No previous report exists that provides these data; thus, this study represents a new paradigm for assessing nutritional health, inflammation, and infectious disease in vulnerable populations. PMID:23210743

  4. Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey.

    PubMed Central

    Sandvik, H; Hunskaar, S; Seim, A; Hermstad, R; Vanvik, A; Bratt, H

    1993-01-01

    STUDY OBJECTIVE--The aim was to validate a simple severity index of female urinary incontinence for subsequent use in an epidemiological survey. DESIGN--The index was created by multiplying the reported frequency (four levels) by the amount of leakage (two levels). The resulting index value (1-8) was further categorised into slight (1-2), moderate (3-4), and severe (6-8). It was validated against a 48 hour "pad weighing" test. Thereafter, an anonymous postal questionnaire survey was performed and the index was used to assess the severity of the leakage. A question about the impact of incontinence was also included. SETTING--The outpatient clinic of the Department of Gynaecology and Obstetrics, Trondheim University Hospital and the rural community of Rissa, Norway. PARTICIPANTS--Altogether 116 incontinent women referred to the clinic by their GP and all 2366 adult women living in Rissa. RESULTS--The difference in median pad weights between moderate and slight incontinence was 9g/24h (95% confidence interval 0-27). The corresponding difference between severe and moderate incontinence was 17g/24h (95% CI 5-30). In the epidemiological survey 29.4% reported urinary incontinence (response rate 77%). The prevalence tended to be highest in middle life and old age. Forty six per cent were classified as slight, 27% moderate, and 27% severe. There was a strong correlation between severity and impact (R = 0.59, p < 0.001). CONCLUSION--The severity index may be a useful tool for assessing the severity of female urinary incontinence in epidemiological surveys. It is confirmed that urinary incontinence is very prevalent in adult women, but most should not be regarded as potential patients. PMID:8120507

  5. The epidemiology of anal incontinence and symptom severity scoring

    PubMed Central

    Nevler, Avinoam

    2014-01-01

    For many patients, anal incontinence (AI) is a devastating condition that can lead to social isolation and loss of independence, contributing to a substantial economic health burden, not only for the individual but also for the allocation of healthcare resources. Its prevalence is underestimated because of poor patient reporting, with many unrecorded but symptomatic cases residing in nursing homes. Endosonography has improved our understanding of the incidence of post-obstetric sphincter tears that are potentially suitable for repair and those cases resulting from anorectal surgery, most notably after fistula and hemorrhoid operations. The clinical scoring systems assessing the severity of AI are discussed in this review, along with their limitations. Improvements in the standardization of these scales will advance our understanding of treatment response in an era where the therapeutic options have multiplied and will permit a better comparison between specific therapies. PMID:24759339

  6. Stem Cells for the Treatment of Urinary Incontinence

    PubMed Central

    Staack, Andrea

    2010-01-01

    Stress urinary incontinence (SUI) is highly prevalent. As of now, there is no minimally invasive long-term treatment available. Adult stem cells are nonimmunogenic and have the ability to self-renew and to differentiate into multiple cell types. Over the past decade, in vivo studies have described periurethral injections of adult-derived stem cells for the treatment of SUI. The ultimate goal has been to achieve a permanent cure for SUI by restoration of the intrinsic and extrinsic urethral sphincter and the surrounding connective tissue, including peripheral nerves and blood vessels. For this purpose, future studies need to focus on delivery systems, cell survival, and functional improvement of the urethral closure mechanism, including improvement of innervation and vascularization. PMID:21113694

  7. [Ectopic ureter as cause of pyonephrosis and urinary incontinence].

    PubMed

    Martín, Martín S; García-Ripoll, Torrecilla J R; Ruíz, Sanz A; Rodríguez, Gonzalo V; Ferro, Rivera J; del Busto, Fernández E

    2008-02-01

    Ectopic ureter accounts with an incidence of 1 in 2000 newborns. When present, ectopic ureter can be associated with duplex kidneys in an 85 % of the cases. Clinical manifestations of this malformation include incontinence and urinary tract infections. Ectopic ureter frequently occurs in association with a dysplastic upper pole renal moiety. When a poorly functioning upper pole segment is present, a standard surgical treatment is upper pole heminephrectomy. A 23-years old woman presented with left renal colic pain, fever and urinary leak. Ultrasound, intravenous pyelogram and antegrade pyelogram revealed a partial duplex right kidney and a complete duplex left kidney with hydronephrosis and ectopic insertion into the urethra of the left upper pole moiety. Following diagnosis upper pole heminephrectomy and partial ureterectomy was performed. PMID:18409479

  8. Treatment Outcomes of Transurethral Macroplastique Injection for Postprostatectomy Incontinence

    PubMed Central

    Lee, Sin Woo; Kang, Jung Hun; Sung, Hyun Hwan; Jeong, U-Seok; Lee, Young-Suk; Baek, Minki

    2014-01-01

    Purpose We investigated the efficacy of transurethral injection of Macroplastique bulking agent (Uroplasty) for male stress urinary incontinence (SUI) after prostate surgery. Materials and Methods This retrospective review included men with SUI treated by transurethral injection for symptoms resulting from prostate surgery. Patients were evaluated at 1 month and 6 months after injection by determining the number of pads used per day and changes in incontinence symptoms. Treatment success was defined as use of 1 pad or fewer per day combined with subjective symptom improvement. Results The study population comprised 30 men with a mean age of 66.1±5.3 years. Of the 30 patients, 24 (80.0%) underwent prostate cancer surgery and the remaining 6 (20.0%) underwent surgery for benign prostatic hyperplasia. The preinjection pad number was 2.9±1.9 pads per day. After injection treatment, the mean follow-up period was 9.3±12.7 months and the success rate was 43% (13/30) at 1 month and 32% (6/19) at 6 months. Injection was more likely to result in a successful outcome in patients with no preinjection radiation treatment history and higher abdominal leak point pressure (ALPP) than in those with a previous history of radiation treatment and lower ALPP, although this result was not statistically significant. Acute urinary retention occurred in 5 patients (17%). Conclusions Transurethral Macroplastique injection treatment is a relatively non-invasive treatment method for male SUI with a success rate of 43% at 1 month and 32% at 6 months. Patients with a higher ALPP and no previous history of radiation therapy may experience better treatment outcomes. PMID:24648873

  9. Urinary incontinence in spina bifida: Initial instrument validation.

    PubMed

    Hubert, Katherine C; Sideridis, Georgios; Sherlock, Rebecca; Rosoklija, Ilina; Kringle, Greta; Johnson, Kathryn; Bauer, Stuart B; Nelson, Caleb P

    2015-05-01

    The purpose of this study was to perform a psychometric assessment of the Incontinence Symptom Index-Pediatric (ISI-P) in a cohort of adolescents with spina bifida (SB) and neuropathic urinary incontinence (UI) to test its validity and reliability. The ISI-P, an 11-item instrument with domains for symptom severity and impairment, was self-administered by subjects 11-17 years old with SB and UI. Controls were 11-17 years old, with nephrolithiasis and no history of UI. Formal psychometric assessment included an evaluation of internal consistency, test re-test reliability and factor analysis. Of 78 study-eligible subjects we attempted to contact, 33 (66.7% female) with a median age of 13.1 years completed the ISI-P (42.3% response rate). 21 control patients also completed the ISI-P. Cronbach's alpha was 0.936 and 0.792 for the severity and bother factors respectively. The delta Chi-square test for the two-factor (vs. one-factor) model was significantly [χ(2)(89) = 107.823, p < 0.05] in favor of the former model with descriptive fit indices being excellent (e.g., comparative fit index = 0.969). Furthermore, category information analysis showed that all categories were associated with different threshold values, namely that each category contributed unique information for the measurement of the latent trait. In conclusion, the ISI-P has desirable psychometric properties for the measurement of UI symptom severity and impairment in adolescents with SB. PMID:25841183

  10. Artificial urinary sphincters for male stress urinary incontinence: current perspectives

    PubMed Central

    Cordon, Billy H; Singla, Nirmish; Singla, Ajay K

    2016-01-01

    The artificial urinary sphincter (AUS), which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable outcomes to primary AUS placement. Several new inventions are on the horizon, although none have been approved for use in the US at this point. PMID:27445509

  11. Prevalence and conditions of urinary incontinence among the elderly.

    PubMed

    Koyama, W; Koyanagi, A; Mihara, S; Kawazu, S; Uemura, T; Nakano, H; Gotou, Y; Nishizawa, M; Noyama, A; Hasegawa, C; Nakano, M

    1998-06-01

    In Japan, elderly disorders and diseases have markedly increased in recent years, because of rapid aging and an increasing number of older persons. The situation is creating serious social and community problems. These disorders, particularly dysuria and urinary incontinence (UI), disturb the quality of life (QOL) in latelife. Few reports on UI have been published, but precise investigation into the community level remains to be made. Our presentation is the development, implementation and evaluation of elderly UI in Kumamoto Prefecture. This study includes 2,304 people (male: 856, female: 1,448), over 65 years of age, living in two different communities; one is an urban (K) and the other is a typical rural area (S). The rate of UI was in homebound elderly persons, male: 4.7%, female: 11.3%, and in nursing home residents, male: 16.2%, female: 23.2%. The condition of UI was: almost Urinary Urgency in male (61.5%), and Stress Incontinence (such as, caused by coughing, sneezing, and exercise) in female (46.3%). The influence of UI on the activity of daily life was investigated. Most of the male cases were giving concerns for family and community. In contrast, females hesitated to participate in group excursions and outdoor exercise, and had a tendency to live alone or indoors. However, most persons (81.5%) with UI did not visit a physician. From this investigation, we conclude that a community health care program and public support system are essential for proper understanding and solution of the elderly UI problem. PMID:9656656

  12. Voiding trial outcome following pelvic floor repair without incontinence procedures

    PubMed Central

    Wang, Rui; Won, Sara; Haviland, Miriam J.; Bargen, Emily Von; Hacker, Michele R.; Li, Janet

    2016-01-01

    Introduction and hypothesis Our aim was to identify predictors of postoperative voiding trial failure among patients who had a pelvic floor repair without a concurrent incontinence procedure in order to identify low-risk patients in whom postoperative voiding trials may be modified. Methods We conducted a retrospective cohort study of women who underwent pelvic floor repair without concurrent incontinence procedures at two institutions from 1 November 2011 through 13 October 2013 after abstracting demographic and clinical data from medical records. The primary outcome was postoperative retrograde voiding trial failure. We used modified Poisson regression to calculate the risk ratio (RR) and 95 % confidence interval (CI). Results Of the 371 women who met eligibility criteria, 294 (79.2 %) had complete data on the variables of interest. Forty nine (16.7%) failed the trial, and those women were less likely to be white (p = 0.04), more likely to have had an anterior colporrhaphy (p = 0.001), and more likely to have had a preoperative postvoid residual (PVR) ≥150 ml (p = 0.001). After adjusting for race, women were more likely to fail their voiding trial if they had a preoperative PVR of ≥150 ml (RR: 1.9; 95 % CI: 1.1–3.2); institution also was associated with voiding trial failure (RR: 3.0; 95 % CI: 1.6–5.4). Conclusions Among our cohort, postoperative voiding trial failure was associated with a PVR of ≥150 ml and institution at which the surgery was performed. PMID:26886553

  13. mirabegron (BETMIGA⁰). Poorly effective in urge urinary incontinence.

    PubMed

    2016-01-01

    Mirabegron interacts with many other drugs via cytochrome P450 isoenzymes. It also has additive adverse effects, in particular cardiac disorders, when combined with antimuscarinic drugs. In view of animal data and the lack of clinical data, mirabegron should not be used by women who are or may be pregnant. In practice, drugs have little value in treating urinary urgency attributed to "overactive bladder". The risk of adverse drug reactions is rarely justified, even when the disorder is severe. Antimuscarinic disorders, such as dry mouth, are less frequent with mirabegron than with antimuscarinic drugs. Like antimuscarinic drugs, mirabegron can cause cardiac arrhythmias, especially tachycardia. Mirabegron may also cause a dose-dependent increase in blood pressure. Other adverse effects include rare cases of kidney stones and rare but sometimes serious skin reactions. When a treatable cause of urinary urgency with incontinence has been ruled out and non-drug measures have failed, recourse to an antimuscarinic drug is slightly effective but exposes patients to numerous, potentially severe adverse effects. Mirabegron (Betmiga⁰, Astellas Pharma), a beta-3 adrenergic receptor agonist, is authorised for use in this setting in the European Union. Clinical evaluation of mirabegron is mainly based on five randomised, double-blind trials versus antimuscarinic drugs, lasting 3 to 12 months and including about 8000 patients with urinary urgency. Mirabegron and the antimuscarinic comparators were similarly effective, even after antimuscarinic drug failure. A meta-analysis of four placebo-controlled trials including about 3500 patients suggested that mirabegron was poorly effective: on average, treatment prevented one episode of urinary incontinence every 2 days. PMID:26942249

  14. Sexual function and help seeking for urinary incontinence in postmenopausal women.

    PubMed

    Pakgohar, Minoo; Sabetghadam, Shadi; Rahimparvar, Seyedeh Fatemeh Vasegh; Kazemnejad, Anoshirvan

    2016-01-01

    Urinary incontinence (UI) is a common condition, especially in middle-aged and older women. UI is known to affect sexual function. Many women with UI do not consult a doctor about their condition. The aim of this study was to determine the relationship of sexual function and help seeking in postmenopausal women with urinary incontinence. This cross-sectional correlation study took place from March to May 2012. The subjects were selected by a clustered sampling method from various zones of Rasht (North of Iran). The data were collected using personal data forms, Questionnaire for Urinary Incontinence Diagnosis, Incontinence Severity Index, and Incontinence Quality of Life questionnaire. Data were analyzed by SPSS17 at the significant level of P < .05 and then were compared by parametric and nonparametric tests. A total of 313 menopausal women aged 45 to 60 years (mean 52.9) were recruited for the study. The mean sexual function score was 31.07 ± 7.52. Only 27.3% of subjects seek care for urinary incontinence. There was a significant correlation between sexual function and help seeking. The results of this study indicate that there is a significant correlation between sexual function and help seeking in postmenopausal women who participated in the present study. Health-care professionals should pay more attention to sexual symptoms of UI and make patients aware of available treatments. PMID:26882204

  15. An evaluation of three community-based projects to improve care for incontinence.

    PubMed

    Byles, Julie E; Chiarelli, Pauline; Hacker, Andrew H; Bruin, Corinna; Cockburn, Jill; Parkinson, Lynne

    2005-01-01

    The Australian National Continence Management Strategy commissioned the implementation and evaluation of three community-based projects designed to improve care for people with incontinence by improving the detection and treatment of urinary incontinence. Projects were located in demographically diverse areas, overseen by co-operating professional groups with an interest in continence and aimed at facilitating a pathway of care for those with incontinence. Project activities focused on health care provider training and improving local referral networks, as well as raising public awareness. Multifaceted evaluation of each project was designed to inform principles for a national approach to continence care. The evaluation indicated that providers involved in each project became more confident in their ability to manage incontinence, had significantly increased knowledge of issues around incontinence and became more aware of local options for referral. However, there was little evidence that projects achieved an increase in seeking professional help among those with incontinence. From the evaluation, six principles were developed to guide future models of community-based continence care. PMID:15316593

  16. The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence

    PubMed Central

    Ozkan, Levend; Tarcan, Tufan

    2010-01-01

    Purpose The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence. Materials and Methods A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards. Results Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference. Conclusions Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC. PMID:20428428

  17. Integrating yoga therapy in the management of urinary incontinence: a case report.

    PubMed

    Vinchurkar, Suhas Ashok; Arankalle, Dhananjay Vijay

    2015-04-01

    A 63-year-old overweight female prediagnosed of stress urinary incontinence presented with exacerbated events of urine leakage. She was advised a residential lifestyle and behavioral program, primarily consisting of a monitored yoga therapy module, apart from her ongoing anticholinergic medicine, for 21 days. Assessments were based on a frequency volume chart, a bladder diary for the entire duration of treatment, and the International Consultation on Incontinence Modular Questionnaire-Urinary Incontinence Short Form questionnaire on the days of admission and discharge. A total of 1.9 kg of weight loss was observed during her stay. Usage of pad, as reported in her diary, reduced from 3 to 1 per day. Her International Consultation on Incontinence Modular Questionnaire-Urinary Incontinence Short Form score reduced from 16 to 9, indicating better continence. She expressed subjective well-being and confidence in her social interactions. This is probably the first case report demonstrating feasibility of integration of yoga therapy in the management of urinary incontinence. PMID:25539839

  18. Development of a cumulative irritation model for incontinence-associated dermatitis.

    PubMed

    Larner, J; Matar, H; Goldman, V S; Chilcott, R P

    2015-01-01

    Incontinence-associated dermatitis (IAD) is a painful yet preventable form of cumulative skin irritation prevalent amongst those with limited movement. Consequently, it has a significant impact on the quality of life for those affected as well as substantial cost implications. Prevention and intervention is typically through good skin hygiene regimes and regular use of barrier products. In this paper, we describe the development of an in vivo model of IAD in healthy volunteers by occluded application of alkaline synthetic urine to the volar aspect of volunteer's forearms for 6 h per day over a five-day period to reproduce the moist and irritant conditions causative of IAD. Irritation was assessed and quantified on a daily basis by a series of non-invasive biophysical measurements and compared to a contralateral saline-treated (control) site. Dermal irritation was assessed by subjective (visual) and objective measurements (laser Doppler and polarisation spectroscopic imaging, infrared thermography, skin reflectance spectroscopy, transepidermal water loss and skin surface pH). The provocation of reproducible, cumulative skin irritation was successfully demonstrated and quantified. This five-day model of irritation is considered appropriate for the initial clinical assessment of topical products to prevent or treat IAD. PMID:25416151

  19. Chapter A7. Section 7.2. Fecal Indicator Viruses

    USGS Publications Warehouse

    Bushon, Rebecca N.

    2003-01-01

    More than 100 types of human pathogenic viruses may be present in fecal-contaminated waters. Coliphages are used as indicators of virus-related fecal contamination and of the microbiological quality of waters. This report provides information on the equipment, sampling protocols, and laboratory methods that are in standard use by U.S. Geological Survey (USGS) personnel for the collection of data on fecal indicator viruses.

  20. Adaptation and validation of the Michigan Incontinence Severity Index in a Turkish population

    PubMed Central

    Sargın, Mehmet Akif; Yassa, Murat; Taymur, Bilge Dogan; Ergun, Emrah; Akca, Gizem; Tug, Niyazi

    2016-01-01

    Objective To translate and validate the Michigan Incontinence Severity Index (M-ISI) for its use in Turkish-speaking women with urinary incontinence. Methods The translation and cross-cultural adaptation were based on international guidelines. Content validity by content validity ratio/content validity index, internal consistency by Cronbach’s alpha, test–retest reliability by Pearson’s correlation, and construct validity by using Spearman rank correlations to show the relationship between individual items and the relevant domains and subdomains were analyzed in 100 female participants with a chief complaint of urinary incontinence. Correlations between the relevant scores of M-ISI and The International Consultation on Incontinence Questionnaire – Short Form scores were analyzed to indicate convergent validity. The Varimax rotation method was used to conduct exploratory factor analysis in order to investigate the factor structures/distribution of M-ISI items. Results Content validity index and content validity ratio values increased to 0.97 and 1.00, respectively, showing sufficient content validity of the Turkish version of the M-ISI. The analysis formed three factors which was slightly different from original developers. In our proposed three-factor construct, all of the ten items demonstrated high correlations with their subdomains and lower correlations with the other domains, indicating good construct validity. Correlations between stress urinary incontinence and urge urinary incontinence (UUI) scores and The International Consultation on Incontinence Questionnaire – Short Form scores were found high, which indicated convergent validity (r: 0.953, P<0.001). Good internal consistency of the scores for each subdomain was observed (stress urinary incontinence, 0.787; UUI, 0.862; pad usage and bother, 0.832). Test–retest reliability was shown for each subdomain (stress urinary incontinence, 0.973; UUI, 0.973; pad usage and bother, 0.979). Conclusion

  1. Textural Analysis of Hyperspectral Images for Improving Contaminant Detection Accuracy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous studies demonstrated a hyperspectral imaging system has a potential for poultry fecal contaminant detection by measuring reflectance intensity. The simple image ratio at 565 and 517-nm images with optimal thresholding was able to detect fecal contaminants on broiler carcasses with high acc...

  2. Fecal detection of enterotoxigenic Bacteroides fragilis.

    PubMed

    Chen, L A; Van Meerbeke, S; Albesiano, E; Goodwin, A; Wu, S; Yu, H; Carroll, K; Sears, C

    2015-09-01

    Bacteroides fragilis is a common colonic symbiote of which one subtype, enterotoxigenic Bacteroides fragilis (ETBF), causes inflammatory diarrhea. However, asymptomatic ETBF colonization is common. Through its primary virulence factor, B. fragilis toxin (BFT), ETBF causes asymptomatic, chronic colitis in C57BL/6 mice and increased colon tumorigenesis in multiple intestinal neoplasia mice. Human studies suggest an association between ETBF infection, inflammatory bowel disease, and colon cancer. Additional studies on ETBF epidemiology are, therefore, crucial. The goal of this study is to develop a reliable fecal diagnostic for ETBF. To develop a sensitive assay for ETBF, we tested multiple protocols on mouse stools spiked with serially diluted ETBF. Each assay was based on either touchdown or quantitative polymerase chain reaction (qPCR) and used primers targeted to bft to detect ETBF. Using touchdown PCR or qPCR, the mean ETBF detection limit was 1.55 × 10(6) colony-forming units (CFU)/g stool and 1.33 × 10(4) CFU/g stool, respectively. Augmentation of Bacteroides spp. growth in fecal samples using PYGB (Peptone Yeast Glucose with Bile) broth enhanced ETBF detection to 2.93 × 10(2) CFU/g stool using the touchdown PCR method and 2.63 × 10(2) CFU/g stool using the qPCR method. Fecal testing using combined culture-based amplification and bft touchdown PCR is a sensitive assay for the detection of ETBF colonization and should be useful in studying the role of ETBF colonization in intestinal diseases, such as inflammatory bowel disease and colon cancer. We conclude that touchdown PCR with culture-based amplification may be the optimal ETBF detection strategy, as it performs as well as qPCR with culture-based amplification, but is a less expensive technique. PMID:26173688

  3. Lactic acid bacteria affect serum cholesterol levels, harmful fecal enzyme activity, and fecal water content

    PubMed Central

    Lee, Do Kyung; Jang, Seok; Baek, Eun Hye; Kim, Mi Jin; Lee, Kyung Soon; Shin, Hea Soon; Chung, Myung Jun; Kim, Jin Eung; Lee, Kang Oh; Ha, Nam Joo

    2009-01-01

    Background Lactic acid bacteria (LAB) are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as lower cholesterol. Although present in many foods, most trials have been in spreads or dairy products. Here we tested whether Bifidobacteria isolates could lower cholesterol, inhibit harmful enzyme activities, and control fecal water content. Methods In vitro culture experiments were performed to evaluate the ability of Bifidobacterium spp. isolated from healthy Koreans (20~30 years old) to reduce cholesterol-levels in MRS broth containing polyoxyethanylcholesterol sebacate. Animal experiments were performed to investigate the effects on lowering cholesterol, inhibiting harmful enzyme activities, and controlling fecal water content. For animal studies, 0.2 ml of the selected strain cultures (108~109 CFU/ml) were orally administered to SD rats (fed a high-cholesterol diet) every day for 2 weeks. Results B. longum SPM1207 reduced serum total cholesterol and LDL levels significantly (p < 0.05), and slightly increased serum HDL. B. longum SPM1207 also increased fecal LAB levels and fecal water content, and reduced body weight and harmful intestinal enzyme activities. Conclusion Daily consumption of B. longum SPM1207 can help in managing mild to moderate hypercholesterolemia, with potential to improve human health by helping to prevent colon cancer and constipation. PMID:19515264

  4. Urinary incontinence after radical prostatectomy – experience of the last 100 cases

    PubMed Central

    Szymański, Michał; Wolski, Jan Karol; Nadolski, Tomasz; Kalinowski, Tomasz; Demkow, Tomasz; Peczkowski, Piotr; Pilichowska, Małgorzata; Ligaj, Marcin; Michalski, Wojciech

    2011-01-01

    Radical prostatectomy (RP) is a recognized treatment method of organ-confined prostate cancer. Among post-surgery complications, urinary incontinence is a major one. The aim of this study was to determine the incontinence rate after RP and to analyze factors that might affect it. Between March 2007 and December 2008, 132 RP's were performed at Warsaw Cancer Center. A questionnaire to assess the condition before and after RP was developed by the authors and sent to all treated patients. The questionnaire focused on health status information, function in urinary domain, rate of returning to “normal” activity level as before RP and satisfaction from the treatment. The median age of patients was 62 years. Out of 132 patients 102 subjects (77.2%) responded to the questionnaire. Of all responders, 35 patients (34.3%) reported total urinary continence after RP. After RP 35(34.3%) patients reported total urinary continence and in 55(53.9%) patients urinary incontinence of medium degree was present. In 12 (11.8%) patients significant urinary incontinence developed. The most common cause of urine dripping (82% of patients with any degree of urinary incontinence) was associated with abdominal muscle pressure. No statistically significant association between urinary incontinence and adjuvant radiotherapy after RP or the surgeon performing the RP was found (>0.79, >0.803). Radical prostatectomy carries a certain risk of complications. We observed an 88.2% rate of significant (total and moderate degree) urinary continence. The adjuvant radiotherapy and surgeons, who performed the RP, did not affect the rate of incontinence. PMID:24578896

  5. Urinary incontinence in Moroccan and Turkish women: a qualitative study on impact and preferences for treatment

    PubMed Central

    van den Muijsenbergh, Maria ETC; Lagro-Janssen, Toine ALM

    2006-01-01

    Aim To gain insight into the impact of urinary incontinence on the daily lives of Moroccan and Turkish women and their preferences for treatment. Design of study A qualitative analysis of data from semi-structured in depth interviews with 30 Moroccan and Turkish migrant women with urinary incontinence. Setting Six general practices with large numbers of immigrant families in four cities in the Netherlands. Method Semi-structured in depth interviews were conducted with Moroccan and Turkish migrant women, who presented with complaints of urinary incontinence in six general practices with large numbers of immigrant families on the practice list in four different cities in the Netherlands. Results All the women adhered closely to bodily cleanliness and considered incontinence to be dirty. As Muslims, they were obliged to perform ritual prayers preceded by ablution five times per day and the urinary incontinence breached their status of ritual purity. Therefore, they had to wash more often and experienced this as a heavy burden. In a number of the women, shame formed a reason why they could not talk to anybody about the incontinence, not even with the doctor. One-third of the women felt that their GP had not taken them seriously. Knowledge about anatomy, physiology and available treatments was mostly lacking. In addition, the women did not understand the aim of the exercises from the physiotherapist. The majority of women gave preference to help from a female doctor. Conclusion Urinary incontinence in Moroccan and Turkish migrant women formed a considerable problem in their daily following of the Islam faith. Shame on the part of the patient and miscommunication at the doctor's surgery led to inadequate care. PMID:17132383

  6. Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

    PubMed Central

    Rivera, Monica; Melnick, Marsha; Allen, Diane D.

    2015-01-01

    Background: Multiple sclerosis (MS) presents with many debilitating symptoms, including urinary incontinence (UI), that physical therapy (PT) may address; UI is widely prevalent, but PT management of symptoms lacks consensus. A meta-analysis of long-term nonsurgical and nonpharmaceutical treatment options may supply this deficiency. We analyzed the current evidence for effectiveness of PT to decrease UI and improve quality of life (QOL) in people with MS. Methods: An electronic search conducted through November 26, 2013, included the following search terms: incontinence, bladder dysfunction, urinary incontinence, multiple sclerosis, MS, physical therapy, physiotherapy, therapy, and rehabilitation. Criteria for inclusion were as follows: MS diagnosis, intervention involved PT for UI or bladder dysfunction, outcomes assessed QOL or UI, and at least a 4 of 10 on the Physiotherapy Evidence Database scale or a 2b level of evidence. Outcomes were combined across studies, and effect sizes are depicted in forest plots. Results: Six studies met the inclusion criteria. Between-group analysis revealed statistically significant differences in incontinence episodes and QOL, but did not reach significance for functional control mechanisms (eg, electromyography data on strength of contraction, relaxation, and endurance). Incontinence leakage episodes and QOL participation improved within groups. Conclusions: Meta-analysis indicates support for PT for minimizing incontinence compared with pretreatment and affecting incontinence and QOL more than control in people with MS. Protocols were heterogeneous regarding duration and type of PT intervention and were applied in different types of MS. Further research may reveal the most effective combination and variety of PT interventions for people with MS. PMID:26300703

  7. What are the probable predictors of urinary incontinence during pregnancy?

    PubMed

    Demircan, Nejat; Özmen, Ülkü; Köktürk, Fürüzan; Küçük, Hamdi; Ata, Şevket; Harma, Müge; Arıkan, İnan İlker

    2016-01-01

    Objectives. The frequency, predisposing factors and impact of urinary incontinence (UI) on quality of life (QoL) during pregnancy were investigated. Materials and Method. A preliminary cross-sectional survey was studied among pregnant women between January and July of 2014. A total of 132 pregnant women were recruited using a questionnaire form for sociodemographic features, the Turkish version of the International Consultation on Incontinence-Short Form (ICIQ-SF), for the characteristics of UI and Wagner's Quality of Life scale to assess impact on QoL. p < 0.05 was set significant. Results.Urinary incontinence was present in 56 out of 132 pregnant women (42.4%, UI-present group): mean age, 26.7 ± 5.4y(p = 0.780); median height, 160 cm (min-max: 153-176, p = 0.037); median BMI, 28.7 kg/m(2)(min-max: 22.4-50.0, p = 0.881); urine leakage occurred per week once (n = 18, 32.1%), twice or thrice (n = 8, 14.3%); per day few times (n = 14, 25%), once (n = 5, 8.9%) and always (n = 8, 14.3%) with mainly a small amount of urine leakage (n = 33, 58.9%) or a moderate (n = 4, 7.1%). There were statistically significant relationships between QoL scores and frequency of UI (p = 0.002) or amount of leakage (p = 0.002). Impact on QoL scores ranged from mild (n = 33, 58.9%), moderate (n = 4, 7.1%) to severe (n = 4, 7.1%) levels in daily life. UI impacted the daily life activities of women by making them less likely to undertake activities outside their homes (23.2%), by affecting their working performance and friendships (8.9%), their daily home activities (7.1%), their general health status (12.5%), their sexual relations (12.5%), by making them more nervous or anxious (10.7%) and by the need to wear pads or protectors (25%). ANOVA, Tukey, and Tamhane tests as the minimal important difference model yielded significant relevance between statistical analyses and clinical outcomes by using standard deviations (p = 0.001, 0.001 and 0.005 respectively). The following features favored

  8. What are the probable predictors of urinary incontinence during pregnancy?

    PubMed Central

    Özmen, Ülkü; Köktürk, Fürüzan; Küçük, Hamdi; Ata, Şevket; Harma, Müge; Arıkan, İnan İlker

    2016-01-01

    Objectives. The frequency, predisposing factors and impact of urinary incontinence (UI) on quality of life (QoL) during pregnancy were investigated. Materials and Method. A preliminary cross-sectional survey was studied among pregnant women between January and July of 2014. A total of 132 pregnant women were recruited using a questionnaire form for sociodemographic features, the Turkish version of the International Consultation on Incontinence-Short Form (ICIQ-SF), for the characteristics of UI and Wagner’s Quality of Life scale to assess impact on QoL. p < 0.05 was set significant. Results.Urinary incontinence was present in 56 out of 132 pregnant women (42.4%, UI-present group): mean age, 26.7 ± 5.4y(p = 0.780); median height, 160 cm (min–max: 153–176, p = 0.037); median BMI, 28.7 kg/m2(min–max: 22.4–50.0, p = 0.881); urine leakage occurred per week once (n = 18, 32.1%), twice or thrice (n = 8, 14.3%); per day few times (n = 14, 25%), once (n = 5, 8.9%) and always (n = 8, 14.3%) with mainly a small amount of urine leakage (n = 33, 58.9%) or a moderate (n = 4, 7.1%). There were statistically significant relationships between QoL scores and frequency of UI (p = 0.002) or amount of leakage (p = 0.002). Impact on QoL scores ranged from mild (n = 33, 58.9%), moderate (n = 4, 7.1%) to severe (n = 4, 7.1%) levels in daily life. UI impacted the daily life activities of women by making them less likely to undertake activities outside their homes (23.2%), by affecting their working performance and friendships (8.9%), their daily home activities (7.1%), their general health status (12.5%), their sexual relations (12.5%), by making them more nervous or anxious (10.7%) and by the need to wear pads or protectors (25%). ANOVA, Tukey, and Tamhane tests as the minimal important difference model yielded significant relevance between statistical analyses and clinical outcomes by using standard deviations (p = 0.001, 0.001 and 0.005 respectively). The following features

  9. Factors Influencing Fecal Contamination in Pond of Bangladesh

    NASA Astrophysics Data System (ADS)

    Knappett, P. S.; Escamilla, V.; Layton, A.; McKay, L. D.; Emch, M.; Mailloux, B. J.; Williams, D. E.; Huq, M. R.; Alam, M.; Farhana, L.; Ferguson, A. S.; Sayler, G. S.; Ahmed, K.; Serre, M. L.; Akita, Y.; Yunus, M.; van Geen, A.

    2010-12-01

    Occurrence of diarrheal disease in villages in rural Bangladesh remains relatively common, even though many households have switched to tubewell water for drinking and cooking. One factor contributing to this may be exposure to fecal contamination in ponds, which are often used for bathing and fishing. The objective of this study is to determine the dominant sources of fecal pollution in typical ponds and to explore the relationship between local population, latrine density, latrine quality and concentrations of fecal bacteria and pathogens in pond water. Forty-three ponds were sampled and analyzed for E. coli using culture-based methods and for E. coli, Bacteroides and adenovirus using quantitative PCR. Population and sanitation infrastructure were surveyed and compared to levels of pond fecal contamination. Molecular fecal source tracking using Bacteroides, determined that humans were the dominant source of fecal contamination in 79% of the ponds. Ponds directly receiving latrine effluent had the highest concentrations of fecal indicator bacteria. Concentrations of fecal indicator bacteria correlated with population surveyed within a distance of 30-70 m (p<0.01) and total latrines surveyed within 50-70 m (p<0.05). Unsanitary latrines with visible effluent within the pond drainage basin were also significantly correlated to fecal indicator concentrations (p<0.05). The vast majority of the surveyed ponds contained unsafe levels of fecal contamination primarily due to unsanitary latrines, and to lesser extent to sanitary latrines and cattle. Since the majority of fecal pollution is from humans, use of pond water could help explain the persistence of diarrheal disease in rural Bangladesh.

  10. Improving diaper design to address incontinence associated dermatitis

    PubMed Central

    2010-01-01

    Background Incontinence associated dermatitis (IAD) is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the polyacrylate superabsorber. The intention was to minimize disturbance of the already weak acid mantle of aged skin. We also employed air-permeable side panels to minimize skin occlusion and swelling of the stratum corneum. Methods The surface pH of diapers was measured after repeated wetting with a urine substitute fluid at the level of the top sheet. Occlusive effects and hydration of the stratum corneum were measured after a 4 hour application of different side panel materials by corneometry on human volunteers. Finally, we evaluated skin symptoms in 12 patients with preexisting IAD for 21 days following the institutional switch to the optimized diaper design. Local skin care protocols remained in place unchanged. Results The improved design created a surface pH of 4.6 which was stable even after repeated wetting throughout a 5 hour period. The "standard design" briefs had values of 7.1, which is alkaline compared to the acidic surface of normal skin. Side panels made from non-woven material with an air-permeability of more than 1200 l/m2/s avoided excessive hydration of the stratum corneum when compared to the commonly employed air-impermeable plastic films. Resolution of pre-existing IAD skin lesions was noted in 8 out of 12 patients after the switch to the optimized brief design. Conclusions An improved design of adult-type briefs can create an acidic pH on the surface and breathable side panels avoid over-hydration of the stratum corneum and occlusion. This may support the

  11. Separation of strontium from fecal matter

    SciTech Connect

    Kester, D.K.

    1994-12-31

    The present invention relates to a method of separating strontium, and, more particularly, to a method of separating strontium from a sample of biomass potentially contaminated with various radionuclides. Radioactive strontium is a radionuclide which represents a hazard to man because of its long half-life and, if ingested, its tendency to be retained in the human body. In the event that radionuclides such as strontium or various actinides are ingested, it is desirable to monitor the discharge or release of these radionuclides from the human body through analysis of fecal matter. In laboratories and other facilities where potential for radionuclide contamination exists, fecal analysis for strontium is routinely conducted for individuals who are terminating from their position or are suspected of having been contaminated with radionuclides. Methods for separating and analyzing radioactive actinides from a biomass sample are well known and have been extensively developed for the US Department of Energy. These methods, described in the Department`s internal procedure, USDOE, RESL/ID, A-16, 1981, as well as in US Patent 5,190,881, involve the use of an iron phosphate precipitation step to separate actinides from a solution, or supernate. However, there are no established procedures for the separation of strontium from a biomass sample wherein an iron phosphate precipitation step is involved.

  12. Fecal bacteria source characterization and sensitivity analysis of SWAT 2005

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Soil and Water Assessment Tool (SWAT) version 2005 includes a microbial sub-model to simulate fecal bacteria transport at the watershed scale. The objectives of this study were to demonstrate methods to characterize fecal coliform bacteria (FCB) source loads and to assess the model sensitivity t...

  13. Escherichia coli and fecal coliforms in freshwater and estuarine sediments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    It has been known for some time that substantial populations of fecal coliforms and E. coli are harbored in freshwater bottom sediments, bank soils, and beach sands. However, the relative importance of sediments as bacterial habitats and as a source of water-borne fecal coliforms and E. coli has not...

  14. Global Inter-Laboratory Fecal Source Identification Methods Comparison Study

    EPA Science Inventory

    Source tracking is key to identifying sources of fecal contamination for remediation as well as risk assessment. Previous intra- and inter-lab studies have investigated the performance of human and cow-associated source tracking markers, as well as library-dependent fecal source ...

  15. CULTURE-INDEPENDENT MOLECULAR METHODS FOR FECAL SOURCE IDENTIFICATION

    EPA Science Inventory

    Fecal contamination is widespread in the waterways of the United States. Both to correct the problem, and to estimate public health risk, it is necessary to identify the source of the contamination. Several culture-independent molecular methods for fecal source identification hav...

  16. IDENTIFICATION OF SOURCES OF FECAL POLLUTION IN ENVIRONMENTAL WATERS

    EPA Science Inventory

    A number of Microbial Source Tracking (MST) methods are currently used to determine the origin of fecal pollution impacting environmental waters. MST is based on the assumption that given the appropriate method and indicator organism, the source of fecal microbial pollution can ...

  17. Semisolid selective-motility enrichment medium for isolation of salmonellae from fecal specimens.

    PubMed Central

    Goossens, H; Wauters, G; de Boeck, M; Janssens, M; Butzler, J P

    1984-01-01

    A semisolid selective-motility enrichment medium for the isolation of salmonellae from fecal specimens was developed which was based on Rappaport enrichment broth. During a 7-year period more than 30,000 stool samples were tested. The medium showed a high specificity (95.1%) and sensitivity (80.3%) when compared with MacConkey agar, SS agar, and brilliant green agar (after Selenite-F Enrichment [BBL Microbiology Systems]). Furthermore, our isolation rate of Salmonella species from fecal samples showed an increase of 22.3% when this semisolid medium was added to the routine culture media. Growth could easily be interpreted. The medium has a bias toward the isolation of Salmonella paratyphi B, but it is unsatisfactory for detecting the nonmotile strains Salmonella typhi and S. paratyphi A. Images PMID:6470105

  18. Using no-rinse skin wipes to treat incontinence-associated dermatitis.

    PubMed

    Baadjies, Ruth; Karrouze, Irene; Rajpaul, Kumal

    2014-11-01

    Individuals who suffer with incontinence, especially in relation to faeces, will often be at risk of skin breakdown and develop incontinence-associated dermatitis (IAD) which, if left untreated, can lead to pressure ulcer formation ( Gray, 2004 ). IAD is caused by increased, unrelieved moisture against the skin, usually from liquid faeces and urine, which can then weaken the skin integrity. The integrity of the skin in this area is also at risk of pressure ulcers caused by shear or friction ( Beeckman et al, 2010a ). Treatment and prevention of IAD lesions involves a three-step process used in post-incontinence episodes, which includes cleansing, moisturisation and protection of the skin ( Beeckman et al, 2011a ). Using a wipe covers all of these steps immediately following incontinence episodes ( Rönner et al, 2010 ). This reduces the need to gather a number of different items required for post-incontinence skin care, which usually includes a dry wipe to be soaked in soapy water to wash the skin, a moisturiser to replace lost moisture and a skin protectant to prevent moisture from direct contact with the skin ( Foxley and Baadjies, 2009 ). This article will give some examples of the use of a particular continence and cleansing wipe in clinical practice. PMID:25382128

  19. Effects of coffee and tea consumption on urinary incontinence in female twins

    PubMed Central

    Tettamanti, G; Altman, D; Pedersen, NL; Bellocco, R; Milsom, I; Iliadou, AN

    2011-01-01

    Objectives To assess the effect of coffee and tea consumption on symptoms of urinary incontinence. Design Population based study Setting The Swedish Twin Register Population In 2005, all twins born between 1959–1985 in Sweden (n = 42 852) were invited to participate in a web-based survey to screen for common complex diseases and common exposures. The present study was limited to female twins with information about at least one urinary symptoms and coffee and tea consumption (n = 14 031). Main outcome measure The association between coffe and tea consumption and urinary incontinence, as well as, nocturia was estimated as odds ratios (ORs) with 95% confidence intervals (CIs). Results Women with a high coffee intake were at lower risk of any urinary incontinence (OR 0.78, 95% confidence intervals (CI) 0.64-0.98) compared to women not drinking coffee. Coffee intake and incontinence subtypes showed no significant associations whereas high tea consumption was specifically associated with a risk for overactive bladder (OR 1.34, 95% CI 11.07-1.67) and nocturia (OR 1.18, 95% CI 1.01-1.38). Results from co-twin control analysis suggested that the associations observed in logistic regression were mainly due to familial effects. Conclusions This study suggests that coffee and tea consumption has a limited effect on urinary incontinence symptoms. Familial and genetic effects may have confounded the associations observed in previous studies. PMID:21401855

  20. [Urinary incontinence in castrated bitches. Part 1: Significance, clinical aspects and etiopathogenesis].

    PubMed

    Arnold, S

    1997-01-01

    Acquired urinary incontinence occurs in 20% of spayed dogs and there exists a strong correlation between body weight and the risk of urinary incontinence. Bitches with a body weight of more than 20 kg have a risk of 30% white smaller dogs have a risk of 10%. A particular breed disposition exists in Boxers in which 65% are affected. Other breeds with a more than average disposition for urinary incontinence are Dobermans and Giant Schnauzers. Urinary incontinence due to spaying manifests itself mainly while the dogs are sleeping. The cause is a urethral sphincter incompetence which can be verified by a urethral pressure profile (UPP). The microtransducer method proved to be a suitable method for urodynamic studies. It could be demonstrated that the urethral closure pressure is significantly lower in incontinent bitches (4.6 +/- 2.3 cm H2O) than in continent bitches (18.6 +/- 10.5 cm H2O). In addition, the urethral closure pressure for continent bitches dropped significantly within 12 months after surgery. Histological examination revealed that the functional urethral closure cannot be explained by the extent of discernible structures of the urethral wall as seen by light microscopy. PMID:9411733

  1. Vaginal position and length in the bitch: relationship to spaying and urinary incontinence.

    PubMed

    Gregory, S P; Holt, P E; Parkinson, T J; Wathes, C M

    1999-04-01

    A study was undertaken to determine if the vagina might be a suitable site for the measurement of intra-abdominal pressure during cystometry in the bitch. The position of the cranial vagina and vaginal length were measured radiographically and the effects of spaying and urinary incontinence on these variables were evaluated in 30 continent and 30 incontinent bitches. The study used retrograde vaginourethrograms which had been obtained from animals used in a previous study. The cranial vagina was intra-abdominal on 36 of the vaginourethrograms, being least commonly intra-abdominal in incontinent bitches (11/30). Vaginal position was related linearly to vaginal length and continence status (P < 0.01), while its length was related to bodyweight (P < 0.01). Allowing for bodyweight, neutered animals had significantly shorter vaginas than entire bitches (P < 0.01). Measurement of intra-abdominal pressure with concomitant measurement of intravesical pressure is essential if accurate assessment of detrusor pressure is to be determined during cystometry. The vagina is unlikely to be a useful location from which to measure intra-abdominal pressure since any pressure-measuring catheter inserted into it may fall outside the abdominal pressure zone. This is particularly true of neutered and/or incontinent bitches, the groups in which urodynamic investigations of urinary incontinence are most frequently indicated. PMID:10340249

  2. Incontinence-associated dermatitis in the elderly: treatment options.

    PubMed

    Corcoran, Eleanor; Woodward, Sue

    Incontinence-associated dermatitis (IAD) is a common problem in older people. However, it is frequently misdiagnosed and poorly treated. There is often uncertainty about which product to use to prevent and treat IAD; the different types, brands and how to apply them. This literature review looks specifically at the use of barrier products in the prevention and treatment of IAD. A systematic search found six primary research papers that analysed the effectiveness of various barrier products; they will be compared and contrasted in this review. There is a lack of evidence to recommend any one barrier product over another for use in a standardised skin care protocol such as the regimen suggested by Gray et al (2012). More research needs to be conducted to establish the most effective barrier products on the market. More research is also needed on the efficacy of barrier products in the prevention and treatment solely of IAD rather than combined studies looking at IAD with pressure ulcers. PMID:23905225

  3. A Wireless Self-Powered Urinary Incontinence Sensor System

    NASA Astrophysics Data System (ADS)

    Tanaka, Ami; Utsunomiya, Fumiyasu; Douseki, Takakuni

    A self-powered urinary incontinence sensor system consisting of a urine-activated coin battery and a wireless transmitter has been developed as an application for wireless biosensor networks. The urine-activated battery makes possible both the sensing of urine leakage and self-powered operation. An intermittent power-supply circuit that uses an electric double-layer capacitor (EDLC) with a small internal resistance suppresses the supply voltage drop due to the large internal resistance of the battery. This circuit and a 1-V surface acoustic wave (SAW) oscillator reduce the power dissipation of a wireless transmitter. The SAW oscillator quickly responds to the on-off control of the power supply, which is suitable for intermittent operation. To verify the effectiveness of the circuit scheme, the authors fabricated a prototype sensor system. When the volume of urine is 0.2 ml, the battery outputs a voltage of over 1.3 V; and the sensor system can transmit signals over a distance of 5 m.

  4. Stem Cell Therapy for Stress Urinary Incontinence: A Critical Review

    PubMed Central

    Lue, Tom F.

    2012-01-01

    Stress urinary incontinence (SUI) is a prevailing health problem that severely impacts quality of life. Because SUI is mainly due to urethral sphincter deficiency, several preclinical and clinical trials have investigated whether transplantation of patient's own skeletal muscle–derived cells (SkMDCs) can restore the sphincter musculature. The specific cell type of SkMDCs has been described as myoblasts, satellite cells, muscle progenitor cells, or muscle-derived stem cells, and thus may vary from study to study. In more recent years, other stem cell (SC) types have also been tested, including those from the bone marrow, umbilical cord blood, and adipose tissue. These studies were mostly preclinical and utilized rat SUI models that were established predominantly by pudendal or sciatic nerve injury. Less frequently used animal models were sphincter injury and vaginal distension. While transurethral injection of SCs was employed almost exclusively in clinical trials, periurethral injection was used in all preclinical trials. Intravenous injection was also used in one preclinical study. Functional assessment of therapeutic efficacy in preclinical studies has relied almost exclusively on leak point pressure measurement. Histological assessment examined the sphincter muscle content, existence of transplanted SCs, and possible differentiation of these SCs. While all of these studies reported favorable functional and histological outcomes, there are questions about the validity of the animal model and claims of multilineage differentiation. In any event, SC transplantation appears to be a promising treatment for SUI. PMID:22121849

  5. Preventing urinary incontinence during pregnancy and postpartum: a review.

    PubMed

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-06-01

    Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease. PMID:23436034

  6. Physiotherapy for Women with Stress Urinary Incontinence: A Review Article

    PubMed Central

    Ghaderi, Fariba; Oskouei, Ali E.

    2014-01-01

    [Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to identify articles that address physiotherapy for SUI, including the Cochrane Library, Medline, and CINAHL. [Results] According to the articles identified in our databases research, greater improvements in SUI occur when women receive a supervised exercise program of at least three months. The effectiveness of physiotherapy treatment is increased if the exercise program is based on some principles, such as intensity, duration, resembling functional task, and the position in which the exercise for pelvic floor muscles is performed. Biofeedback and electrical stimulation may also be clinically useful and acceptable modalities for some women with SUI. [Conclusion] We concluded that the plan for physiotherapy care should be individualized for each patient and include standard physiotherapy interventions. PMID:25276044

  7. Female urinary incontinence: what the epidemiologic data tell us.

    PubMed

    Mallett, Veronica T

    2005-01-01

    The prevalence of urinary incontinence (UI) in women has been the subject of many epidemiologic studies. Since 1968 the field has accumulated sufficient data that we now know how stress UI and urge UI appear in populations categorized by race, age, parity, body mass index and other demographic factors. The first comprehensive study in the U.S., the MESA study, was done in 1983. For community-dwelling women 60 years or older, it came up with the now familiar figure of 38% in this age-group. Very similar figures have been found in other national populations, but there are great differences in sub-populations and also by type--stress, urge, or mixed UI. However, with all differences in prevalence acknowledged, no type of UI is unusual in a population of older women. This article delineates, with detailed discussion of individual studies, prevalence by type, age, race, obstetric and gynecologic-surgery history, and anatomic dysfunction, plus consideration of the effects of obesity and menopause on UI. The conclusion is that a problem so widespread is a candidate for prevention, and that the few trials in this direction should be augmented. PMID:15971716

  8. [Urinary incontinence, should fertile women undergo surgical procedure?].

    PubMed

    Panel, L; Mares, P; de Tayrac, R

    2009-02-01

    The goal of this study was to make a Medline research about pregnancies which occur after surgical procedures for stress urinary incontinence (SUI). Therefore, we do not know the recurrence rate of SUI after pregnancy and the influence of the way of delivery on the risk of recurrence. We do not know either if we should apply a surgical procedure on women who have not achieved their pregnancies. In 1998, a questionnaire based survey conducted in the USA showed a lower risk of recurrence after a caesarean section than after a vaginal delivery (p=0,03) when women had previously colposuspension or sling procedures. We found ten case reports and a French national survey (2006) about pregnancies after TOT or TVT procedure. No complication related to the tape was described during pregnancy. The recurrence rate along the pregnancy is about 15%, and the global recurrence rate (during pregnancy and after the childbirth) is about 20%. As a conclusion, pregnancy itself has an influence, and vaginal delivery seams to increase the risk of recurrence after the birth compare to the c-section. However this recurrence rate and these data do not appear enough to us to refuse a surgical treatment for women who have not completed their pregnancies and who suffer from UI without efficacy of physiotherapy. We do not have objective data to assess the best way of delivery. Further and large studies are needed although they are difficult to be carried through. PMID:19117785

  9. Knowledge and Attitudes of Nursing Home Staff and Surveyors about the Revised Federal Guidance for Incontinence Care

    ERIC Educational Resources Information Center

    DuBeau, Catherine E.; Ouslander, Joseph G.; Palmer, Mary H.

    2007-01-01

    Purpose: We assessed nursing home staff and state nursing home surveyors regarding their knowledge and attitudes about urinary incontinence, its management, and the revised federal Tag F315 guidance for urinary incontinence. Design and Methods: We conducted a questionnaire survey of a convenience sample of nursing home staff and state nursing home…

  10. Fecal pollution source tracking toolbox for identification, evaluation and characterization of fecal contamination in receiving urban surface waters and groundwater.

    PubMed

    Tran, Ngoc Han; Gin, Karina Yew-Hoong; Ngo, Huu Hao

    2015-12-15

    The quality of surface waters/groundwater of a geographical region can be affected by anthropogenic activities, land use patterns and fecal pollution sources from humans and animals. Therefore, the development of an efficient fecal pollution source tracking toolbox for identifying the origin of the fecal pollution sources in surface waters/groundwater is especially helpful for improving management efforts and remediation actions of water resources in a more cost-effective and efficient manner. This review summarizes the updated knowledge on the use of fecal pollution source tracking markers for detecting, evaluating and characterizing fecal pollution sources in receiving surface waters and groundwater. The suitability of using chemical markers (i.e. fecal sterols, fluorescent whitening agents, pharmaceuticals and personal care products, and artificial sweeteners) and/or microbial markers (e.g. F+RNA coliphages, enteric viruses, and host-specific anaerobic bacterial 16S rDNA genetic markers) for tracking fecal pollution sources in receiving water bodies is discussed. In addition, this review also provides a comprehensive approach, which is based on the detection ratios (DR), detection frequencies (DF), and fate of potential microbial and chemical markers. DR and DF are considered as the key criteria for selecting appropriate markers for identifying and evaluating the impacts of fecal contamination in surface waters/groundwater. PMID:26298247

  11. Impact of Dietary Markers on Fecal Microbial Ecology, Fecal VFA, and Nutrient Digestibility Coefficients in Finishing Pigs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of the experiment was to determine the impact of three commonly utilized markers (Cr, Fe, and Ti) in digestibility studies on fecal microbial ecology, fecal VFA, and nutrient digestibility coefficients. Forty eight gilts, initial BW 115.1 kg, were allotted to 4 dietary treatments based...

  12. Comparison between the Health Belief Model and Subjective Expected Utility Theory: predicting incontinence prevention behaviour in post-partum women.

    PubMed

    Dolman, M; Chase, J

    1996-08-01

    A small-scale study was undertaken to test the relative predictive power of the Health Belief Model and Subjective Expected Utility Theory for the uptake of a behaviour (pelvic floor exercises) to reduce post-partum urinary incontinence in primigravida females. A structured questionnaire was used to gather data relevant to both models from a sample antenatal and postnatal primigravida women. Questions examined the perceived probability of becoming incontinent, the perceived (dis)utility of incontinence, the perceived probability of pelvic floor exercises preventing future urinary incontinence, the costs and benefits of performing pelvic floor exercises and sources of information and knowledge about incontinence. Multiple regression analysis focused on whether or not respondents intended to perform pelvic floor exercises and the factors influencing their decisions. Aggregated data were analysed to compare the Health Belief Model and Subjective Expected Utility Theory directly. PMID:9238593

  13. Treatments of faecal incontinence: recommendations from the French national society of coloproctology.

    PubMed

    Vitton, V; Soudan, D; Siproudhis, L; Abramowitz, L; Bouvier, M; Faucheron, J-L; Leroi, A-M; Meurette, G; Pigot, F; Damon, H

    2014-03-01

    Faecal incontinence is common and significantly affects quality of life. Its treatment involves dietary manipulation, medical treatments, perineal rehabilitation or surgery. In this paper, the French National Society of Coloproctology offers recommendations based on the data in the current literature, including those on recently developed treatments. There is a lack of high quality data and most of the recommendations are therefore based either on grade of recommendation B or expert recommendation (Level 4). However, the literature supports the construction of an algorithm based on the available scientific evidence and expert recommendation which may be useful in clinical practice. The French National Society of Coloproctology proposes a decision-making algorithm that includes recent developments of treatment. The current recommendations support sacral nerve modulation as the key treatment for faecal incontinence. They do not support the use of sphincter substitutions except in certain circumstances. Transanal irrigation is a novel often successful treatment of faecal incontinence due to neurological disorders. PMID:24521273

  14. Management of incontinence-associated dermatitis with a skin barrier protectant.

    PubMed

    Southgate, Geraldine; Bradbury, Sarah

    The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinence-associated dermatitis (IAD). IAD is skin breakdown related to faecal and/or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage. PMID:27172503

  15. Fecal Microbial Transplant Effect on Clinical Outcomes and Fecal Microbiome in Active Crohn’s disease

    PubMed Central

    Suskind, David L.; Brittnacher, Mitchell J.; Wahbeh, Ghassan; Shaffer, Michele L.; Hayden, Hillary S.; Qin, Xuan; Singh, Namita; Damman, Christopher J.; Hager, Kyle R.; Nielson, Heather; Miller, Samuel I.

    2014-01-01

    Objective Crohn’s disease (CD) is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Fecal Microbial Transplant (FMT) is a potential therapeutic option for individuals with CD based on the hypothesis that changing the fecal dysbiosis could promote less intestinal inflammation. Design Nine patients, ages 12–19 years, with mild to moderate symptoms defined by Pediatric Crohn’s disease activity index (PCDAI of 10–29) were enrolled into a prospective open label study of FMT in CD (FDA IND 14942). Patients received FMT by nasogastric tube with follow up evaluations at 2, 6, and 12 weeks. PCDAI, C-reactive protein (CRP), and fecal calprotectin were evaluated at each study visit. Results All reported adverse events (AE) were graded as mild except for one individual who reported moderate abdominal pain after FMT. All AE were self limiting. Metagenomic evaluation of stool microbiome indicated evidence of FMT engraftment in seven out of nine patients. The mean PCDAI score improved with patients having a baseline of 19.7 ± 7.2, with improvement at 2 weeks to 6.4 ± 6.6, and at 6 weeks to 8.6 ± 4.9. Based upon PCDAI, 7/9 patients were in remission at 2 weeks, and 5/9 patients who did not receive additional medical therapy were in remission at week 6 and 12 weeks. No or modest improvement were seen in the patients who did not engraft or whose microbiome was most similar to their donor. Conclusion This is the first study to demonstrate that FMT for CD may be a possible therapeutic option for Crohn’s disease. Further prospective studies are required to fully assess the safety and efficacy of the FMT in patients with Crohn’s disease. PMID:25647155

  16. Barriers to Urinary Incontinence Care Seeking in White, Black, and Latina Women

    PubMed Central

    Willis-Gray, Marcella G.; Sandoval, Juan S.; Maynor, Jean; Bosworth, Hayden B.; Siddiqui, Nazema Y.

    2016-01-01

    Introduction We compared barriers to urinary incontinence (UI) healthcare seeking between white, black, and Latina women. Methods This is a cross-sectional study using a convenience sample of white, black, and Latina women. Women completed the Barriers to Incontinence Care Seeking Questionnaire (BICS-Q), the Incontinence Quality of Life Instrument (I-QOL), the Questionnaire for Urinary Incontinence Diagnosis (QUID), and the Incontinence Severity Index (ISI). The primary objective was to assess barriers to UI care seeking among groups, as measured by the BICS-Q. Secondary objectives were to assess factors associated with barriers to incontinence care and to compare specific barriers using BICS-Q subscale scores. Regression analyses were used to further assess for differences among groups while adjusting for potential confounding variables. Results We included a total of 93 subjects, including 30 white, 33 black, and 30 Latina women. Mean I-QOL, QUID, and ISI scores were not significantly different among our three groups. Barriers, based on BICS-Q scores, were lowest in white women and higher in blacks and Latinas (2.9 vs. 7.3 vs. 10.9 respectively, p<0.001). When adjusting for potential confounders such as age, income, education, presence of UI, ISI score, and I-QOL score, Latinas continued to demonstrate higher barriers compared to white or black women (β= 7.4, 95% CI: 2.2–12.7; p=0.006). There were no significant differences between black women compared to other groups in the adjusted analyses. Conclusions Latinas experience more barriers to UI healthcare seeking compared to white and black women. PMID:25185610

  17. Fecal Impaction: A Cause for Concern?

    PubMed Central

    Obokhare, Izi

    2012-01-01

    Fecal impaction (FI) is a common cause of lower gastrointestinal tract obstruction lagging behind stricture for diverticulitis and colon cancer. It is the result of chronic or severe constipation and most commonly found in the elderly population. Early recognition and diagnosis is accomplished by way of an adequate history and physical examination in conjunction with an acute abdominal series. Prompt identification and treatment minimizes the risks of complications such as bowel obstruction leading to aspiration, stercoral ulcers, perforation, and peritonitis. Treatment options include gentle proximal softening in the absence of complete bowel obstruction, distal washout, and manual extraction. Surgical resection of the involved colon or rectum is reserved for cases of FI complicated by ulceration and perforation leading to peritonitis. Recurrence is common, and can be managed by increasing dietary fiber content to 30 gm/day, increased water intake, and discontinuation of medications that can contribute to colonic hypomotility. PMID:23449376

  18. Mortality of fecal bacteria in seawater

    SciTech Connect

    Garcia-Lara, J.; Menon, P.; Servais, P.; Billen, G. )

    1991-03-01

    The authors propose a method for determining the mortality rate for allochthonous bacteria released in aquatic environments without interference due to the loss of culturability in specific culture media. This method consists of following the disappearance of radioactivity from the trichloracetic acid-insoluble fraction in water samples to which ({sup 3}H)thymidine-prelabeled allochthonous bacteria have been added. In coastal seawater, they found that the actual rate of disappearance of fecal bacteria was 1 order of magnitude lower than the rate of loss of culturability on specific media. Minor adaptation of the procedure may facilitate assessment of the effect of protozoan grazing and bacteriophage lysis on the overall bacterial mortality rate.

  19. Fecal immunochemical test as a biomarker for inflammatory bowel diseases: can it rival fecal calprotectin?

    PubMed Central

    Hiraoka, Sakiko; Nakarai, Asuka; Takashima, Shiho; Inokuchi, Toshihiro; Ichinose, Masao

    2016-01-01

    Accurate evaluation of disease activity is essential for choosing an appropriate treatment and follow-up plan for patients with inflammatory bowel disease (IBD). Endoscopy is required for accurately evaluating disease activity, but the procedures are sometimes invasive and burdensome to patients. Therefore, alternative non-invasive methods for evaluating or predicting disease activity including mucosal status are desirable. Fecal calprotectin (Fcal) is the most widely used fecal marker for IBD, and many articles have described the performance of the marker in predicting disease activity, mucosal healing (MH), treatment efficacy, and risk of relapse. Fecal immunochemical test (FIT) can quantify the concentration of hemoglobin in stool and was originally used for the screening of colorectal cancer. We recently reported that FIT is also a useful biomarker for IBD. A direct comparison between the use of Fcal and FIT showed that both methods predicted MH in ulcerative colitis equally well. However, in the case of Crohn's disease, FIT was less sensitive to lesions in the small intestine, compared to Fcal. FIT holds several advantages over Fcal in regards to user-friendliness, including a lower cost, easy and clean handling, and the ability to make rapid measurements by using an automated measurement system. However, there is insufficient data to support the application of FIT in IBD. Further studies into the use of FIT for evaluating the inflammatory status of IBD are warranted. PMID:26884729

  20. [Potential Applicability of Fecal NIRs: A Review].

    PubMed

    Yan, Xu; Du, Zhou-he; Bai, Shi-qie; Zuo, Yan-chun; Zhou, Xiao-kang; Kou, Jing; Yan, Jia-jun; Zhang, Jian-bo; Li, Ping; You, Ming-hong; Zhang, Yu; Li, Da-xu; Zhang, Chang-bing; Zhang, Jin

    2015-12-01

    Near-infrared reflectance spectroscopy (NIRS) is an inexpensive, rapid, environment-friendly and non-invasive analytical technique that has been extensively applied in the analysis of the dietary attributes and the animal products. Acquisition of dietary attributes is essential for nutritional diagnoses to provide animals with reasonable diet. Traditionally, the calibration equations for the prediction of dietary attributes (e. g. crude protein) are developed from feed NIR spectra and the results of conventional chemical analysis (i. e. reference data). It is difficult to obtain the NIR spectra of forages consumed by grazing animals, so the method of this calibration is inappropriate for free-grazing herbivores. Feces, as the animal's metabolites, contain the information about both the animal's diet and the animal itself. Recently, Fecal-NIRS (F. NIRS) has been directly used to monitor diet information (botanical composition, chemical composition and digestibility), based on correlation between reference data and fecal NIR profile. Subsequently, some additional application (such as sex and species discrimination, reproductive and parasite status) of F. NIRS also is outlined. In the last, application of NIRS in animal manure is summarized. NIRS was shown to be an alternative to conventional wet chemical methods for analyzing some nutrient concentrations in animal manure rapidly. Overall, this paper proves that F. NIRS is a rapid and valid tool for the determination of the dietary attributes and of the physiological status of animal, although more efforts need to be done to improve the accuracy of the F. NIRS technique. Several researchers in English have reviewed the applications of F. NIRS. In China, however, there is a paucity of research and application regarding F. NIRS. We expect that this paper in Chinese will be helpful to the development of F. NIRS in China. At the same time, we propose NIRS as a simple and rapid analytical method for predicting the main

  1. Incontinence-associated dermatitis: step-by-step prevention and treatment.

    PubMed

    Beeckman, Dimitri; Woodward, Sue; Gray, Mikel

    2011-08-01

    Incontinence-associated dermatitis (IAD) is one of the clinical manifestations of moisture-associated skin damage. It is a common problem in community dwelling patients with faecal and/or urinary incontinence, and IAD management is an important challenge for community nurses. The aim of this practice focused article is to provide a brief update about the evidence of: (1) the pathophysiology of IAD, (2) the differentiation between IAD and pressure ulcers, and (3) the prevention/treatment of IAD. Recommendations for patient care in the community is described with reference to a patient case study. PMID:21841630

  2. [Invasive studies at the office in the diagnosis of stress urinary incontinence].

    PubMed

    Iris de la cruz, S

    1996-06-01

    A revision of the available diagnostic method is being made for the stress urinary incontinence, paying special attention to those which can be enhanced in the doctor's office. Three of the requiring catheters, endoscopic instruments or another kind of advices for his realization and they can be considered such as "Invasive test". There is mentioned that with these techniques there can be found an appropriate diagnosis of the genuine incontinence even up to a 75% of the cases. The remaining percentage requires studies either urodynamic or of any other kind in order to complete the diagnosis. The criterions are enlisted in order to send the patient to a specialized center. PMID:8754729

  3. Gastrointestinal transit and prolonged ambulatory colonic motility in health and faecal incontinence

    PubMed Central

    Herbst, F; Kamm, M; Morris, G; Britton, K; Woloszko, J; Nicholls, R

    1997-01-01

    Background—Colonic motor function has not been studied in the ambulatory setting over a prolonged period in the unprepared state. Furthermore, the disturbance of this function in patients with faecal incontinence is unknown. 
Aim—To study colonic function over two to three days in the ambulatory, unprepared state in health and in patients with idiopathic faecal incontinence. 
Methods—Six healthy women and six women with faecal incontinence and a structurally intact anal sphincter ingested a dual radioisotope meal, and had a six sensor, solid state manometric probe colonoscopically inserted into the left colon. Scanning was performed until radioisotope left the gut and pressure was recorded for a median of 44hours. 
Results—Three of six patients showed abnormal gastric emptying. Patients showed no disturbance of colonic radioisotope transit. Controls had a median of 12, whereas patients had a median of 16, high amplitude propagated waves per 24 hours. In three patients urge incontinence was associated with high amplitude (up to 500 cm water) propagated waves which often reached the rectum. These high pressure waves were identical to those occuring in healthy subjects, the only difference being the lack of adequate sphincter response. Passive incontinence was not associated with colonic motor activity. Defaecation in all subjects was associated with identical propagated waves, and distal movement of 13% (median) of right colonic content and excretion of 32% from the left colon and rectum. The urge to defaecate was associated with either propagated waves (45%) or non-propagated contractions (55%). Rectal motor complexes were recorded in both groups of subjects, but similar rhythmic activity was also recorded in the sigmoid and descending colon. 
Conclusions—Normal colonic function consists of frequent high pressure propagated waves. Rhythmic activity occurs both proximal to and in the rectum. Defaecation is characterised by high pressure propagated

  4. Urinary Incontinence due to Overactive Detrusor Muscle: A Rare Side Effect of Venlafaxine

    PubMed Central

    Selvaraj, Vithyalakshmi; Gunasekar, Palanikumar; Kumar, Suneel; Alsakaf, Imad

    2015-01-01

    We report a case of reemergence of urinary incontinence (UI) in a patient with benign prostatic hyperplasia (BPH) after starting treatment with venlafaxine who was stabilized on tamsulosin and finasteride for about 6 years. A 66-year-old Caucasian male with prior history of major depressive disorder developed UI within a week of starting venlafaxine 75 mg per day. He described symptoms in the form of involuntary leakage of urine both during the day and at night. His symptoms of UI resolved after stopping the venlafaxine. To the best of our knowledge, there are only four case reports of venlafaxine induced urinary incontinence which have been published. PMID:26491599

  5. Macular posterior pigmentary incontinence: its relation to macular amyloidosis and notalgia paresthetica.

    PubMed

    Westermark, P; Ridderström, E; Vahlquist, A

    1996-07-01

    Patients with clinical features of dorsal macular amyloidosis but without subepidermal amyloid deposits were followed for 2-11 years. The clinical appearance was fairly stable during this period of time, with little tendency of healing. Only 2 of the patients developed typical macular amyloidosis during the follow-up. It is concluded that a condition strongly resembling macular amyloidosis but without amyloid is an entity, and the designation "macular posterior pigmentary incontinence" is proposed. The relationship between macular posterior pigmentary incontinence and the two conditions macular amyloidosis and notalgia paresthetica is discussed. PMID:8869690

  6. Surgical treatment for stress urinary incontinence in women: novelties, concerns and ethics.

    PubMed

    Zimmern, Philippe E

    2012-01-01

    The International Continence Society (ICS) is the largest international body of nurses, physical therapists, drug researchers, clinicians, gynecologists, urologists and other specialists united yearly to discuss the topic of incontinence. This year, over 2500 attendees from all over the world participated in the annual meeting held in Glasgow, Scotland. Several presentations deserve recognition, but we will focus on a few key issues, such as the latest information on the surgical treatment of stress urinary incontinence, a novel approach to patient's study participation in randomized controlled trials via internet recruitment, and ethical concerns related to disclosure and transparency, as these are keenly relevant topics in women's health. PMID:22171771

  7. Experience with a routine fecal sampling program for plutonium workers

    SciTech Connect

    Bihl, D.E.; Buschbom, R.L.; Sula, M.J. )

    1993-11-01

    A quarterly fecal sampling program was conducted at the U. S. Department of Energy's Hanford site for congruent to 100 workers at risk for an intake of plutonium oxide and other forms of plutonium. To our surprise, we discovered that essentially all of the workers were excreting detectable activities of plutonium. Further investigation showed that the source was frequent, intermittent intakes at levels below detectability by normal workplace monitoring, indicating the extraordinary sensitivity of fecal sampling. However, the experience of this study also indicated that the increased sensitivity of routine fecal sampling relative to more common bioassay methods is offset by many problems. These include poor worker cooperation; difficulty in distinguishing low-level chronic intakes from a more significant, acute intake; difficulty in eliminating interference from ingested plutonium; and difficulty in interpreting what a single void means in terms of 24-h excretion. Recommendations for a routine fecal program include providing good communication to workers and management about reasons and logistics of fecal sampling prior to starting, using annual (instead of quarterly) fecal sampling for class Y plutonium, collecting samples after workers have been away from plutonium exposure for a least 3 d, and giving serious consideration to improving urinalysis sensitivity rather than going to routine fecal sampling.

  8. Using fecal glucocorticoids for stress assessment in Mourning Doves

    USGS Publications Warehouse

    Washburn, B.E.; Millspaugh, J.J.; Schulz, J.H.; Jones, S.B.; Mong, T.

    2003-01-01

    Fecal glucocorticoid assays provide a potentially useful, noninvasive means to study physiological responses of wildlife to various stressors. The objective of our study was to validate a method for measuring glucocorticoid metabolites in Mourning Dove (Zenaida macroura) feces. We validated the assay using standard procedures (e.g., parallelism, recovery of exogenous corticosterone) to demonstrate that the assay accurately and precisely measured glucocorticoid metabolites in Mourning Dove fecal extracts. We conducted adrenocorticotropin (ACTH) challenge experiments to validate the assay's ability to determine biologically important changes in fecal glucocorticoids. Fecal glucocorticoid levels increased significantly approximately 2-3 hr after administration of ACTH at 50 IU per kg body mass to wild Mourning Doves held in captivity. In contrast, fecal glucocorticoid metabolites did not increase in control birds, birds that received saline injections, or a lower dose of ACTH (1 IU per kg body mass). Variation in overall fecal glucocorticoid metabolite levels may have been influenced by season and the length of time birds were held in captivity. Non-invasive fecal glucocorticoid metabolite analyses, in combination with demographic information, may have considerable utility for monitoring the effects of natural and anthropogenic disturbances on Mourning Dove populations.

  9. Claudin-3 and occludin tissue content in the glands of colonic mucosa with and without a fecal stream.

    PubMed

    Martinez, Carlos Augusto Real; de Campos, Fabio Guilherme Caserta Maryssael; de Carvalho, Viviel Rodrigo José; de Castro Ferreira, Caroline; Rodrigues, Murilo Rocha; Sato, Daniela Tiemi; Pereira, José Aires

    2015-04-01

    The synthesis of the proteins of the apical tight junctions (TJs) depends on a continuous supply of short-chain fatty acids (SCFAs) in colonic epithelium. No studies have evaluated the tissue contents of the TJs proteins in colon segments devoid of a fecal stream. To evaluate the contents of claudin-3 and occludin in the glands of colonic mucosa devoid of a fecal stream. Forty-five rats underwent a diversion of the fecal stream via a left side colostomy and distal mucous fistula. Three groups of 15 animals each were sacrificed at 6, 12 or 18 weeks after surgery. The presence and severity of colitis were defined by histology and inflammation grading scales, respectively. The expression of claudin-3 and occludin were evaluated by immunohistochemistry, and their contents were evaluated by computer-assisted image analysis. Mann-Whitney and Kruskal-Wallis tests were used to evaluate the results at a significance level of 5% (p < 0.05). The colonic epithelium without a fecal stream had a higher degree of inflammation. Colonic glands without a fecal stream showed a reduction in claudin-3 content independent of the time and reduction in occludin content after 12 weeks of intestinal exclusion. The content of claudin-3 and occludin were mainly reduced at the apical surfaces of the colon glands, whereas segments retaining the fecal stream were maintained. The content of claudin-3 was not reduced with time, although the levels of occludin were reduced after 6 weeks and did not vary thereafter. Deficiencies in SCFAs decreased the content of claudin-3 and occludin in colonic glands with the areas of worst inflammation, confirming the importance of an adequate supply of SCFAs in maintaining the integrity of TJ proteins. PMID:25649016

  10. Textural Analysis of Hyperspectral Images for Improving Detection Accuracy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Detection of fecal contamination is crucial for food safety to protect consumers from food pathogens. Previous studies demonstrated a hyperspectral imaging system has a potential for poultry fecal contaminant detection by measuring reflectance intensity. The simple image ratio with optimal thresho...

  11. Fecal corticoid monitoring in whooping cranes (Grus americana) undergoing reintroduction

    USGS Publications Warehouse

    Hartup, B.K.; Olsen, G.H.; Czekala, N.M.

    2005-01-01

    We used radioimmunoassay to determine fecal corticoid concentrations and assess potential stress in 10 endangered whooping cranes (Grus americana) undergoing reintroduction to the wild. Fecal samples were collected shortly after hatching at a captive facility in Maryland, during field training in Wisconsin, and throughout a human-led migration to Florida. After a 14-day decline following hatching, fecal corticoid concentrations stabilized at baseline levels for the duration of the captive period, despite exposure to potentially stressful stimuli. Shipment of the cranes to the field training site was correlated with an eight- to 34-fold increase in fecal corticoid concentrations, which returned to baseline levels within 1 week. Increases were positively correlated with age but not body weight at the time of shipping. Fecal corticoid concentrations during the training period increased slightly and exhibited greater variation than levels observed at the captive facility, but were well within expected norms based on previous studies. Fecal corticoid concentrations increased twofold following premigration physical examinations and placement of radiotransmitters, and persisted for up to 4 days before they returned to baseline levels. Though fecal corticoid concentrations and variation during the migration period were similar to training levels, there was an overall decline in fecal corticoid concentrations during the artificial migration. Acute stressors, such as capture, restraint, and severe storms, were associated with stress responses by the cranes that varied in accordance with lasting physical or psychological stimuli. The overall reintroduction process of costume-rearing, ultralight aircraft habituation, training, and artificial migration was not associated with elevations in fecal corticoid concentrations suggestive of chronic stress.

  12. Fecal corticoid monitoring in whooping cranes (Grus americana) undergoing reintroduction

    USGS Publications Warehouse

    Hartup, B.K.; Olsen, G.H.; Czekala, N.M.

    2005-01-01

    We used radioimmunoassay to determine fecal corticoid concentrations and assess potential stress in 10 endangered whooping cranes (Grus americana) undergoing reintroduction to the wild. Fecal samples were collected shortly after hatching at a captive facility in Maryland, during field training in Wisconsin, and throughout a human-led migration to Florida. After a 14-day decline following hatching, fecal corticoid concentrations stabilized at baseline levels for the duration of the captive period, despite exposure to potentially stressful stimuli. Shipment of the cranes to the field training site was correlated with an eight- to 34-fold increase in fecal corticoid concentrations, which returned to baseline levels within 1 week. Increases were positively correlated with age but not body weight at the time of shipping. Fecal corticoid concentrations during the training period increased slightly and exhibited greater variation than levels observed at the captive facility, but were well within expected norms based on previous studies. Fecal corticoid concentrations increased twofold following premigration physical examinations and placement of radiotransmitters, and persisted for up to 4 days before they returned to baseline levels. Though fecal corticoid concentrations and variation during the migration period were similar to training levels, there was an overall decline in fecal corticoid concentrations during the artificial migration. Acute stressors, such as capture, restraint, and severe storms, were associated with stress responses by the cranes that varied in accordance with lasting physical or psychological stimuli. The overall reintroduction process of costume-rearing, ultralight aircraft habituation, training, and artificial migration was not associated with elevations in fecal corticoid concentrations suggestive of chronic stress. ?? 2005 Wiley-Liss, Inc.

  13. Predictors of Care Seeking in Women with Urinary Incontinence

    PubMed Central

    Minassian, Vatche A; Yan, Xiaowei; Lichtenfeld, Marc J; Sun, Haiyan; Stewart, Walter F

    2012-01-01

    Aims To determine predictors of health care utilization in women with urinary incontinence (UI) from the population to specialty care. Methods The General Longitudinal Overactive Bladder Evaluation – UI is a population-based study on the natural history of UI in women ≥ 40 years of age. Prevalence of UI was estimated by using the bladder health survey (BHS). Survey data were linked with electronic health records (EHR) to examine factors associated with a clinical UI diagnosis using logistic regression. Risk factors analyzed included: UI symptoms, subtypes, bother, severity, duration and effect on quality of life, and demographic and other health characteristics. All statistical tests were two-sided with a p-value < 0.05 being significant. Results The overall prevalence of any UI based on responses to the BHS was 1,618/4064 (40%). Of the 1,618 women with UI, there were only 398 (25%) women with EHR (clinical) diagnosis of UI. Women with UI versus those without UI were more likely to be have a BMI >25kg/m2 (70% versus 58%), more likely to be parous (91% versus 87%) and college educated (54% versus 46%), P<0.001. After adjusting for confounders in the model, variables significantly associated with clinical UI diagnosis included: older age (OR=1.96), higher parity (> 1 birth) (OR=1.76), higher urgency UI (OR=1.08), adaptive behavior (OR=1.2), and UI bother scores (OR=1.01), as well as more frequent outpatient visits (OR=1.03), P<0.05. Conclusions UI is a highly prevalent condition with only a minority of women seeking care. Factors associated with health care utilization include older age, parity (1+), number of doctor visits, urgency UI subtype, UI bother and impact on behavior. PMID:22378605

  14. A Prospective, Descriptive, Quality Improvement Study to Decrease Incontinence-Associated Dermatitis and Hospital-Acquired Pressure Ulcers.

    PubMed

    Hall, Kimberly D; Clark, Rebecca C

    2015-07-01

    Incontinence is a common problem among hospitalized patients and has been associated with multiple health complications, including incontinence-associated dermatitis (IAD) and hospital-acquired pressure ulcers (HAPUs). A prospective, descriptive study was conducted in 2 acute care neurology units to 1) assess the prevalence of incontinence and incidence of IAD and HAPUs among incontinent patients, and 2) evaluate the effect of caregiver education and use of a 1-step cleanser, moisturizer, barrier product on the development of IAD and HAPUs among patients with incontinence. During a period of 1 month, the incontinence status of admitted patients was recorded and skin was assessed for the presence/absence of IAD and HAPUs twice per day. After the 1-month data collection, all clinicians on the study units completed a facility-based online education program about IAD, HAPUs, and skin care followed by the implementation of a 1-step cleanser/barrier product for skin care of all patients with incontinence. Data collection procedures remained the same. Data were collected using a paper/pencil instrument and entered into a spreadsheet for analysis. Descriptive statistics were calculated and prevalence and incidence rates were compared between the pre-intervention and post-intervention phase using Fisher's exact analysis. During the first phase of the study, 17 of 40 admitted patients (42.5%) were incontinent. Of those, 5 (29.4%) developed IAD and all of these patients developed HAPUs (5 of 40 admitted, 29.4%) during an average length of stay of 7.3 (range: 2-14) days. In the intervention phase of the study, 25 of 46 (54.3%) patients were incontinent and none developed IAD or a HAPU during an average length of stay of 7.4 (range: 2-14) days. The average Braden scale score was 14.14 in the pre-intervention group of patients with incontinence and 12.74 in the intervention group. The prevalence of incontinence among patients admitted to acute care neurology units and the rate

  15. IDENTIFICATION OF CHICKEN-SPECIFIC FECAL MICROBIAL SEQUENCES USING A METAGENOMIC APPROACH

    EPA Science Inventory

    In this study, we applied a genome fragment enrichment (GFE) method to select for genomic regions that differ between different fecal metagenomes. Competitive DNA hybridizations were performed between chicken fecal DNA and pig fecal DNA (C-P) and between chicken fecal DNA and an ...

  16. Contact with beach sand, concentrations of fecal indicators, and enteric illness risk

    EPA Science Inventory

    Recent studies ofbeach sand fecal contamination have triggered interest among scientists and in the media. Although evidence shows that beach sand can harbor fecal indicator organisms as well as fecal pathogens, illness risk associated with beach sand contact and fecal indicators...

  17. Incontinence-associated dermatitis: a cross-sectional prevalence study in the Australian acute care hospital setting.

    PubMed

    Campbell, Jill L; Coyer, Fiona M; Osborne, Sonya R

    2016-06-01

    The purpose of this cross-sectional study was to identify the prevalence of incontinence and incontinence-associated dermatitis (IAD) in Australian acute care patients and to describe the products worn to manage incontinence, and those provided at the bedside for perineal skin care. Data on 376 inpatients were collected over 2 days at a major Australian teaching hospital. The mean age of the sample group was 62 years and 52% of the patients were male. The prevalence rate of incontinence was 24% (91/376). Urinary incontinence was significantly more prevalent in females (10%) than males (6%) (χ(2)  = 4·458, df = 1, P = 0·035). IAD occurred in 10% (38/376) of the sample group, with 42% (38/91) of incontinent patients having IAD. Semi-formed and liquid stool were associated with IAD (χ(2)  = 5·520, df = 1, P = 0·027). Clinical indication of fungal infection was present in 32% (12/38) of patients with IAD. Absorbent disposable briefs were the most common incontinence aids used (80%, 70/91), with soap/water and disposable washcloths being the clean-up products most commonly available (60%, 55/91) at the bedside. Further data are needed to validate this high prevalence. Studies that address prevention of IAD and the effectiveness of management strategies are also needed. PMID:24974872

  18. Pharmacologic treatment for urgency-predominant urinary incontinence in women diagnosed using a simplified algorithm: a randomized trial

    PubMed Central

    Huang, Alison J.; Hess, Rachel; Arya, Lily A.; Richter, Holly E.; Subak, Leslee L.; Bradley, Catherine S.; Rogers, Rebecca G.; Myers, Deborah L.; Johnson, Karen C.; Gregory, W. Thomas; Kraus, Stephen R.; Schembri, Michael; Brown, Jeanette S.

    2013-01-01

    Objective The purpose of this study was to evaluate clinical outcomes associated with the initiation of treatment for urgency-predominant incontinence in women diagnosed by a simple 3-item questionnaire. Study Design We conducted a multicenter, double-blinded, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence in ambulatory women diagnosed by the simple 3-item questionnaire. Participants (N = 645) were assigned randomly to fesoterodine therapy (4-8 mg daily) or placebo. Urinary incontinence was assessed with the use of voiding diaries; postvoid residual volume was measured after treatment. Results After 12 weeks, women who had been assigned randomly to fesoterodine therapy reported 0.9 fewer urgency and 1.0 fewer total incontinence episodes/day, compared with placebo (P ≤ .001). Four serious adverse events occurred in each group, none of which was related to treatment. No participant had postvoid residual volume of ≥250 mL after treatment. Conclusion Among ambulatory women with urgency-predominant incontinence diagnosed with a simple 3-item questionnaire, pharmacologic therapy resulted in a moderate decrease in incontinence frequency without increasing significant urinary retention or serious adverse events, which provides support for a streamlined algorithm for diagnosis and treatment of female urgency-predominant incontinence. PMID:22542122

  19. Serum Estradiol Levels Are Not Associated with Urinary Incontinence in Mid-life Women Transitioning through Menopause

    PubMed Central

    Waetjen, L. Elaine; Johnson, Wesley O.; Xing, Guibo; Feng, Wen-Ying; Greendale, Gail A.; Gold, Ellen B.

    2012-01-01

    Objective We evaluated the relationship between annually measured serum endogenous estradiol and the development or worsening of stress and urge incontinence symptoms over 8 years in women transitioning through menopause. Methods This is a longitudinal analysis of women with incontinence in the Study of Women’s Health Across the Nation (SWAN), a multi-center, multi-racial/ethnic prospective cohort study of community-dwelling women transitioning through menopause. At baseline and each of 8 annual visits, SWAN elicited frequency and type of incontinence in a self-administered questionnaire and drew a blood sample on days 2-5 of the menstrual cycle. All endocrine assays were performed using a double-antibody chemiluminescent immunoassay. We analyzed data using discrete Cox survival models and generalized estimating equations with time dependent covariates. Results Estradiol levels drawn at either the annual visit concurrent with or previous to the first report of incontinence were not associated with the development of any (hazard ratio (HR) = 0.99, 95% CI 0.99, 1.01), stress, or urge incontinence in previously continent women. Similarly, estradiol levels were not associated with worsening of any (odds ratio (OR) = 1.00, 95% CI 0.99, 1.01), stress, or urge incontinence in incontinent women. Change in estradiol levels from one year to the next was also not associated with the development (HR = 0.98, 95% confidence interval 0.97, 1.00) or worsening (OR = 1.03, 95% CI 0.99, 1.05) of incontinence. Conclusions We found that annually measured values and year-to-year changes in endogenous estradiol levels had no effect on the development or worsening of incontinence in women transitioning through menopause. PMID:21785372

  20. COMPETITION POTENTIALS OF ENVIRONMENTALLY APPLIED BACTERIA WITH HUMAN FECAL MICROBIOTA

    EPA Science Inventory

    One of the potential human health effects associated with the environmental release. his of genetically engineered microorganisms is colonization of the intestinal tract study uses serial transfer techniques to monitor the in vitro survival and competition with human fecal microb...

  1. Methods of targeting animal sources of fecal pollution in water

    EPA Science Inventory

    In this chapter, proposed chemical and biological MST indicators for the determination of animal fecal sources are discussed. The biological indicators are grouped based on the phylogenetic description of the proposed target (eukarya, bacteria, and virus). A comprehensive descrip...

  2. Changes of Cattle Fecal Microbiome Under Field Conditions

    EPA Science Inventory

    Next generation sequencing (NGS) has been applied to study the microbiome in wastewater, sewage sludge, and feces. Previous microbial survival studies have shown different fecal-associated microbes have different decay rates and regrowth behaviors.

  3. Changes of Cattle Fecal Microbiome Under Field Conditions.

    EPA Science Inventory

    Next generation sequencing (NGS) has been applied to study the microbiome in wastewater, sewage sludge, and feces. Previous microbial survival studies have shown different fecal-associated microbes have different decay rates and regrowth behaviors.

  4. Fecal Indicator Bacteria and Environmental Observations: Validation of Virtual Beach

    EPA Science Inventory

    Contamination of recreational waters by fecal material is often assessed using indicator bacteria such as enterococci. Enumeration based on culturing methods can take up to 48 hours to complete, limiting the accuracy of water quality evaluations. Molecular microbial techniques em...

  5. FECAL POLLUTION, PUBLIC HEALTH AND MICROBIAL SOURCE TRACKING

    EPA Science Inventory

    Microbial source tracking (MST) seeks to provide information about sources of fecal water contamination. Without knowledge of sources, it is difficult to accurately model risk assessments, choose effective remediation strategies, or bring chronically polluted waters into complian...

  6. Absenteeism, Educational Plans, and Anxiety among Children with Incontinence and Their Parents

    ERIC Educational Resources Information Center

    Filce, Hollie G.; LaVergne, Leslie

    2015-01-01

    Background: Children with incontinence have more absenteeism, poorer academic performance, and potential social difficulties during the school years. These children and their parents are at risk for illness-related anxiety. Whereas educational plans are designed to remediate educational, medical, and social-emotional barriers at school, little…

  7. Distance Learning: A Strategy for Improving Incontinence Care in Nursing Homes

    ERIC Educational Resources Information Center

    Rahman, Anna N.; Schnelle, John F.; Yamashita, Takashi; Patry, Gail; Prasauskas, Ruta

    2010-01-01

    Purpose: This article describes a distance learning model designed to help nursing homes implement incontinence management best practices. A basic premise is that translating research into practice requires both a feasible intervention and a dissemination strategy responsive to the target audience's needs. Design and Methods: Over 8 months, nurse…

  8. Spaying-related urinary incontinence and oestrogen therapy in the bitch.

    PubMed

    Veronesi, Maria Cristina; Rota, Alessandro; Battocchio, Massimiliano; Faustini, Massimo; Mollo, Antonio

    2009-03-01

    Some aspects of spaying-related urinary incontinence in the bitch still remain incompletely clarified. Therefore, the aims of the present study were to evaluate the prevalence of the disease among spayed dogs, to detect differences in risk related to the type of surgery, to describe the characteristics of incontinent bitches, to assess the influence of age at surgery on the onset of incontinence occurrence, and to assess the effectiveness and long-term side effects of oestrogen therapy in affected bitches. Among 750 bitches submitted to ovariectomy or ovariohysterectomy, those showing spaying-related urinary incontinence were evaluated. Oestrogen replacement therapy consisted of administering an effective dose followed by an individual maintenance dose. The results showed that the disease occurred in 5% of neutered bitches, the type of surgery did not affect the disease occurrence, affected bitches frequently represented large or giant breeds or large-size mongrels, the body weight of the affected bitches at surgery was often > 20 kg, the disease seems to be associated with tail docking, the age at surgery influences the onset ofincontinence, with earlier occurrence in older bitches, and that a strong co-operation between owners and veterinarians is necessary to achieve successful response to oestrogen replacement therapy. Long-term administration seems to be unrelated to oestrogenic side effects. PMID:19457785

  9. Pelvic Floor Biofeedback via a Smart Phone App for Treatment Of Stress Urinary Incontinence.

    PubMed

    Starr, Julie A; Drobnis, Erma Z; Cornelius, Chelsea

    2016-01-01

    Biofeedback can be useful for treatment of stress urinary incontinence. Many women have difficulty isolating their pelvic floor muscles and adhering to a daily exercise regimen. This case study highlights a woman's experience using PeriCoach, a home biofeedback device that assists women in strengthening their pelvic floor muscles through Bluetooth technology using a smartphone. PMID:27281866

  10. In Search of Dignity: One Family Caring for Their Child's Incontinence

    ERIC Educational Resources Information Center

    Coelho, Amy

    2009-01-01

    This article shares a story of a family with a child who has a spastic quadriplegia cerebral palsy, a form of cerebral palsy (CP) that affects all four limbs and torso with debilitating muscle dysfunction. It describes how the family cares for their child's incontinence. It also shares the experience of the child's mother, Kathy, who attributes…

  11. The use of synthetic materials in the treatment of stress urinary incontinence

    PubMed Central

    Kądziołka, Przemysław; Stanek, Anna M.; Szymanowski, Krzysztof; Wilczak, Maciej

    2016-01-01

    Stress urinary incontinence is a very serious problem which has been noticed by the WHO. This difficult medical condition poses a serious problem as it affects c.a. 20% of the female population and it increases up to 35% in the group of females over 60 years of age. Since there is no single standard surgical procedure which could solve this problem, numerous synthetic materials are used for the operations. It seems that the materials are effective as they improve the condition of women suffering from stress urinary incontinence. Unfortunately these materials have their shortcomings which might lead to certain post-operative complications. Stress urinary incontinence is a disease which affects the social life of the patients. It has a high percentage of recurrence and causes the patient substantial difficulties with keeping high standards of personal hygiene which is consequence makes it impossible to fulfill their social roles. The etiology of this disease is complex and calls for a cross-disciplinary approach to the problem. As there are no standardized or unanimous treatment methods of stress urinary incontinence, numerous sources based on the clinical experience of many medical centers suggest performing TVT and TOT procedures as the most effective treatment methods. The efficacy of the TOT procedure is about 90.8%. PMID:27582680

  12. Current interventional management of male stress urinary incontinence following urological procedures

    PubMed Central

    Ostrowski, Ireneusz; Śledź, Emil; Ciechan, Janusz; Bukowczan, Jakub; Przydacz, Mikolaj; Wiatr, Tomasz; Stangel-Wojcikiewicz, Klaudia; Chłosta, Piotr L.

    2015-01-01

    Introduction Despite improvements in surgical techniques and implementation of minimally invasive procedures, male stress urinary incontinence affects a substantial number of patients after prostatic surgery. In response to increasing demand of optimal treatment modality, new alternatives to artificial urinary sphincter have recently been introduced. This review summarises the therapeutic surgical options with their outcomes in management of postprostatectomy stress incontinence. Material and methods We performed a literature review by searching the PubMed, Web of Science and Embase databases for articles published from January 2000 until April 2015 based on clinical relevance. Results Artificial urinary sphincter is currently considered the “gold standard” treatment of male stress urinary incontinence. Although the new devices in this group have recently been investigated, the AMS 800 remains the only widely used implant. Male slings and adjustable continence devices, achieve the social continence rates up to 60%. Periurethral injections of bulking agents, have limited efficacy of male stress incontinence. Argus sling and ProACT are both associated with substantial explantation rates. Stem cell therapy is a promising option but still requires additional testing. Conclusions The development of new alternatives to artificial urinary sphincter is constantly progressing. Although recently introduced minimally invasive treatment options have not yet surpassed the outcomes of the artificial urinary sphincter they should continue to be evaluated and compared against the gold standard. PMID:26568879

  13. The artificial urinary sphincter and male sling for postprostatectomy incontinence: Which patient should get which procedure?

    PubMed Central

    Dobberfuhl, Amy D.

    2016-01-01

    Surgery is the most efficacious treatment for postprostatectomy incontinence. The ideal surgical approach depends on a variety of patient factors including history of prior incontinence surgery or radiation treatment, bladder contractility, severity of leakage, and patient expectations. Most patients choose to avoid a mechanical device, opting for the male sling over the artificial urinary sphincter. The modern male sling has continued to evolve with respect to device design and surgical technique. Various types of slings address sphincteric incompetence via different mechanisms of action. The recommended surgery, however, must be individualized to the patient based on degree of incontinence, detrusor contractility, and urethral compliance. A thorough urodynamic evaluation is indicated for the majority of patients, and the recommendation for an artificial urinary sphincter, a transobturator sling, or a quadratic sling will depend on urodynamic findings and the patient's particular preference. As advancements in this field evolve, and our understanding of the pathophysiology of incontinence and mechanisms of various devices improves, we expect to see continued evolution in device design. PMID:26966721

  14. The use of synthetic materials in the treatment of stress urinary incontinence.

    PubMed

    Stanek, Robert; Kądziołka, Przemysław; Stanek, Anna M; Szymanowski, Krzysztof; Wilczak, Maciej

    2016-06-01

    Stress urinary incontinence is a very serious problem which has been noticed by the WHO. This difficult medical condition poses a serious problem as it affects c.a. 20% of the female population and it increases up to 35% in the group of females over 60 years of age. Since there is no single standard surgical procedure which could solve this problem, numerous synthetic materials are used for the operations. It seems that the materials are effective as they improve the condition of women suffering from stress urinary incontinence. Unfortunately these materials have their shortcomings which might lead to certain post-operative complications. Stress urinary incontinence is a disease which affects the social life of the patients. It has a high percentage of recurrence and causes the patient substantial difficulties with keeping high standards of personal hygiene which is consequence makes it impossible to fulfill their social roles. The etiology of this disease is complex and calls for a cross-disciplinary approach to the problem. As there are no standardized or unanimous treatment methods of stress urinary incontinence, numerous sources based on the clinical experience of many medical centers suggest performing TVT and TOT procedures as the most effective treatment methods. The efficacy of the TOT procedure is about 90.8%. PMID:27582680

  15. School Nurse Interventions in Managing Functional Urinary Incontinence in School-Age Children

    ERIC Educational Resources Information Center

    Rivers, Charisse L.

    2010-01-01

    Uncomplicated urinary incontinence (UI) in school-age children is a prevalent yet underrecognized problem that has remained in the shadow of other concerns commonly perceived as more prominent or urgent. There is good evidence that functional UI in children can be treated and managed effectively. When there is no structural or neurologic…

  16. Education on Adult Urinary Incontinence in Nursing School Curricula: Can It Be Done in Two Hours?

    ERIC Educational Resources Information Center

    Morishita, Lynne; And Others

    1994-01-01

    Responses from 339 undergraduate nursing programs (74%) showed that 98% included urinary incontinence content in their curricula. Although most agreed the subject was important and felt their teaching was effective, the didactic component averaged two hours, and clinical experience was not systematic; few faculty are prepared to teach this…

  17. Effect of an Incontinence Training Program on Nursing Home Staff's Knowledge, Attitudes, and Behavior.

    ERIC Educational Resources Information Center

    Campbell, Emily B; And Others

    1991-01-01

    Nursing staff (n=166) in four nursing homes participated in quasi-experimental study to measure knowledge and attitudes about urinary incontinence and compliance with toileting protocols. Intervention group (n=96) showed slight increase in knowledge; their attitudes remained positive over four testing times. Compliance with protocol was only 72…

  18. Predicting Nursing Home Admissions among Incontinent Older Adults: A Comparison of Residential Differences across Six Years.

    ERIC Educational Resources Information Center

    Coward, Raymond T.

    1995-01-01

    Uses data from the Longitudinal Studies on Aging (1984-90) to examine a sample who at baseline lived in community settings and reported problems with urinary incontinence (n=719). Analyses indicate that residents of less urbanized and more thinly populated nonmetropolitan counties were more likely to have a nursing home admission than others. (JPS)

  19. Behavioral Intervention to Eliminate Socially Mediated Urinary Incontinence in a Child with Autism

    ERIC Educational Resources Information Center

    Ricciardi, Joseph N.; Luiselli, James K.

    2003-01-01

    We report the case of an 11-year-old boy with autism who demonstrated urinary incontinence that appeared to be maintained by social contingencies (adult attention and escape from activity "demands"). Although he wet himself frequently, he also used the bathroom appropriately and made many self-initiated toileting requests. Intervention was…

  20. Microbial quality of tilapia reared in fecal-contaminated ponds.

    PubMed

    El-Shafai, Saber A; Gijzen, Huub J; Nasr, Fayza A; El-Gohary, Fatma A

    2004-06-01

    The microbial quality of tilapia reared in four fecal-contaminated fishponds was investigated. One of the fishponds (TDP) received treated sewage with an average fecal coliform count of 4 x 10(3)cfu/100mL, and feed of fresh duckweed grown on treated sewage was used. The number of fecal coliform bacteria attached to duckweed biomass ranged between 4.1 x 10(2) and 1.6 x 10(4)cfu/g fresh weight. The second fishpond (TWP) received treated sewage, and the feed used was wheat bran. The third fishpond (FDP) received freshwater, and the feed used was the same duckweed. Pond 4 (SSP) received only settled sewage with an average fecal coliform count of 2.1 x 10(8)/100mL. The average counts in the fishponds were 2.2 x 10(3), 1.7 x 10(3), 1.7 x 10(2), and 9.4 x 10(3)cfu/100mL in TDP, TWP, FDP, and SSP, respectively. FDP had a significantly (P < 0.05) lower fecal coliform count than the treated sewage-fed ponds and SSP. The microbial quality of the tilapia indicated that all tissue samples except muscle tissues were contaminated with fecal coliform. Ranking of the fecal coliform contamination levels showed a decrease in the order intestine>gills>skin>liver. Poor water quality (ammonia and nitrite) in SSP resulted in statistically higher fecal coliform numbers in fish organs of about 1 log(10) than in treatments with good water quality. Pretreatment of sewage is therefore recommended. PMID:15147929

  1. Quantitative PCR for genetic markers of human fecal pollution.

    PubMed

    Shanks, Orin C; Kelty, Catherine A; Sivaganesan, Mano; Varma, Manju; Haugland, Richard A

    2009-09-01

    Assessment of health risk and fecal bacterial loads associated with human fecal pollution requires reliable host-specific analytical methods and a rapid quantification approach. We report the development of quantitative PCR assays for quantification of two recently described human-specific genetic markers targeting Bacteroidales-like cell surface-associated genes. Each assay exhibited a range of quantification from 10 to 1 x 10(6) copies of target DNA. For each assay, internal amplification controls were developed to detect the presence or absence of amplification inhibitors. The assays predominantly detected human fecal specimens and exhibited specificity levels greater than 97% when tested against 265 fecal DNA extracts from 22 different animal species. The abundance of each human-specific genetic marker in primary effluent wastewater samples collected from 20 geographically distinct locations was measured and compared to quantities estimated by real-time PCR assays specific for rRNA gene sequences from total Bacteroidales and enterococcal fecal microorganisms. Assay performances combined with the prevalence of DNA targets in sewage samples provide experimental evidence supporting the potential application of these quantitative methods for monitoring fecal pollution in ambient environmental waters. PMID:19592537

  2. The Role of Fecal Calprotectin in Investigating Inflammatory Bowel Diseases

    PubMed Central

    Erbayrak, Mustafa; Turkay, Cansel; Eraslan, Elife; Cetinkaya, Hulya; Kasapoglu, Benan; Bektas, Mehmet

    2009-01-01

    INTRODUCTION: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. OBJECTIVE: The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease. METHOD: Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatients diagnosed with inflammatory bowel disease comprised the control group. RESULTS: In the present study, all patients in the control group had an fecal calprotectin value lower than the cut-off point (50 mg/kg). CONCLUSION: In conclusion, fecal calprotectin was found to be strongly associated with colorectal inflammation indicating organic disease. Fecal calprotectin is a simple and non-invasive method for assessing excretion of macrophages into the gut lumen. Fecal calprotectin values can be used to evaluate the response to treatment, to screen asymptomatic patients, and to predict inflammatory bowel disease relapses. PMID:19488608

  3. Functional fecal retention visualized by (111)In-DTPA colon transit scintigraphy.

    PubMed

    Infante, Jose Rafael; Rayo, Juan I; Serrano, Justo; Dominguez, Maria L; Garcia, Lucia; Moreno, Manuel

    2015-06-01

    Constipation is an extremely common problem in children, varying from mild and short-lived to severe and chronic. Chronic constipation is a serious childhood condition and requires further investigation, including blood test, colonoscopy, radio-opaque marker study, and/or scintigraphy. We present small bowel and colon transit scintigraphy of a 14-year-old girl with history of chronic constipation, abdominal pain, weight loss, and poor response to medical treatment. After oral administration of In-DTPA in water, planar and SPECT/CT images showed normal small bowel transit time and functional fecal retention in colon transit study. PMID:25706788

  4. Fecal Microbiota Transplantation for Inflammatory Bowel Disease

    PubMed Central

    Lopez, Joanna

    2016-01-01

    The gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (FMT) in the treatment of Clostridium difficile infection. This success has led to studies exploring the role of FMT in other conditions, including inflammatory bowel disease (IBD). Both Crohn’s disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiologies. A shift in gut microbial composition in genetically susceptible individuals, an altered immune system, and environmental factors are all hypothesized to have a role in the pathogenesis of IBD. While numerous case reports and cohort studies have described the use of FMT in patients with IBD over the last 2 decades, the development of new sequencing techniques and results from 2 recent randomized, controlled trials have allowed for a better understanding of the relationship between the microbiome and the human host. However, despite these efforts, knowledge remains limited and the role of FMT in the management of IBD remains uncertain. Further investigation is necessary before FMT joins the current armamentarium of treatment options in clinical practice. PMID:27493597

  5. Fecal Microbiota Transplantation for Inflammatory Bowel Disease.

    PubMed

    Lopez, Joanna; Grinspan, Ari

    2016-06-01

    The gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (FMT) in the treatment of Clostridium difficile infection. This success has led to studies exploring the role of FMT in other conditions, including inflammatory bowel disease (IBD). Both Crohn's disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiologies. A shift in gut microbial composition in genetically susceptible individuals, an altered immune system, and environmental factors are all hypothesized to have a role in the pathogenesis of IBD. While numerous case reports and cohort studies have described the use of FMT in patients with IBD over the last 2 decades, the development of new sequencing techniques and results from 2 recent randomized, controlled trials have allowed for a better understanding of the relationship between the microbiome and the human host. However, despite these efforts, knowledge remains limited and the role of FMT in the management of IBD remains uncertain. Further investigation is necessary before FMT joins the current armamentarium of treatment options in clinical practice. PMID:27493597

  6. Performance of PCR-based assays targeting Bacteroidales genetic markers of human fecal pollution in sewage and fecal samples

    EPA Science Inventory

    There are numerous PCR-based methods available to characterize human fecal pollution in ambient waters. Each assay employs distinct oligonucleotides and many target different genes and microorganisms leading to potential variations in method performance. Laboratory comparisons ...

  7. FSH and LH plasma levels in bitches with differences in risk for urinary incontinence.

    PubMed

    Reichler, Iris Margaret; Hung, Elisabeth; Jöchle, Wolfgang; Piché, Claude A; Roos, Malgorzata; Hubler, Madeleine; Arnold, Susi

    2005-05-01

    To determine whether the height of the plasma gonadotropin levels after spaying is associated with urinary incontinence, the concentrations of plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined once in 191 intact and 308 spayed bitches. The bitches were grouped according to their risk for urinary incontinence and the medians of their respective gonadotropin levels were compared. For intact anestrous bitches, the FSH- and LH-plasma concentrations were 5.2 (4, 8) ng/mL (median (Q1, Q3)) and 0.5 (0.5-0.5) ng/mL, respectively. In the first year after spaying, the gonadotropin concentrations rose significantly, then stabilised at a level around 10 times those of intact bitches (FSH 62.5 (44, 91) ng/mL; LH 6.1(4, 11) ng/mL). The plasma gonadotropin concentrations of long-term spayed (>12 months) continent bitches (n=209) were higher (FSH 66.8 (46, 104) ng/mL; LH 6.5 (4, 11) ng/mL) than in spayed incontinent bitches (n=60) (FSH 51.5 (38, 74) ng/mL; LH 5.5 (3, 8) ng/mL), the latter also had a higher body weight. Multiple regression analysis showed that the FSH-plasma concentration and not the body weight was decisive for the occurrence of urinary incontinence. The results of this study suggest that levels of gonadotropins are associated, directly or indirectly in the pathophysiology of urinary incontinence after spaying. PMID:15826681

  8. Injectable silicone biomaterial for faecal incontinence due to internal anal sphincter dysfunction

    PubMed Central

    Kenefick, N J; Vaizey, C J; Malouf, A J; Norton, C S; Marshall, M; Kamm, M A

    2002-01-01

    Background: A weak or disrupted internal anal sphincter can cause passive faecal incontinence. Conservative measures may help some patients but there is no simple surgical solution for those who fail conservative treatment. A successful technique using trans-sphincteric injection of a bulking agent to augment the internal anal sphincter was developed in a previous pilot study. Aim: To determine the clinical results and underlying physiological effects of biomaterial injection. Patients: Six patients (four males, median age 53 years (range 36–65)) with faecal incontinence to solid or liquid stool related to poor internal anal sphincter function, of varied aetiology, were recruited. Methods: Silicone based biomaterial injections were performed, under local anaesthesia, with antibiotic cover. Three injections were placed circumferentially, trans-sphincterically, entering away from the anal margin and injecting at or just above the dentate line. Anorectal physiological studies, endoanal ultrasound, a bowel symptom diary, a validated incontinence score, and quality of life questionnaires were completed before treatment and on completion of follow up. Results: At a median follow up of 18 months (range 15–19), five of six patients had marked symptom improvement. Faecal incontinence scores improved from a median of 14/24 (range 11–20) before to 8/24 (6–15) after injection. Short form-36 quality of life physical and social function scores improved from a median of 26/100 (5–33) to 79/100 (25–100) and from 10/100 (5–37) to 100/100 (50–100), respectively. There was a corresponding physiological increase in maximum anal resting and squeeze pressures. Ultrasound showed the Bioplastique to be retained in the correct position in the improved patients without migration. There were no complications. Conclusion: Trans-sphincteric injection of silicone biomaterial can provide a marked improvement in faecal incontinence related to a weak or disrupted internal anal

  9. Microbial community analysis and identification of alternative host-specific fecal indicators in fecal and river water samples using pyrosequencing.

    PubMed

    Jeong, Ju-Yong; Park, Hee-Deung; Lee, Kyong-Hee; Weon, Hang-Yeon; Ka, Jong-Ok

    2011-08-01

    It is important to know the comprehensive microbial communities of fecal pollution sources and receiving water bodies for microbial source tracking. Pyrosequencing targeting the V1-V3 hypervariable regions of the 16S rRNA gene was used to investigate the characteristics of bacterial and Bacteroidales communities in major fecal sources and river waters. Diversity analysis indicated that cow feces had the highest diversities in the bacterial and Bacteroidales group followed by the pig sample, with human feces having the lowest value. The Bacteroidales, one of the potential fecal indicators, totally dominated in the fecal samples accounting for 31%-52% of bacterial sequences, but much less (0.6%) in the river water. Clustering and Venn diagram analyses showed that the human sample had a greater similarity to the pig sample in the bacterial and Bacteroidales communities than to samples from other hosts. Traditional fecal indicators, i.e., Escherichia coli, were detected in the human and river water samples at very low rates and Clostridium perfringens and enterococci were not detected in any samples. Besides the Bacteroidales group, some microorganisms detected in the specific hosts, i.e., Parasutterella excrementihominis, Veillonella sp., Dialister invisus, Megamonas funiformis, and Ruminococcus lactaris for the human and Lactobacillus amylovorus and Atopostipes sp. for the pig, could be used as potential host-specific fecal indicators. These microorganisms could be used as multiple fecal indicators that are not dependent on the absence or presence of a single indicator. Monitoring for multiple indicators that are highly abundant and host-specific would greatly enhance the effectiveness of fecal pollution source tracking. PMID:21887641

  10. Basin-Wide Analysis of the Dynamics of Fecal Contamination and Fecal Source Identification in Tillamook Bay, Oregon

    PubMed Central

    Shanks, Orin C.; Nietch, Christopher; Simonich, Michael; Younger, Melissa; Reynolds, Don; Field, Katharine G.

    2006-01-01

    The objectives of this study were to elucidate spatial and temporal dynamics in source-specific Bacteroidales 16S rRNA genetic marker data across a watershed; to compare these dynamics to fecal indicator counts, general measurements of water quality, and climatic forces; and to identify geographic areas of intense exposure to specific sources of contamination. Samples were collected during a 2-year period in the Tillamook basin in Oregon at 30 sites along five river tributaries and in Tillamook Bay. We performed Bacteroidales PCR assays with general, ruminant-source-specific, and human-source-specific primers to identify fecal sources. We determined the Escherichia coli most probable number, temperature, turbidity, and 5-day precipitation. Climate and water quality data collectively supported a rainfall runoff pattern for microbial source input that mirrored the annual precipitation cycle. Fecal sources were statistically linked more closely to ruminants than to humans; there was a 40% greater probability of detecting a ruminant source marker than a human source marker across the basin. On a sample site basis, the addition of fecal source tracking data provided new information linking elevated fecal indicator bacterial loads to specific point and nonpoint sources of fecal pollution in the basin. Inconsistencies in E. coli and host-specific marker trends suggested that the factors that control the quantity of fecal indicators in the water column are different than the factors that influence the presence of Bacteroidales markers at specific times of the year. This may be important if fecal indicator counts are used as a criterion for source loading potential in receiving waters. PMID:16885307

  11. Basin-wide analysis of the dynamics of fecal contamination and fecal source identification in Tillamook Bay, Oregon.

    PubMed

    Shanks, Orin C; Nietch, Christopher; Simonich, Michael; Younger, Melissa; Reynolds, Don; Field, Katharine G

    2006-08-01

    The objectives of this study were to elucidate spatial and temporal dynamics in source-specific Bacteroidales 16S rRNA genetic marker data across a watershed; to compare these dynamics to fecal indicator counts, general measurements of water quality, and climatic forces; and to identify geographic areas of intense exposure to specific sources of contamination. Samples were collected during a 2-year period in the Tillamook basin in Oregon at 30 sites along five river tributaries and in Tillamook Bay. We performed Bacteroidales PCR assays with general, ruminant-source-specific, and human-source-specific primers to identify fecal sources. We determined the Escherichia coli most probable number, temperature, turbidity, and 5-day precipitation. Climate and water quality data collectively supported a rainfall runoff pattern for microbial source input that mirrored the annual precipitation cycle. Fecal sources were statistically linked more closely to ruminants than to humans; there was a 40% greater probability of detecting a ruminant source marker than a human source marker across the basin. On a sample site basis, the addition of fecal source tracking data provided new information linking elevated fecal indicator bacterial loads to specific point and nonpoint sources of fecal pollution in the basin. Inconsistencies in E. coli and host-specific marker trends suggested that the factors that control the quantity of fecal indicators in the water column are different than the factors that influence the presence of Bacteroidales markers at specific times of the year. This may be important if fecal indicator counts are used as a criterion for source loading potential in receiving waters. PMID:16885307

  12. Fecal excretion of Bifidobacterium infantis 35624 and changes in fecal microbiota after eight weeks of oral supplementation with encapsulated probiotic

    PubMed Central

    Charbonneau, Duane; Gibb, Roger D.; Quigley, Eamonn M.M.

    2013-01-01

    Certain randomized, placebo-controlled trials of oral supplementation with B. infantis 35624 have demonstrated the amelioration of symptoms of irritable bowel syndrome. Potential GI colonization by B. infantis 35624 or effects of supplementation on resident GI microbiota may pertain to these clinical observations. In this study, fecal excretion of B. infantis 35624 before, during and after 8 weeks of daily treatment was compared in subjects with IBS who received either the encapsulated oral supplement (n = 39) or placebo (n = 37) and in healthy subjects who received the supplement (n = 41). Secondarily, changes in assessed fecal microbiota and IBS symptoms were determined. Supplementation significantly increased fecal B. infantis 35624 excretion vs. placebo in IBS subjects; excretion in healthy subjects receiving supplement was quantitatively similar. Fecal levels of the probiotic declined and approached baseline once dosing ceased, documenting that colonization is transient. Although supplementation increased numbers of B infantis 35624 within the GI tract, limited changes in 10 other fecal taxa were observed either in healthy subjects or those with IBS. No impact on IBS symptoms was observed. Detection of bacterial DNA in fecal samples suggests that the probiotic is able to survive transit through the GI tract, although strain selective culture techniques were not performed to confirm viability of B. infantis 35624 in the feces. Continuous probiotic administration was necessary to maintain steady-state transit. Given the complex spectrum of GI microbiota, however, monitoring perturbations in selected taxa may not be not a useful indicator of probiotic function. PMID:23549409

  13. The effect of drinking milk containing conjugated linoleic acid on fecal microbiological profile, enzymatic activity, and fecal characteristics in humans

    PubMed Central

    Farnworth, Edward R; Chouinard, Yvan P; Jacques, Helene; Venkatramanan, Sudha; Maf, Akier A; Defnoun, Sabrina; Jones, Peter JH

    2007-01-01

    Background The primary objective was to determine whether consumption of conjugated linoleic acids (CLAs) affected the fecal microbiota composition, fecal enzyme activity or fecal composition. Methods Human subjects consumed (1 L/day) cows' milk (4% fat) containing (5 mg/g fat) cis-9, trans-11 CLA (CONT), (32 mg/g fat) cis-9, trans-11 CLA (NAT) and (32 mg/g fat) trans-10, cis-12 CLA and cis-9, trans-11 CLA (SYN) for 8 weeks, in addition to their normal diet. Milk feeding periods were separated by 4 week washout periods. Fecal samples were obtained at the beginning (day 0) and the end (day 56) of each milk feeding period. Fecal samples were analysed for microbiological profile, enzyme activity, pH and short chain fatty acid content. Results Samples taken at day 0 and day 56 indicated that the numbers of lactobacilli and bifidobacteria significantly decreased after consumption of all experimental milks; total aerobes, total anaerobes, enterobacteria, and enterococci + streptococci did not change. At day 56, the activities of β-glucosidase, nitroreductase, and urease enzymes had decreased compared to samples taken on day 0 for all treatments. β-glucuronidase activity did not change. Fecal pH and ammonia content did not change. Conclusion It was concluded that observed changes could have been attributed to increased milk intake; no differences could be attributed to consumption of the different CLAs. PMID:17620127

  14. Human-induced trophic cascades along the fecal detritus pathway.

    PubMed

    Nichols, Elizabeth; Uriarte, María; Peres, Carlos A; Louzada, Julio; Braga, Rodrigo Fagundes; Schiffler, Gustavo; Endo, Whaldener; Spector, Sacha H

    2013-01-01

    Human presence and activity in tropical forest is thought to exert top-down regulation over the various 'green-world' pathways of plant-based foodwebs. However, these effects have never been explored for the 'brown-world' pathways of fecal-detritus webs. The strong effects of humans on tropical game mammals are likely to indirectly influence fecal detritivores (including Scarabaeine dung beetles), with subsequent indirect impacts on detrivore-mediated and plant-facilitating detrital processes. Across a 380-km gradient of human influence in the western Brazilian Amazon, we conducted the first landscape-level assessment of human-induced cascade effects on the fecal detritus pathway, by coupling data on human impact, game mammal and detritivore community structure, and rate measurements of a key detritus process (i.e. dung beetle-mediated secondary seed dispersal). We found evidence that human impact indirectly influences both the diversity and biomass of fecal detritivores, but not detritivore-mediated processes. Cascade strength varied across detritivore groups defined by species' traits. We found smaller-bodied dung beetles were at higher risk of local decline in areas of human presence, and that body size was a better predictor of cascade structure than fecal resource manipulation strategy. Cascade strength was also stronger in upland, unflooded forests, than in seasonally flooded forests. Our results suggest that the impact of human activity in tropical forest on fecal-detritus food web structure is mediated by both species' traits and habitat type. Further research will be required to determine the conditions under which these cascade effects influence fecal-detritus web function. PMID:24146780

  15. Human-Induced Trophic Cascades along the Fecal Detritus Pathway

    PubMed Central

    Nichols, Elizabeth; Uriarte, María; Peres, Carlos A.; Louzada, Julio; Braga, Rodrigo Fagundes; Schiffler, Gustavo; Endo, Whaldener; Spector, Sacha H.

    2013-01-01

    Human presence and activity in tropical forest is thought to exert top-down regulation over the various ‘green-world’ pathways of plant-based foodwebs. However, these effects have never been explored for the ‘brown-world’ pathways of fecal-detritus webs. The strong effects of humans on tropical game mammals are likely to indirectly influence fecal detritivores (including Scarabaeine dung beetles), with subsequent indirect impacts on detrivore-mediated and plant-facilitating detrital processes. Across a 380-km gradient of human influence in the western Brazilian Amazon, we conducted the first landscape-level assessment of human-induced cascade effects on the fecal detritus pathway, by coupling data on human impact, game mammal and detritivore community structure, and rate measurements of a key detritus process (i.e. dung beetle-mediated secondary seed dispersal). We found evidence that human impact indirectly influences both the diversity and biomass of fecal detritivores, but not detritivore-mediated processes. Cascade strength varied across detritivore groups defined by species' traits. We found smaller-bodied dung beetles were at higher risk of local decline in areas of human presence, and that body size was a better predictor of cascade structure than fecal resource manipulation strategy. Cascade strength was also stronger in upland, unflooded forests, than in seasonally flooded forests. Our results suggest that the impact of human activity in tropical forest on fecal-detritus food web structure is mediated by both species' traits and habitat type. Further research will be required to determine the conditions under which these cascade effects influence fecal-detritus web function. PMID:24146780

  16. The Toileting Habit Profile Questionnaire: Screening for Sensory-Based Toileting Difficulties in Young Children with Constipation and Retentive Fecal Incontinence

    ERIC Educational Resources Information Center

    Beaudry-Bellefeuille, Isabelle; Lane, Shelly J.; Ramos-Polo, Eduardo

    2016-01-01

    This study examined the face and preliminary content validity of the Toileting Habit Profile Questionnaire, a tool designed to screen for sensory-based defecation difficulties in children. A panel of experts reviewed a pilot version of the questionnaire and responded to probe questions. Two reviewers conducted direct content analysis of responses;…

  17. Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders.

    PubMed

    Evrensel, Alper; Ceylan, Mehmet Emin

    2016-08-31

    Fecal microbiota transplantation has a 1700-year history. This forgotten treatment method has been put into use again during the last 50 years. The interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. New evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. There is a large number of experimental and clinical researches in the field of gut-brain axis. There is limited information on fecal microbiota transplantation. Despite this, initial results are promising. It is commonly used in the treatment of gastrointestinal diseases such as Clostridium difficile infection, Crohn's disease, ulcerative colitis. It is also experimentally used in the treatment of metabolic and autoimmune diseases. There are case reports that it is effective in the treatment of autism, Parkinson's disease, multiple sclerosis, chronic fatigue syndrome and irritable bowel syndrome. Its implementation is easy, and it is a cheap and reliable treatment method. However, the long-term risks are unknown. Additionally, standard application protocols have not yet been established. There are a lot of questions to be answered. A university in Turkey has got official permission this year, and started to apply fecal microbiota transplantation. In this review, neuropsychiatric areas of use of fecal microbiota transplantation have been discussed in the light of the current information. PMID:27489376

  18. Non-invasive fecal metabonomic detection of colorectal cancer

    PubMed Central

    Phua, Lee Cheng; Chue, Xiu Ping; Koh, Poh Koon; Cheah, Peh Yean; Ho, Han Kiat; Chan, Eric Chun Yong

    2014-01-01

    Colorectal cancer (CRC) is a major cause of mortality in many developed countries. Effective screening strategies were called for to facilitate timely detection and to promote a better clinical outcome. In this study, the role of fecal metabonomics in the non-invasive detection of CRC was investigated. Gas chromatography/time-of-flight mass spectrometry (GC/TOFMS) was utilized for the metabolic profiling of feces obtained from 11 CRC patients and 10 healthy subjects. Concurrently, matched tumor and normal mucosae surgically excised from CRC patients were profiled. CRC patients were differentiated clearly from healthy subjects based on their fecal metabonomic profiles (orthogonal partial least squares discriminant analysis [OPLS-DA], 1 predictive and 3 Y-orthogonal components, R2X = 0.373, R2Y = 0.995, Q2 [cumulative] = 0.215). The robustness of the OPLS-DA model was demonstrated by an area of 1 under the receiver operator characteristic curve. OPLS-DA revealed fecal marker metabolites (e.g., fructose, linoleic acid, and nicotinic acid) that provided novel insights into the tumorigenesis of CRC. Interestingly, a disparate set of CRC-related metabolic aberrations occurred at the tissue level, implying the contribution of processes beyond the direct shedding of tumor cells to the fecal metabotype. In summary, this work established proof-of-principle for GC/TOFMS-based fecal metabonomic detection of CRC and offered new perspectives on the underlying mechanisms. PMID:24424155

  19. Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders

    PubMed Central

    Evrensel, Alper; Ceylan, Mehmet Emin

    2016-01-01

    Fecal microbiota transplantation has a 1700-year history. This forgotten treatment method has been put into use again during the last 50 years. The interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. New evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. There is a large number of experimental and clinical researches in the field of gut-brain axis. There is limited information on fecal microbiota transplantation. Despite this, initial results are promising. It is commonly used in the treatment of gastrointestinal diseases such as Clostridium difficile infection, Crohn’s disease, ulcerative colitis. It is also experimentally used in the treatment of metabolic and autoimmune diseases. There are case reports that it is effective in the treatment of autism, Parkinson’s disease, multiple sclerosis, chronic fatigue syndrome and irritable bowel syndrome. Its implementation is easy, and it is a cheap and reliable treatment method. However, the long-term risks are unknown. Additionally, standard application protocols have not yet been established. There are a lot of questions to be answered. A university in Turkey has got official permission this year, and started to apply fecal microbiota transplantation. In this review, neuropsychiatric areas of use of fecal microbiota transplantation have been discussed in the light of the current information. PMID:27489376

  20. Detection and confirmation of Mycobacterium avium subsp. paratuberculosis in direct quantitative PCR positive fecal samples by the manual fluorescent MGIT culture system.

    PubMed

    Kawaji, Satoko; Nagata, Reiko; Mori, Yasuyuki

    2014-01-01

    An efficient protocol for the manual fluorescent MGIT culture system combined with rapid confirmation of Mycobacterium avium subsp. paratuberculosis (MAP) growth in the broth culture was established and evaluated for the detection of viable MAP in direct quantitative PCR (QPCR) positive bovine feces. Manually detected fluorescence emissions from MGIT tubes were analyzed objectively using an open source software, ImageJ. For molecular confirmation of MAP growth, DNA samples harvested by simply boiling the broth, an inexpensive and time- and labor-saving DNA preparation method, yielded adequate results. The sheep strain of MAP required longer incubation time relative to the cattle strain, suggesting that the MGIT system may not support well the growth of ovine isolates as described previously. Of 61 direct QPCR positive bovine feces, the recovery rate of MAP in the MGIT system (62.3%) was significantly higher (P<0.05) than that using 7H10 agar-based slants (44.3%). The time to obtain a final result for fecal culture by the MGIT system was several weeks earlier compared to solid media. In MGIT culture positive samples, the time to detect fluorescence was correlated with the DNA quantity detected in fecal QPCR. As a positive result in the direct fecal QPCR test does not mean fecal excretion of viable MAP, bacterial isolation by fecal culture could be conducted to verify the QPCR result. For this purpose, the manual MGIT system is a sensitive and rapid culture method at least for bovine samples. PMID:24065085