Science.gov

Sample records for post-prostatectomy urinary incontinence

  1. Adjustable perineal male sling using tissue expander as an effective treatment of post-prostatectomy urinary incontinence

    PubMed Central

    Balci, Melih; Tuncel, Altug; Bilgin, Ovunc; Aslan, Yilmaz; Atan, Ali

    2015-01-01

    Purpose To report our intermediate experience in treating patients with severe incontinence using an adjustable perineal male sling with a tissue expander. Materials and Methods An adjustable male sling procedure was performed on 21 patients with severe incontinence. The underlying etiology of urinary incontinence was radical prostatectomy in 13 patients, open prostatectomy in 5 patients and transurethral prostate resection in 3 patients. The difference between the classical and the adjustable sling is that in the latter there is a 25 mL tissue expander between the two layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via an inflation port, in case of recurrence or persistence of incontinence. Results The mean age of the patients was 66.2±7.3 (50-79) years and mean pad usage was 6.4±0.6 per day. The mean follow-up time was 40.1±23.2 (6-74) months. The balloon was postoperatively inflated on average with 11.6±5.7 (5-25) mL. After the mean 40.1 months of follow-up, 16 of the 21 patients (76.2%) were dry (11 patients, 0 pads; 5 patients using safety pads), 3 patients (14%) had mild and 2 (9.8%) had moderate degree post-prostatectomy urinary incontinence (PPI). The average maximum urine flow rate of the patients was 15.6±4.7 (10-31) mL/s. No residual urine was found. In 2 patients, all parts of the device were removed due to infection and discomfort, and in 3 patients only the inflation component was removed due to local scrotal infection. Conclusions Our results show that using an adjustable perineal male sling with a tissue expander seems to be an efficient, and safe surgical treatment option in patients with PPI. PMID:26005973

  2. Investigating Urinary Conditions Prior to Robot-assisted Radical Prostatectomy in Search of a Desirable Method for Evaluating Post-prostatectomy Incontinence.

    PubMed

    Kadono, Yoshifumi; Nohara, Takahiro; Kadomoto, Suguru; Nakashima, Kazufumi; Iijima, Masashi; Shigehara, Kazuyoshi; Narimoto, Kazutaka; Izumi, Kouji; Mizokami, Atsushi

    2016-08-01

    The aims of the study were to investigate desirable evaluation methods for post-prostatectomy incontinence (PPI) by analyzing the urinary status before robot-assisted radical prostatectomy (RARP).Questionnaires were evaluated from 155 patients prior to operation. The 24-h pad test before RARP revealed a weight of 1.1 g. The mean scores were as follows: total International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score, 1.2; total International Prostate Symptom Score (IPSS), 10.0; IPSS quality of life, 2.7; Overactive Bladder Symptom Score (OABSS), 2.9; and Expanded Prostate Cancer Index Composite urinary summary, 92.8. The abdominal leak point pressure test in 111 patients before RARP was negative in all cases. Desirable evaluation methods for PPI should be based on a combination of subjective and objective evaluations and comparisons between pre- and post-RP. ICIQ-SF is considerably convenient for evaluating incontinence, and the 24-h pad test enables evaluation of the incontinence volume in a highly objective manner. PMID:27466547

  3. 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 ...

  4. Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

    PubMed Central

    Hoy, Nathan Y.; Rourke, Keith F.

    2014-01-01

    Introduction: The AUS remains the gold standard treatment for post-prostatectomy incontinence (PPI), although most patients with mild-moderate PPI prefer a sling without strong evidence of procedural equivalence. This study compares outcomes of 2 procedures for the treatment of mild-moderate PPI. Methods: A retrospective review of 124 patients (76 transobturator sling, 48 AUS) with mild-moderate PPI requiring intervention over an 8-year period. The primary outcome was continence. Secondary outcomes included global patient satisfaction, improvement, and complication rates. Mild to moderate incontinence was defined as requiring ≤5 pads/day. Results: There was no significant difference in age (66.2 vs. 68.1 years; p = 0.17) or prostate cancer characteristics for slings and AUS, respectively. AUS patients had higher Charlson comorbidity scores and were more likely to have previous radiotherapy. Median length of follow up was 24 months for slings and 42 months for AUS. There was no difference in continence rates, 88.2% vs. 87.5% (p = 0.79), rate of improvement, 94.7% vs. 95.8% (p = 1.00), or patient satisfaction, 93.4% vs. 91.7% (p = 0.73), for slings and AUS, respectively. Complication rates were equivalent (19.7% vs. 16.7%; p = 1.00), though a significantly higher proportion of complications with AUS were Clavien Grade 3 (0% vs. 75%; p = 0.006). Conclusions: For mild to moderate PPI there is no difference in continence, satisfaction, or improvement rates, between AUS and slings. AUS complications tend to be more severe. Our study supports the use of slings as first-line treatment for mild-moderate PPI. PMID:25210552

  5. Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence?

    PubMed

    Løvvik, Anja; Müller, Stig; Patel, Hitendra R H

    2016-08-01

    Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man. Antimuscarinic drugs, phosphodiesterase inhibitors, duloxetine, and α-adrenergic drugs have been proposed as medical treatments for PPI. Most studies were small and used different criteria for quantifying incontinence and assessing treatment results. Thus, there is not enough evidence to recommend the use of these medications as standard treatment of PPI. To determine whether medical therapy is a viable option in the treatment of PPI, randomized, placebo-controlled studies are needed that also assess side effects in the elderly population. PMID:27554370

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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

  14. 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 ...

  15. 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

  16. 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 ...

  17. 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 ...

  18. 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 & ...

  19. 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 ...

  20. 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 ...

  1. 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

  2. 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. ...

  3. 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. ...

  4. 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 ...

  5. 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

  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. Stress urinary incontinence

    MedlinePlus

    ... you urinate. Urinalysis to check for urinary tract infection. Urinary stress test: You stand with a full bladder ... out of the bed or chair Unpleasant odors Urinary tract infections Vaginal discharge The condition may get in the ...

  8. 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 ...

  9. 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…

  10. [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

  11. [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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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…

  17. 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 ...

  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. 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

  20. [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

  1. 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, ...

  2. [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

  3. [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

  4. 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

  5. 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

  6. 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…

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. [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

  16. [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

  17. 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 ...

  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. [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

  20. 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

  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. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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 ...

  9. 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 ...

  10. 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

  11. 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

  12. 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

  13. [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

  14. [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

  15. 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

  16. 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

  17. 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

  18. [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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. [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

  6. 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

  7. [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

  8. 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

  9. 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

  10. 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

  11. 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

  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. 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

  14. 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

  15. Could Urinary Tract Infection Cause Female Stress Urinary Incontinence? A Clinical Study

    PubMed Central

    Heydari, Fatemeh; Motaghed, Zahra; Abbaszadeh, Fatemeh

    2016-01-01

    Background Stress urinary incontinence (SUI), the most common type of urinary incontinence (UI), is usually defined as leakage of urine during movement or activity which puts pressure on the bladder, such as coughing, sneezing, running or heavy lifting. It is reported in most countries that 15% to 40% of women struggle with SUI and its severe implications for daily life, including social interactions, sexuality, and psychological wellbeing. Objectives The aim of our study was to assess the relationship between urinary tract infection and the severity of stress urinary incontinence (SUI). Patients and Methods This research was a cross-sectional study conducted in a public urology clinic in Tehran. The study population was all females with complaints of SUI who visited the clinic during 2014. We compared Valsalva leak point pressure (VLPP) in two groups of patients, with and without history of urinary tract infection (UTI). Results According to the findings of our study, the mean VLPP was 83.10 cm H2O in the group with UTI history, and 81.29 cm H2O in those without history of UTI. The difference in VLPP between the two groups was not significant (P < 0.05), even after controlling for confounding variables including age, body mass index, history of hysterectomy and number of deliveries. Conclusions Our study did not confirm a significant relationship between UTI and severity of SUI as measured by VLPP. A decisive opinion would require extensive future studies by prospective methods. PMID:26981500

  16. 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

  17. [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

  18. 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

  19. 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

  20. [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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity?

    PubMed Central

    Karstens, Lisa; Asquith, Mark; Davin, Sean; Stauffer, Patrick; Fair, Damien; Gregory, W. Thomas; Rosenbaum, James T.; McWeeney, Shannon K.; Nardos, Rahel

    2016-01-01

    Objectives: Traditionally, the urinary tract has been thought to be sterile in the absence of a clinically identifiable infection. However, recent evidence suggests that the urinary tract harbors a variety of bacterial species, known collectively as the urinary microbiome, even when clinical cultures are negative. Whether these bacteria promote urinary health or contribute to urinary tract disease remains unknown. Emerging evidence indicates that a shift in the urinary microbiome may play an important role in urgency urinary incontinence (UUI). The goal of this prospective pilot study was to determine how the urinary microbiome is different between women with and without UUI. We also sought to identify if characteristics of the urinary microbiome are associated with UUI severity. Methods: We collected urine from clinically well-characterized women with UUI (n = 10) and normal bladder function (n = 10) using a transurethral catheter to avoid bacterial contamination from external tissue. To characterize the resident microbial community, we amplified the bacterial 16S rRNA gene by PCR and performed sequencing using Illumina MiSeq. Sequences were processed using the workflow package QIIME. We identified bacteria that had differential relative abundance between UUI and controls using DESeq2 to fit generalized linear models based on the negative binomial distribution. We also identified relationships between the diversity of the urinary microbiome and severity of UUI symptoms with Pearson's correlation coefficient. Results: We successfully extracted and sequenced bacterial DNA from 95% of the urine samples and identified that there is a polymicrobial community in the female bladder in both healthy controls and women with UUI. We found the relative abundance of 14 bacteria significantly differed between control and UUI samples. Furthermore, we established that an increase in UUI symptom severity is associated with a decrease in microbial diversity in women with UUI

  20. [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

  1. 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

  2. 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

  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. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up

    PubMed Central

    Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

    2016-01-01

    This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70–2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76–2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones. PMID:27536881

  11. Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

    PubMed

    Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

    2016-01-01

    This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70-2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76-2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones. PMID:27536881

  12. 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

  13. 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

  14. [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

  15. 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

  16. 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

  17. [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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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…

  5. 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…

  6. 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…

  7. 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

  8. 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

  9. 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

  10. 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

  11. Association of Urinary Tract Infection in Married Women Presenting with Urinary Incontinence in a Hospital based Population

    PubMed Central

    Eswara, Shilpalakshmiprasad; Yesudhason, Bineshlal

    2016-01-01

    Introduction Urinary incontinence (UI) is increasingly recognized as a significant health problem, which remains a hygienic as well as social problem. Women have higher risk of developing incontinence in their lifetime compared with men. Urinary tract infection can increase the incidence of incontinence. Present study was undertaken to assess the association of UTI in married women who presented with UI. Aim The present study was aimed to identify the patients (married women) with complaints of UI and determining its association with UTI; and to identify the causative organism for the UTI along with its antimicrobial susceptibility pattern. Materials and Methods This is a cross-sectional, non-randomized study of 107 married women with UI, who attended outpatient department in our hospital. Mid-stream urine (MSU) samples were collected from these patients with positive history of incontinence. Screening of urine for significant bacteriuria and culture to identify the etiological agents were performed followed by evaluation of their antimicrobial susceptibility profiles using Kirby Bauer disc diffusion method. Results Overall 25.2% of patients with incontinence had a positive urine culture. History of UTI was elicited in around 38.3% of patients, among which 15% had positive urine culture and 10.3% of the patients who did not have a history had positive culture. Escherichia coli was the commonest causative organism (66.6) causing UTI, followed by Enterococcus spp. (22.3%), Klebsiella pneumoniae (7.4%) and Proteus mirabilis (3.7%). The antimicrobial susceptibility pattern for Escherichia coli showed high sensitivity to Nitrofurantoin (94.4%) and high resistance to Ampicillin (94.4%). Conclusion Our study revealed one in every four incontinent patients had UTI and almost half of them suffered from previous episodes of UTI. Thus appropriate correction of the existing UTI can help in the treatment of UI. PMID:27134871

  12. Urinary symptoms and incontinence in women: relationships between occurrence, age, and perceived impact.

    PubMed Central

    Swithinbank, L V; Donovan, J L; du Heaume, J C; Rogers, C A; James, M C; Yang, Q; Abrams, P

    1999-01-01

    BACKGROUND: The prevalence of urinary symptoms that impact on quality-of-life will be important in determining resource allocation in primary care groups. AIM: To determine the prevalence of urinary symptoms and their perceived impact in a community population of women. METHOD: A postal survey using a validated self-completed questionnaire among all women aged over 18 years and registered with one general practice in a major British city. The prevalence rates and perceived impact of a wide range of urinary symptoms and their relationship with age was determined. Data were analysed using the chi-squared test and the chi-squared test for trend. Spearman's rank correlation was used to assess the relationship between symptom severity and perceived impact. RESULTS: The number of completed questionnaires returned was 2075, giving an 80% response rate. Of these, the number of women who reported some degree of incontinence in the previous month was 1414 (69%), although only 578 (30%) indicated that it had social or hygienic impact. Other lower urinary tract symptoms reported included nocturia (19%), poor stream (19%), urgency (61%), and dysuria (23%). The most troublesome symptoms were incontinence for no obvious reason, nocturnal incontinence, and nocturia, with 73%, 69%, and 63% of sufferers, respectively, finding these symptoms troublesome. CONCLUSIONS: Incontinence and other urinary symptoms are more common than previously thought. These symptoms are not always perceived as bothersome or as having a social or hygienic impact, and therefore many women who report urinary leakage do not require treatment. Nocturnal symptoms in women are commoner than might have been supposed and are extremely troublesome to sufferers. PMID:10818656

  13. 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

  14. [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

  15. 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

  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. 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

  18. 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

  19. Urinary incontinence in extended care facilities: a literature review and proposal for continuous quality improvement.

    PubMed

    Heavner, K

    1998-12-01

    Despite inconsistencies in the literature regarding research design, definitions, outcomes measures, and maintenance programs, the majority of continence experts have accepted prompted voiding as a successful method for decreasing urinary incontinence in extended care facilities. Research findings to date lack a consistent definition of urinary incontinence, and no objective outcomes measures are available to evaluate the success of an intervention. Furthermore, maintenance of an intervention is often not included in the research design. The findings to date suggest that prompted voiding programs in extended care facilities can help decrease cost of care and dependence, increase self esteem, increase dignity, maintain skin health, and increase satisfaction with care among significant others. Implications for research include developing more structured approaches to maintaining continence, comprehensive training programs for extended care facility staff at all levels, and realistic maintenance protocols for interventions used to maintain continence. PMID:10026548

  20. Urinary incontinence a first presentation of central pontine myelinolysis: a case report.

    PubMed

    Syed, Asmah Hassan; Shak, Joanna; Alsawaf, Ali

    2015-09-01

    An 84-year-old lady was treated for hyperosmolar hyperglycaemia with IV insulin, fluids and catheterisation for fluid balance monitoring. Trial without catheter failed as the patient complained of new-onset urinary incontinence and lack of awareness of bladder filling. In light of her breast cancer history, we excluded cauda equina. Ultrasound KUB showed an enlarged bladder. Whole-body MRI revealed a lesion in the pons which was highly suggestive of central pontine myelinolysis (CPM). Her electrolytes were normal throughout her admission; thus, the rapid fluctuation in osmolality, secondary to her hyperglycaemic state, was the likely cause of CPM. CPM has been reported secondary to hyperglycaemia; however, this is the first reported case of CPM presenting as urinary incontinence and loss of bladder sensation. PMID:26209689

  1. [Is it necessary to conduct a urodynamic study in the diagnosis of urinary incontinence?].

    PubMed

    Juarranz Sanz, M; Campos López-Carrión, M; Fernández-Micheltorena, C; Sánchez Sánchez, D

    2006-03-01

    Urinary incontinence is a dysfunction that affects 20%-50% of the women in Spain, depending on age. Even though it does not involve a prognosis of severity, it reduces self-esteem, limits independence and clear deteriorates quality of life. The diagnosis is generally made following the international criteria collected in the clinical practice guidelines. Even if it is true that the symptoms make it possible to suspect the nature of the functional disorder, this is not always sufficient or conclusive and there may be errors even in the clearest cases. Even so, the need to conduct a urodynamic study in the assessment of women with urinary incontinence diagnosed according to the symptoms mentioned continues to be debatable and there are no unified and defined criteria in our setting in regards to when it is necessary to request urodynamic tests. PMID:16597382

  2. The use of expert systems on the differential diagnosis of urinary incontinence.

    PubMed

    Lopes, Maria Helena Baena de Moraes; Marin, Heimar de Fátima; Ortega, Neli Regina Siqueira

    2009-09-01

    The differential diagnosis of urinary incontinence classes is sometimes difficult to establish. As a rule, only the results of urodynamic testing allow an accurate diagnosis. However, this exam is not always feasible, because it requires special equipment, and also trained personnel to lead and interpret the exam. Some expert systems have been developed to assist health professionals in this field. Therefore, the aims of this paper are to present the definition of Artificial Intelligence; to explain what expert system and system for decision support are and its application in the field of health and to discuss some expert systems for differential diagnosis of urinary incontinence. It is concluded that expert systems may be useful not only for teaching purposes, but also as decision support in daily clinical practice. Despite this, for several reasons, health professionals usually hesitate to use the computer expert system to support their decision making process. PMID:19842606

  3. 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 ...

  4. 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

  5. [Acupoints selection rules analysis of ancient acupuncture for urinary incontinence based on data mining technology].

    PubMed

    Zhang, Wei; Tan, Zhigao; Cao, Juanshu; Gong, Houwu; Qin, Zuoai; Zhong, Feng; Cao, Yue; Wei, Yanrong

    2015-12-01

    Based on ancient literature of acupuncture in Canon of Chinese Medicine (4th edition), the articles regarding acupuncture for urinary incontinence were retrieved and collected to establish a database. By Weka data mining software, the multi-level association rules analysis method was applied to analyze the acupoints selection characteristics and rules of ancient acupuncture for treatment of urinary incontinence. Totally 356 articles of acupuncture for urinary incontinence were collected, involving 41 acupoints with a total frequency of 364. As a result, (1) the acupoints in the yin-meridian of hand and foot were highly valued, as the frequency of acupoints in yin-meridians was 2.6 times than that in yang-meridians, and the frequency of acupoints selected was the most in the liver meridian of foot-jueyin; (2) the acupoints in bladder meridian of foot-taiyang were also highly valued, and among three yang-meridians of foot, the frequency of acupoints in the bladder meridian of foot-taiyang was 54, accounting for 65.85% (54/82); (3) more acupoints selected were located in the lower limbs and abdomen; (4) specific acupoints in above meridians were mostly selected, presenting 73.2% (30/41) to the ratio of number and 79.4% (289/364) to the frequency, respectively; (5) Zhongji (CV 3), the front-mu point of bladder meridian, was seldom selected in the ancient acupuncture literature, which was different from modern literature reports. The results show that urinary incontinence belongs to external genitalia diseases, which should be treated from yin, indicating more yin-meridians be used and special acupoints be focused on. It is essential to focus inheritance and innovation in TCM clinical treatment, and applying data mining technology to ancient literature of acupuncture could provide classic theory basis for TCM clinical treatment. PMID:26964186

  6. Pelvic Static Magnetic Stimulation to Control Urinary Incontinence in Older Women: A Randomized Controlled Trial

    PubMed Central

    Wallis, Marianne C.; Davies, Elizabeth A.; Thalib, Lukman; Griffiths, Susan

    2012-01-01

    Objectives To determine the efficacy of non-invasive static magnetic stimulation (SMS) of the pelvic floor compared to placebo in the treatment of women aged 60 years and over with urinary incontinence for 6 months or more. Subjects and Methods A single-blinded randomized, placebo-controlled, parallel-group trial. Subjects were excluded if they had an implanted electronic device, had experienced a symptomatic urinary tract infection, or had commenced pharmacotherapy for the same in the previous 4 weeks, or if they were booked for pelvic floor or gynecological surgery within the next 3 months. Once written consent was obtained, subjects were randomly assigned to the active SMS group (n=50) or the placebo group (n=51). Treatment was an undergarment incorporating 15 static magnets of 800–1200 Gauss anterior, posterior, and inferior to the pelvis for at least 12 hours a day for 3 months. Placebo was the same protocol with inert metal disks replacing the magnets. Primary outcome measure was cessation of incontinence as measured by a 24-hour pad test. Secondary outcomes were frequency and severity of symptoms as measured by the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF), the Incontinence Severity Index, a Bothersomeness Visual Analog scale, and a 24-hour bladder diary. Data were collected at baseline and 12 weeks later. Results There were no statistically significant differences between groups in any of the outcome measures from baseline to 12 weeks. Initial evidence of subjective improvement in the treatment group compared to the placebo group was not sustained with sensitivity analysis. Conclusion This study found no evidence that static magnets cure or decrease the symptoms of urinary incontinence. Additional work into the basic physics of the product and garment design is recommended prior to further clinical trials research. PMID:21817123

  7. Diagnostic Accuracy of Anthropometric Indicators in the Prediction of Urinary Incontinence in Physically Active Older Women.

    PubMed

    Menezes, Enaiane Cristina; Virtuoso, Janeisa Franck; Capeletto, Eduardo; Silva, Lislayne Luiza da; Chagas, Jodelle Machado; Mazo, Giovana Zarpellon

    2016-08-01

    Purpose To determine the diagnostic accuracy and the cutoff point of the variables conicity index, waist to height ratio and fat percentage to detect urinary incontinence in physically active older women. Method A total of 152 women were analyzed. The instruments used were the International Physical Activity Questionnaire (IPAQ [Area 4]) to check the level of physical activity, and the Diagnostic Form to obtain sociodemographic data and presence of urinary incontinence. To calculate the conicity index, waist to height ratio and fat percentage, body mass, height and waist circumference were measured. Descriptive and inferential statistics were used. Cutoff points, sensitivity (S) and specificity (SP) were determined by receiver operating characteristic (ROC) curves. A 5% significance level was adopted. Results The prevalence of urinary incontinence was of 32.2%. The cutoff point with better sensitivity and specificity for the conicity index was 1.23 (S = 87.8; SP = 35.9); for the waist to height ratio, it was 0.57 (S = 79.6; SP = 45.6); and for the fat percentage, it was 39.71 (S = 89.8; SP = 42.7). The area under the ROC curve was 0.666 for the conicity index, 0.653 for the waist to height ratio, and 0.660 for the fat percentage. Conclusions The cutoff points for the anthropometric measurements conicity index, waist to height ratio and fat percentage indicate that these measures can be used to predict urinary incontinence in physically active older women. Furthermore, fat percentage seemed to be the best measure for this population. PMID:27571385

  8. Vaginal Calculus in a Woman With Mixed Urinary Incontinence and Vaginal Mesh Exposure.

    PubMed

    Winkelman, William D; Rabban, Joseph T; Korn, Abner P

    2016-01-01

    Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite. PMID:26825410

  9. Urinary Incontinence during Sleep Associated with Extended Release Form of Bupropion HCI

    PubMed Central

    Izci, Filiz; Iris Koc, Merve; Bilici, Rabia; Yalcin, Murat; Bestepe, Engin Emrem

    2015-01-01

    Bupropion hydrochloride (HCI) is an antidepressant that acts as a norepinephrine and dopamine reuptake inhibitor and has three different dosage forms including immediate release (IR), sustained release (SR), and extended release (ER). Despite its relatively safe side effect profile bupropion may cause several side effects. Here, we aimed to report a case with major depression using extended release form of bupropion hydrochloride who was presented with urinary incontinence during sleep, an uncommon side effect of bupropion. PMID:26613061

  10. Acupuncture for urinary incontinence after stroke: a protocol for systematic review

    PubMed Central

    Sun, Zhongren; Yu, Nannan; Yue, Jinhuan; Zhang, Qinhong

    2016-01-01

    Introduction The aim of this study, which will include randomised controlled trials (RCTs), is to assess the efficacy and safety of acupuncture for patients with stroke and urinary incontinence. Methods and analysis RCTs will be searched electronically in the MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL and four Chinese medical databases from their inception to present. Manual retrieval will also be conducted. RCTs will be included if acupuncture was evaluated as the sole or adjunct treatment for patients with stroke and urinary incontinence. The primary outcome will be measured by using the pad-weighing test. The secondary outcomes will include urination diary, bladder capacity, clinical symptom scores, the number of patients healed completely in trial follow-up period and adverse events. The study selection, data extraction and evaluation of study quality will be performed independently by two researchers. The methodological quality of the included trials will be assessed by using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. Dissemination This systematic review will assess the current evidence of acupuncture treatment for patients with stroke and urinary incontinence. The findings of this study will be published through a peer-reviewed journal and presented at a relevant conference. Trial registration number CRD42014015611. PMID:26908510

  11. AB101. Therapeutic effect of low intensity pulsed ultrasound in stress urinary incontinence

    PubMed Central

    Yang, Bicheng; Lei, Hongen; Guan, Ruili; Li, Huixi; Xin, Zhongcheng

    2016-01-01

    Objective Stress urinary incontinence, a major type of urinary incontinence, increases with age and is often developed after partum injury. Low intensity pulsed ultrasound (LIPUS) has been investigated in the treatment of many diseases showing its ability of restoring soft tissue injury. We investigated the therapeutic effect of low intensity pulsed ultrasound in stress urinary incontinence. Methods Thirty-two Sprague Dawley rats in SUI group underwent vaginal distension (VD) and bilateral ovariectomy mimicking partum injury. Eight rats served as mock operation control. Eight rats each in SUI group was treated with low-dosage LESW (0.03 mJ/mm2), medium-dosage LESW (0.06 mJ/mm2), or high-dosage LESW (0.09 mJ/mm2). The rest eight rats served as none-treatment group. For functional study, leak point pressure test (LPP) was performed 2 weeks after the last LESW. Masson trichrome staining was performed to validate the pathological changes. Results The LPP was restored in medium-dosage LESW and high-dosage LESW groups, but not in low-dosage LESW group. More robust striated muscle regeneration was found in these two groups comparing with the none-treatment group. Conclusions LIPUS ameliorate the symptom of SUI via activating striated muscle regeneration.

  12. Stem Cell Therapy for Treatment of Stress Urinary Incontinence: The Current Status and Challenges

    PubMed Central

    Zhou, Shukui; Zhang, Kaile; Atala, Anthony; Khoury, Oula; Murphy, Sean V.; Zhao, Weixin; Fu, Qiang

    2016-01-01

    Stress urinary incontinence (SUI) is a common urinary system disease that mostly affects women. Current treatments still do not solve the critical problem of urethral sphincter dysfunction. In recent years, there have been major developments in techniques to obtain, culture, and characterize autologous stem cells as well as many studies describing their applications for the treatment of SUI. In this paper, we review recent publications and clinical trials investigating the applications of several stem cell types as potential treatments for SUI and the underlying challenges of such therapy. PMID:26880983

  13. Effectiveness of deslorelin acetate subcutaneous implantation in a domestic queen with after-spaying urinary incontinence.

    PubMed

    Pisu, Maria Carmela; Veronesi, Maria Cristina

    2014-04-01

    A 2-year-old female ovariectomised Norwegian Forest cat with a history of post-spaying urinary incontinence was diagnosed with acquired urinary sphincter mechanism incompetence (USMI) after complete clinical and laboratory examination. Although there is no literature regarding the treatment of post-spaying USMI in cats, deslorelin acetate is successful in the treatment of post-spaying USMI in dogs. Deslorelin acetate implants have been shown previously to be effective for contraception and oestrus suppression in queens, and suppression of reproductive function in tomcats. Therefore, deslorelin acetate implant treatment was chosen for treatment of post-spaying USMI in this queen. Follow-up examinations were performed on days 8, 15 and 30 after deslorelin implant insertion. Urinary continence was restored about 25 days after implantation and maintained for at least 15 months, without treatment-related negative effects. In the present case report, the post-spaying urinary incontinence related to the acquired USMI was successfully treated with a deslorelin acetate implant. In addition, safe implantation was easy in cats and the single injection resulted in long-lasting efficacy. Further studies are needed to confirm the usefulness of deslorelin acetate treatment for post-spaying USMI in queens and to better delineate the duration of efficacy. PMID:23873046

  14. The efficacy and safety of urethral injection therapy for urinary incontinence in women: a systematic review.

    PubMed

    Matsuoka, Priscila Katsumi; Locali, Rafael Fagionato; Pacetta, Aparecida Maria; Baracat, Edmund Chada; Haddad, Jorge Milhem

    2016-02-01

    To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were identified. However, only fourteen eligible trials fulfilled the prerequisites. Altogether, the review included 1814 patients in trials of eight different types of bulking agents, and all studies were described and analyzed. The measured outcomes were evaluated using a large variety of instruments. The most common complications of the bulking agents were urinary retention and urinary tract infection. Additionally, there were certain major complications, such as one case of death after use of autologous fat. However, the lack of adequate studies, the heterogeneous populations studied, the wide variety of materials used and the lack of long-term follow-up limit guidance of practice. To determine which substance is the most suitable, there is a need for more randomized clinical trials that compare existing bulking agents based on standardized clinical outcomes. PMID:26934239

  15. The efficacy and safety of urethral injection therapy for urinary incontinence in women: a systematic review

    PubMed Central

    Matsuoka, Priscila Katsumi; Locali, Rafael Fagionato; Pacetta, Aparecida Maria; Baracat, Edmund Chada; Haddad, Jorge Milhem

    2016-01-01

    To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were identified. However, only fourteen eligible trials fulfilled the prerequisites. Altogether, the review included 1814 patients in trials of eight different types of bulking agents, and all studies were described and analyzed. The measured outcomes were evaluated using a large variety of instruments. The most common complications of the bulking agents were urinary retention and urinary tract infection. Additionally, there were certain major complications, such as one case of death after use of autologous fat. However, the lack of adequate studies, the heterogeneous populations studied, the wide variety of materials used and the lack of long-term follow-up limit guidance of practice. To determine which substance is the most suitable, there is a need for more randomized clinical trials that compare existing bulking agents based on standardized clinical outcomes. PMID:26934239

  16. Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the Prostate

    PubMed Central

    Nam, Jong Kil; Kim, Hyeon Woo; Lee, Dong Hoon; Han, Ji-Yeon; Lee, Jeong Zoo

    2015-01-01

    Purpose To investigate the factors associated with the occurrence of and recovery from transient urinary incontinence (TUI) after holmium laser enucleation of the prostate (HoLEP). Materials and Methods From March 2009 to December 2012, 391 consecutive patients treated with HoLEP for benign prostatic hyperplasia were enrolled. Information regarding age, prostate volume, International Prostate Symptom Score, Overactive Bladder Symptom Score, peak urinary flow rate, postvoid residual urine, and operation time was collected. TUI was defined as a patient complaint of urine leakage, regardless of type. Logistic regression was used to investigate the factors associated with the occurrence of TUI, and the Kaplan-Meier test was used to analyze the TUI recovery period. Results TUI after HoLEP occurred in 65 patients (16.6%), 52 patients of whom (80.0%) showed recovery within three months. Stress and urge urinary incontinence and postvoid dribbling occurred in 16 patients (4.1%), 29 patients (7.4%), and 33 patients (8.4%), respectively. Age (odds ratio [OR]=3.494; 95% confidence interval [CI]=1.565~7.803; p=0.002) and total operation time (OR=3.849; 95% CI=1.613~9.185; p=0.002) were factors that significantly affected the occurrence of TUI. Conclusions TUI, defined as any type of urine leakage, occurred after HoLEP in some patients, most of whom recovered within three months. Stress urinary incontinence occurred in only 4% of patients after HoLEP. Age and total operation time were associated with the occurrence of postoperative TUI. PMID:26331125

  17. [Urinary incontinence and puppy coat due to spaying in the bitch. An overview of pathophysiology, diagnosis and therapy].

    PubMed

    Reichler, I M

    2010-06-01

    Urinary incontinence as a consequence of an insufficient urethral closure mechanism (urethral sphincter mechanism incompetence, USMI) or an impaired storing capacity of the urinary bladder is a considerable side effect of castration in the female dog. Different factors such as breed, body weight and time of spaying have an impact on the risk of urinary incontinence. Loss of urine while the patient is recumbent is the most typical symptom which is first observed at a mean time of 2.8 years after castration. Diagnosis is obtained by excluding other causes, whereas a precise patient history is particularly helpful. Therapy is aimed at increasing the closing pressure of the urethra and/or the compliance of the urinary bladder. Usually success can be achieved by medical therapy, thus surgical intervention is normally not required. In addition to urinary incontinence, coat changes can be observed as an undesirable effect of castration in certain dog breeds. To date, the pathophysiology of decreased urethral closing pressure, altered storing function of the urinary bladder and coat changes induced by castration are still not fully understood. Apart from the well-known hypothesis of estrogen deficiency, altered secretion of the hypothalamic and pituitary hormones GnRH, FSH and LH due to castration may have an influence. In addition to a-adrenergic medication, Flavoxate and Estriol, depot formulations of GnRH analogues have been successfully used to treat urinary incontinence. These depot formulations have also been described for the treatment of coat changes due to spaying. PMID:22290549

  18. Pelvic floor muscle training for urgency urinary incontinence in women: a systematic review.

    PubMed

    Greer, Joy A; Smith, Ariana L; Arya, Lily A

    2012-06-01

    The objective of this study is to evaluate the effectiveness of existing physiotherapy modalities for the treatment of urge urinary incontinence (UUI). A systematic review was performed for primary studies of physiotherapy techniques for UUI published in English between 1996 and August 2010 in major electronic databases. Only randomized clinical trials that reported outcomes separately for women with UUI were included. Outcomes assessed were reduction in UUI, urinary frequency, and nocturia. Data from 13 full-text trials including the modalities of pelvic floor muscles exercises with or without biofeedback, vaginal electrical stimulation, magnetic stimulation, and vaginal cones were analyzed. The methodologic quality of these trials was fair. Significant improvement in UUI was reported for all physiotherapy techniques except vaginal cone therapy. There are insufficient data to determine if pelvic physiotherapy improves urinary frequency or nocturia. Evidence suggests that physiotherapy techniques may be beneficial for the treatment of UUI. PMID:22246576

  19. 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

  20. 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…

  1. Vaginal cone use in passive and active phases in patients with stress urinary incontinence

    PubMed Central

    Haddad, Jorge Milhem; Ribeiro, Ricardo Muniz; Bernardo, Wanderley Marques; Abrão, Maurício Simões; Baracat, Edmund Chada

    2011-01-01

    OBJECTIVE: To evaluate vaginal cone therapy in two phases, passive and active, in women with stress urinary incontinence. METHODS: A prospective study was conducted at the Department of Obstetrics and Gynecology, São Paulo University, Brazil. Twenty-four women with a clinical and urodynamic diagnosis of stress urinary incontinence were treated with vaginal cones in a passive phase (without voluntary contractions of the pelvic floor) and an active phase (with voluntary contractions), each of which lasted three months. Clinical complaints, a functional evaluation of the pelvic floor, a pad test, and bladder neck mobility were analyzed before and after each phase. RESULTS: Twenty-one patients completed the treatment. The reduction in absolute risk with the pad test was 0.38 (p<0.034) at the end of the passive phase and 0.67 (p<0.0001) at the end of the active phase. The reduction in absolute risk with the pelvic floor evaluation was 0.62 (p<0.0001) at the end of the passive phase and 0.77 (p<0.0001) at the end of the active phase. The reduction in absolute risk of bladder neck mobility was 0.38 (p<0.0089) at the end of the passive phase and 0.52 (p<0.0005) at the end of the active phase. Complete reversal of symptomatology was observed in 12 (57.1%) patients, and satisfaction was expressed by 19 (90.4%). CONCLUSION: Using vaginal cones in the passive phase, as other researchers did, was effective. Inclusion of the active phase led to additional improvement in all of the study parameters evaluated in women with stress urinary incontinence. Randomized studies are needed, however, to confirm these results. PMID:21789381

  2. Coping with stress and quality of life in women with stress urinary incontinence

    PubMed Central

    Adamczuk, Jolanta; Szymona-Pałkowska, Katarzyna; Robak, Jacek Marcin; Rykowska-Górnik, Katarzyna; Steuden, Stanisława

    2015-01-01

    Introduction Urinary incontinence (UI) involves uncontrolled leakage of urine through the urethra as a result of damage to its sphincter muscle and a disturbed function of the urogenital diaphragm within the pelvis minor. The symptoms of UI radically impair psychological, somatic, and social functioning. The aim of each disease stress coping process is to reduce the impact of harmful agents as well as the acquisition of necessary preventive measures in order to combat the disorder. Aim of the study was to assess the relationship between coping styles used when dealing with stress associated with disease and the quality of life. Material and methods The study was carried out at an outpatients’ clinic located in the Lublin Province (eastern Poland), covering 150 women with diagnosed stress urinary incontinence, aged between 32 and 79. The following methods were used: (a) Coping Inventory for Stressful Situations (Endler, Parker) to assess coping styles, (b) CASP-19 scale (Higgins, Hyde, Wiggins, Blade) to measure the overall quality of life, and (c) Urinary Incontinence Life Quality Scale (Szymona-Pałkowska, Kraczkowski). Results The preferred style in the studied group of women was Task-Oriented Coping. This style is associated with a low score on the Independence from Symptoms scale and low Control, being simultaneously correlated with Autonomy and Self-Realisation. Emotion-Oriented Coping is associated with low psychological, physical and social well-being, as well as with little independence from the disease symptoms, little pleasure and self-realisation, but it gives a sense of internal control. Avoidance-Oriented Coping does not significantly correlate with any of the Overall Quality of Life dimensions. Conclusions Women suffering from UI tend to try to solve their problem by means of cognitive transformation. In their situation, clinging to the problem turns out to be a depressing factor and entails a lower quality of their life. PMID:26528106

  3. The potential role of stem cells in the treatment of urinary incontinence

    PubMed Central

    Tran, Christine

    2015-01-01

    Voiding dysfunction encompasses a wide range of urologic disorders including stress urinary incontinence and overactive bladder that have a detrimental impact on the quality of life of millions of men and women worldwide. In recent years, we have greatly expanded our understanding of the pathophysiology of these clinical conditions. However, current gold standard therapies often provide symptomatic relief without targeting the underlying etiology of disease development. Recently, the use of stem cells to halt disease progression and reverse underlying pathology has emerged as a promising method to restore normal voiding function. Stem cells are classically thought to aid in tissue repair via their ability for multilineage differentiation and self-renewal. They may also exert a therapeutic effect via the secretion of bioactive factors that direct other stem and progenitor cells to the area of injury, and that also possess antiapoptotic, antiscarring, neovascularization, and immunomodulatory properties. Local injections of mesenchymal, muscle-derived, and adipose-derived stem cells have all yielded successful outcomes in animal models of mechanical, nerve, or external urethral sphincter injury in stress urinary incontinence. Similarly, direct injection of mesenchymal and adipose-derived stem cells into the bladder in animal models of bladder overactivity have demonstrated efficacy. Early clinical trials using stem cells for the treatment of stress urinary incontinence in both male and female patients have also achieved promising functional results with minimal adverse effects. Although many challenges remain to be addressed prior to the clinical implementation of this technology, novel stem-cell-based therapies are an exciting potential therapy for voiding dysfunction. PMID:25642292

  4. New Paradigms for Patient-Centered Outcomes Research in Electronic Medical Records: An Example of Detecting Urinary Incontinence Following Prostatectomy

    PubMed Central

    Hernandez-Boussard, Tina; Tamang, Suzanne; Blayney, Douglas; Brooks, Jim; Shah, Nigam

    2016-01-01

    Introduction: National initiatives to develop quality metrics emphasize the need to include patient-centered outcomes. Patient-centered outcomes are complex, require documentation of patient communications, and have not been routinely collected by healthcare providers. The widespread implementation of electronic medical records (EHR) offers opportunities to assess patient-centered outcomes within the routine healthcare delivery system. The objective of this study was to test the feasibility and accuracy of identifying patient centered outcomes within the EHR. Methods: Data from patients with localized prostate cancer undergoing prostatectomy were used to develop and test algorithms to accurately identify patient-centered outcomes in post-operative EHRs – we used urinary incontinence as the use case. Standard data mining techniques were used to extract and annotate free text and structured data to assess urinary incontinence recorded within the EHRs. Results A total 5,349 prostate cancer patients were identified in our EHR-system between 1998–2013. Among these EHRs, 30.3% had a text mention of urinary incontinence within 90 days post-operative compared to less than 1.0% with a structured data field for urinary incontinence (i.e. ICD-9 code). Our workflow had good precision and recall for urinary incontinence (positive predictive value: 0.73 and sensitivity: 0.84). Discussion. Our data indicate that important patient-centered outcomes, such as urinary incontinence, are being captured in EHRs as free text and highlight the long-standing importance of accurate clinician documentation. Standard data mining algorithms can accurately and efficiently identify these outcomes in existing EHRs; the complete assessment of these outcomes is essential to move practice into the patient-centered realm of healthcare. PMID:27347492

  5. [Magnetic urethral closure device. Negative outcome after implantation for the treatment of female urinary incontinence].

    PubMed

    Anding, R; van Ahlen, H; Müller, S C; Latz, S

    2015-07-01

    We report on a negative outcome after implantation of a magnetic urethral closure device, consisting of one part screwed into the pubic bone and one part as a vaginal cone, for the treatment of urinary stress incontinence grade III. Continence was never achieved for the patient. The urethra narrowed over time due to erosion and scarring and the patient started intermittent catheterization, because spontaneous micturition was not possible. The magnet was broken, the bladder neck was eroded, several fragments were found in the bladder, and numerous fragments were scattered throughout the small pelvis. Surgery consisted of removing most of the fragments, followed by bladder neck closure and suprapubic diversion. PMID:25989875

  6. The constraints of a normal life: the management of urinary incontinence by middle aged women.

    PubMed

    Peake, Susan; Manderson, Lenore

    2003-01-01

    In this paper, we explore social aspects of the management of urinary incontinence (UI) by women in their middle years. Drawing on interview data with 75 women, and on sociological theories of the body, we illustrate the problematic nature of UI. The occurrence of UI is commonly regarded as a sign of bodily neglect and a lack of self-discipline. To ensure continued social membership, women must devise ways and adhere to various social rules to manage the physiologically "leaky" body that defies cultural norms of restraint and control. Managing UI involves anticipating and masking a problem that invokes persistent cultural ideas about the female body. PMID:12839306

  7. Future Trends in the Treatment of Urinary Incontinence

    PubMed Central

    Chancellor, Michael B

    2001-01-01

    Anticholinergic drugs act on efferent nerves to counteract overactive bladder (OAB) after it occurs. To prevent the occurrence of OAB, therapies should be directed at blocking the afferent nerves that control the bladder. Tachykinin-receptor antagonists hold great promise in this regard, since they can be administered orally and do not increase the risk of urinary retention that occurs with anticholinergics. Advanced drug delivery systems, such as controlled-release oral oxybutynin (oxybutynin-XL) can reduce the incidence of anticholinergic side effects. In a similar manner intravesical therapy for OAB is site specific, and thus also reduces the occurrence of adverse events. Moreover, the difficulties of intravesical therapy may now be overcome with advanced delivery techniques such as an implantable, long-acting drug-delivery pump. Another intravesical therapy that has met with great acceptance and success is the administration of chili pepper extracts, especially resiniferitoxin, which may be effective for up to 3 months with one application. Finally, gene therapy holds great promise for OAB, because it is possible to access all of the genitourinary organs via endoscopy and other minimally invasive techniques that are ideally suited for gene therapy. PMID:16985993

  8. The Impact of Central Obesity on Storage Luts and Urinary Incontinence After Prostatic Surgery.

    PubMed

    Gacci, Mauro; Sebastianelli, Arcangelo; Salvi, Matteo; De Nunzio, Cosimo; Tubaro, Andrea; Gravas, Stavros; Moncada, Ignacio; Serni, Sergio; Maggi, Mario; Vignozzi, Linda

    2016-09-01

    In the developed and developing countries, the overall prevalence of central obesity in the elderly men is growing. In addition, the progressive aging of male population increased the possibilities of coexisting morbidities associated with obesity such as lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) or to prostate cancer (PCa) needing primary treatment, including radical prostatectomy (RP), which can further adversely affect the quality of life. Simple and radical prostatectomy are the most common surgical procedures in urologic unit all over the world for BPE and PCa, respectively. After both interventions, patients can present bothering storage LUTS that can worsen all the other clinical outcomes. Preset study will review the role of central obesity as a risk factor for storage LUTS or urinary incontinence, after prostatic surgery for BPE or PCa. PMID:27432378

  9. Minimally invasive treatment for female stress urinary incontinence – Romanian highlights

    PubMed Central

    Surcel, C; Chibelean, C; Iordache, A; Mirvald, C; Gîngu, C; Margaritis, S; Stoica, R; Codoiu, C; Savu, C; Marksteiner, R; Sinescu, I

    2011-01-01

    Rationale: Stress urinary incontinence is still a "battlefield" for many minimally invasive therapies, but, unfortunately, few can restore the anatomical and functional background of this disorder. Objective: Assessing the latest minimally invasive procedures of intra and perisphincterian injection of autologous stem cells. Method and Result: The first stem cell implantation (myoblasts and /or mature fibroblasts grown and multiplied in the laboratory from biopsy samples taken from the pectoralis muscle) in the urethral sphincter was performed on October 18, 2010, in “Fundeni” Clinic of Urology and Renal Transplantation, in Romania. Discussion: The follow-up at six weeks with the quality of life questionnaires, micturition diary and clinical examination revealed a decrease of urine loss from six pads/ day at one per day, which significantly improved the patient’s quality of life according to visual analogue scale. Clinical and urodynamic evaluations will continue and will be future scientific topics. Abbreviations: SUI = stress urinary incontinence; TVT = tension free vaginal tape; TVT-O = tension free vaginal tape obturator; QoL = quality of life PMID:22514562

  10. [Postoperative evaluation of different surgical procedures in genuine stress urinary incontinence: a retrospective study].

    PubMed

    Rodríguez-Colorado, S; Pérez-Soriano, P; Alvarez-Mercado, R L; Herbert, A; Kunhardt-Rasch, J

    1996-06-01

    An evaluation of the surgical treatment for stress and mixed urinary incontinence and pelvic relaxation. One-year follow-up, was done. A retrospective study with 144 files from the surgeries performed between February 1993 and June 1994, at the Clínica de Urología Ginecológica del Instituto Nacional de Perinatología. We excluded 37 files because of incomplete information. The age, parity, hormonal stage, preoperative diagnosis by urodynamic studies, surgical treatments and one-year follow-up were analyzed. The mean age was 45.5 years. Pereyra procedure was performed in 53, Burch procedure in 47, anterior colporrhaphy in 5, and sling procedure in 2 patients. The incidence of complications was similar between the different groups. Resumption of spontaneous postsurgical voiding was delayed in the Pereyra group. The Burch urethropexy and Pereyra procedures were equally effective, with no statistical differences observed. Burch vaginal suspension was not more effective for the correction of urinary stress incontinence than Pereyra procedure. PMID:8754724

  11. Urinary Incontinence as a Predictor of Death: A Systematic Review and Meta-Analysis

    PubMed Central

    Bardini, Claire; Combescure, Christophe; Dällenbach, Patrick

    2016-01-01

    Background The association between urinary incontinence (UI) and increased mortality remains controversial. The objective of our study was to evaluate if this association exists. Methods We performed a systematic review and meta-analysis of observational studies comparing death rates among patients suffering from UI to those without incontinence. We searched in Medline, Embase and the Cochrane library using specific keywords. Studies exploring the post-stroke period were excluded. Hazard ratios (HR) were pooled using models with random effects. We stratified UI by gender and by UI severity and pooled all models with adjustment for confounding variables. Results Thirty-eight studies were retrieved. When compared to non-urinary incontinent participants, UI was associated with an increase in mortality with pooled non adjusted HR of 2.22 (95%CI 1.77–2.78). The risk increased with UI severity: 1.24 (95%CI: 0.79–1.97) for light, 1.71 (95%CI: 1.26–2.31) for moderate, and 2.72 (95%CI: 1.90–3.87) for severe UI respectively. When pooling adjusted measures of association, the resulting HR was 1.27 (95%CI: 1.13–1.42) and increased progressively for light, moderate and severe UI: 1.07 (95%CI: 0.79–1.44), 1.25 (95%CI: 0.99–1.58), and 1.47 (95%CI: 1.03–2.10) respectively. There was no difference between genders. Conclusion UI is a predictor of higher mortality in the general and particularly in the geriatric population. The association increases with the severity of UI and persists when pooling models adjusted for confounders. It is unclear if this association is causative or just reflects an impaired general health condition. As in most meta-analyses of observational studies, methodological issues should be considered when interpreting results. PMID:27410965

  12. 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.

  13. 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

  14. Conservative Treatment of Stress Urinary Incontinence In Women: A 10-Year (2004-2013) Scoping Review of the Literature.

    PubMed

    McIntosh, Louise; Andersen, Elizabeth; Reekie, Manuela

    2015-01-01

    Stress urinary incontinence is a serious threat to the well-being of women world-wide. In this scoping review of the literature, we examined the most prominent research foci between the years 2004 and 2013. In this article, conservative treat-ment is operationalized as any non-surgical or non-pharmacological treatment modalities that could be carried out by specially trained nurses, physiotherapists, or physicians to treat stress urinary incontinence in women. The two most frequently described or systematically investigated treatment options identified in our review were 1) strengthening pelvic floor muscles with pelvic floor muscle training, including biofeedback and weighted vaginal cones; and 2) the use of intravaginal support devices, such as incontinence pessaries. Other treatment modalities were also explored in the literature review, such as intraurethral devices, behavioral and lifestyle interventions, products, and alternative therapies, such as acupuncture and acupressure. However, the focus of this article is on the two most frequently described options. PMID:26402992

  15. The Influence of Urinary Incontinence on Publicly Financed Home Care Services to Low-Income Elderly People.

    ERIC Educational Resources Information Center

    Baker, Dorothy I.; Bice, Thomas W.

    1995-01-01

    A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

  16. Transurethral Radiofrequency Collagen Denaturation for Treatment of Female Stress Urinary Incontinence: A Review of the Literature and Clinical Recommendations

    PubMed Central

    Lukban, James Chivian

    2012-01-01

    Stress urinary incontinence is a prevalent condition in women with a significant negative effect on quality of life. Intervention includes behavioral modification, intravaginal devices, pelvic floor muscle exercises, biofeedback, functional electrical stimulation, and surgical procedures. We will review a new in-office procedure for the treatment of SUI that may serve as a viable nonsurgical option. PMID:22007230

  17. A Pilot Randomized Placebo Controlled Trial of Electroacupuncture for Women with Pure Stress Urinary Incontinence

    PubMed Central

    Xu, Huanfang; Liu, Baoyan; Wu, Jiani; Du, Ruosang; Liu, Xiaoxu; Yu, Jinna; Liu, Zhishun

    2016-01-01

    Background Acupuncture is a potential conservative therapy for women with stress urinary incontinence (SUI). There is limited evidence to support its effectiveness due to the poor quality of existing studies. Methods We performed a pilot randomized, controlled trial to preliminarily assess the efficacy of electroacupuncture (EA) in women with pure SUI. A total of 80 women with pure SUI were randomly assigned to receive EA with deep needling at BL33 and BL35 (n = 40) or sham EA with non-penetrating needling at sham acupoints (n = 40) three sessions per week for 6 weeks. The women were followed for 24 weeks. The primary outcome was the change from baseline in the amount of urine leakage measured by a 1-hour pad test after 6 weeks. The secondary outcomes included the 72-hour incontinence episode frequency (IEF), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score, and patient self-evaluation of therapeutic effect. Adverse events (AEs) were monitored throughout the trial. Results The median decrease from baseline of urine leakage measured by the 1-hour pad test was 2.5 g [interquartile range (IQR): 1.80–14.6 in the EA group, which was greater than the median decrease of 0.05 g (IQR: -2.80–+0.50) in the sham EA group after 6 weeks (p<0.01). The differences between groups in the decrease from baseline of 72-hour IEF became statistically significant at week 30 with a median decrease of 3.25 g (IQR: 1.25–5.69) in the EA group, and a median decrease of 1.00 g (IQR: -0.69–+2.88) in the sham EA group (p = 0.01). The participants in the EA group showed greater decreases in ICIQ-SF score and higher ratings in the help they received from the treatment than those in the sham EA group at weeks 6,18 and 30 (all p<0.05). No obvious AEs were observed in either group. Conclusion EA may effectively and safely relieve urinary incontinence symptoms and improve quality of life in women with pure SUI. EA demonstrated more than a placebo effect. Since

  18. Urinary incontinence

    MedlinePlus

    ... close the bladder. This can be caused by prostate surgery in men, or surgery to the vagina in ... your provider may recommend surgery. The type of surgery you have ... enlarged prostate , enlarged uterus, or other causes) If you have ...

  19. Urinary Incontinence

    MedlinePlus

    ... neuromodulation (ner-roh-mod-yoo-LAY-shun), can work for you. The doctor will first place a device outside your body to deliver a pulse. If it works well, a surgeon will implant the device. Biofeedback ...

  20. Urinary Incontinence

    MedlinePlus

    ... decisions about when and where they should receive healthcare. Unfortunately, most people lack the medical knowledge needed to make these decisions safely. FreeMD.com is powered by a computer program that performs symptom triage. The goal of ...

  1. Urinary Incontinence

    MedlinePlus

    ... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... bladder and urethra. Biofeedback can be helpful when learning pelvic muscle exercises. Timed voiding may help you ...

  2. Cystolithiasis in women as a distant complication after minimal invasive treatment of stress urinary incontinence

    PubMed Central

    Markowski, Michał; Kliś, Rafał; Różański, Waldemar

    2014-01-01

    Introduction Stress urinary incontinence (SUI) is a condition of social dimension which generally pertains to women of various age. The only effective treatments of SUI are surgical procedures. The use of tension-free vaginal tape (TVT) ensures low invasiveness but also carries the risk of complications. One of the complications may be migration of the tape into the urinary bladder creating conditions for urinary stones. There is a number of treatment methods for cystolithiasis, among them the optical lithotripter, ultrasound and pneumatic probes, and recently, the holmium laser. Material and methods From January 2009 to February 2010, six women suffering from bladder stones were treated at our department. All patients had previously undergone SUI procedures and over time, thread or tape had penetrated into the urinary bladder. The stone diameters were in the range of 1.6 cm–3.5 cm. Lithotripsy was performed with the use of an 80 W holmium YAG laser as an endoscopic procedure: beam frequency length of 2100 nm and applied energy was in the range of 0.2–3.5 J. Results The urinary bladder stones were disintegrated and suctioned out. During the same procedure, the threads or tape from the SUI procedure were excised from the bladder. All patients were discharged from the hospital in good general condition after two days. Conclusions The holmium laser is an effective treatment for patients with bladder stone complications after SUI procedures when threads or tape have migrated and penetrated the bladder wall. The procedure is straightforward and safe for patients. PMID:25247087

  3. Concomitant repair of stress urinary incontinence with proximal urethrovaginal fistula: Our experience

    PubMed Central

    Chodisetti, Subbarao; Boddepalli, Yogesh; Kota, Malakonda Reddy

    2016-01-01

    Introduction: Proximal urethrovaginal fistula (UVF) located close to the bladder neck may cause extensive sphincter damage and is usually associated with continuous incontinence, which may mask the associated stress urinary incontinence (SUI). Simultaneous correction of SUI avoids a second surgery for SUI, which needs dissection in ischemic fields and carries a high risk of failure. The aim of this study is to describe our technique of concomitant repair of SUI with proximal UVF and our results. Methods: Between July 2010 and August 2014, 14 patients underwent UVF repair in Jackknife position by the interposition of a Martius flap and simultaneous correction of SUI by modified McGuire pubovaginal autologous fascial sling. The procedure was carried out a minimum of 3 months of presentation and after detailed preoperative evaluation. Results: After a mean follow-up of 28 months, all 14 patients were continent. None of the patients developed recurrence of the UVF. Two patients presented with retention immediately after catheter removal and clean intermittent catheterization training was given to both of them. Two patients became pregnant during the follow-up period and were advised cesarean section near term. Conclusions: Repair of proximal UVF and correction of SUI can be performed in the same session to avoid the operation in an ischemic field. PMID:27555683

  4. 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

  5. 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

  6. Female sexual function following mid-urethral slings for the treatment of stress urinary incontinence.

    PubMed

    Alwaal, A; Tian, X; Huang, Y; Zhao, L; Ma, L; Lin, G; Deng, D

    2016-07-01

    The aim of our study was to describe the impact of mid-urethral sling procedure for the treatment of stress urinary incontinence (SUI) on female sexual function. We used PubMed (updated March 2015) to conduct a literature electronic search that included peer-reviewed English language articles. We analyzed the studies about the impact of mid-urethral slings on female sexual function. There are different and contradictory results of the effects of mid-urethral sling on female sexual function. However, more papers show that women undergoing mid-urethral sling procedures report that their sexual function is improved or remains unchanged. The main mechanism of this improved sexuality is the complete relief from coital incontinence, reduction in anxiety and avoidance of sex, whereas the most common symptom related to worsened sexual activity is dyspareunia. Women undergoing sling procedures for SUI should be informed that their sexual activity is likely to remain unchanged or even improve after the operation, but that dyspareunia may occur. PMID:27146350

  7. De Novo Pudendal Neuropathy After TOT-O Surgery for Stress Urinary Incontinence

    PubMed Central

    Baker, James

    2011-01-01

    Background and Objectives: Five cases of pelvic nerve complications after transobturator tape (TOT) inside-out surgical procedures for stress urinary incontinence are presented. Methods: We conducted a chart review of patients with complications referred to our practice. Results: Five patients with nerve complications after TOT inside-out procedures were investigated. Pudendal neuropathy and interstitial cystitis were seen in this series of patients with several patients having myofascial pain in the lower abdominal area. Conclusions: Although not commonly reported, complications from needle placement and from the area of needle exit in a TOT procedure can exist, and the surgeon must be careful when placing the needle through the area of the obturator fossa. PMID:21985718

  8. Urinary incontinence quality improvement in nursing homes: where have we been? Where are we going?

    PubMed

    Palmer, Mary H

    2008-12-01

    The Centers for Medicare and Medicaid Services (CMS) has made urinary incontinence (UI) a quality indicator as part of the Nursing Home Quality Initiative (NHQI). In addition, CMS issued revised guidance on UI and catheters (known as tag F315) for nursing homes regarding compliance in the evaluation and management of UI and catheters, and an investigative protocol for state nursing home surveyors to use during regulatory inspections. The prevalence of UI in nursing homes remains high despite many years of research and clinical efforts to cure or improve it. Nurses play a key role in assuring appropriate assessment of nursing home residents to prevent and treat UI. Changes at the organizational level and inpatient care are needed to make dignity of nursing home residents central to UI quality improvement efforts. This article reviews the epidemiology of UI, the evidence for behavioral interventions, and the types of quality improvement strategies used for UI in nursing homes. PMID:19241782

  9. Urinary Incontinence: Its Assessment and Relationship to Depression among Community-Dwelling Multiethnic Older Women

    PubMed Central

    Laganà, Luciana; Bloom, David William; Ainsworth, Andrew

    2014-01-01

    Urinary Incontinence (UI) affects many older adults. Some of its deleterious consequences include stress, major depression, diminished quality of life, sexual dysfunction, and familial discord. Of the various mental health problems identified in the literature as being comorbid with UI, the most notable one continues to be depression. Despite a wealth of research contributions on this topic, the available literature is underrepresentative of ethnic minority older women. Culture has been shown to have a significant impact on a woman's perception of her own UI symptoms; this demonstrates the necessity for the recruitment of ethnically and culturally diverse samples when studying UI. In the present study, we determined the prevalence of UI among 140 community-dwelling, ethnically diverse older women (28.2%), discovered that our new UI screener is reliable, and did not find the UI-depression link to be significant. The clinical and research implications of our findings are discussed. PMID:24982981

  10. 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

  11. Social and cultural construction of urinary incontinence among Korean American elderly women.

    PubMed

    Kang, Youngmi; Crogan, Neva L

    2008-01-01

    The purpose of this article is to describe the social and cultural constructions that influence help-seeking for urinary incontinence (UI) among Korean American elderly women. Many Korean American elder women do not perceive UI as a problem worthy of attention. The reason may lie in its social and cultural construction. The social construction is rooted in the collectivist nature of Korean culture, which makes UI a family, rather than an individual, problem. The cultural construction is related to Confucianism, which directs conceptions about ageism, shame, and fatalism. This article will help the gerontological nurse to better understand Korean American elderly women's sociocultural background related to UI care and could lead to appropriate family centered interventions to manage or treat UI in this population. PMID:18394511

  12. Urinary Incontinence among older Mexican American men: Risk factors and psycho-social consequences

    PubMed Central

    Gerst, K.; Ray, L.A.; Samper-Ternent, R; Espino, D.V; Markides, K.S.

    2011-01-01

    Extant literature on Urge Urinary Incontinence (UUI) focuses on women and non-Hispanic White and little is known about ethnic minority men. We analyzed 700 Mexican-American men aged 75 and older from the fifth Wave (2004/5) of the Hispanic Established Population for the Epidemologic Study of the Elderly. Logistic regression analyses examined risk factors for self-reported UUI and the impact of UUI on mental health and social support. Twenty-nine percent reported having difficulty holding their urine until they could get to a toilet. Men with more co-morbid conditionsand men with prostate problems were more likely to report UUI symptoms. Men with UUI were less likely to report having a confidant and had a higher risk of high depressive symptoms. This study is the first to examine risk factors for and consequences of self-reported UUI among older Mexican-American men using a large community-based survey. PMID:20811953

  13. [Research review on apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years].

    PubMed

    Song, Feng-Jun; Zhang, Hong; Zheng, Shi-Li; Fang, Jun-Hui; Liu, Hai-Fei

    2011-10-01

    The relevant documents of apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years have been collated and analyzed in aspect of current situation of acupuncture-moxibustion treatment, acupoint selection, manipulation and problems. The result indicates that the main therapy for this disease is acupuncture-moxibustion combined with electroacupuncture or other methods, and the acupuncture-moxibustion therapy is superior to the medicine. The clinical research has made considerable progress and the great importance has been attached to the research method. The main problems are low credibility of total quality, inconsistent curative course, incomplete case of illness, missing of quality control, disordered standards of clinical diagnosis and curative effect evaluation, varied observation index and phatic discussion of mechanism. It is suggested to carry on scientific research, enhance research lever, expand mind, innovate ideas, and establish uniformed standards of diagnosis and curative effect evaluation and observation index. PMID:22043698

  14. 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 ...

  15. Novel Application of Statistical Methods to Identify New Urinary Incontinence Risk Factors

    PubMed Central

    Ogunyemi, Theophilus O.; Siadat, Mohammad-Reza; Arslanturk, Suzan; Killinger, Kim A.; Diokno, Ananias C.

    2012-01-01

    Longitudinal data for studying urinary incontinence (UI) risk factors are rare. Data from one study, the hallmark Medical, Epidemiological, and Social Aspects of Aging (MESA), have been analyzed in the past; however, repeated measures analyses that are crucial for analyzing longitudinal data have not been applied. We tested a novel application of statistical methods to identify UI risk factors in older women. MESA data were collected at baseline and yearly from a sample of 1955 men and women in the community. Only women responding to the 762 baseline and 559 follow-up questions at one year in each respective survey were examined. To test their utility in mining large data sets, and as a preliminary step to creating a predictive index for developing UI, logistic regression, generalized estimating equations (GEEs), and proportional hazard regression (PHREG) methods were used on the existing MESA data. The GEE and PHREG combination identified 15 significant risk factors associated with developing UI out of which six of them, namely, urinary frequency, urgency, any urine loss, urine loss after emptying, subject's anticipation, and doctor's proactivity, are found most highly significant by both methods. These six factors are potential candidates for constructing a future UI predictive index. PMID:23193394

  16. First experience with the ATOMS® implant, a new treatment option for male urinary incontinence

    PubMed Central

    Cansino, Jose Ramón; Portilla, María Alejandra; Rodriguez, Simón Claudio; Hidalgo, Luis; De la Peña, Javier

    2014-01-01

    Introduction Urinary incontinence (UI) is defined as any complaint of involuntary urine leakage. A description is provided of our experience with the ATOMS® (Adjustable Transobturator Male System. Agency for Medical Innovations. A.M.I.) adjustable implant in patients with mild to moderate UI. Material and methods A retrospective study was made of the data referring to 13 patients treated with this adjustable system. Demographic and personal data were collected along with information on the etiology, severity, characteristics, duration of UI, complementary tests, surgery times, complications and results obtained. Results The full continence (no use of pad) recovery rate at the close of the study was 12/13 (92.3%). Three cases required a single filling during the mean 16 months of follow–up (range 4–32; median 14 months). A complication in the form of perineal hematoma was resolved with conservative treatment and a case of urinary retention was resolved by placing a bladder catheter for the duration of one week. Three patients experienced perineal–scrotal dysesthesias that disappeared spontaneously in the first three months. Conclusions The described adjustable continence system has been found to be very effective in males with mild to moderate UI. In our experience, the ATOMS® implant offers excellent results over the middle term with a very low rate of complications that were easily resolved in all cases. PMID:25667760

  17. Urolastic for the treatment of women with stress urinary incontinence: 24-month follow-up

    PubMed Central

    Zajda, Janusz; Farag, Fawzy

    2015-01-01

    Introduction To evaluate the efficacy and durability of Urolastic, a new urethral bulking agent in women with stress urinary incontinence (SUI), after a follow-up of 24-months. Material and methods A follow-up study of women with SUI who received a Urolastic injection and successfully passed the 12-month follow-up. Assessment included the Stamey Grade, 1-h Pad weight test, and the International quality of life (I-QoL) score. Results Nineteen women who completed the 12-month follow-up were invited for the 24-month follow-up study. One patient did not respond to the correspondence. Four of the 18 patients who responded to the correspondence reported removal of the Urolastic implant at another facility, based on their desire. The explanation for this removal was painful intercourse (n = 1) or less than optimal dryness (n = 3). The overall objective improvement in continence status at 24-months was 66% compared to the 89% at the 12-month follow-up, while in addition the 1-h pad weight test showed >50% reduction in pad weight in 66% of patients compared to 84% at the 12-month follow-up. Adverse events reported were urinary tract infection (n = 1), local genital infection with erosion into the vagina (n = 1), painful intercourse (n = 2), and urgency (n = 4). Conclusions Urolastic is comparable to other bulking agents in terms of durability, efficacy, and complications. PMID:26568877

  18. Use of a percutaneously controlled hydraulic occluder for treatment of refractory urinary incontinence in three female cats.

    PubMed

    Wilson, Kendall E; Berent, Allyson C; Weisse, Chick W

    2016-03-01

    CASE DESCRIPTION 3 cats were referred for evaluation of chronic urinary incontinence. CLINICAL FINDINGS A presumptive diagnosis of urethral sphincter mechanism incompetence (USMI) was made in all 3 cats. Preoperatively, incontinence was mild in 1 cat (incontinence during sleep) and moderate to severe (incontinence while awake and at rest) in 2. Structural abnormalities noted during cystoscopy included urethrovestibular junction stenosis (n = 1), vaginal stenosis (1), short urethra (1), and intrapelvic bladder (1). TREATMENT AND OUTCOME All 3 cats were treated by means of implantation of an inflatable silicone hydraulic occluder (HO) via a ventral midline celiotomy. Immediately prior to HO implantation, patients underwent cystoscopy to detect any anatomic abnormalities and confirm the absence of ureteral ectopia. Following surgery, all 3 patients attained complete continence, needing 0 or 1 inflation of the device. Complications included cystoscopy-associated urethral tear (n = 1), constipation (1), stranguria (1), hematuria (2), and urinary tract infection (2). Device explantation was performed 14 weeks after surgery in 1 cat because of postoperative constipation. Constipation persisted and urinary incontinence recurred but was markedly improved following device removal in this cat (leakage of urine only when sleeping at follow-up 29 months after surgery [26 months after device explantation]). At the time of last follow-up, 2 of the 3 cats remained fully continent approximately 3 and 6 years after device implantation. CLINICAL RELEVANCE Findings suggested that implantation of an HO may be a safe and effective long-term treatment for some cats with USMI. Further studies are necessary to evaluate the potential for treatment-related complications and the long-term outcome. PMID:26885598

  19. Stress urinary incontinence animal models as a tool to study cell-based regenerative therapies targeting the urethral sphincter.

    PubMed

    Herrera-Imbroda, Bernardo; Lara, María F; Izeta, Ander; Sievert, Karl-Dietrich; Hart, Melanie L

    2015-03-01

    Urinary incontinence (UI) is a major health problem causing a significant social and economic impact affecting more than 200million people (women and men) worldwide. Over the past few years researchers have been investigating cell therapy as a promising approach for the treatment of stress urinary incontinence (SUI) since such an approach may improve the function of a weakened sphincter. Currently, a diverse collection of SUI animal models is available. We describe the features of the different models of SUI/urethral dysfunction and the pros and cons of these animal models in regard to cell therapy applications. We also discuss different cell therapy approaches and cell types tested in preclinical animal models. Finally, we propose new research approaches and perspectives to ensure the use of cellular therapy becomes a real treatment option for SUI. PMID:25453264

  20. Urinary Retention, Incontinence, and Dysregulation of Muscarinic Receptors in Male Mice Lacking Mras.

    PubMed

    Ehrhardt, Annette; Wang, Bin; Yung, Andrew C; Wang, Yanni; Kozlowski, Piotr; van Breemen, Cornelis; Schrader, John W

    2015-01-01

    Here we show that male, but not female mice lacking expression of the GTPase M-Ras developed urinary retention with distention of the bladder that exacerbated with age but occurred in the absence of obvious anatomical outlet obstruction. There were changes in detrusor morphology in Mras-/- males: Smooth muscle tissue, which exhibited a compact organization in WT mice, appeared disorganized and became increasingly 'layered' with age in Mras-/- males, but was not fibrotic. Bladder tissue near the apex of bladders of Mras-/- males exhibited hypercontractility in response to the cholinergic agonist carbachol in in vitro, while responses in Mras-/- females were normal. In addition, spontaneous phasic contractions of detrusors from Mras-/- males were increased, and Mras-/- males exhibited urinary incontinence. We found that expression of the muscarinic M2 and M3 receptors that mediate the cholinergic contractile stimuli of the detrusor muscle was dysregulated in both Mras-/- males and females, although only males exhibited a urinary phenotype. Elevated expression of M2R in young males lacking M-Ras and failure to upregulate M3R with age resulted in significantly lower ratios of M3R/M2R expression that correlated with the bladder abnormalities. Our data suggests that M-Ras and M3R are functionally linked and that M-Ras is an important regulator of male bladder control in mice. Our observations also support the notion that bladder control is sexually dimorphic and is regulated through mechanisms that are largely independent of acetylcholine signaling in female mice. PMID:26516777

  1. Urinary Retention, Incontinence, and Dysregulation of Muscarinic Receptors in Male Mice Lacking Mras

    PubMed Central

    Ehrhardt, Annette; Wang, Bin; Yung, Andrew C.; Wang, Yanni; Kozlowski, Piotr; van Breemen, Cornelis; Schrader, John W.

    2015-01-01

    Here we show that male, but not female mice lacking expression of the GTPase M-Ras developed urinary retention with distention of the bladder that exacerbated with age but occurred in the absence of obvious anatomical outlet obstruction. There were changes in detrusor morphology in Mras-/- males: Smooth muscle tissue, which exhibited a compact organization in WT mice, appeared disorganized and became increasingly ‘layered’ with age in Mras-/- males, but was not fibrotic. Bladder tissue near the apex of bladders of Mras-/- males exhibited hypercontractility in response to the cholinergic agonist carbachol in in vitro, while responses in Mras-/- females were normal. In addition, spontaneous phasic contractions of detrusors from Mras-/- males were increased, and Mras-/- males exhibited urinary incontinence. We found that expression of the muscarinic M2 and M3 receptors that mediate the cholinergic contractile stimuli of the detrusor muscle was dysregulated in both Mras-/- males and females, although only males exhibited a urinary phenotype. Elevated expression of M2R in young males lacking M-Ras and failure to upregulate M3R with age resulted in significantly lower ratios of M3R/M2R expression that correlated with the bladder abnormalities. Our data suggests that M-Ras and M3R are functionally linked and that M-Ras is an important regulator of male bladder control in mice. Our observations also support the notion that bladder control is sexually dimorphic and is regulated through mechanisms that are largely independent of acetylcholine signaling in female mice. PMID:26516777

  2. Pelvic artery embolization in the management of pelvic arterial bleeding following midurethral sling surgery for stress urinary incontinence

    PubMed Central

    Cho, Eun-Ji; Kim, Jun-Bum; Park, So-Yun; Kim, Sung-Hoon; Kim, Chung-Hoon; Kang, Byung-Moon

    2016-01-01

    The transobturator tape (TOT) method is the recent minimally invasive midurethral sling surgery. The TOT method was invented to reduce complication rate of surgical technique for female stress urinary incontinence. Pelvic bleeding following TOT procedure, although extremely rare, could be occurred. We presented three cases which treat pelvic arterial bleeding after midurethral sling (TOT and tension-free vaginal tape Secur) surgery via pelvic artery embolization. Therefore we report our cases with brief review of the literature. PMID:27004210

  3. A Novel Method of Urinary Sphincter Deficiency: Serial Histopathology Evaluation in a Rat Model of Urinary Incontinence.

    PubMed

    Khorramirouz, Reza; Mozafarpour, Sarah; Kameli, Seyedeh Maryam; Ladi Seyedian, Seyedeh Sanam; Oveisi, Nasim; Rahimi, Zahra; Alijani, Maryam; Kajbafzadeh, Abdol-Mohammad

    2016-02-01

    In this study, a novel technique of irreversible sphincter deficiency by pudendal nerve transection (PNT) using 40 female rats for studying the pathophysiology of stress urinary incontinence associated with childbirth was developed. Of the 40 rats, 10 served as controls and the remaining underwent bilateral PNT at the anastomotic lumbosacral trunk level. Urethral morphological changes following bilateral PNT were assessed with serial hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining methods at 50, 90, and 130 days post-intervention. Leak point pressure (LPP) measurement was used to determine the effect of pudendal injury on urethral outlet resistance after the transection. H&E and IHC staining showed irreversible loss of striated muscle mass of the sphincter region and increase in collagen deposition compatible with muscle atrophy. LPP measurements also significantly decreased following bilateral PNT. In conclusion, a novel method of irreversible sphincter insufficiency was developed. This model effectively decreased urethral outlet resistance and caused irreversible striated muscle atrophy. It was suggested that this technique can be used to develop a permanent sphincter deficiency model for the preclinical testing of treatment modalities exclusively triggering the pudendal nerve. PMID:26574901

  4. Can an individualized and comprehensive care strategy improve urinary incontinence (UI) among nursing home residents?

    PubMed

    Tanaka, Yukiko; Nagata, Kumiko; Tanaka, Tomoe; Kuwano, Koichi; Endo, Hidetoshi; Otani, Tetsuya; Nakazawa, Minato; Koyama, Hiroshi

    2009-01-01

    Urinary incontinence (UI) is one of the most common and distressing conditions among nursing home residents. Although scheduled care is usually provided for them, incontinence care should be individualized regarding going to the toilet, changing diapers, and taking food and water. We have developed an individualized and comprehensive care strategy to address the problem. We conducted an intervention study that involved training chiefs of staffs, who in turn trained other staffs, and encouraging residents. A total of 153 elderly subjects selected from 1290 residents in 17 nursing homes were eligible to receive our individualized and comprehensive care. The goals of the care strategy were (i) to complete meal intake; (ii) to take fluids up to 1500 ml/day; (iii) to urinate in a toilet; (iv) to spend over 6h out of bed; and (v) to reduce time spent in wet diapers. We explained the aims of our strategy to the chiefs of staff of each nursing home and instructed them to encourage residents to take an active part in our individualized and comprehensive care strategy for 12 weeks. For 3 days before and after that period, we assessed the changes in fluid volume intake, time spent in wet diapers, size of diaper pads, and urination habits. The result was that fluid volume intake significantly increased (p<0.001) while time spent in wet diapers decreased (p<0.001). The number of residents wearing diapers decreased as did the size of pads during the day (p=0.0017). The proportion of residents using diapers at night was reduced and those using toilets at night increased (p=0.007). This study suggests that such an individualized and comprehensive care strategy can offer a measurable improvement in UI care. PMID:19095315

  5. Different sling procedures for stress urinary incontinence: a lesson from 453 patients.

    PubMed

    Luo, De-Yi; Wang, Kun-Jie; Zhang, Han-Chao; Dai, Yi; Yang, Tong-Xing; Shen, Hong

    2014-03-01

    Several midurethral sling (MUS) procedures, such as tension-free vaginal tape (TVT), TVT obturator (TVT-O), tension-free vaginal tape SECUR (TVT-S), and pubovaginal sling (PVS), have been used for the treatment of female stress urinary incontinence (SUI); however, which method is best for a particular patient group is not known. This study aimed to identify the best rationale for choosing the optimal MUS procedure for each patient. In total, 453 consecutive female patients with SUI who were treated with MUSs in West China Hospital of Sichuan University from September 2003 to September 2011 were enrolled in this study. All the patients underwent comprehensive pre-, intra-, and postoperative evaluations, including collection of demographic information, pelvic examination, and urodynamic testing, and operation-related complications were recorded. The Incontinence Quality of Life questionnaire was also completed. Under local or general anesthesia, 105 cases were treated with TVT, 243 with TVT-O, 90 with TVT-S, and 15 with PVS. Patients with different profiles in terms of age, symptom duration, concomitant procedures, urodynamic parameters, and pelvic organ prolapse (POP) quantification score were treated successfully; the body mass index did not differ significantly among the various treatment options. The cure and improvement rates were similar among the treatment groups: 97.14% (102/105) in TVT, 100% (243/243) in TVT-O, 98.89% (89/90) in TVT-S, and 100% (15/15) in PVS. Only minor complications were experienced by the patients. In conclusion, each MUS procedure was observed to be safe and effective in different subpopulations of patients, and the results suggest that appropriate patient selection is crucial for the success of each MUS procedure. PMID:24581214

  6. Cost-Effectiveness of an Internet-Based Treatment Program for Stress Urinary Incontinence

    PubMed Central

    Sjöström, Malin; Umefjord, Göran; Lindholm, Lars; Samuelsson, Eva

    2015-01-01

    Aims To perform a deterministic cost-utility analysis, from a 1-year societal perspective, of two treatment programs for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. The treatments were compared with each other and with no treatment. Methods We performed this economic evaluation alongside a randomized controlled trial. The study included 250 women aged 18–70, with SUI ≥ 1 time/week, who were randomized to 3 months of pelvic floor muscle training via either an Internet-based program including e-mail support from an urotherapist (n = 124) or a program sent by post (n = 126). Recruitment was web-based, and participants were self-assessed with validated questionnaires and 2-day bladder diaries, supplemented by a telephone interview with a urotherapist. Treatment costs were continuously registered. Data on participants' time for training, incontinence aids, and laundry were collected at baseline, 4 months, and 1 year. We also measured quality of life with the condition-specific questionnaire ICIQ-LUTSqol, and calculated the quality-adjusted life-years (QALYs) gained. Baseline data remained unchanged for the no treatment option. Sensitivity analysis was performed. Results Compared to the postal program, the extra cost per QALY for the Internet-based program ranged from 200€ to 7,253€, indicating greater QALY-gains at similar or slightly higher costs. Compared to no treatment, the extra cost per QALY for the Internet-based program ranged from 10,022€ to 38,921€, indicating greater QALY-gains at higher, but probably acceptable costs. Conclusion An Internet-based treatment for SUI is a new, cost-effective treatment alternative. Neurourol. Urodynam. 34:244–250, 2015. © 2013 The Authors. Neurourology and Urodynamics published by Wiley Periodicals, Inc. PMID:24347521

  7. Low serum Insulin Like Growth Factor - 1 in patients with Stress Urinary Incontinence

    PubMed Central

    Ozbek, Emin; Otunctemur, Alper; Sahin, Suleyman; Ozcan, Levent; Dursun, Murat; Polat, Emrecan; Tulubas, Feti; Cekmen, Mustafa

    2016-01-01

    ABSTRACT Objective: SUI, involuntary loss of urine, occurs when intra abdominal pressure exceeds urethral pressure in women. Recent animal study has shown that there are therapeutic effects of Insulin-like growth factors (IGF-1) on stress urinary incontinence in rats with simulated childbirth trauma. IGF-1 is an important mediator of cell growth, differentiation and transformation in various tissues and stimulates fibroblast proliferation and enhances collagen synthesis. The purpose of the current study was to determine the association between IGF-1 levels and SUI. Materials and Methods: All patients were evaluated for SUI and divided into two groups: 116 women with SUI and 76 women without SUI. Diagnosis of SUI was based on the International Consultation on Incontinence Questionnaire-Short Form (ICIQSF). Levels of IGF-1 were measured in serum by enzyme-linked immunosorbent assay. The relationship between IGF-1 levels and SUI in patients was evaluated statisticaly. Results: The mean age of patients wiyh SUI was 49.9±8.6 and 48.7±7.8 in control group. Plasma IGF-1 levels were significantly lower in SUI than in control group (106.5±26.4 and 133.3±37.1ng/mL, respectively, P <0.001). Body mass indexes were higher in women with SUI than women without SUI. Conclusion: In this study lower serum IGF-1 levels were found to be associated with SUI. Serum IGF-1 level appears to be a specific predictor of SUI, and it may be used in early prediction of SUI in female population. PMID:27564291

  8. The effect of parity on pelvic floor muscle strength and quality of life in women with urinary incontinence: a cross sectional study

    PubMed Central

    Özdemır, Özlem Çınar; Bakar, Yesim; Özengın, Nuriye; Duran, Bülent

    2015-01-01

    [Purpose] The purpose of this study was to analyze the pelvic floor muscle (PFM) activity after vaginal birth, and the effect of parity on PFM strength and quality of life (QoL) in women with urinary incontinence. [Subjects and Methods] Patients (n=241) who gave birth vaginally and experienced urinary incontinence were divided into three groups: group 1 consisted of women having 1–3 children, group 2 consisted of women having 4–6 children, and group 3 consisted of women having more than 6 children. All patients underwent detailed examination of the PFM. The Turkish version of the self-administered Incontinence Quality of Life Instrument (I-QoL) questionnaire was used to evaluate the effects of stress urinary incontinence on participants’ QoL. [Results] Comparison of PFM strengths showed a significant intergroup difference. Group 1 showed significantly higher PFM strength scores than those of groups 2 and 3. I-QoL scores related to stress incontinence showed a significant intergroup difference. As number of deliveries increased, quality of life decreased. Comparison of PFM strengths and I-QoL scores related to stress incontinence showed a significant intergroup difference. [Conclusion] Increasing the awareness of PFM training in women will reduce potential postpartum incontinence due to a weak PFM strength; and will increase quality of life. PMID:26311939

  9. Intensive lifestyle intervention reduces urinary incontinence in overweight/obese men with Type 2 diabetes: Results from the look AHEAD trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Purpose: We determined the effect of an intensive lifestyle intervention on the prevalence, incidence and resolution of bothersome nocturia, increased daytime urinary voiding and urinary incontinence in overweight/obese men with type 2 diabetes after 1 year in the Look AHEAD trial. Materials and Me...

  10. Urinary incontinence in the elderly and in the oldest old: correlation with frailty and mortality.

    PubMed

    Berardelli, Maurizio; De Rango, Francesco; Morelli, Michele; Corsonello, Andrea; Mazzei, Bruno; Mari, Vincenzo; Montesanto, Alberto; Lattanzio, Fabrizia; Passarino, Giuseppe

    2013-06-01

    Urinary incontinence (UI) is very common in the elderly and has personal and social implications. Many authors have pointed out the necessity to analyze UI in correlation with the overall quality of aging, to better understand this syndrome and define measures for its prevention and treatment. In the present study, we addressed this problem by analyzing the UI correlation with frailty, which has emerged in the last decade as the geriatric syndrome correlated with individual homeostatic capacity and then as the basis of the age-related physical decline. In addition, the monitoring of our sample for a long period allowed us to estimate the prognostic significance of UI by analyzing the correlation between UI and mortality. The analysis was performed in a large sample that included numerous ultra-nonagenarians, a population segment that is still poorly known for UI and other geriatric parameters. We found a strict correlation between UI and frailty, suggesting that UI is correlated to the homeostatic and physiological decline leading to frailty. In addition, we found that UI is an independent mortality risk factor in ultra-nonagenarians, suggesting that the neurological sensitivity needed to be continent is lost very soon when the frailty associated physiological decline begins. On the whole, our study suggests that UI is a marker of frailty and that UI patients should be monitored and, in case, treated in a timely manner to avoid, or to limit, the effects of frailty such as malnutrition, falls, and the consequent accumulation of disabilities. PMID:23496115

  11. Urinary Incontinence, Depression and Post-traumatic Stress Disorder in Women Veterans

    PubMed Central

    Bradley, Catherine S.; Nygaard, Ingrid E.; Mengeling, Michelle A.; Torner, James C.; Stockdale, Colleen K.; Booth, Brenda M.; Sadler, Anne G.

    2012-01-01

    Objective To study associations between urinary incontinence (UI) symptoms, depression and post-traumatic stress disorder (PTSD) in women veterans. Study Design This cross-sectional study enrolled women 20 to 52 years of age registered at two Midwestern U.S. Veterans Affairs Medical Centers or outlying clinics within five years preceding study interview. Participants completed a computer-assisted telephone interview assessing urogynecologic, medical and mental health. Multivariable analyses studied independent associations between stress and urgency UI and depression and PTSD. Results 968 women mean age 38.7 ± 8.7 years were included. 191 (19.7%) reported urgency/mixed UI and 183 (18.9%) stress UI. PTSD (OR [95%CI] = 1.8 [1.0, 3.1]) but not depression (OR [95%CI] = 1.2 [0.73, 2.0]) was associated with urgency/mixed UI. Stress UI was not associated with PTSD or depression. Conclusion In women veterans, urgency/mixed UI was associated with PTSD but not depression. PMID:22631867

  12. Analysis of risk factors associated with vaginal erosion after synthetic sling procedures for stress urinary incontinence.

    PubMed

    Chen, Huey-Yi; Ho, Ming; Hung, Yao-Ching; Huang, Li-Chia

    2008-01-01

    The goal of this study was to analyze the risk factors associated with vaginal erosion after synthetic sling procedure for stress urinary incontinence. Follow-up evaluations were at 1 week, 1 to 3 months, 6 months, and annually after the operation. The evaluations included detailed history taking, vaginal examinations, and perineal ultrasonographic urethrocystography. The vaginal erosion rate (6/239) after the synthetic sling procedure was 2.5%. We assessed the relationship between clinical features and vaginal erosion. Of these, only diabetes mellitus (DM) was a significant risk factor for vaginal erosion. Women with DM were 8.3 times more at risk than women without DM for developing vaginal erosion after synthetic sling procedure (p < 0.05). The vaginal erosion-free rate during the 24-month follow-up decreased significantly in women with DM. The rate of vaginal erosion associated with type III multifilamentous polypropylene sling (intravaginal slingplasty) is 10.7% more than that with type I monofilament polypropylene sling (such as tension-free vaginal tape and inside out transobturator vaginal tape) (p = 0.054). Women with DM should be informed that vaginal erosion is a possible complication after synthetic sling procedure. PMID:17594046

  13. Autologous adipose stem cells in treatment of female stress urinary incontinence: results of a pilot study.

    PubMed

    Kuismanen, Kirsi; Sartoneva, Reetta; Haimi, Suvi; Mannerström, Bettina; Tomás, Eija; Miettinen, Susanna; Nieminen, Kari

    2014-08-01

    The purpose of our study was to find out whether transurethral injections of autologous adipose stem cells (ASCs) are an effective and a safe treatment for female stress urinary incontinence (SUI). We treated five SUI patients with ASCs combined with bovine collagen gel and saline. Prior to the treatment, the ASCs were isolated from subcutaneous fat and expanded for 3 weeks in a good manufacturing practice-level laboratory. The mixture of ASCs and collagen was injected transurethrally via cystoscope. Additionally, viability, multipotency, and surface marker profile of ASCs were analyzed in vitro. We followed up with patients 3, 6, and 12 months after the injections. The primary endpoint was a cough test to measure objectively the effect of the treatment. Validated questionnaires were used to determine the subjective cure rate. After 6 months, 1 of 5 patients displayed a negative cough test with full bladder filled with 500 ml of saline. At 1 year, the cough test was negative with three patients; two of them were satisfied with the treatment and did not wish further treatment for SUI. Validated questionnaires showed some subjective improvement in all five patients. This is the first study describing the use of autologous ASCs in combination with collagen gel for female SUI treatments. Thus far, the treatment with autologous ASCs has proven safe and well tolerated. However, the feasibility and efficacy of the treatment were not optimal; therefore, additional research is needed to develop SUI injection therapies. PMID:24985079

  14. Social-Interaction Knowledge Translation for In-Home Management of Urinary Incontinence and Chronic Care.

    PubMed

    Jansen, Lynn; McWilliam, Carol L; Forbes, Dorothy; Forchuk, Cheryl

    2013-12-01

    Although urinary incontinence (UI) can be managed conservatively, it is a principal reason for the breakdown of in-home family care. This study explored the social interaction processes of knowledge translation (KT) related to how UI management knowledge might be translated within in-home care. In-depth interview data were collected from a theoretical sample of 23 family caregivers, older home care recipients, and home care providers. Constant comparison and Glaser’s analysis criteria were used to create translating knowledge through relating , a substantive theory with 10 subthemes: living with the problem; building experiential knowledge; developing comfort; easing into a working relationship; nurturing mutuality; facilitating knowledge exchange; building confidence; fi ne-tuning knowledge; putting it all together; and managing in-home care. Findings inform both theory and practice of in-home UI KT, illuminating how intersubjectivity and bi-directional relational interactions are essential to translating in-home chronic care knowledge, which is largely tacit and experiential in nature. PMID:24063503

  15. Urinary catheters

    MedlinePlus

    ... that you use a catheter if you have: Urinary incontinence (leaking urine or being unable to control when ... Surgery Bladder Diseases Spinal Cord Injuries Urethral Disorders Urinary Incontinence Urine and Urination Browse the Encyclopedia A.D. ...

  16. Use of antibiotics for urinary tract infection in women undergoing surgery for urinary incontinence: a cohort study

    PubMed Central

    Guldberg, Rikke; Kesmodel, Ulrik Schiøler; Brostrøm, Søren; Kærlev, Linda; Hansen, Jesper Kjær; Hallas, Jesper; Nørgård, Bente Mertz

    2014-01-01

    Objective To describe the use of antibiotics for urinary tract infection (UTI) before and after surgery for urinary incontinence (UI); and for those with use of antibiotics before surgery, to estimate the risk of treatment for a postoperative UTI, relative to those without use of antibiotics before surgery. Design A historical population-based cohort study. Setting Denmark. Participants Women (age ≥18 years) with a primary surgical procedure for UI from the county of Funen and the Region of Southern Denmark from 1996 throughout 2010. Data on redeemed prescriptions of antibiotics ±365 days from the date of surgery were extracted from a prescription database. Main outcome measures Use of antibiotics for UTI in relation to UI surgery, and the risk of being a postoperative user of antibiotics for UTI among preoperative users. Results A total of 2151 women had a primary surgical procedure for UI; of these 496 (23.1%) were preoperative users of antibiotics for UTI. Among preoperative users, 129 (26%) and 215 (43.3%) also redeemed prescriptions of antibiotics for UTI within 0–60 and 61–365 days after surgery, respectively. Among preoperative non-users, 182 (11.0%) and 235 (14.2%) redeemed prescriptions within 0–60 and 61–365 days after surgery, respectively. Presurgery exposure to antibiotics for UTI was a strong risk factor for postoperative treatment for UTI, both within 0–60 days (adjusted OR, aOR=2.6 (95% CI 2.0 to 3.5)) and within 61–365 days (aOR=4.5 (95% CI 3.5 to 5.7)). Conclusions 1 in 4 women undergoing surgery for UI was treated for UTI before surgery, and half of them had a continuing tendency to UTIs after surgery. Use of antibiotics for UTI before surgery was a strong risk factor for antibiotic use after surgery. In women not using antibiotics for UTI before surgery only a minor proportion initiated use after surgery. PMID:24496697

  17. Anticholinergic Versus Botulinum Toxin A Comparison Trial for the Treatment of Bothersome Urge Urinary Incontinence: ABC Trial

    PubMed Central

    Visco, Anthony G.; Brubaker, Linda; Richter, Holly E.; Nygaard, Ingrid; Paraiso, Marie Fidela; Menefee, Shawn A.; Schaffer, Joseph; Wei, John; Chai, Toby; Janz, Nancy; Spino, Cathie; Meikle, Susan

    2011-01-01

    This trial compares the change in urgency urinary incontinence episodes over 6 months, tolerability and cost effectiveness between women receiving daily anticholinergic therapy plus a single intra-detrusor injection of saline versus a single intra-detrusor injection of 100 unit of botulinum toxin A plus daily oral placebo tablets. We present the rationale and design of a randomized controlled trial, Anticholinergic versus Botulinum Toxin, Comparison Trial for the Treatment of Bothersome Urge Urinary Incontinence: ABC Trial, conducted by the NICHD-funded Pelvic Floor Disorders Network. We discuss the innovative nature of this trial and the challenges related to choice of patient population, maintaining masking, cost-effectiveness, ethical considerations, measuring adherence, and placebo development and testing. Enrollment began in April, 2010. 242 participants will be randomized and primary outcome data analysis is anticipated to begin in mid 2012. Several challenges in the trial design are discussed. Randomization to placebo intradetrusor injections may limit recruitment, potentially impacting generalizability. Other challenges included the heavy marketing of drugs for overactive bladder which could impact recruitment of drug naïve women. In addition, anticholinergic medications often cause dry mouth, making masking difficult. Finally, adverse reporting of transient urinary retention is challenging as there is no standardized definition; yet this is the most common adverse event following intradetrusor botulinum toxin injection. The ABC trial will help women with urgency urinary incontinence balance efficacy, side effects and cost of anticholinergic medication versus botulinum toxin intradetrusor injection. The results have the potential to fundamentally change the therapeutic approach to this condition. PMID:22008247

  18. Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial.

    PubMed

    Visco, Anthony G; Brubaker, Linda; Richter, Holly E; Nygaard, Ingrid; Paraiso, Marie Fidela; Menefee, Shawn A; Schaffer, Joseph; Wei, John; Chai, Toby; Janz, Nancy; Spino, Cathie; Meikle, Susan

    2012-01-01

    This trial compares the change in urgency urinary incontinence episodes over 6 months, tolerability and cost effectiveness between women receiving daily anticholinergic therapy plus a single intra-detrusor injection of saline versus a single intra-detrusor injection of 100 U of botulinum toxin A plus daily oral placebo tablets. We present the rationale and design of a randomized-controlled trial, Anticholinergic versus Botulinum Toxin, Comparison Trial for the Treatment of Bothersome Urge Urinary Incontinence: ABC trial, conducted by the NICHD-funded Pelvic Floor Disorders Network. We discuss the innovative nature of this trial and the challenges related to choice of patient population, maintaining masking, cost effectiveness, ethical considerations, measuring adherence, and placebo development and testing. Enrollment began in April, 2010. 242 participants will be randomized and primary outcome data analysis is anticipated to begin in mid 2012. Several challenges in the trial design are discussed. Randomization to placebo intra-detrusor injections may limit recruitment, potentially impacting generalizability. Other challenges included the heavy marketing of drugs for overactive bladder which could impact recruitment of drug-naïve women. In addition, anticholinergic medications often cause dry mouth, making masking difficult. Finally, adverse reporting of transient urinary retention is challenging as there is no standardized definition; yet this is the most common adverse event following intra-detrusor botulinum toxin injection. The ABC trial will help women with urgency urinary incontinence balance efficacy, side effects and cost of anticholinergic medication versus botulinum toxin intra-detrusor injection. The results have the potential to fundamentally change the therapeutic approach to this condition. PMID:22008247

  19. Urinary tract infections in women with stress urinary incontinence treated with transobturator suburethral tape and benefit gained from the sublingual polibacterial vaccine

    PubMed Central

    Lorenzo Gómez, María F.; Collazos Robles, Rafael E.; Virseda Rodríguez, Álvaro J.; García Cenador, María B.; Mirón Canelo, José A.

    2015-01-01

    Introduction and objectives: Stress urinary incontinence (SUI) and recurrent urinary tract infections (RUTIs) are highly prevalent diseases. Our purpose was to investigate the relationship between RUTIs and surgical correction of SUI with transobturator suburethral tape (TOT) and to describe the benefit gained from a sublingual polibacterial preparation on RUTIs developed after TOT. Materials and methods: A retrospective study was performed on 420 women who underwent TOT surgery due to SUI between April 2003 and October 2011. Group A: patients without urinary tract infections (UTIs) before TOT (n = 294). Group B: patients with UTIs before TOT (n = 126). Variables: age, personal history, number of UTIs/month prior to and after surgery, appearance of urgent urinary incontinence (UUI) with or without UTIs, response to International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and Short Form 36 (SF-36) questionnaires. Results: Group A: 85% dry; 5% UUI; 4% de novo UTIs with good response to antibiotics over 6 days. No RUTIs during the follow-up period, 2% with sporadic UTIs. Group B: 47.61% RUTIs; 52.39% sporadic UTIs; greater incidence of diabetes mellitus (p < 0.0025) and smoking (p < 0.0031) than group A. After TOT: 79.36% dry; 10% RUTIs. After treatment with antibiotics for 6 days and bacterial preparation for 3 months, 82% of patients did not have a UTI anymore. Postoperative cystourethrogram revealed 38% of nondiagnosed cystoceles before TOT. No patient had a postvoiding volume greater than 100 cm3 after TOT. Improvement of ICIQ-SF (p < 0.001) and SF-36 (p < 0.0004) in both groups. Conclusion: After eliminating bias associated with the tape, the technique and the surgeon’s skills, SUI correction may decrease the number of UTIs and improve the quality of life. UTIs disappeared in 82% of patients with RUTIs after TOT. PMID:26445597

  20. Female stress urinary incontinence: standard techniques revisited and critical evaluation of innovative techniques

    NASA Astrophysics Data System (ADS)

    de Riese, Cornelia; de Riese, Werner T. W.

    2003-06-01

    Objectives: The treatment of female urinary incontinence (UI) is a growing health care concern in our aging society. Publications of recent innovations and modifications are creating expectations. This brief review provides some insight and structure regarding indications and expected outcomes for the different approaches. Materials: Data extraction is part of a Medline data base search, which was performed for "female stress incontinence" from 1960 until 2000. Additional literature search was performed to cover 2001 and 2002. Outcome data were extracted. Results: (1) INJECTION OF BULKING AGENTS (collagen, synthetic agents): The indication for mucosal coaptation was more clearly defined and in the majority of articles limited to ISD. (2) OPEN COLPOSUSPENSION (Burch, MMK): Best long-term results of all operative procedures, to date considered the gold standard. (3) LAPAROSCOPIC COLPOSUSPENSION (different modifications): Long-term success rates appear dependent on operator skills. There are few long-term data. (4) NEEDLE SUSPENSION: (Stamey, Pareyra and modifications): Initial results were equal to Burch with less morbidity, but long-term success rates are worse. (5) SLING PROCEDURES (autologous, synthetic, allogenic graft materials, different modes of support and anchoring, free tapes): The suburethral sling has traditionally been considered a procedure for those in whom suspension had failed and for those with severe ISD. The most current trend shows its use as a primary procedure for SUI. Long-term data beyond 5 years are insufficient. (6) EXTERNAL OCCLUSIVE DEVICES (vaginal sponges and pessaries, urethral insert): Both vaginal and urethral insert devices can be effective in selected patients. (7) IMPLANTABLE ARTEFICIAL URETHRAL SPHINCTERS: Modifications and improvements of the devices resulted in improved clinical results regarding durability and efficacy. CONCLUSION: (1) The Burch colposuspension is still considered the gold standard in the treatment of female

  1. 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

  2. Potential risk factors associated with stress urinary incontinence among Iranian women

    PubMed Central

    Vahdatpour, Babak; Zargham, Mahtab; Chatraei, Maryam; Bahrami, Faranak; Alizadeh, Farshid

    2015-01-01

    Background: Stress urinary incontinence (SUI) is considered as one of the major hygienic problems among women. The main aim of the study is to assess the potential risk factors associated with SUI among Iranian women. Materials and Methods: This study was conducted on 90 married women with history of SUI diagnosed by an urologist and were selected randomly. Their pelvic muscles contraction (PMC) and the history of the subjects were assessed for some of risk factors such as age, height, weight, body mass index (BMI), pregnancy history, miscarriage, type of delivery (normal vaginal delivery or cesarean section), number of offspring born healthy in addition to other risk factors such as chronic cough, constipation and hypothyroidism by use of POP Questionnaire. Data were analyzed using Pearson correlation coefficient and SPSS version 18 Software. Results: There was a significant relation between SUI and height (P < 0.05, r = 0.45), vaginal delivery (NVD) (P < 0.05, r = 0.2), number of genitourinary surgery (P < 0.05, r = 0.42), hypothyroidism and constipation (P < 0.05). An inverse relatively strong significant relation was found between SUI and cesarean section (P < 0.05, r = –0.50) No significant relation was found between SUI and weight, BMI, age, chronic cough and miscarriage, and other study parameters. An inverse significant relation between PMC and weight (P < 0.05, r = –0.52), BMI (P < 0.05, r = –0.42) and number of genitourinary surgery (P < 0.05, r = –0.18). Conclusion: Cesarean section had a preventive effect on SUI versus normal vaginal delivery. The rate of SUI was higher in taller women or those suffering from hypothyroidism or constipation or who had genitourinary surgery. The women with high BMI had lower pelvic floor muscles strength. PMID:26601093

  3. Mini–slings – an option in stress urinary incontinence treatment. Case studies

    PubMed Central

    Markowski, Michał; Kliś, Rafał; Różański, Waldemar

    2015-01-01

    Introduction Stress urinary incontinence (SUI) is a social disease caused by numerous contributing factors such as natural childbirth, obesity, hormonal deficiencies and changes in collagen fibers, to name a few. Currently, mini–slings, among all the surgical treatment methods, have gained significance. The aim of this study was to establish the effectiveness of this method. Material and methods From 2008 to 2012, one hundred sixty women suffering from SUI underwent surgical procedures to implant mini–slings under the middle part of the urethra and 140 (87.5%) of them remained under observation. In 65 cases, Johnson & Johnson's TVT–Secur was used; in 70 cases, BARD's Adjust mini–sling was used; and in 5 cases, AMS Mini–Arc mini–sling was used. The average period of hospitalization was 3 days per admission, operation and discharge day. Results In 82 cases, patients urinated well after the removal of the catheter, and had full urine continence. Fourteen patients showed great improvement, and in four cases temporary urine retention was observed. In two cases vaginal bleeding was observed, yet there was no need for wound revision. Evaluation of the ‘quality of life improvement’ was done using the Visual Analog Scale (VAS). Conclusions The obtained results allowed the conclusion that the implantation of mini–slings is a low invasive, relatively safe and effective procedure for the treatment of SUI even in cases of recurrence. Almost full recovery was achieved in all the cases of this study. The mini–sling has become an important element in modern urogynecology. PMID:25914841

  4. The Iceberg of Health Care Utilization in Women with Urinary Incontinence

    PubMed Central

    Minassian, Vatche A; Yan, Xiaowei; Lichtenfeld, Marc J; Sun, Haiyan; Stewart, Walter F

    2012-01-01

    Objective To estimate prevalence of urinary incontinence (UI) health care utilization in women from the population to specialty care. Method The General Longitudinal Overactive Bladder Evaluation – UI (GLOBE-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 to build the different steps of the iceberg of disease. Descriptive statistics were used to estimate the prevalence estimates at all levels of the iceberg. Results A total sample of 7,059 women received the BHS. Of those, 3,316 (47%) responded. Prevalence of UI was 1,366 (41%). Women with or without UI did not differ by age or marital status. However, women with versus without UI were more parous (91% vs 87%), significantly more overweight or obese (74% vs 61%), and more likely to have a college education or higher (54% vs 46%), P<0.01. Nine-hundred fifty eight (73%) women with UI reported duration of more than two years and 72% reported moderate to severe UI symptoms. Of all 1,366 women with BHS UI diagnosis, only 339 (25%) sought care, 313 (23%) received some care, and 164 (12%) received subspecialty care. Conclusion UI is a highly prevalent disease. Only a minority with UI appears to seek care and a fraction sees a pelvic floor specialist. It is important not only to educate women, but also primary care providers about this highly prevalent yet treatable condition. PMID:22527544

  5. Argus T® versus Advance® Sling for postprostatectomy urinary incontinence: A randomized clinical trial

    PubMed Central

    Lima, João Paulo Cunha; Pompeo, Antonio Carlos Lima; Bezerra, Carlos Alberto

    2016-01-01

    ABSTRACT Objective To compare the results of two slings, Argus T® and Advance®, for the treatment of postprostatectomy urinary incontinence (PPUI). Material and Methods: From December 2010 to December 2011, 22 patients with PPUI were randomized as follows: 11 (mean age 62.09(±5.30)) underwent treatment with Advance® and 11 (mean age 62.55(±8.54)) with Argus T®. All patients were evaluated preoperatively with urodynamic testing, quality of life questionnaire (ICIQ-SF), voiding diary and 24-hour pad test. Exclusion criteria were: neurological diseases, severe detrusor overactivity and urethral stenosis. Evaluation was performed at 6, 12 and 18 months after the surgery. After implantation of the Argus T® sling, patients who experienced urine leakage equal to or greater than the initial volume underwent adjustment of the sling tension. Results were statistically analyzed using the Fisher’s test, Kolmogorov-Smirnov test, Friedman’s non-parametric test or the Mann-Whitney test. Results Significant improvement of the 24-hour pad test was observed with the Argus T® sling (p=0.038) , With regard to the other parameters, there was no significant difference between the two groups. Removal of the Argus T® device due to perineal pain was performed in one patient (9%). Despite non uniform results, both devices were considered useful to improve quality of life (ICIQ-SF): Argus T® (p=0.018) and Advance® (p=0.017). Conclusions Better results were observed in the 24h pad test and in levels of satisfaction with the Argus T® device. Both slings contributed to improve quality of life (ICIQ-SF), with acceptable side effects. PMID:27286117

  6. Laser treatment of female stress urinary incontinence: optical, thermal, and tissue damage simulations

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Chang, Chun-Hung; Myers, Erinn M.; Kennelly, Michael J.; Fried, Nathaniel M.

    2016-02-01

    Treatment of female stress urinary incontinence (SUI) by laser thermal remodeling of subsurface tissues is studied. Light transport, heat transfer, and thermal damage simulations were performed for transvaginal and transurethral methods. Monte Carlo (MC) provided absorbed photon distributions in tissue layers (vaginal wall, endopelvic fascia, urethral wall). Optical properties (n,μa,μs,g) were assigned to each tissue at λ=1064 nm. A 5-mm-diameter laser beam and power of 5 W for 15 s was used, based on previous experiments. MC output was converted into absorbed energy, serving as input for ANSYS finite element heat transfer simulations of tissue temperatures over time. Convective heat transfer was simulated with contact cooling probe set at 0 °C. Thermal properties (κ,c,ρ) were assigned to each tissue layer. MATLAB code was used for Arrhenius integral thermal damage calculations. A temperature matrix was constructed from ANSYS output, and finite sum was incorporated to approximate Arrhenius integral calculations. Tissue damage properties (Ea,A) were used to compute Arrhenius sums. For the transvaginal approach, 37% of energy was absorbed in endopelvic fascia layer with 0.8% deposited beyond it. Peak temperature was 71°C, treatment zone was 0.8-mm-diameter, and almost all of 2.7-mm-thick vaginal wall was preserved. For transurethral approach, 18% energy was absorbed in endopelvic fascia with 0.3% deposited beyond it. Peak temperature was 80°C, treatment zone was 2.0-mm-diameter, and only 0.6 mm of 2.4-mm-thick urethral wall was preserved. A transvaginal approach is more feasible than transurethral approach for laser treatment of SUI.

  7. Smooth Muscle Precursor Cells Derived from Human Pluripotent Stem Cells for Treatment of Stress Urinary Incontinence.

    PubMed

    Wang, Zhe; Wen, Yan; Li, Yan Hui; Wei, Yi; Green, Morgaine; Wani, Prachi; Zhang, Pengbo; Pera, Renee Reijo; Chen, Bertha

    2016-03-15

    There is great interest in using stem cells (SC) to regenerate a deficient urethral sphincter in patients with urinary incontinence. The smooth muscle component of the sphincter is a significant contributor to sphincter function. However, current translational efforts for sphincter muscle restoration focus only on skeletal muscle regeneration because they rely on adult mesenchymal SC as cell source. These adult SC do not yield sufficient smooth muscle cells (SMCs) for transplantation. We may be able to overcome this limitation by using pluripotent stem cell (PSC) to derive SMCs. Hence, we sought to investigate whether smooth muscle precursor cells (pSMCs) derived from human PSCs can restore urethral function in an animal model generated by surgical urethrolysis and ovariectomy. Rats were divided into four groups: control (no intervention), sham saline (surgery + saline injection), bladder SMC (surgery + human bladder SMC injection), and treatment (surgery + pSMC injection, which includes human embryonic stem cell (hESC) H9-derived pSMC, episomal reprogrammed induced pluripotent stem cells (iPSCs)-derived pSMC, or viral reprogrammed iPSC-derived pSMC). pSMCs (2 × 10(6) cells/rat) were injected periurethrally 3 weeks postsurgery. Leak point pressure (LPP) and baseline external urethral sphincter electromyography were measured 5 weeks postinjection. Both iPSC-derived pSMC treatment groups showed significantly higher LPP compared to the sham saline group, consistent with restoration of urethral sphincter function. While the difference between the H9-derived pSMC treatment and sham saline group was not significant, it did show a trend toward restoration of the LPP to the level of intact controls. Our data indicate that pSMCs derived from human PSCs (hESC and iPSC) can restore sphincter function. PMID:26785911

  8. Association of Functional Ability and Benign Prostatic Hyperplasia With Urinary Incontinence in Older Korean Men

    PubMed Central

    2016-01-01

    Purpose: The purpose of this study was to determine the prevalence of urinary incontinence (UI) and analyze its association with instrumental activities of daily living (IADL) and benign prostatic hyperplasia (BPH) in community-dwelling older men in Korea. Methods: This study was a secondary analysis of data from the Actual Living Condition of the Elderly and Welfare Need Survey conducted in the year 2008. Data was subjected to hierarchical logistic regression analysis to examine the association of IADL and BPH with UI in older men, entering IADL and BPH in model 1, and age, body mass index (BMI) and education in model 2, and then comorbidities and walking speed in model 3. Results: Of 6,185 men, 243 (3.9%) had self-reported UI. The prevalence of UI was 1.8% in men aged 60–64 years and 11.7% in those aged 85 years and above, indicating an increase in the prevalence of UI with their age. IADL and BPH remained the only significant factors associated with UI in model 1 (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.44–1.64 and OR, 2.73; 95% CI, 1.47–5.10, respectively), model 2 (OR, 1.50; 95% CI, 1.40–1.61 and OR, 2.68; 95% CI, 1.42–5.07), and model 3 (OR, 1.43; 95% CI, 1.32–1.54 and OR, 2.58; 95% CI, 1.36–4.90). Conclusions: IADL limitations and presence of BPH were associated with UI in older men after controlling for BMI, education, comorbidities, and walking speed. Thus, UI should be assessed in older Korean men with IADL decline and BPH. Gender-sensitive interventions to attenuate IADL limitations and manage BPH should be developed and applied to improve UI in older men. PMID:27377946

  9. Functional disability and compromised mobility among older women with urinary incontinence

    PubMed Central

    Erekson, Elisabeth A.; Ciarleglio, Maria M.; Hanissian, Paul D.; Strohbehn, Kris; Bynum, Julie P.W.; Fried, Terri R.

    2014-01-01

    Objective Our objective was to determine the prevalence of functional disability among older women with urinary incontinence (UI). Methods We conducted a secondary analysis of the 2005-06 National Social Life, Health and Aging Project (NSHAP). Daily UI was defined as answering “daily” to the question, “How frequently...have you had difficulty controlling your bladder, including leaking small amounts of urine, leaking when you cough or sneeze, or not being able to make it to the bathroom on time?” We then explored functional status. Women were asked about seven basic activities of daily living (ADLs). Statistical analyses with percentage estimates and 95% confidence intervals (CI) were performed. Logistic regression was performed to assess the association between functional status and daily UI. Results In total, 1,412 women were included in our analysis. Daily UI was reported by 177 (12.5%) women. Functional dependence or disability with any ADLs was reported in 62.1% (95% CI 54.2%, 70.1%) of women with daily UI. Among women with daily UI, 23.6% (95% CI 16.8%, 30.5%) reported specific difficulty or dependence with using the toilet signifying functional limitations which may contribute to urine leakage. After adjusting for age category, race/ethnicity, education level, and parity, women with daily UI had 3.31 increased odds of functional difficulty or dependence compared with continent older women. Conclusion Over 60% of older women with daily UI reported functional difficulty or dependence and 1/4 of women with daily UI specifically reported difficulty or dependence with using the toilet. PMID:25185600

  10. Transperineal ultrasonography in stress urinary incontinence: The significance of urethral rotation angles

    PubMed Central

    Al-Saadi, Wasan Ismail

    2015-01-01

    Objective To assess, using transperineal ultrasonography (TPUS), the numerical value of the rotation of the bladder neck [represented by the difference in the anterior (α angle) and posterior urethral angles (β angle)] at rest and straining, in continent women and women with stress urinary incontinence (SUI), to ascertain if there are significant differences in the angles of rotation (Rα and Rβ) between the groups. Patients, subjects and methods In all, 30 women with SUI (SUI group) and 30 continent women (control group) were included. TPUS was performed at rest and straining (Valsalva manoeuver), and the threshold value for the urethral angles (α and β angles) for each group were estimated. The degree of rotation for each angle was calculated and was considered as the angle of rotation. Results Both the α and β angles were significantly different between the groups at rest and straining, and there was a significant difference in the mean increment in the value of each angle. Higher values of increment (higher rotation angles) were reported in the SUI group for both the α and β angles compared with those of the control group [mean (SD) Rα SUI group 19.43 (12.76) vs controls 10.53 (2.98) °; Rβ SUI group 28.30 (12.96) vs controls 16.33 (10.8) °; P < 0.001]. Conclusion Urethral rotation angles may assist in the assessment and diagnosis of patients with SUI, which may in turn reduce the need for more sophisticated urodynamic studies. PMID:26966596