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Sample records for imaging fecal incontinence

  1. Fecal Incontinence

    MedlinePlus

    ... org editorial staff Tags: bowel management program, bowel movements, defecation, fecal incontinence, leaking feces, leaking stool, perineal exercises Family Health, Seniors, Women September 2000 Copyright © American Academy of Family PhysiciansThis ...

  2. Fecal Incontinence

    MedlinePlus

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

  3. Fecal Incontinence in Children

    MedlinePlus

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

  4. Management of Fecal Incontinence

    PubMed Central

    2008-01-01

    Fecal incontinence is a common condition that often impairs quality of life. It is generally caused by a variety of conditions that are associated with anorectal sensorimotor dysfunction and/or diarrhea. A detailed characterization of symptoms, particularly bowel habits, is useful for assessing symptom severity and guiding management. A careful digital rectal examination is invaluable for gauging anal resting and squeeze pressures and anorectal evacuation. Tests should be tailored to age, symptom severity, and response to previous therapy. Anorectal manometry and sphincter imaging are useful starting tests. Depending upon the clinical circumstances, additional testing and therapeutic options may be useful. Fecal continence can be improved by measures to regulate bowel habits and pelvic floor retraining. Surgical repair of anal sphincter defects improves fecal continence in the short but not in the long term. Newer surgical therapies and devices are of limited and/or unproven utility. PMID:21960903

  5. Fecal incontinence in older adults.

    PubMed

    Tariq, Syed H

    2007-11-01

    Fecal incontinence is an underreported and underappreciated problem in older adults. Although fecal incontinence is more common in women than in men, this difference narrows with aging. Risk factors that lead to the development of fecal incontinence include dementia, physical disability, and fecal impaction. Treatment options include medical or conservative therapy for older adults who have mild incontinence, and surgical options can be explored in selected older adults if surgical expertise is available.

  6. Fecal incontinence - Challenges and solutions

    PubMed Central

    Saldana Ruiz, Nallely; Kaiser, Andreas M

    2017-01-01

    Fecal incontinence is not a diagnosis but a frequent and debilitating common final pathway symptom resulting from numerous different causes. Incontinence not only impacts the patient’s self-esteem and quality of life but may result in significant secondary morbidity, disability, and cost. Treatment is difficult without any panacea and an individualized approach should be chosen that frequently combines different modalities. Several new technologies have been developed and their specific roles will have to be defined. The scope of this review is outline the evaluation and treatment of patients with fecal incontinence. PMID:28104977

  7. Current Management of Fecal Incontinence

    PubMed Central

    Wang, Jennifer Y; Abbas, Maher A

    2013-01-01

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

  8. Fecal Incontinence: Etiology, Evaluation, and Treatment

    PubMed Central

    Hayden, Dana M.; Weiss, Eric G.

    2011-01-01

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

  9. A Content Incontinent: Report of Liposomal Bupivacaine Induced Fecal Incontinence

    PubMed Central

    Rai, Vinay K.

    2016-01-01

    Proper surgical management of anal fistula demands sound clinical judgment and extraordinary care to prevent incontinence and adequate postoperative pain control and provide satisfactory resolution to optimize quality of life. Fecal incontinence can be a devastating complication of procedures performed for fistula in ano. We report a unique case in which temporary incontinence (for less than 4 days) followed injection of liposomal bupivacaine for postoperative pain control after draining seton placement for fistula in ano. Patients and physicians should be aware as it may be mistaken for a more serious anatomical and permanent cause of fecal incontinence. PMID:27747127

  10. Novel Treatment Options for Fecal Incontinence

    PubMed Central

    Barker, Adam; Hurley, Jefferson

    2014-01-01

    Fecal incontinence (FI) is a devastating condition affecting a substantial portion of the population. The etiologies of FI are wide ranging, as are the treatment options. When conservative measures fail, often surgical intervention is required. As in any area where a wide range of treatment options exist, there is no one perfect solution. Fortunately, novel treatment options for FI are becoming available, namely, posterior tibial nerve stimulation, magnetic anal sphincter, stem cell transplant, pyloric transplantation, and acupuncture. PMID:25320572

  11. Incidence and Characteristics of Incontinence Associated Dermatitis in Community-Dwelling Persons with Fecal Incontinence

    PubMed Central

    Bliss, Donna Zimmaro; Funk, Taylor; Jacobson, Megan; Savik, Kay

    2016-01-01

    Purpose Little is known about the incidence and characteristics of incontinence associated dermatitis (IAD) in community-living individuals with fecal incontinence. The primary aim of this study was to describe the incidence and characteristics of self-reported IAD among community-living individuals with fecal incontinence. The study also examined whether IAD was associated with older age, gender, presence of urinary incontinence, or fecal incontinence severity. Design Secondary data analysis using a prospective cohort design. Subjects and Setting Community-living adults (N = 98) with fecal incontinence (76% female, 34% aged 65+ years, 90% White) who participated in a study about dietary fiber supplementation and were free of IAD at the start. Thirty five percent also had urinary incontinence. Methods Subjects assessed their skin for IAD daily for 52 days reporting types of IAD damage (redness, rash/fungal infection, and skin loss), location of IAD, and symptoms. They reported fecal incontinence on a diary for the first and last 14 study days. Results The incidence of IAD was 41% (40/98). The fecal incontinence severity score for subjects developing IAD was 1.2 higher than those who never had IAD (p < .001). There was no significant association of IAD with age, gender, or dual fecal and urinary incontinence. Incontinence Associated Dermatitis developed within 2 weeks and healed in approximately 1 week. The most common sign and symptom were redness (60% patients) and soreness (78%), respectively. Most subjects (85%) had IAD in one location. Conclusions Assessing for IAD in community-living patients with fecal incontinence is important as IAD is common and causes discomfort. The relatively mild severity of IAD offers WOC nurses opportunity for improving patient outcomes by preventing and managing this problem. PMID:26336048

  12. Office-Based Management of Fecal Incontinence

    PubMed Central

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

    2013-01-01

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

  13. [Fecal incontinence and rectal prolapse. Clinico-functional assessment].

    PubMed

    Santini, L; Pezzullo, L; Caracò, C; Candela, G; Esposito, B

    1995-09-01

    Rectal Prolapse is a rare and distressing condition, with a multifactorial etiopathogenesis. Often, this pathology is associated with fecal incontinence. The recommended approach to the patient with rectal prolapse and fecal incontinence is to repair the prolapse first, then deal particularly with fecal incontinence at a second operation. A retrospective, clinical and manometric study has varying degrees of fecal incontinence. Clinically five of their operation, and a further three patients improved, in two patients the degree of fecal incontinence remained invariable. One patient was worsened after surgery. Manometrically resting and pressure (RAP) was significantly higher in continent patients than in voluntary contraction pressure (MVCP) (p < 0.05) in preoperative testing. Postoperatively, there was a significant increase in the resting anal pressure as well as in maximum voluntary contraction pressure. Patients who remained incontinent had a significantly lower RAP and MVCP than patients who improved our regained continence. In conclusion this study shows an alteration of internal and external sphincteric function in patients with rectal prolapse. The surgical treatment of this disease improves sphincteric function. Incontinent patients with RAP < 10 mmHg and MCVP < 20 mmHg, probably they would be better treated simultaneously either for rectal prolapsus and incontinence. In this kind of patients the perianal proctectomy with total sphincteroplasty could be the elective treatment.

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

    PubMed

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

    2015-04-01

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

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

    PubMed Central

    2016-01-01

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

  16. 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

  17. Advances in the surgical treatment of fecal incontinence.

    PubMed

    Person, Benjamin; Wexner, Steven D

    2005-03-01

    Although surgery for fecal incontinence has been shown to be effective, it is still very challenging and sometimes frustrating. Overlapping sphincteroplasty, by far the most common procedure, is effective in patients with sphincter defects; however, recent data suggest that success rates tend to deteriorate over time. A thorough preoperative evaluation incorporates numerous factors, including patient characteristics, severity of incontinence, type and size of the sphincter defect as assessed by physical examination, anal ultrasound, and anorectal physiology studies including anal manometry, electromyography, and pudendal nerve terminal motor latency assessment. The use of these evaluation methods has allowed better patient assignment for a variety of new alternative treatment options. Innovations in the surgical treatment of fecal incontinence range from simple, office-based sphincter augmentation techniques to surgical implantation of mechanical devices. This article reviews 5 alternative surgical treatment options for fecal incontinence: injection of carbon-coated beads in the submucosa of the anal canal, radiofrequency energy delivery, stimulated graciloplasty, artificial bowel sphincter, and sacral nerve stimulation.

  18. Urinary and Fecal Incontinence in Nursing Home Residents

    PubMed Central

    Leung, Felix W.; Schnelle, John F.

    2008-01-01

    Urinary and fecal incontinence (UI, FI) are co-morbid conditions affecting over 50% of nursing home residents. Both forms of incontinence are risk factors for elderly persons to be placed in the nursing home, and such institutionalization itself is a risk factor for developing incontinence. Management should focus on identifying and treating underlying causes, such as detrusor instability, urinary tract infections, diet- or medication-induced diarrhea, constipation and fecal impaction. Despite appropriate management, residents may remain incontinent because of dementia and health or restraint-related immobility. Nursing homes lack the staff and financial resources to provide residents with sufficiently frequent toileting assistance (including prompted voiding). Use of special undergarments and absorbent pads is the usual practice. The article reviews the results of studies that have documented how prompted voiding programs can significantly reduce UI and FI, particularly if the intervention includes dietary and exercise components. Recent systematic anorectal testing of nursing home residents with FI has documented impaired sphincter function (risk factor for FI), decreased rectal sensation and sphincter dyssynergia (risk factor for constipation and impaction). The data suggest that the use of laxatives and stool softeners for prophylaxis against constipation and impaction related to underlying dyssynergia may have produced sufficient fluidity in the stool to predispose the residents with impaired sphincter function to manifest FI. Documentation of non-invasive and efficacious interventions by RCT and the labor costs of implementing these measures can lead to changes in how nursing home care is provided and funded. PMID:18794004

  19. Health Literacy and Emotional Responses Related to Fecal Incontinence

    PubMed Central

    Patel, Kristina; Bliss, Donna Z.; Savik, Kay

    2017-01-01

    Purpose The primary purpose was to begin to examine continence literacy of individuals with fecal incontinence (FI) by describing terms by which these individuals referred to FI and to explore their emotional responses to FI. A secondary aim was to compare differences in these results between male versus female and younger (< 65 yrs) versus older persons with FI. Design Secondary analysis of data collected prospectively in a clinical trial of fiber supplementation for FI. Methods Content analysis of participants’ statements reported in field notes of data collectors and their responses to data forms and questions. Results Six thematic categories of terms for FI emerged. Only one person used the term “fecal incontinence.” Alternate terms described stool characteristics, named other gastrointestinal problems, or referred to FI using a term that seemed to depersonalize the problems. Emotional responses to FI focused on the influence of bothersome symptoms of FI, interference with social activities, and need for control. Others showed use of humor for coping and emotional benefits gained from being in a study. Women were impacted by the social limitations of having FI more than men. Younger people expressed feelings of emotional upset. Conclusion There is need to increase health literacy about fecal incontinence. Continence nurse specialists are well qualified to educate patients about FI and to evaluate if higher continence literacy increases reporting of FI. Understanding the various emotional responses to FI may guide the optimal support that nurses can provide and facilitate better management of FI. PMID:20075695

  20. Impact of fecal incontinence on quality of life

    PubMed Central

    Bartlett, Lynne; Nowak, Madeleine; Ho, Yik-Hong

    2009-01-01

    AIM: To explore the impact of fecal incontinence (FI) on quality of life (QOL) of patients attending urogynecology and colorectal clinics (CCs). METHODS: Cross-sectional study of 154 patients (27 male) with FI, who attended the clinics at a regional hospital in North Queensland, Australia in 2003 and 2004, and completed the Fecal Incontinence Quality of Life Scale (FIQL: 1 = very affected; 4 = not affected). RESULTS: More than 22% of patients had their QOL affected severely by FI. Patients reported that they had not previously been asked about FI by a medical practitioner nor did they voluntarily disclose its presence. The median FIQL scores for all participants were: lifestyle = 3.24; coping = 2.23; depression = 2.42; and embarrassment = 2.33. Increasing frequency of soiling had a negative effect on all four FIQL scales (P < 0.001) as did the quantity of soiling (P < 0.01). Female CC patients had poorer FIQL scores than urogynecology clinic patients for lifestyle (P = 0.015), coping (P = 0.004) and embarrassment (P = 0.009), but not depression (P = 0.062), despite having experienced FI for a shorter period. CONCLUSION: Failure to seek treatment for FI degrades the quality of patients’ lives over time. FI assessment tools should incorporate the quantity of fecal loss. PMID:19598304

  1. Evidence-Based Update on Treatments for Fecal Incontinence in Women

    PubMed Central

    Meyer, Isuzu; Richter, Holly E.

    2016-01-01

    Synopsis Fecal incontinence is a highly prevalent and distressing condition which negatively impacts quality of life. The etiology is often multifactorial, and the evaluation and treatment of this condition can be hindered by a lack of understanding of the mechanisms and currently available treatment options. This article will review the evidence-based update for the management of fecal incontinence. PMID:26880511

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

    PubMed Central

    Van Koughnett, Julie Ann M; Wexner, Steven D

    2013-01-01

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

  3. Fecal Incontinence: Prevalence, Severity, and Quality of Life Data from an Outpatient Gastroenterology Practice

    PubMed Central

    Alsheik, Eva H.; Coyne, Thomas; Hawes, Sara K.; Merikhi, Laleh; Naples, Scott P.; Kanagarajan, Nandhakumar; Reynolds, James C.; Myers, Scott E.; Ahmad, Asyia S.

    2012-01-01

    Background. The prevalence of fecal incontinence varies tremendously as a result of inadequate data collection methods. Few office-based studies have assessed the prevalence of fecal incontinence and none have looked at modifiable risk factors or effect on quality of life. Design, Settings, Patients, and Main Outcome Measures. Five hundred patients who visited our inner city, university-based gastroenterology practice, were asked about symptoms of fecal incontinence. We also retrospectively reviewed 500 charts to identify the frequency of patient-physician reporting of fecal incontinence. Results. Of the 500 patients that were directly questioned, 58 (12%, 43 women, 15 men) admitted to fecal incontinence compared to 12 (2.4%) in the retrospective arm. Patients with fecal incontinence and loose/watery stool reported the lowest quality of life scores. While the average severity score was similar between men and women, women had a significantly lower average quality of life score (3.04 versus 2.51; P < 0.03). Conclusions. The identification of fecal incontinence increases when patients are directly questioned. Identifying and treating patients with loose stool is a potential strategy to improve quality of life in this patient population. In men and women with similar severity of fecal incontinence, women have a significantly lower quality of life. PMID:21960998

  4. Current and Emerging Treatment Options for Fecal Incontinence

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  6. Functional disability among older women with fecal incontinence

    PubMed Central

    EREKSON, Elisabeth A.; CIARLEGLIO, Maria M.; HANISSIAN, Paul D.; STROHBEHN, Kris; BYNUM, Julie P.W.; FRIED, Terri R.

    2014-01-01

    Objectives The prevalence of functional disability for basic activities of daily living (ADLs) in older women with fecal incontinence (FI) is not well characterized. Our objective was to determine the prevalence of functional disability among in community-dwelling older women with fecal incontinence. Study Design We conducted a secondary database analysis of the 2005–06 National Social Life, Health and Aging Project (NSHAP), a cross-sectional study of community-dwelling older adults conducted by single in-home interviews. FI was defined an affirmative answer to the question, “Have you lost control of your bowels (stool incontinence or anal incontinence)?” with a frequency of “at least monthly”. We then examined functional status. Women were asked about seven basic ADLs. Statistical analyses with percentage estimates and 95% confidence intervals (CI) were performed. Results 1,412 women were included in our analysis. FI, at least monthly, was reported by 5.5% (n=77) of community-dwelling older women. 63.2% (95% CI 50.1, 76.4) of women with FI reported difficulty or dependence with ≥1 ADLs and 31.2% (95% CI 18.9, 43.6) specifically reported difficulty or dependence with using the toilet. After adjusting for age category, race/ethnicity, education level, women with FI had 2.6 increased odds (95% CI 1.26, 5.35) of difficulty or dependence compared with women with no FI. Other significant risk factors for increased functional difficulty/dependence included obesity (body mass index ≥30kg/m2) and depressive symptoms. Conclusions Consistent with other large epidemiologic studies, we found monthly FI was reported by 5.5% (n/N=77/1,412) of older women. Over 60% of community-dwelling older women with FI report functional difficulty or dependence with ≥1 ADL and specifically, over 30% of women with FI report difficulty or dependence using/reaching the toilet. Due to the high prevalence of functional disability in older women with FI, we purpose that initial

  7. External incontinence devices

    MedlinePlus

    ... devices; Urinary incontinence - devices; Fecal incontinence - devices; Stool incontinence - devices ... of these different products are listed below. FECAL INCONTINENCE DEVICES There are many types of products for managing long-term diarrhea or fecal incontinence . ...

  8. Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence

    PubMed Central

    Sreepati, Gouri; James-Stevenson, Toyia

    2017-01-01

    Patient: Female, 51 Final Diagnosis: Fecal incontinence Symptoms: Constipation • fecal incontinence Medication: — Clinical Procedure: Sacral nerve stimulator Specialty: Gastroenterology and Hepatology Objective: Rare co-existance of disease or pathology Background: Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. Case Report: A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction. Pelvic floor testing showed poor ability to squeeze the anal sphincter, which indicated sphincter weakness as a major contributor to her fecal incontinence symptoms. Additionally, on defecography she was unable to widen her posterior anorectal angle or relax the anal sphincter during defecation consistent with dyssynergic defecation. A sacral nerve stimulator was placed for management of her fecal incontinence. Interestingly, her constipation also dramatically improved with sacral neuromodulation. Conclusions: This unique case highlights the emerging role of sacral nerve stimulation in the treatment of complex pelvic floor dysfunction with improvement in symptoms beyond fecal incontinence in a patient with dyssynergic-type constipation. PMID:28265107

  9. Neurostimulation for fecal incontinence after correction of repair of imperforate anus

    PubMed Central

    Bougie, Alexandre; McFadden, Nathalie; Mayer, Sandeep; Lebel, Michel; Devroede, Ghislain

    2017-01-01

    We are reporting the case of a 32-year-old female who had suffered from fecal incontinence (FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI. PMID:28352637

  10. Dietary fiber supplementation for fecal incontinence: a randomized clinical trial.

    PubMed

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

    2014-10-01

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

  11. [First case of sacral neuromodulation for treatment of urinary and fecal incontinence in Mexico. Case report.].

    PubMed

    Sucar-Romero, S; Decanini-Terán, C; Ruiz-Galindo, G H

    2009-01-01

    Sacral neuromodulation is a new treatment for urinary and fecal incontinence that has demonstrated good therapeutic results. This treatment modality has shown not only to reduce urinary dysfunction symptoms and urinary and fecal incontinence but improve quality of life scores as well. We present a 73 years old female patient with severe fecal and urinary incontinence with major quality of life impact. She was referred after failure of different surgical and conservative therapeutic approaches. Her evaluation met inclusion criteria for sacral neuromodulation treatment. Acute sacral nerve evaluation (PNE) proved to be therapeutic in the patient as measured by at least a 50 percent improvement in her symptoms so a permanent implant (Medtronic InterStim System) was placed. After the implant there was a significant improvement in urinary and fecal functional scores. Fecal Incontinence Severity Index improved from 34 to 8 and Urinary Sandvik's Severity Index from very severe urinary incontinence to minor urinary incontinence after the placement of the implant. Using standard quality of life questionnaires, she improved in the areas of lifestyle,coping and behavior and her experience with depression and self-perception.

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

    PubMed Central

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

    2015-01-01

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

  13. Associated Factors and the Impact of Fecal Incontinence in Women with Urge Urinary Incontinence: From the Urinary Incontinence Treatment Network’s BEDRI Study

    PubMed Central

    MARKLAND, Alayne D.; RICHTER, Holly E.; KENTON, Kimberly S.; WAI, Clifford; NAGER, Charles W.; KRAUS, Stephen R.; XU, Yan; TENNSTEDT, Sharon L.

    2009-01-01

    Objectives To determine prevalence, risk factors, and impact on quality of life (QOL) that fecal incontinence (FI) symptoms have on women seeking treatment for urge urinary incontinence (UUI). Study Design Baseline sociodemographic, history, physical examination, and validated questionnaire data were analyzed in 307 women enrolled in the Behavior Enhances Drug Reduction of Incontinence (BEDRI) study for associations with FI. FI was defined as loss of liquid/solid stool occurring at least monthly. Multivariable logistic regression models compared women with FI and UUI to women with only UUI. Results Prevalence of monthly FI was 18%, liquid stool (12%) and solid stool (6%). In multivariable analysis, FI was associated with vaginal delivery, posterior vaginal wall prolapse, higher body mass index, and UUI symptoms. QOL was worse in women with FI/UUI than isolated UUI. Conclusion Women seeking treatment for UUI have high rates of monthly FI with a negative impact on QOL. PMID:19200939

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  15. Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

    PubMed Central

    2013-01-01

    Background Fecal incontinence is highly prevalent among nursing home residents. Previous nursing home studies have identified co-morbidity associated with fecal incontinence, but as this population is increasingly old and frail, we wanted to see if the rate of fecal incontinence had increased and to investigate correlates of fecal incontinence further. Methods Cross-sectional study of the entire nursing home population in one Norwegian municipality. Registered nurses filled in a questionnaire for all residents in the municipality (980 residents aged ≥65). Statistical methods used are descriptive statistics, binary logistic regression and multivariable logistic regression. Results The response rate of the study was 90.3%. The prevalence of fecal incontinence was 42.3%. In multivariable analysis of FI, residents with diarrhea (OR 7.33, CI 4.39-12.24), urinary incontinence (OR 2.77, CI 1.73-4.42) and dementia (OR 2.17, CI 1.28-3.68) had higher odds of having fecal incontinence compared to those without the condition. Residents residing in a nursing home between 4–5 years had higher odds of having fecal incontinence compared to residents who had stayed under a year (OR 2.65, CI 1.20-5.85). Residents with deficiency in feeding (2.17, CI 1.26-3.71), dressing (OR 4.03, CI 1.39-11.65), toilet use (OR 7.37, CI 2.65-20.44) and mobility (OR 2.54, CI 1.07-6.00) had higher odds of having fecal incontinence compared to residents without deficiencies in activities of daily living (ADL). Needing help for transfer between bed and chair was a protective factor for fecal incontinence compared to residents who transferred independently (OR 0.49, CI 0.26-0.91). Conclusions Fecal incontinence is a prevalent condition in the nursing home population and is associated with ADL decline, frailty, diarrhea and quality of care. This knowledge is important for staff in nursing home in order to provide the best treatment and care for residents with fecal incontinence. PMID:24119057

  16. Incontinence - resources

    MedlinePlus

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

  17. Fecal incontinence in acutely and critically ill patients: options in management.

    PubMed

    Beitz, Janice M

    2006-12-01

    Fecal incontinence presents a major challenge in the comprehensive nursing care of acutely and critically ill patients. When manifested as diarrhea, the effects of fecal incontinence can range from mild (superficial skin irritation) to profound (severe perineal dermatitis, dehydration, electrolyte imbalance, and sepsis). Fecal incontinence has many etiologies and risk factors. These include damage to the anal sphincter or pelvic floor, liquid stool consistency, abnormal colonic transport, and decreased intestinal capacity. To avoid or minimize complications, the cause of diarrhea should be addressed, fecal leakage prevented, stool contained, and skin integrity preserved. Management options addressing these goals include diet, pharmacological therapy, and the use of containment products. Management options and their respective advantages and disadvantages are presented with a special focus on safety issues. Diverse approaches are safe only if they are knowledgeably selected, carefully instituted, and constantly monitored for their effects on patient outcomes. Research to identify which options work best in selected clinical situations and which combinations of therapies are most effective is needed.

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

    PubMed Central

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

    2016-01-01

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

  19. [Surgical management of urinary and fecal incontinence in neurological sphincter disorders of children and adolescents].

    PubMed

    Lemelle, J L; Barthelme, H; Schmitt, M

    1999-01-01

    The management of urinary and fecal incontinence in children and adolescents with neurogenic disorders related to congenital or acquired conditions was frequently considered to be of secondary importance compared with orthopaedic complications. The improvement of artificial urinary sphincter and continent urinary diversion techniques allowed to establish for each case an individual plan considering overall, abilities and voiding dysfunction as well as renal complications. Antegrade colonic enema has greatly improved the quality of life of children with fecal incontinence or intractable constipation. Surgical management requires a large contribution by the patients and their closest relatives and complete information about goals, advantages and obligations of surgical management. Surgical principles for bladder augmentation, bladder neck reconstruction and continent urinary diversion are presented and discussed according to data in the recent literature and the author's clinical experience.

  20. A new technique: prolene mesh sphincteroplasty for the treatment of fecal incontinence.

    PubMed

    Ayan, F; Zengin, K; Ulualp, K

    2008-08-01

    Although successful short-term results have been achieved with the use of overlapping sphincteroplasty and primary end-to- end repairs to treat fecal incontinence due to sphincteric injury, long-term failure rates may reach as high as 50%. This disadvantage associated with tension repairs may be overcome by utilizing a tension-free technique. Here the authors describe a new tension-free technique involving the use of prolene mesh.

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

    PubMed Central

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

    2016-01-01

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

  2. Perineal skin care for patients with frequent diarrhea or fecal incontinence.

    PubMed

    Haugen, V

    1997-01-01

    In this article, the author presents an overview of normal skin and a description of perineal skin injury. The focus is to identify the goals for treatment for persons with frequent diarrhea or fecal incontinence as it relates to their perineal skin care. Specific algorithms for acute care and ambulatory settings are defined, and two case studies are presented. The treatment goals include evaluation of and recommendations for reviewing and choosing perineal skin products.

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

    SciTech Connect

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

    2012-05-01

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

  4. 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…

  5. The impact of fecal and urinary incontinence on quality of life 6 months after childbirth

    PubMed Central

    Handa, Victoria L.; Zyczynski, Halina M.; Burgio, Kathryn L.; Fitzgerald, Mary Pat; Borello-France, Diane; Janz, Nancy K.; Fine, Paul M.; Whitehead, William; Brown, Morton B.; Weber, Anne M.

    2011-01-01

    Objective The objective of the study was to investigate the impact of postpartum fecal incontinence (FI) and urinary incontinence (UI) on quality of life (QOL). Study Design Seven hundred fifty-nine primiparous women in the Childbirth and Pelvic Symptoms study were interviewed 6 months postpartum. FI and UI were assessed with validated questionnaires. We measured QOL with SF-12 summary scores, health utility index score (a measure of self-rated overall health), and the modified Manchester Health Questionnaire. Results Women with FI had worse self-rated health utility index scores (85.1 ± 9.8 vs 88.0 ± 11.6, P = .02) and Medical Outcomes Study Short Form Health Survey (SF-12) mental summary scores (46.8 ± 9.2 vs 51.1 ± 8.7, P < .0001) than women without FI or flatal incontinence. Women with UI had worse SF-12 mental summary scores (48.3 ± 9.8 vs 51.6 ± 7.8, P < .01) and self-rated health utility index scores (84.1 ± 12.5 vs 88.7 ± 10.1, P < .01) than women without UI. Women with both FI and UI had the lowest SF-12 mental summary scores (44.5 ± 9.0). Conclusion Six months after delivery, women experiencing FI or UI reported negative effects on health-related QOL. FI and UI together have a greater impact than either condition alone. PMID:18060960

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

    PubMed

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

    2014-01-01

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

  7. The association between urinary and fecal incontinence and social isolation in older women

    PubMed Central

    Yip, Sallis O.; Dick, Madeline A.; McPencow, Alexandra M.; Martin, Deanna K.; Ciarleglio, Maria M.; Erekson, Elisabeth A.

    2013-01-01

    Objective To describe the association between social isolation and urinary incontinence (UI) and fecal incontinence (FI) in older women. Methods We conducted a secondary database analysis of the National Social Life, Health and Aging Project (NSHAP) for women aged 57 to 85 years old. Our primary outcome was self-report of often feeling isolated. We explored self-report of daily UI and weekly FI. Two logistic regression analyses were performed to assess the association between often feeling isolated and 1) daily UI and 2) weekly fecal incontinence. Results A total of 1,412 women were included in our analysis. Daily UI was reported by 12.5% (177/1,412) of community-dwelling older women. More women with daily UI reported often feeling isolated (6.6%, 95% CI [1.3–11.9] vs. 2.6%, 95% [1.7–3.5], p=.04) compared with women without daily UI. Women with daily UI had 3.0 (95% CI 1.1, 7.6) increased odds of often feeling isolated after adjusting for depressive symptoms, age, race, education, and overall health. Weekly FI was reported by 2.9% (41/1,412) of women. Weekly FI and often feeling isolated were associated on univariable analysis (Crude Odds Ratio(OR) = 4.6 (95% CI 1.4, 15.1). However after adjusting for depressive symptoms, age, race, education, and overall health the association between weekly FI and often feeling isolated was not significant (Adjusted OR=0.65 (95% CI 0.1, 5.3, p=0.65)). Conclusion After adjusting for confounders, daily UI was significantly associated with often feeling isolated. Weekly FI was not found to be associated with often feeling isolated on multivariable logistic regression. PMID:23159696

  8. [Incontinence].

    PubMed

    Rueda López, J; Muñoz Bueno, A M; Guerrero Palmero, A; Segovia Gómez, T

    2007-12-01

    Incontinence presents an additional problem for a bedridden patient, among other reasons because incontinence increases the risk of perineal dermatitis. Recently evaluation scales have been drawn up which permit evaluating the effects incontinence provokes on the integrity of the skin and new products have been developed which act as non-irritating barriers and which permit professionals to visually inspect the affected area. These new products increase the arsenal of already known products and tools such as bed pans, catheters, etc. which professionals have at their disposal to control incontinence.

  9. The association between fecal incontinence and sexual activity and function in women attending a tertiary referral center

    PubMed Central

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

    2013-01-01

    Introduction and hypothesis To determine whether fecal incontinence (FI) is associated with sexual activity and to compare sexual function in women with and without FI. Methods We conducted a retrospective chart review of all new patients seen in an academic urogynecology clinic. Women who reported fecal incontinence, as defined by loss of fecal material on the Wexner scale, were compared with those without fecal incontinence. We compared sexual activity and Pelvic Organ Prolapse Incontinence Sexual Questionnaire-12 (PISQ-12) scores between groups. Results In our population of women with pelvic floor disorder, 588 women reported FI compared with 527 who did not. On multivariate analysis, FI was not associated with sexual activity status, but was associated with worsened PISQ-12 scores (p<0.001). PISQ-12 item analysis found that women with FI reported more dyspareunia, fear, and avoidance of sexual activity with greater partner problems (all p <0.05) than women without FI. Conclusions Women with FI were as likely to engage in sexual relations as women without FI; however, sexually active women with FI had poorer sexual function than those without FI. PMID:23389640

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed

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

    2015-06-10

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

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

    PubMed Central

    Richter, Holly E.

    2015-01-01

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

  13. Incontinence Treatment: Newer Treatment Options

    MedlinePlus

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

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

    PubMed Central

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

    2014-01-01

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

  15. Fecal Incontinence in Older Women: Are Levator Ani Defects a Factor?

    PubMed Central

    Lewicky-Gaupp, Christina; Brincat, Cynthia; Yousuf, Aisha; Patel, Divya A.; DeLancey, John O.L.; Fenner, Dee E.

    2012-01-01

    Objective To compare pelvic floor structure and function between older women with and without fecal incontinence (FI) and young continent women. Study Design Young (YC, n=9) and older (OC, n=9) continent women were compared to older women with FI (OI, n=8). Patients underwent a POP-Q, measurement of levator ani (LA) force at rest (FLAR) and with maximum contraction (FLAC), and MRI. Displacement of structures and LA defects were determined on dynamic MRI. Results LA defects were more common in the OI v. the YC (75% v. 11%, p=0.01) and OC groups (22%, p=0.14); women with FI were more likely to have LA defects than women without (OR 14.0, 95% CI: 1.8-106.5). OI women generated 27.0% and 30.1% less FLAC v. the OC group (p=0.13) and YC groups (p=0.04). During Kegel, OI absolute structural displacements were smaller than in the OC group (p=0.01). Conclusions OI women commonly have LA defects, and cannot augment pelvic floor strength. PMID:20452496

  16. Onset and Risk Factors for Fecal Incontinence in a US Community

    PubMed Central

    Rey, Enrique; Choung, Rok Seon; Schleck, Cathy D.; Zinsmeister, Alan R.; Locke, G. Richard; Talley, Nicholas J.

    2010-01-01

    OBJECTIVES The natural history of fecal incontinence (FI) in community subjects is uncertain and the onset rate is unknown. The aim of the study is to estimate the prevalence, new-onset rate, and risk factors for FI in community subjects. METHODS A random sample of 2,400 community subjects aged ≥ 50 years was surveyed in 1993, using a validated questionnaire. Responders were recontacted in 2003. FI was defined as self-reported problems with leakage of stool. Onset rate was calculated as the proportion of subjects without FI who became new cases. Logistic regression models were constructed to identify predictive factors for developing FI and changes in bowel habit associated with the onset of FI. RESULTS Overall, 1,540 (64%) subjects responded to the initial survey, and 674 (44%) of them responded to the second survey a median of 9 (8.8 – 9.5) years later. The prevalence of FI in the first survey was 15.3% (13.4 – 17.3%). In the second survey, 37 reported incident FI; thus, the onset rate of FI was 7.0% (5.0 – 9.6) per 10 years. Predictive factors at baseline for the onset of FI were self-reported diarrhea (odds ratio (OR) = 3.8 (1.5, 9.4)), incomplete evacuation (OR = 3.4 (1.2, 9.8)), and pelvic radiation (OR = 5.1 (1.01, 25.9)). Development of urgency was the primary predictor among the set of predictors reflecting changes in bowel symptoms that were associated with the onset of FI (OR = 24.9 (10.6, 58.4)). CONCLUSIONS The onset rate of FI is approximately 7% per 10 years in community subjects aged ≥ 50 years. Prevention may be possible if bowel habit is appropriately managed in high-risk individuals. PMID:19844202

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

    PubMed Central

    Richter, Holly E.

    2014-01-01

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

  18. SEMI-AUTOMATED VECTORIAL ANALYSIS OF ANORECTAL MOTION BY MAGNETIC RESONANCE DEFECOGRAPHY IN HEALTHY SUBJECTS AND FECAL INCONTINENCE

    PubMed Central

    Noelting, Jessica; Bharucha, Adil E.; Lake, David S.; Manduca, Armando; Fletcher, J.G.; Riederer, Stephen J.; Melton, L. Joseph; Zinsmeister, Alan R.

    2012-01-01

    Background Inter-observer variability limits the reproducibility of pelvic floor motion measured by magnetic resonance imaging (MRI). Our aim was to develop a semi-automated program measuring pelvic floor motion in a reproducible and refined manner. Methods Pelvic floor anatomy and motion during voluntary contraction (squeeze) and rectal evacuation were assessed by MRI in 64 women with fecal incontinence (FI) and 64 age-matched controls. A radiologist measured anorectal angles and anorectal junction motion. A semi-automated program did the same and also dissected anorectal motion into perpendicular vectors representing the puborectalis and other pelvic floor muscles, assessed the pubococcygeal angle, and evaluated pelvic rotation. Key Results Manual and semi-automated measurements of anorectal junction motion (r = 0.70; p < 0.0001) during squeeze and evacuation were correlated, as were anorectal angles at rest, squeeze, and evacuation; angle change during squeeze or evacuation were less so. Semi-automated measurements of anorectal and pelvic bony motion were also reproducible within subjects. During squeeze, puborectalis injury was associated (p ≤ 0.01) with smaller puborectalis but not pelvic floor motion vectors, reflecting impaired puborectalis function. The pubococcygeal angle, reflecting posterior pelvic floor motion, was smaller during squeeze and larger during evacuation. However, pubococcygeal angles and pelvic rotation during squeeze and evacuation did not differ significantly between FI and controls. Conclusion & Inferences This semi-automated program provides a reproducible, efficient and refined analysis of pelvic floor motion by MRI. Puborectalis injury is independently associated with impaired motion of puborectalis, not other pelvic floor muscles in controls and women with FI. PMID:22765510

  19. [Improvement of fecal incontinence with silicone implants in patients with internal anal sphincter injury: First report in North America].

    PubMed

    Vergara-Fernández, O; Valdovinos-Díaz, M A; Hagerman-Ruiz Galindo, G; Salinas-Aragón, L E; Ruíz-Campos, M; Castillo-Machado, W

    2011-01-01

    The injection of bulking agents has been described as a useful treatment of urinary and fecal incontinence. Among them, silicone implants have shown benefits in patients with internal anal sphincter (IAS) injury. We describe two patients with a history of hemorrhoidectomy and IAS injuries, which underwent placement of silicone implants. The implants were inserted into the intersphincteric space and the IAS under ultrasound guidance. The Wexner continente score fell from 17 and 19 before treatment, to 6 and 8 at six months follow up, respectively. Patients had no postoperative complications or implants migration. In our patients, injection of silicone implants improved fecal continence score, without postoperative complications or implants migration at six month follow up.

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

    PubMed Central

    Bielefeldt, Klaus

    2016-01-01

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

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

    PubMed

    Whitebird, Robin R; Bliss, Donna Zimmaro; Savik, Kay; Lowry, Ann; Jung, Hans-Joachim G

    2010-12-01

    Recruitment of participants to clinical trials remains a significant challenge, especially for research addressing topics of a sensitive nature such as fecal incontinence (FI). In the Fiber Study, a randomized controlled trial on symptom management for FI, we successfully enrolled 189 community-living adults through collaborations with specialty-based and community-based settings, each employing methods tailored to the organizational characteristics of their site. Results show that using the two settings increased racial and ethnic diversity of the sample and inclusion of informal caregivers. There were no differential effects on enrollment, final eligibility, or completion of protocol by site. Strategic collaborations with complementary sites can achieve sample recruitment goals for clinical trials on topics that are sensitive or known to be underreported.

  2. Predictors of Fecal Incontinence and Related Quality of Life After a Total Mesorectal Excision With Primary Anastomosis for Patients With Rectal Cancer

    PubMed Central

    Kornmann, Verena N. N.; Boerma, Djamila; de Roos, Marnix A. J.; van Westreenen, Henderik L.

    2015-01-01

    Purpose After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL. Methods Patients who underwent TME with primary anastomosis for rectal cancer between December 2008 and June 2012 completed the fecal incontinence quality of life scale (FIQoL) and Wexner incontinence score. Factors associated with these scores were identified using a linear regression analysis. Results A total of 80 patients were included. Multivariate analysis identified a diverting ileostomy (n = 58) as an independent predictor of an unfavorable outcome on the FIQoL subscale coping/behavior (P = 0.041). Ileostomy closure within and after 3 months resulted in median Wexner scores of 5.0 (interquartile range [IQR], 2.5-8.0) and 10.5 (IQR, 6.0-13.8), respectively (P < 0.001). The median FIQoL score was 15.0 (IQR, 13.1-16.0) for stoma closure within 3 months versus 12.0 (IQR, 10.5-13.9) for closure after 3 months (P = 0.001). Conclusion A diverting ileostomy is a predictor for an impaired FIQoL after a TME for rectal cancer. Stoma reversal within 3 months showed better outcomes than reversal after 3 months. Patients with a diverting ileostomy should be informed about the impaired QoL, even after stoma closure. PMID:25745623

  3. Prevalence of fecal incontinence (FI) and associated factors in institutionalized older adults.

    PubMed

    Jerez-Roig, Javier; Souza, Dyego L B; Amaral, Fabienne L J S; Lima, Kenio C

    2015-01-01

    The objective of this work is to determine the prevalence of FI and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December 2013, in 10 nursing homes (NHs) of the city of Natal (Northeast Brazil). Individuals over the age of 60 were included in the study, while those hospitalized or in terminal phase were excluded. Data collection included sociodemographic information, FI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). FI was verified through the Minimum Data Set (MDS) 3.0, which was also used to assess toileting programs. The Chi-square test and the linear Chi-square test were performed for bivariate analysis, as well as logistic regression for multivariate analysis. The final sample consisted of 321 elderly, mostly females, with mean age of 81.5 years. The prevalence of FI was 42.68% (CI 95%, 37.39-48.15). Most residents presenting FI were always incontinent (83.9%) and the most frequent incontinence type was total FI (solid and liquid stools). Incontinence control measures were applied only to 9.7% of the residents. The final model revealed a statistically significant association between FI and functional and cognitive impairments. It is concluded that FI is a health issue that affects almost half of the institutionalized elderly, and is associated with functional and cognitive disability.

  4. [Prevalence of fecal incontinence in diabetic patients: epidemiological study of patients assisted as outpatients at the Clinical Hospital of the Medical School at the University of São Paulo].

    PubMed

    Amaral, S S; Teixeira, M G; Brito, S L; Amaral, G A; Jorge, J M; Habr-Gama, A; Pinotti, H W

    1997-01-01

    The object of this research was to establish the prevalence of fecal incontinence in those diabetics attended as outpatients at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Individual verbal interviewing was the an adopted method. The classification of diabetes mellitus of World Health Organization was employed (1985). Data was aggregated relative sex, age, color, type of diabetes mellitus, fecal incontinence, duration of diabetes mellitus, peripheral neuropathy, intestinal habits (normal, constipation and diarrhea), urgency to evacuate, sensation of incomplete evacuation, urinary incontinence, vaginal deliveries and its characteristics. The study involved 258 diabetics, 167 of female sex having an average age of 56.2 years (17 to 78 years of age) and 91 of the male sex having average age of 55.8 years (10 to 74 years of age). With relation to color, 57% were white, 28.7% mullato, 11.2% black and 3.1% yellow. Fecal incontinence was prevalent in 18.6% of the cases studied. It occurred also in types I and II diabetics with predominance in the male sex. It also occurred in diabetics having an average history of 10.8 years to onset of illness. Peripheral neuropathy was observed in 8.5% of the diabetics investigated however no association was observed between the peripheral neuropathy and fecal incontinence. Constipation occurred in 29.5% of the patients and diarrhea in 21.3%. Incomplete evacuation was apparent in 15.1% of diabetics and urgency to evacuate in 12.8%. A relationship was identified between fecal incontinence with diarrhea and incomplete evacuation in the group investigated. Total vaginal deliveries was 458 with 70 episiotomies and 25 by forceps. There was no statistical evidence of association between the average number of vaginal deliveries, episiotomies and forceps in diabetics demonstrating or not demonstrating fecal incontinence. Urinary incontinence was more prevalent that fecal incontinence. No relationship was

  5. Hyperspectral Imaging of fecal contamination on chickens

    NASA Technical Reports Server (NTRS)

    2003-01-01

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

  6. Diaper area granuloma of incontinence.

    PubMed

    Mostafa, W Z; Abahussein, A A; Alzayer, A A

    1992-05-01

    Granulomas in the diaper area developed in four patients; two male infants following surgery for Hirschsprung's disease and two female children with urinary (and/or fecal) incontinence. The use of the term 'Diaper area granuloma of incontinence' is suggested to describe these lesions seen in the elderly, as well as in incontinent infants and children.

  7. Inspection of fecal contamination on strawberries using fluorescence imaging

    NASA Astrophysics Data System (ADS)

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

    2013-05-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An imaging device to detect fecal contamination in fresh produce fields could allow the producer to avoid harvesting fecal-contaminated produce. E.coli O157:H7 outbreaks have been associated with fecal-contaminated leafy greens. In this study, in-field spectral profiles of bovine fecal matter, soil,...

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

    NASA Astrophysics Data System (ADS)

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

    2010-04-01

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

  10. Automatic identification of fungi under complex microscopic fecal images.

    PubMed

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

    2015-07-01

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

  11. Urinary Incontinence

    MedlinePlus

    ... It may begin around the time of menopause. Urgency urinary incontinence happens when people have a sudden need ... urinary incontinence is a mix of stress and urgency urinary incontinence. You may leak urine with a laugh ...

  12. MR imaging of the female urethra and supporting ligaments in assessment of urinary incontinence: spectrum of abnormalities.

    PubMed

    Macura, Katarzyna J; Genadry, Rene R; Bluemke, David A

    2006-01-01

    The traditional methods for evaluation of urinary incontinence in women include urodynamics, cystourethroscopy, cystourethrography, and ultrasonography. Magnetic resonance (MR) imaging has not played a major role in the assessment of women with urinary incontinence. However, high-resolution MR imaging allows detailed visualization of the urethral sphincter and supporting ligaments in women and may contribute to the diagnosis and staging of sphincteric incompetence related to intrinsic sphincter deficiency or urethral hypermobility. Both the anatomy and the function of the female urethra can be depicted on MR images. The spectrum of abnormalities detected at MR imaging in women with stress urinary incontinence are classified as (a) findings related to the urethral sphincter deficiency and (b) defects of the urethral support ligaments and urethral hypermobility. These abnormalities include a small urethral sphincter, funneling at the bladder neck, distortion of the urethral support ligaments, cystocele, an asymmetric pubococcygeus muscle, abnormal shape of the vagina, enlargement of the retropubic space, and an increased vesicourethral angle.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  15. [German Artificial Sphincter System--GASS. Development and in vitro evaluation of a novel, fully-implantable, highly integrated sphincter prosthesis for therapy of high-grade fecal incontinence].

    PubMed

    Schrag, Hans J; Padilla, Federico F; Doll, A; Goldschmidtböing, Frank; Woias, Peter; Hopt, Ulrich T

    2004-10-01

    No highly integrated sphincter prosthesis for therapy of major fecal incontinence exists. Therefore, we developed a novel neosphincter, made of polyurethane. The GASS consists of a support ring (SR) which includes a fluid reservoir, fixed on the outer diameter of the SR, and a multi-chamber occluding cuff (C(int)) on the inside diameter. The total inflation volume of C(int) is about 23 cc. The integrated micropump based on piezotechnology measures 30x13x1 mm3 (flowrate 1.4 cc/min, max. backpressure 40,000 Pa) . GASS was evaluated around the external sphincter of isolated porcine anal canals. The threshold of continence was defined as the inflating volume which water ceased to leak through the area occluded by C(int) under an induced rectal pressure of 150 cm H2O. Minimal filling volumes maintained continence for liquids against high luminal pressures. A low intraanal resting pressure (delta p(anal)) induced by activated GASS indicates a little risk of ischemic injury of the anal canal in vivo (median delta p(anal) 24.1 mm hg:15 cc vs 46.9 mm hg:21 cc). In summary, a highly integrated and efficient high-tech neosphincter for the therapy of major fecal incontinence could be realized.

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

    NASA Astrophysics Data System (ADS)

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

    2016-05-01

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

  17. Urinary Incontinence

    MedlinePlus

    ... urinary incontinence. Initial pilot studies have shown that acupuncture can provide some short-term benefit, but more ... Urology. 2013;190:113. Wang Y, et al. Acupuncture for stress urinary incontinence in adults. Cochrane Database ...

  18. Bowel Control Problems (Fecal Incontinence)

    MedlinePlus

    ... A health care provider can help with proper technique. Biofeedback therapy may also help a person perform the exercises properly. This therapy also improves a person’s awareness of sensations in the rectum, teaching how to coordinate squeezing of the external sphincter ...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  1. Skin care and incontinence

    MedlinePlus

    Incontinence - skin care; Incontinence - pressure sore; Incontinence - pressure ulcer ... redness, peeling, irritation, and yeast infections likely. Bedsores ( pressure sores ) may also develop if the person: Has ...

  2. Bowel incontinence

    MedlinePlus

    ... may lead to incontinence in some people include: Alcohol Caffeine Dairy products (in people who are unable to digest lactose , a sugar found in most dairy products) Fatty, fried, or greasy foods Spicy foods Cured or ...

  3. [Urinary incontinence].

    PubMed

    Kuhn, Annette

    2010-01-01

    Incontinence is a common age-dependent and increasing problem in women that may mainly present as stress incontinence, overactive bladder, mixed incontinence or other forms. A thorough history, gynaecological and neurological examination and urinalysis as initial step will lead to the diagnosis and treatment. If midstream urine is difficult to receive, a catheter urine will be easy to obtain. Further investigations as urodynamics, cystoscopy and ultrasound may be required. As initial step, stress incontinence should be treated with physiotherapy and pelvic floor exercises, if not successful with operations as suburethral slings. Slings have good long-term success rates of approximately 85 % with a low morbidity and can even be inserted under local anaesthetic. The treatment of idiopathic overactive bladder consists of bladder training, a behavioural therapy, and mainly anticholinergics. Anticholinergics may cause side effects particularly in the elderly who are under several medications that may add anticholinergic effects as antidepressants, antibiotics or antihistaminics.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Current meat inspection in slaughter plants, for food safety and quality attributes including potential fecal contamination, is conducted through by visual examination human inspectors. A handheld fluorescence-based imaging device (HFID) was developed to be an assistive tool for human inspectors by ...

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

    PubMed

    Aghaei, Atena; Sadeghi, Ramin; Saeedi, Parisa

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-04-01

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

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

    PubMed

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

    2016-12-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Kupec, Tomas; Stickeler, Elmar

    2016-01-01

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

  10. Incontinence Treatment: Surgical Treatments

    MedlinePlus

    ... Bowel Incontinence Signs & Symptoms Symptoms of Incontinence Diarrhea Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding a Doctor ...

  11. Incontinence in persons with Angelman syndrome.

    PubMed

    Wagner, C; Niemczyk, J; Equit, M; Curfs, L; von Gontard, A

    2017-02-01

    Angelman syndrome (AS) is a congenital syndrome with a prevalence of 1:15,000. Individuals with AS often have severe intellectual disability, typical dysmorphic signs, and behavioral problems. The aim of the study was to investigate the rate of incontinence and associated psychological problems in children and adults with AS. Ninety children (4-18 years) and 54 adults (18-31 years) with AS were recruited through a parent support group (55.6% male, mean age 15.1 years). The Parental Questionnaire: Enuresis/Urinary Incontinence, the Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms (ICIQ-CLUTS), as well as the Developmental Behaviour Checklist for parents (DBC-P) or for adults (DBC-A) were filled out by parents or caregivers. 85.6% of individuals with AS were affected by at least one subtype of incontinence (82.7% nocturnal enuresis (NE), 64.7% daytime urinary incontinence (DUI), and 57.1% fecal incontinence (FI)). 52.5% of the children and 32.6% of adults reached a clinically relevant DBC score. Incontinence was not associated with behavioral problems. NE and DUI were associated with genotype and epilepsy.

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

    NASA Astrophysics Data System (ADS)

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

    2016-05-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  14. [Biofeedback effectiveness in patients with fecal incontinence].

    PubMed

    Guerra-Mora, José Raúl; Buenrostro-Acebes, José María; Erciga-Vergara, Nancy; Zubieta-O'Farrill, Gregorio; Castillo-Calcáneo, Juan de Dios; Mosqueda, Maria Elena; Monroy-Argumedo, Montserrat; González-Alvarado, Carlos; Villanueva-Saenz, Eduardo

    2015-01-01

    Introducción: el origen anómalo de la arteria coronaria izquierda del seno coronario derecho (ACAOS) se caracteriza porque la arteria coronaria principal izquierda se origina anómalamente del seno de valsalva aórtico coronario derecho y cuyo trayecto puede seguir cuatro diferentes caminos hacia el lado izquierdo del corazón. Caso clínico: masculino de 73 años de edad, que ingresó al hospital por dolor precordial de tipo opresivo, intensidad 10/10 con irradiación a brazo izquierdo y cuello, acompañado de diaforesis y nausea. El diagnóstico fue de un síndrome isquémico coronario agudo sometido a terapia trombolítica Su evolución posterior fue no satisfactoria debido a diferentes complicaciones que lo llevaron a la muerte. Conclusiones: el diagnóstico del origen anómalo de la arteria coronaria izquierda del seno opuesto (ACAOS), se establece únicamente a través de métodos de diagnósticos como la angiotomografía computada cardiaca o un cateterismo cardiaco como parte del abordaje de un síndrome isquémico coronario agudo que permiten establecer las características morfológicas de las arterias coronarias como las diferentes variantes anatómicas y sus características particulares respecto a las estructuras adyacentes.

  15. Urinary incontinence in women.

    PubMed

    Norton, Peggy; Brubaker, Linda

    2006-01-07

    Urinary incontinence is common in women, but is under-reported and under-treated. Urine storage and emptying is a complex coordination between the bladder and urethra, and disturbances in the system due to childbirth, aging, or other medical conditions can lead to urinary incontinence. The two main types of incontinence in women, stress urinary incontinence and urge urinary incontinence, can be evaluated by history and simple clinical assessment available to most primary care physicians. There is a wide range of therapeutic options, but the recent proliferation of new drug treatments and surgical devices for urinary incontinence have had mixed results; direct-to-consumer advertising has increased public awareness of the problem of urinary incontinence, but many new products are being introduced without long-term assessment of their safety and efficacy.

  16. Urinary Incontinence in Women.

    PubMed

    Jay, J; Staskin, D

    1998-10-01

    Despite the prevalence of urinary incontinence, most affected women don't seek help, primarily because of embarrassment or because they are not aware that effective treatment is available. Failure to store urine may be caused by an abnormality in any component of the lower urinary tract. Common abnormalities are poor bladder compliance and bladder outlet failure. Patients who experience failure to empty can present with recurrent urinary tract infections, retention or incontinence. Using a symptom-based classification of incontinence, this would be referred to as overflow incontinence. Other possible categories of urinary incontinence are failure to store and empty and functional incontinence. A combination of a failure to store and empty is difficult to diagnose and treat clinically. Treatments are directed at the particular cause of incontinence and can include medical or surgical therapies.

  17. Incontinence in individuals with Angelman syndrome: a comparative study.

    PubMed

    Radstaake, Maartje; Didden, Robert; Giesbers, Sanne; Korzilius, Hubert; Peters-Scheffer, Nienke; Lang, Russell; von Gontard, Alexander; Curfs, Leopold M G

    2013-11-01

    Frequency and type of incontinence and variables associated with incontinence were assessed in individuals with Angelman syndrome (AS; n=71) and in a matched control group (n=69) consisting of individuals with non-specific intellectual disability (ID). A Dutch version of the "Parental Questionnaire: Enuresis/Urinary Incontinence" (Beetz, von Gontard, & Lettgen, 1994) was administered and information on primary caretakers' perspectives regarding each individual's incontinence was gathered. Results show that diurnal incontinence and fecal incontinence during the day more frequently occurred in the control group than in the AS group. In both groups, nocturnal enuresis was the most common form of incontinence. More incontinence was seen in individuals with AS who were younger, had a lower level of adaptive functioning and/or had epilepsy. Individuals with AS were able to stay dry for longer periods of time than the controls and often showed both in-toilet urination and urinary accidents during the day, whereas accidents and correct voids during the day were more set apart in the control group. Also, persons with AS had a lower micturition frequency implying possible voiding postponement. Both groups showed high rates of LUTS (lower urinary tract symptoms) possibly indicative of functional bladder disorders such as voiding postponement, dysfunctional voiding, or even an underactive bladder. In general, most primary caretakers reported severe intellectual disability as the main cause for urinary incontinence. Based on these results incontinence does not appear to be part of the behavioral phenotype of Angelman syndrome. Therefore, pediatric or urologic diagnostics and treatment are recommended for all persons with incontinence and intellectual disability. Further implications for practice and research are given.

  18. Waveband selection and algorithm development to distinguish fecal contamination using multispectral imaging with solar light

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fecal contamination in fresh produce fields caused by animals or livestock entering the fields can lead to outbreaks of foodbourne illnesses. E.coli O157:H7 originating in the intestines of animals can transfer onto leafy greens via fecal matter. Leafy greens are often eaten fresh without thermal tr...

  19. Automatic identification of human helminth eggs on microscopic fecal specimens using digital image processing and an artificial neural network.

    PubMed

    Yang, Y S; Park, D K; Kim, H C; Choi, M H; Chai, J Y

    2001-06-01

    In order to automate routine fecal examination for parasitic diseases, we propose in this study a computer processing algorithm using digital image processing techniques and an artificial neural network (ANN) classifier. The morphometric characteristics of eggs of human parasites in fecal specimens were extracted from microscopic images through digital image processing. An ANN then identified the parasite species based on those characteristics. We selected four morphometric features based on three morphological characteristics representing shape, shell smoothness, and size. A total of 82 microscopic images containing seven common human helminth eggs were used. The first stage (ANN-1) of the proposed ANN classification system isolated eggs from confusing artifacts. The second stage (ANN-2) classified eggs by species. The performance of ANN was evaluated by the tenfold cross-validation method to obviate the dependency on the selection of training samples. Cross-validation results showed 86.1% average correct classification ratio for ANN-1 and 90.3% for ANN-2 with small variances of 46.0 and 39.0, respectively. The algorithm developed will be an essential part of a completely automated fecal examination system.

  20. Surgery for Stress Urinary Incontinence

    MedlinePlus

    ... Events Advocacy For Patients About ACOG Surgery for Stress Urinary Incontinence Home For Patients Search FAQs Surgery ... Incontinence FAQ166, July 2014 PDF Format Surgery for Stress Urinary Incontinence Special Procedures What is stress urinary ...

  1. Risperidone-associated urinary incontinence in patients with autistic disorder with mental retardation.

    PubMed

    Kumazaki, Hirokazu; Watanabe, Koichiro; Imasaka, Yasushi; Iwata, Kazuhiko; Tomoda, Akemi; Mimura, Masaru

    2014-10-01

    We report several cases in which patients with autistic disorder with mental retardation who received risperidone experienced urinary incontinence. We retrospectively investigated the medical records of patients housed in facilities for patients with autistic disorder with mental retardation. Those who had undergone a medical examination at a hospital in Tokyo from April 1999 to March 2009 were included in the study.Retrospective data were gathered including age, sex, IQ, birth weight, dosage of risperidone, urinary density, as well as existence of urinary and fecal incontinence. We divided the participants into those who did and did not experience urinary incontinence after taking risperidone and compared the 2 groups. Risperidone had been prescribed to 35 patients. In spite of the fact that no patient had a history of urinary incontinence, 14 patients experienced urinary incontinence after receiving risperidone. Moreover, 4 of these 14 patients also had fecal incontinence. Among the variables we examined, the only significant difference between groups was in sex, with significantly more women experiencing incontinence compared with men. When the dose of risperidone was reduced or the patients switched to other drugs, urinary incontinence of the patients improved.Hence, risperidone may have a casual relationship with urinary incontinence. Further research is needed to understand the pathophysiology of possible effect.

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

    SciTech Connect

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

    1987-04-01

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

  3. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... incontinence. Over time, the leakage may come back. Alternative Names ... Incontinence Update Panel of the American Urological Association Education and Research. Update of AUA guideline on the ...

  4. Skin care in the frail, elderly, dependent, incontinent patient.

    PubMed

    Jeter, K F; Lutz, J B

    1996-01-01

    Despite a plethora of recommendations, protocols and dictums in the nursing literature, no research studies have defined the basic elements of preventive skin care for incontinent patients, and the prevalence of skin problems associated with incontinence is unknown. Yet the importance of skin care for incontinent elderly or immobilized patients has long been acknowledged. This literature review sought to determine current practices and principles for skin care of frail, elderly, dependent, incontinent patients. Protocols vary widely. And although there is mounting evidence that incontinence, particularly fecal incontinence, is a primary risk factor for pressure ulcer development, most preventive efforts focus on pressure relief, repositioning, and nutrition, rather than incontinence care. More clinical trials are needed in this area. The design and analysis of these trials should take into account the frequency and manner in which skin is cleansed, products used for skin care, risks and benefits of absorbent products and devices, the presence of infection, and patients' concomitant medical conditions and degree of immobility.

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

    NASA Astrophysics Data System (ADS)

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

    2013-05-01

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

  6. Prevalence of Bowel Incontinence

    MedlinePlus

    ... Urinary Incontinence in Adults. December 12, 2007. Drossman DA, Li Z, Andruzzi E, et al. U.S. Householder ... Rectum Vol. 41, No. 10 October 1998. Drossman DA, Sandler RS, Broom CM, et al. Urgency and ...

  7. Incontinence Treatment: Biofeedback

    MedlinePlus

    ... Allis, WI . Lifestyle Changes Dietary Tips Medication ... of Hope "For a person who is incontinent, replacing feelings of helplessness with a measure of empowerment , with teaching a person that they can take steps to ...

  8. Eldercare at Home: Incontinence

    MedlinePlus

    ... on long trips or in unfamiliar settings. However, diapers and pads can worsen incontinence if the older person relies only on them and does not practice bladder exercises. If pads or diapers are necessary, change them often to avoid odor, ...

  9. Urinary incontinence - injectable implant

    MedlinePlus

    Intrinsic sphincter deficiency repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Urine leakage that gets worse Pain where the injection was done Allergic reaction to the material Implant ...

  10. Female urinary incontinence and sexuality.

    PubMed

    Mota, Renato Lains

    2017-01-01

    Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.

  11. Female urinary incontinence and sexuality

    PubMed Central

    Mota, Renato Lains

    2017-01-01

    ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence. PMID:28124522

  12. Urinary incontinence surgery - female - discharge

    MedlinePlus

    ... gov/ency/patientinstructions/000134.htm Urinary incontinence surgery - female - discharge To use the sharing features on this ... Dmochowski RR, Blaivas JM, Gormley EA, et al; Female Stress Urinary Incontinence Update Panel of the American ...

  13. Urinary incontinence. Noninvasive treatment options.

    PubMed

    Maloney, C; Cafiero, M R

    1999-06-01

    One in six women older than 45 experiences incontinence, but 31% of them never discuss their condition with anyone. A proactive approach on the part of all health care providers is needed to break this silence, particularly among clinicians who care for women. Urinary incontinence is classified as stress, urge, mixed, overflow or functional incontinence. Differential diagnosis of incontinence is essential to choosing appropriate treatment options. This article outlines noninvasive treatment options that are specific to diagnosis.

  14. [Conservative treatment of urinary incontinence].

    PubMed

    Soljanik, I; Schorsch, I; Stanislaus, P; Bauer, R; Mayer, M; Hocaoglu, Y; Becker, A; May, F

    2007-09-20

    Urinary incontinence can be treated with medicinal products in addition to active pelvic floor muscle training and electrostimulation. A local hormone therapy should be first discussed with the gynaecologist. The active substance duloxetine has been used for a few years for treating stress incontinence. Several older and newer active substances are available for treating irritable bladder and stress incontinence.

  15. Automated detection of fecal contamination of apples by multispectral laser-induced fluorescence imaging

    NASA Astrophysics Data System (ADS)

    Lefcourt, Alan M.; Kim, Moon S.; Chen, Yud-Ren

    2003-07-01

    Animal feces are a suspected source of contamination of apples by disease-causing organisms such as Escherichia coli O157. Laser-induced fluorescence was used to detect different amounts of feces from dairy cows, deer, and a dairy pasture applied to Red Delicious apples. One day after application, detection for 1:2 and 1:20 dilutions was nearly 100%, and for 1:200 dilutions (<15 ng of dry matter) detection was >80%. Detection after apples had been washed and brushed was lowest for pasture feces; detection for 1:2, 1:20, and 1:200 dilutions of feces was 100%, 30%, and 0%, respectively. This technology may encourage development of commercial systems for detecting fecal contamination of apples.

  16. Fecal impaction

    MedlinePlus

    ... hard and dry. This makes it difficult to pass. Fecal impaction often occurs in people who have ... Small, semi-formed stools Straining when trying to pass stools Other possible symptoms include: Bladder pressure or ...

  17. Fecal culture

    MedlinePlus

    ... fecal culture is a lab test to find organisms in the stool (feces) that can cause gastrointestinal ... Results There are no abnormal bacteria or other organisms in the sample. Talk to your provider about ...

  18. [Sexuality and incontinence].

    PubMed

    Buffat, J

    2009-03-18

    Incontinence is anything that inhibits the expression of sexuality. Male problems like premature ejaculation and erectile dysfunctions are forms of incontinence. The inability to retain ejaculation or maintain erection long enough to give pleasure to the partner generates feelings of shame and guilt which weaken virility. Feminine sexual dysfunctions like loss of desire, anorgasmia and vaginismus are results of excessive continence due to negative familial and religious education, moral and social values. The sexologist's task is first to find out the origins of the sexual trouble then to propose an adequate treatment.

  19. Faecal incontinence in the elderly.

    PubMed

    Lee, K S; Owen, R E; Choo, P W; Jayaratnam, F J

    1991-04-01

    Faecal incontinence is distressing both to the patient and the carers. However with accurate diagnosis of its cause, the condition can often be treated. Causes can be classified by pathophysiology. The most common cause in the elderly is faecal impaction with overflow incontinence. Other causes include inflammatory conditions of the bowel, neurological disorder, functional incontinence and iatrogenic incontinence. Management depends on an accurate diagnosis. A proper bowel and drug history is important. A rectal examination is mandatory, in order not to miss a diagnosis of faecal impaction with overflow incontinence. Specific treatment is directed at the cause.

  20. Symptoms of Incontinence

    MedlinePlus

    ... might feel the urge to have a bowel movement, but impaired muscles are unable to control it ... sure when an episode might strike. The personal impact of incontinence becomes even more profound as sufferers begin to withdraw from social situations because of the problem. They may participate ...

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

    SciTech Connect

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

    2011-04-01

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

  2. [Incontinence--a common issue for people with Parkinson's disease. A systematic literature review].

    PubMed

    Siegl, Eva; Lassen, Britta; Saxer, Susi

    2013-09-01

    Parkinson's disease is among the most common neurological diseases. About 4.1 million people are attected worldwide. The course of Parkinson's disease is chronically progressive. With L-Dopa therapy the life expectancy of people being affected by Parkinon's disease is not shortened compared with people who are not affected. Therefore people with Parkinson's disease often suffer from the serious effects for decades which include motor symptoms as well as vegetative disturbance, which concerns bladder function and functions of the gastrointestinal tract. Urinary and fecal incontinence involve severe impairment of quality of life. In this review the occurence of urinary and fecal incontinence should be determined in order to be able to describe its extent. There are different measures for treatment or improvement. These are reviewed based on the following research question: Which effects do interventions have in improving urinary and fecal incontinence in persons with Parkinson's disease compared to usual care? In order to answer the questions a systematic review was conducted. The literature search occured in the electronic databases Cochrane database, PubMed and CINAHL. Three studies investigating the prevalence with a total sample size of n = 1077 and for the evaluation of interventions four studies with a total sample size of n = 48 have been included. 25 percent of the women with Parkinson's disease suffer from urgency incontinence compared to seven percent of the women without Parkinson's disease (p < 0.01). Among men with Parkison's disease 28 percent are affected and six percent among men without Parkinson's disease (p < 0.01). In respect to stress and fecal incontinence there were no significant differences between people affected and people not affected by Parkinson's disease. With pelvic floor muscle exercises and accompanying measures as well as with injections of botulinum toxin A a reduction of urinary incontinence seems to be possible. Due to

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

    PubMed Central

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

    2015-01-01

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

  4. Urinary Incontinence in the Elderly

    PubMed Central

    Ouslander, Joseph G.

    1981-01-01

    Urinary incontinence is a common and distressing problem for elderly patients, their families and friends, and the health professionals who care for them. It is a heterogeneous condition, and appropriate management depends on a thorough evaluation and understanding of the multiple factors that can play a role in its cause and perpetuation. Identifying reversible causes of transient incontinence, and appropriate management of incontinence that is associated with acute illness, can be important in preventing the problem from becoming established. A thorough diagnostic evaluation of urinary incontinence in the elderly, and appropriate use of the different types of therapy, will greatly improve the management in these cases. The need and opportunities for research to improve the management of incontinent elderly persons should be considered by all those involved in caring for this population. PMID:7039134

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  6. Managing incontinence: women's normalizing strategies.

    PubMed

    Skoner, M M; Haylor, M J

    1993-01-01

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

  7. Management of male urinary incontinence

    PubMed Central

    Moore, Katie C.; Lucas, Malcolm G.

    2010-01-01

    The majority of male urinary incontinence seen is secondary to sphincter weakness following prostatic surgery. As there is a rising elderly population and increasing numbers of surgical interventions for prostate cancer, incidence of male incontinence is increasing. Hence, management of male incontinence has become a subject of increased interest for urologists. Various non-surgical and surgical approaches have been suggested for this devastating condition. Non-invasive therapies are suggested for early postoperative and mild incontinence. For surgical treatment the artificial urinary sphincter is still labeled the gold standard despite the introduction of several more minimally invasive treatments. However, as yet there is no consensus on the optimal timing and best modality for managing these men. Well designed, centrally funded clinical trials are required to establish which treatment modality to offer and when in the broad spectrum of male incontinence. This review focuses mainly on the management of post-prostatectomy incontinence since the management of other types varies little from the modalities of treatment in women. PMID:20877603

  8. Incontinence-associated skin damage in nursing home residents: a secondary analysis of a prospective, multicenter study.

    PubMed

    Zimmaro Bliss, Donna; Zehrer, Cindy; Savik, Kay; Thayer, Debra; Smith, Graham

    2006-12-01

    More than half of the nursing home population is incontinent of urine or feces, presenting challenges to perineal skin health. To determine the occurrence and severity of skin damage in nursing home residents with incontinence, a secondary analysis of data collected from a multisite, open-label, quasi-experimental study of cost and efficacy of four regimens for preventing incontinence-associated dermatitis in nursing home residents was performed. Sixteen randomly selected nursing homes from across the US were included in the study. Participating nursing home residents were incontinent of urine and/or feces and free of skin damage. Of the 1,918 persons screened, 51% (n = 981) qualified for prospective surveillance. Perineal skin was assessed over a 6-week period; frequency, type, and severity of skin damage were observed. Skin damage developed after a median of 13 (range 6 to 42) days in 45 out of 981 residents (4.6%), of which 3.4% was determined to be incontinence-associated dermatitis. Some residents (14 out of 45, 31%) had incontinence-associated dermatitis of other skin damage in more than one area. This study is one of the first to report the characteristics of incontinence-associated dermatitis in a large sample of nursing home residents. The sample size and random selection of nursing homes impart generalizability to the findings. Incontinence-associated dermatitis is a risk in nursing home residents, especially those with fecal incontinence. These findings suggest that the rate and severity of incontinence-associated dermatitis are low with close monitoring and use of a defined skin care regimen that includes a pH-balanced cleanser and moisture barrier.

  9. Urinary incontinence - what to ask your doctor

    MedlinePlus

    ... to help with my urinary incontinence? What are Kegel exercises? What can I do when I want ... tape Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Self catheterization - ...

  10. [Urinary incontinence and obesity].

    PubMed

    Legendre, G; Fritel, X; Capmas, P; Pourcelot, A-G; Fernandez, H

    2012-06-01

    Obesity, defined as a body mass index (BMI) more than or equal to 30kg/m(2), promotes pelvic floor disorders such as urinary incontinence (UI) and genital prolapse. Datas from cohort studies found an association between high BMI and the onset of UI. This association seems to be predominant with for mixed UI and stress UI. For the urge UI and overactive bladder syndrome, the analysis of the literature found a weaker association. The weight is therefore the only modifiable risk factor. Thus, the weight loss by a hypocaloric diet associated with pelvic floor muscle training should be the front line treatment in the obese patient suffering from UI. Bariatric surgery can be discussed in the most obese patient, even if the risk/benefit balance should be weighed because of significant morbidity of this surgery. The results of sub urethral sling (by retropubic tension-free vaginal tape or transobturator sling) in obese patients appear to be equivalent to those obtained in patients of normal weight. Datas on per- and postoperative complications for suburethral slings are reassuring.

  11. 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…

  12. [Stress incontinence in elderly women].

    PubMed

    Loertzer, H; Schneider, P

    2013-06-01

    Stress incontinence is one of the major challenges in geriatric medicine. This is becoming more apparent in routine urology practice with the demographic changes in the population. A thorough diagnosis for a correct treatment of stress incontinence is as important in elderly women as it is in younger patients. This includes assessing the risk factors of incontinence and obesity, parturition, pelvic surgery and changes in hormone levels are risk factors usually found in elderly women. These are the main reasons why this patient group is most frequently affected. Treatment options do not differ significantly from these of younger women. Lifestyle modification, weight loss and supervised pelvic floor training are the mainstays of conservative therapy and surgical treatment should only be considered after these options have been exhausted. In these cases minimally invasive surgical techniques offer clear advantages especially for elderly often multimorbid women.

  13. Urinary incontinence: is cesarean delivery protective?

    PubMed

    Nygaard, Ingrid

    2006-10-01

    About half of all women develop transient urinary incontinence during pregnancy. Three months postpartum, the prevalence and incidence rates of urinary incontinence are 9% to 31% and 7% to 15%, respectively. Antenatal incontinence increases the risk of postpartum incontinence, which in turn increases the risk of long-term persistent incontinence. After the first delivery, women delivered vaginally have two-fold more incontinence than those delivered by cesarean. The protective effect of cesarean on urinary incontinence may dissipate after further deliveries, decreases with age, and is not present in older women. Data are mixed about whether cesarean done before labor confers greater protection than cesarean done after labor. To understand the true impact of cesarean delivery on urinary incontinence, future studies must compare incontinence by planned (not actual) delivery modes, consider a woman's entire reproductive career, focus on leakage severe enough to be problematic, consider other bladder symptoms as well as incontinence, and take into account other risk factors, particularly antepartum urinary incontinence.

  14. Some Observations on the Surgical Treatment of Urinary Incontinence

    PubMed Central

    Millin, Terence

    1939-01-01

    Types: A. Essential. B. Paradoxical. C. False. D. True. True incontinence.—A. Congenital: (a) Developmental abnormalities. (b) Malformations of nervous system. B. Acquired: (a) Local abnormalities. (b) False passages. (c) Disturbance of innervation. Anatomy of sphincteric mechanism in male and female. Diagnosis: Need for careful investigation including cysto-urethroscopy, cysto-urethrography, and cysto-manometry. Treatment: A. Physiotherapy. B. Direct surgical repair. C. Surgical diversion of urine. Types of true incontinence amenable to direct surgical repair: A. Epispadias. B. Aberrant ureteric ostia. C. Fistulæ. D. Congenital or acquired defective sphincteric mechanism. Operative treatment of vesico-vaginal fistulæ. Transvesical operation for cure of congenitally defective sphincteric mechanism—report of seven cases. Stress incontinence.—Value of urethrograms to ascertain nature of defect. Operative treatment. Incontinence following prostatic surgery.—Types of operation advocated. New operative procedure utilizing ribbon catgut with demonstrative moving picture. ImagesFig. 1, Fig. 2, Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8 PMID:19991939

  15. [Therapy for urinary incontinence in general practice].

    PubMed

    Wiedemann, A; Füsgen, I

    2009-08-01

    In national and international guidelines the general practitioner plays an important role in the diagnosis and first-line therapy for urinary incontinence. Nevertheless, there is a lack of data concerning details of the management of incontinence in primary care in Germany. Therefore a series of nationwide educational events for general practitioners and gynaecologists was used to perform a survey dealing with the situation of urinary incontinence in general practice. With 2530 questionnaires filled out and returned, this is the largest European survey on this subject. General practitioners declare in 57.3 % to be often involved with urinary incontinence. They usually question elderly patients about urinary incontinence (73.7 %) or those patients with diseases carrying the risk of developing urinary incontinence (64.9 %). Based on the diagnostic options in primary care, an incontinence anamnesis and urine evaluation are performed. A sonography or micturition diary was more infrequent in primary care in this survey. General practitioners most frequent refer the patient to a specialist (76.6 %) or prescribe the incontinence-type anticholinergic drugs (59.4 %) or absorbent products (45.4 %); duloxetine (27.3 %) is less frequently prescribed. The knowledge about urinary incontinence is gained in educational events (72.2 %); the course of studies was the source of incontinence skills for general practitioners only in 35 %. In conclusion, this survey gives a realistic view on the incontinence management in primary care in Germany. The majority of general practitioners are engaged in incontinence, perform basic diagnostic features and prescribe drugs or absorbent products. The course of (university medical school) studies as a source of skills to diagnose or to treat incontinence should be improved.

  16. 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

  17. Conservative treatment for anal incontinence

    PubMed Central

    Carter, Dan

    2014-01-01

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

  18. [Female urinary incontinence: An update].

    PubMed

    González-Ruiz de León, C; Pérez-Haro, M L; Jalón-Monzón, A; García-Rodríguez, J

    2017-03-16

    The urinary incontinence is a highly prevalent symptom in the adult female population. It has important psychosocial and economic connotations, and affects the quality of life of these patients. As it is an under-diagnosed problem due to patients not always consulting for it, it is very important to keep this in mind and to provide an opportunistic screening from Primary Health Care. It is difficult to determine the costs of this, but it is estimated to be the 2% of the health budget. Because of all of this, it is very important to know how to make a correct diagnose of this condition, to determine the different types of incontinence, possible causes, and treatments available. The purpose of this review is to show the different diagnostic and therapeutic tools available, to show the Primary Health Care role in this condition, and when to refer to specialist care.

  19. Discreet products for women with urinary incontinence.

    PubMed

    Evans, Debra

    It is estimated that 10 million women in the UK suffer with urinary incontinence (Hunskarr et al, 2004). Many women consider bladder weakness to be an inevitable consequence of childbirth or the menopause. Haslam (2004) reported on a telephone survey that examined whether women were aware of stress urinary incontinence, their attitude to it and the impact it had on their daily lives. In the UK, 505 women were interviewed, 206 of whom responded positively to a question about symptoms of stress urinary incontinence, giving a prevalence rate of 41 per cent. There is also evidence that most patients with urinary incontinence do not present to their doctors

  20. 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…

  1. Managing a common dermatological problem: incontinence dermatitis.

    PubMed

    Nazarko, Linda

    2007-08-01

    Incontinence dermatitis is an under-recognized and under-researched problem that mostly affects older people who have continence problems. Nurses who are aware of the risk factors can provide care that reduces the risk of this distressing problem. If incontinence dermatitis occurs, evidence-based care can be used to treat the person and reduce the risks of further complications.

  2. Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: Design and methods

    PubMed Central

    Jelovsek, J. Eric; Markland, Alayne D.; Whitehead, William E.; Barber, Matthew D.; Newman, Diane K.; Rogers, Rebecca G.; Dyer, Keisha; Visco, Anthony; Sung, Vivian W.; Sutkin, Gary; Meikle, Susan F.; Gantz, Marie G.

    2015-01-01

    The goals of this trial are to determine the efficacy and safety of two treatments for women experiencing fecal incontinence. First, we aim to compare the use of loperamide to placebo and second, to compare the use of anal sphincter exercises with biofeedback to usual care. The primary outcome is the change from baseline in the St. Mark's (Vaizey) Score 24 weeks after treatment initiation. As a Pelvic Floor Disorders Network (PFDN) trial, subjects are enrolling from eight PFDN clinical centers across the United States. A centralized data coordinating center supervises data collection and analysis. These two first-line treatments for fecal incontinence are being investigated simultaneously using a two-by-two randomized factorial design: a medication intervention (loperamide versus placebo) and a pelvic floor strength and sensory training intervention (anal sphincter exercises with manometry-assisted biofeedback versus usual care using an educational pamphlet). Interventionists providing the anal sphincter exercise training with biofeedback have received standardized training and assessment. Symptom severity, diary, standardized anorectal manometry and health-related quality of life outcomes are assessed using validated instruments administered by researchers masked to randomized interventions. Cost effectiveness analyses will be performed using prospectively collected data on care costs and resource utilization. This article describes the rationale and design of this randomized trial, focusing on specific research concepts of interest to researchers in the field of female pelvic floor disorders and all other providers who care for patients with fecal incontinence. PMID:26291917

  3. Fecal Pollution of Water.

    EPA Science Inventory

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

  4. Fecal Pollution of Water

    EPA Science Inventory

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

  5. Role of clinical pathway in improving the quality of care for patients with faecal incontinence: A randomised trial

    PubMed Central

    Hussain, Zeiad I; Lim, Michael; Stojkovic, Stevan

    2017-01-01

    AIM To assess the development and implementation of the Integrated Rapid Assessment and Treatment (IRAT) pathway for the management of patients with fecal incontinence and measure its impact on patients’ care. METHODS Patients referred to the colorectal unit in our hospital for the management of faecal incontinence were randomised to either the Standard Care pathway or the newly developed IRAT pathway in this feasibility study. The IRAT pathway is designed to provide a seamless multidisciplinary care to patients with faecal incontinence in a timely fashion. On the other hand, patients in the Standard Pathway were managed in the general colorectal clinic. Percentage improvements in St. Marks Incontinence Score, Cleveland Clinic Incontinence Score and Rockwood Faecal Incontinence Quality of Life Scale after completion of treatment in both groups were the primary outcome measures. Secondary endpoints were the time required to complete the management and patients’ satisfaction score. χ2, Mann-Whitney-U and Kendall tau-c correlation coefficient tests were used for comparison of outcomes of the two study groups. A P value of 0.05 or less was considered significant. RESULTS Thirty-nine patients, 34 females, consented to participate. Thirty-one (79.5%) patients completed the final assessment and were included in the outcome analysis. There was no significant difference in the quality of life scales and incontinence scores. Patients in the IRAT pathway were more satisfied with the time required to complete management (P = 0.033) and had stronger agreement that all aspects of their problem were covered (P = 0.006). CONCLUSION Despite of the lack of significant difference in outcome measures, the new pathway has positively influenced patient’s mindset, which was reflected in a higher satisfaction score. PMID:28217378

  6. Mapping liquid distribution in absorbent incontinence products.

    PubMed

    Landeryou, M A; Yerworth, R J; Cottenden, A M

    2003-01-01

    This paper reviews methods available for mapping the distribution of fluid in incontinence pad materials to assist with evaluating existing products and developing new ones, and to provide data for building and validating predictive models. Specifically, the following technologies are considered and their strengths and limitations described: discrete sensors based on conductance, temperature or optical measurements, optical imaging, gravimetric methods, X-ray imaging and magnetic resonance imaging. It is suggested that the ideal method would enable fluid distribution to be mapped in three dimensions with good spatial and time resolution in single materials and composite structures of simple and complex geometries under static and dynamic mechanical loading. It would also allow liquid to be mapped in products when worn by users. It is concluded that, although each existing method meets some of these requirements, and each requirement is met, at least reasonably well, by at least one method, improved techniques are needed. The particular need for methods that can provide some measurement of liquid saturation within absorbent products, both in the laboratory and in real use, is highlighted. In many cases, simple methods used appropriately are sufficient to elicit the important aspects of liquid transport and storage within absorbent products.

  7. Nonsurgical Treatment of Urinary Incontinence in Elderly Women.

    PubMed

    Parker, William P; Griebling, Tomas Lindor

    2015-11-01

    Urinary incontinence is a prevalent condition in elderly women with significant associated morbidity. Incontinence can by grouped into several types: stress incontinence, urgency incontinence, overflow incontinence, functional incontinence, and mixed urinary incontinence. Careful evaluation, including history and physical examination, is critical to making the correct diagnosis and guiding therapy. A variety of nonsurgical treatments, including behavioral therapies, pelvic floor muscle exercise, medications, and other treatments, are available; can be successful for many older women; and may preclude the need for surgery. Working closely with the patient, understanding her goals of care, and targeting treatments accordingly are essential for success.

  8. Obesity and female stress urinary incontinence.

    PubMed

    Osborn, David James; Strain, Matthew; Gomelsky, Alex; Rothschild, Jennifer; Dmochowski, Roger

    2013-10-01

    The purpose of this article was to review the epidemiology, pathophysiology, and treatment options for stress urinary incontinence in the obese female patient and draw conclusions regarding the optimal treatment of this condition in this unique patient population. Obesity results in increased intra-abdominal pressure and this leads to weakening of the pelvic floor innervation and musculature. Weight loss through lifestyle modification and bariatric surgery improves stress urinary incontinence. Success of stress urinary incontinence surgery in obese women is similar to nonobese patients. Obese women should not be excluded from potentially curative surgery based on their body mass index (BMI) alone.

  9. New drug treatments for urinary incontinence.

    PubMed

    Robinson, Dudley; Cardozo, Linda

    2010-04-01

    Urinary incontinence remains a common and distressing condition affecting many women and is known to have a significant effect on quality of life (QoL). Whilst conservative and behavioural therapy are important in the management of women with both stress incontinence and overactive bladder (OAB) ultimately many may benefit from pharmacological therapy. Antimuscarinic drugs are the commonly used agents in the treatment of OAB although often compliance and persistence are affected by adverse effects. Consequently many newer agents remain under investigation. In addition duloxetine has recently been introduced for the management of women with stress incontinence and may offer an alternative to surgery in selected cases. The aim of this review is to provide an overview of the current and new developments in the management of women with urinary incontinence as well as reviewing the role of oestrogen therapy in relation to lower urinary tract dysfunction.

  10. Selecting appropriate absorbent products to treat urinary incontinence.

    PubMed

    Payne, Drew

    2015-11-01

    Urinary incontinence can have a significant negative effect on a person's life, especially if left unmanaged and untreated. Continence assessment, often carried out by community nurses, is an important element in the management of a person's urinary incontinence, and so is the selection of appropriate absorbent incontinence pads. This article reviews: the causes and effects of urinary incontinence; how to derive the most appropriate information from a continence assessment; strategies for selecting incontinence pads for a person, on the basis of the results of the continence assessment; and some of the problems and risks associated with the use of incontinence pads.

  11. The fecal bacteria

    USGS Publications Warehouse

    Sadowsky, Michael J.; Whitman, Richard L.

    2011-01-01

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

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

    PubMed

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

    2012-12-01

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

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

    PubMed

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

    2010-12-01

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

  14. Urinary incontinence in the elderly. Drug treatment options.

    PubMed

    Chutka, D S; Takahashi, P Y

    1998-10-01

    Urinary incontinence is commonly seen in the elderly. It has multiple complications and is often the reason an elderly person is forced to abandon independent living and enter a nursing home. There are multiple causes of urinary incontinence: it is not a single entity or a specific diagnosis. In most patients, the incontinence can be placed into 1 of the following 4 categories: detrusor overactivity (urge incontinence), overflow incontinence, stress incontinence (outlet incompetence) or functional incontinence. To understand the pathophysiology of urinary incontinence, some knowledge of the urinary tract anatomy and physiology is required. It is also important to know how the anatomy and physiology changes in response to the aging process. Successful treatment depends on the specific cause of the incontinence. If incorrectly diagnosed, various treatments may actually worsen the incontinence or cause other problems. Since most elderly patients do not volunteer a problem of urinary incontinence, questions regarding the presence of symptoms must be asked. In most patients, the specific type of incontinence can be diagnosed with a thorough medical history and physical examination. Several simple and widely available laboratory tests may also be useful in the evaluation. Occasionally, urological consultation or urodynamic testing should be performed. Once correctly diagnosed, there are a large number of pharmacological as well as nonpharmacological treatments (behavioural, surgical) available. This article concentrates on the pharmacological therapies for patients with various types of urinary incontinence. Since most patients with urinary incontinence are elderly, they are more susceptible to the effects as well as the adverse effects of medications. This must be taken into account before any pharmacological therapy is initiated. Although many elderly patients believe their symptoms of urinary incontinence to be a part of growing old, urinary incontinence is never a

  15. Effects of bariatric surgery on urinary incontinence

    PubMed Central

    Bulbuller, Nurullah; Habibi, Mani; Yuksel, Mustafa; Ozener, Onur; Oruc, Mehmet Tahir; Oner, Osman Zekai; Kazak, Mehmet Altug

    2017-01-01

    Introduction Obesity is an important modifiable etiological factor associated with several diseases. There is strong evidence that urinary incontinence (UI) is positively correlated with body mass index (BMI). Aim One of the many benefits experienced by obese patients after bariatric surgery is decrease in UI. To investigate this correlation, we aimed to examine the effects of weight loss on UI in female patients who had undergone laparoscopic sleeve gastrectomy (LSG). Materials and methods Obese female patients (n=120), ≥18 years of age, and planning to undergo LSG were included in this prospective study. We administered the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and Incontinence Impact Questionnaire (IIQ-7) to the patients prior to surgery and 6 months after the surgery. Using the collected data, we determined the incidence of UI and examined the relationship between the preoperative and postoperative BMI and UI values. Results The mean age of the patients was 39.19 (standard deviation [SD] =9.94) years and the mean preoperative BMI was 46.17 (SD =5.35). Of the 120 patients, 72 (60%) complained of UI preoperatively. Among these 72 patients, 23 (31.95%) described urge incontinence, 18 (25%) stress incontinence, and 31 (43.05%) mixed-type incontinence. At 6 months postoperatively, the percentage of excess weight loss was 70.33% (SD =14.84%). For all three UI subtypes, the 6-month postoperative ICIQ-UI-SF and IIQ-7 scores decreased significantly compared to the preoperative scores (P<0.05). Conclusion LSG results in a clinically significant improvement in most common types of UI, regardless of patient reproductive history, existence of comorbid conditions, and smoking status. PMID:28176911

  16. Cell Therapy for Stress Urinary Incontinence.

    PubMed

    Hart, Melanie L; Izeta, Ander; Herrera-Imbroda, Bernardo; Amend, Bastian; Brinchmann, Jan E

    2015-08-01

    Urinary incontinence (UI) is the involuntary loss of urine and is a common condition in middle-aged and elderly women and men. Stress urinary incontinence (SUI) is caused by leakage of urine when coughing, sneezing, laughing, lifting, and exercise, even standing leads to increased intra-abdominal pressure. Other types of UI also exist such as urge incontinence (also called overactive bladder), which is a strong and unexpected sudden urge to urinate, mixed forms of UI that result in symptoms of both urge and stress incontinence, and functional incontinence caused by reduced mobility, cognitive impairment, or neuromuscular limitations that impair mobility or dexterity. However, for many SUI patients, there is significant loss of urethral sphincter muscle due to degeneration of tissue, the strain and trauma of pregnancy and childbirth, or injury acquired during surgery. Hence, for individuals with SUI, a cell-based therapeutic approach to regenerate the sphincter muscle offers the advantage of treating the cause rather than the symptoms. We discuss current clinically relevant cell therapy approaches for regeneration of the external urethral sphincter (striated muscle), internal urethral sphincter (smooth muscle), the neuromuscular synapse, and blood supply. The use of mesenchymal stromal/stem cells is a major step in the right direction, but they may not be enough for regeneration of all components of the urethral sphincter. Inclusion of other cell types or biomaterials may also be necessary to enhance integration and survival of the transplanted cells.

  17. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  18. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  19. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  20. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  1. 21 CFR 876.5920 - Protective garment for incontinence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  2. Incontinence-associated dermatitis: reducing adverse events.

    PubMed

    Rippon, Mark; Colegrave, Melanie; Ousey, Karen

    2016-10-13

    Incontinence-associated dermatitis (IAD) is a common problem in patients with faecal and/or urinary incontinence. Urine alters the normal skin flora and increases permeability of the stratum corneum and faecal enzymes on the skin contribute to skin damage. Faecal bacteria can then penetrate the skin, increasing the risk of secondary infection. However, IAD can be prevented and healed with timely and appropriate skin cleansing and skin protection. This includes appropriate use of containment devices. This article also looks at HARTMANN incontinence pads that have been developed to absorb the fluids that cause IAD and maintain the skin's acidic pH. The acidic pH of the skin contributes to its barrier function and defence against infection. Therefore, maintaining an acidic pH will help protect the skin from damage.

  3. [Stress urinary incontinence. Its surgical management].

    PubMed

    Neri Ruz, E S; Azcona Arteaga, F J

    1991-10-01

    Ninety eight patients with stress urinary incontinence treated surgically at Central Military Hospital, were studied. We analyzed the risk factors as age, weight, height, parity, menopause age, and previous medical and surgical procedures. They were divided in two groups. The Group I, vaginal approach, with 35 patients and Group II, retropubic surgery, with 63 patients. There were no differences both groups regarding age, weight, height, parity and menopausal age. The most frequent illness associated with stress urinary incontinence, was pelvic floor relaxation. The complications were 17.1% and 33.3%, respectively. The efficacy of Burch is procedure for the management of stress urinary incontinence, with a success rate of 84.1% versus 62.1% in the vaginal approach, was confirmed.

  4. Female Epispadias Presenting as Urinary Incontinence

    PubMed Central

    Popovic, Nusret; Zvizdic, Zlatan; Milišic, Emir; Karavdic, Kenan; Paddy, Dewan

    2017-01-01

    Isolated female epispadias without bladder exstrophy is a rare congenital anomaly affecting 1 in 484,000 females. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 6-year-old girl presented with primary urinary incontinence who on physical examination had a bifid clitoris and labia minora. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux and a funnel shaped proximal urethra. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck, labia minora and clitoris was performed.

  5. Female Epispadias Presenting as Urinary Incontinence.

    PubMed

    Jonuzi, Asmir; Popovic, Nusret; Zvizdic, Zlatan; Milišic, Emir; Karavdic, Kenan; Paddy, Dewan

    2017-01-01

    Isolated female epispadias without bladder exstrophy is a rare congenital anomaly affecting 1 in 484,000 females. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 6-year-old girl presented with primary urinary incontinence who on physical examination had a bifid clitoris and labia minora. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux and a funnel shaped proximal urethra. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck, labia minora and clitoris was performed.

  6. Incontinence Pad Usage in Medical Welfare Facilities in Korea

    PubMed Central

    Lee, Sang Hyub; Kang, Ji Soon; Kim, Jeong-Wha

    2013-01-01

    Purpose The prevalence of urinary incontinence and the usage of incontinence pads by elderly residents in Korean medical welfare facilities were investigated. Methods From a total of 1,832 facilities, 33 medical welfare facilities in the capital area were randomly selected; all nursing homes were excluded. All data were collected by questionnaires to investigate the residents' age and sex, the presence or absence of urinary incontinence, incontinence pad usage per month, and management methods for urinary incontinence. Surveys were also conducted from January 2010 to August 2010. Results A total number of residents in medical welfare facilities were 2,783, and all of them were selected for this study. Approximately, 65.3% of residents (1,816 individuals) had incontinence. The mean usage was 75 incontinence pads per month. Only 15.6% of residents received proper management for urinary incontinence, while the remaining 84.4% of residents did not have any experience in evaluating or managing their urinary symptoms. Conclusions The prevalence of urinary incontinence in medical welfare facilities in Korea was about 65.3%. However, the management of urinary incontinence was insufficient. Urologists should make further efforts for the proper management of urinary incontinence in elders in these facilities. PMID:24466466

  7. Prevention of incontinence-related skin breakdown for acute and critical care patients: comparison of two products.

    PubMed

    Brunner, Mary; Droegemueller, Carol; Rivers, Sonja; Deuser, William E

    2012-01-01

    Perineal protection products were compared for their efficacy in preventing skin breakdown in the hospitalized patient with urinary and/or fecal incontinence. Each product was used for the duration of the hospital stay with daily observations for perineal skin condition. Results indicated the spray product and wipe product were comparable in rate of skin breakdown prevention. Findings suggest the wipe product is more cost-effective for use during hospitalization, and the spray product preserves skin integrity over a longer period of time, beyond average hospitalization duration.

  8. Electrokinetic properties of incontinence nonwoven devices

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  9. Management of patients with faecal incontinence

    PubMed Central

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

    2016-01-01

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

  10. Incontinence products and devices for the elderly.

    PubMed

    Newman, Diane K

    2004-08-01

    Devices and products to contain or collect the urine are part of the management of bladder dysfunction, particularly urinary incontinence (UI) (Newman, Bliss, & Fader, in press). The aim of continence nurse experts and those who care for incontinent individuals during the past decade has been to greatly decrease the indiscriminate use of absorbent pads and garments, external collecting devices, and indwelling catheterization, through the successful treatment of urinary incontinence (UI) with behavioral interventions, drug therapies, and new surgical procedures. However, these products and devices can be beneficial for persons who are elderly, fail treatment and remain incontinent, who are too ill or disabled to participate in behavioral programs, who cannot be helped by medications, or who have a type of UI that cannot be alleviated by other interventions (Newman, 2003). The judicious use of products to contain urine loss and maintain skin integrity is a first-line defense for these patients (Fantl et al., 1996). Urinary collection devices and products that are appropriate for elderly patients, that are used by nurses in all clinical settings, and are available at local pharmacies, retail stores, medical equipment dealers or directly from manufacturers are discussed.

  11. Faecal incontinence products and quality of life.

    PubMed

    Evans, Debra

    Faecal incontinence has been defined as the involuntary or inappropriate passage of faeces (Royal College of Physicians, 1995). It is a distressing and isolating problem that affects people of all ages, with an estimated incidence of 1-2 per cent of the population (Soffer and Hull, 2000). Many people must rely on continence products to manage this stigmatising and embarrassing problem.

  12. Coping with the Impact of Incontinence

    ERIC Educational Resources Information Center

    Gartley, Cheryle

    2008-01-01

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

  13. The medical management of urinary incontinence.

    PubMed

    Shaban, Ahmed; Drake, Marcus J; Hashim, Hashim

    2010-01-15

    Urinary incontinence is the involuntary leakage of urine; it affects millions of people worldwide, causing significant detrimental effects on their quality of life. Direct expenses, such as containment products, long-term drug prescriptions and surgery, complemented by indirect costs, such as reduced employment productivity, result in overall expenditure running to billions of dollars. Stress urinary incontinence (SUI) occurs on physical exertion, and results from weakness of the bladder outlet. Urgency urinary incontinence (UUI) results from inability to resist a sudden compelling desire to pass urine, arising as a consequence of bladder dysfunction. Clinical evaluation clarifies the underlying mechanisms and excludes diseases causing similar symptoms. Urodynamic studies to measure bladder and abdominal pressures and deduce the bladder and outlet function are undertaken when invasive treatments are being considered or when the nature of the incontinence is not entirely clear. Initial management of SUI involves pelvic floor muscle exercise training; if insufficient symptom improvement results, surgical measures are needed. UUI treatment commences with advice on suitable fluid intake and measures to improve ability to defer voiding, followed by antimuscarinic drugs. Refractory UUI is a difficult problem, currently managed with a range of surgical interventions, including bladder injections of botulinum-A neurotoxin, augmentation cystoplasty and nerve stimulation methods. New treatment options are needed, because of the risk of impeding voiding function, resulting in urinary retention. Persistent leakage is controlled with containment products, such as pads, or collection devices, such as catheters.

  14. Functional daytime incontinence: non-pharmacological treatment.

    PubMed

    van Gool, J D; Vijverberg, M A; Messer, A P; Elzinga-Plomp, A; de Jong, T P

    1992-01-01

    In children with 'functional incontinence', defined as any form of (daytime) wetting caused by non-neuropathic bladder/sphincter dysfunction, most signs and symptoms are rooted in habitual non-physiological responses to signals from bladder and urethra. These responses develop at toddler age, when children learn how to remain dry. Once they have become a habit, incomplete bladder emptying and recurrent urinary tract infections come into play, reiterating the non-physiological responses into fixed patterns of bladder/sphincter dysfunction with functional incontinence as the leading symptom. Non-pharmacological treatment of functional incontinence implies relearning and training the normal responses to signals from bladder and urethra: a cognitive process, with perception of the signals reinforced by biofeedback. This type of treatment is best combined with long-term chemoprophylaxis. Severe cases will benefit from anticholinergic drugs, as adjuvants to the training programme. Urodynamics play a crucial role in documenting the specific patterns of incontinence and in providing biofeedback. For a successful programme, psychological screening of the children is indispensable.

  15. Glycemic Control and Urinary Incontinence in Women with Diabetes Mellitus

    PubMed Central

    Karter, Andrew J.; Thai, Julie N.; Van Den Eeden, Stephen K.; Huang, Elbert S.

    2013-01-01

    Abstract Background Although many studies have shown that diabetes increases the risk for urinary incontinence, it is unclear whether poor glycemic control in women with diabetes is associated with incontinence. This study aims to determine the relationship between the hemoglobin A1c (HbA1c) level and urinary incontinence in a large, diverse cohort of older women. Methods We examined 6026 older women who responded to a survey (62% response rate) and were enrolled in the Diabetes and Aging Study, an ethnically stratified random sample of patients with diabetes enrolled in Kaiser Permanente Northern California. Our primary independent variable was the mean of all HbA1c measurements in the year preceding the survey. Outcomes included the presence/absence of incontinence and limitations in daily activities due to incontinence. We used modified Poisson regression and ordinal logistic regression models to account for age, race, body mass index, parity, diabetes treatment, duration of diabetes, and comorbidity. Results Sixty-five percent of women reported incontinence (mean age 59±10 years). After adjustment, HbA1c levels were not associated with the presence or absence of incontinence. However, among women reporting incontinence, HbA1c ≥9% was associated with more limitations due to incontinence than HbA1c <6% (adjusted odds ratio 1.67, 95% confidence interval: 1.09–2.57). Conclusion In this cross-sectional analysis, HbA1c level is not associated with the presence or absence of incontinence. However, for women with incontinence, poor glycemic control (HbA1c ≥9%) is associated with more limitations in daily activities due to incontinence. Longitudinal studies are needed to determine whether improving glycemic control to HbA1c <9% leads to fewer limitations in daily activities due to incontinence. PMID:24032999

  16. [Fecal microbiota transplantation].

    PubMed

    García-García-de-Paredes, Ana; Rodríguez-de-Santiago, Enrique; Aguilera-Castro, Lara; Ferre-Aracil, Carlos; López-Sanromán, Antonio

    2015-03-01

    Bacteria can no longer be seen as an enemy. Nowadays, there is enough evidence to place the microbiota as a key element in human homeostasis. Despite initial skepticism, fecal microbiota transplantation (FMT) is a real therapeutic alternative for patients with recurrent Clostridium difficile infection. Moreover, this procedure has shown promising results in ulcerative colitis and other non-gastrointestinal disorders. There is still a lack of knowledge and clinical trials with long- term follow-up. Therefore, the available data should be interpreted with caution. In this document we provide a detailed review of the literature on the intestinal microbiota and FMT.

  17. [Fecal microbiota transplantation: review].

    PubMed

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

    2015-01-01

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

  18. Fecal Microbiota Transplantation.

    PubMed

    Vindigni, Stephen M; Surawicz, Christina M

    2017-03-01

    Fecal microbiota transplantation (FMT) is the transfer of stool from a healthy donor into the colon of a patient whose disease is a result of an altered microbiome, with the goal of restoring the normal microbiota and thus curing the disease. The most effective and well-studied indication for FMT is recurrent Clostridium difficile infection. At this time, there is insufficient evidence to recommend FMT for other gastrointestinal diseases, but studies are under way. There is also insufficient evidence to recommend FMT for nongastrointestinal diseases at this time. The field is rapidly emerging.

  19. Predictors of female urinary incontinence at midlife and beyond.

    PubMed

    Menezes, M; Pereira, M; Hextall, A

    2010-02-01

    Urinary incontinence (UI) is an important middle age health issue and approximately 20% of women over 40 years of age have problems with continence. Urinary incontinence poses a significant negative impact on social functioning and quality of life to many individuals. It is estimated that around three million people are regularly incontinent in the UK with a prevalence of about 40 per 1000 adults. There are various factors which can cause incontinence such as pregnancy, childbirth, obesity, menopause, or just inherent connective-tissue weakness. All of these factors can cause pathophysiology changes in the muscular and fascial structures of the pelvic floor and lead to pelvic support defects and possibly pelvic floor dysfunction. We aim with this review article to highlight predictors or predisposing factors of incontinence; in order to help clinicians during their decisions and put in place a policy of a preventive strategy to decrease the incontinence rate in the general population.

  20. Urinary incontinence in a vulnerable population: older women.

    PubMed

    Criner, J A

    2001-01-01

    Urinary incontinence creates a tremendous hardship on older women and results in social isolation, anxiety, low self-esteem, depression, and decreased life satisfaction. Stress, urge, overflow, and functional incontinence can be treated by behavioral methods, medications, or invasive techniques. The nurse should complete a health history before making an informed decision with the older women about the most appropriate treatment plan. There can be improved quality of life for women with incontinence if health care providers focus on this problem.

  1. Mixed Incontinence: How Best to Manage It?

    PubMed

    Porena, Massimo; Costantini, Elisabetta; Lazzeri, Massimo

    2013-03-01

    Although common in women, mixed urinary incontinence (MUI) is under-reported and under-treated. It is linked to concomitant disturbances, which may be due to childbirth, ageing, or other medical conditions, in the complex bladder-urethra coordinated system of urine storage and emptying. Primary care physicians can evaluate MUI through history and simple clinical assessment or they can avail of more complex device and tools, such as urodynamic assessment. There is a wide range of therapeutic options. The recent proliferation of new drug treatments and surgical devices for urinary incontinence offers innovative strategies for therapy but products risk being introduced without long-term safety and efficacy assessment. Direct-to-consumer advertising has increased public awareness of MUI.

  2. Double incontinence as a first symptom of saddle embolism of the aorta leads to sudden paraplegia.

    PubMed

    Sabzi, Feridoun; Faraji, Reza

    2015-11-01

    An aortic saddle embolus causing cauda equine syndrome followed by paraplegia is an exceedingly rare phenomenon in post-operative period in coronary artery bypass grafting. In non-CABG cases, reported documentation of neurological recovery from this event is even rarer. A 57-year-old male 8 days after uneventful OPCAP presented with severe lower extremity pain and sudden fecal and urinary incontinence, followed by the absence of pulsations in the lower limbs and paraplegia, during 20-minute period. He underwent immediate bilateral transfemoral embolectomy. The postoperative period was uneventful. The paraplegia recovered immediately after embolectomy and recovery from anesthesia. An angiography has been made to verify that a high origin of the great radicular artery above T12 level may be responsible for better recovery of paraplegia when its ostium obstructed by a saddle embolus relieved using embolectomy. Early surgical intervention in restoring the blood flow into the great radicular artery may prevent severe histological changes hitherto responsible for non-recovery from paraplegia in the earlier reports. Three unique characteristics of this article are as follows: 1) Occurrence of this complication in the post-operative period in off-pump CABG surgery; 2) Commencing of emboli with bizarre symptoms of double incontinence; 3) Combination of cauda equine syndrome and complete paralysis.

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

    PubMed

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

    2011-01-01

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

  4. [A survey on urinary incontinence in the institutionalized elderly].

    PubMed

    Homma, Y; Takai, K; Takahashi, S; Higashihara, E; Aso, Y; Urushibara, A

    1992-08-01

    A survey on urinary incontinence in 161 (41 male, 120 female) institutionalized elderly was independently performed by urologists and attending nurses. Urinary incontinence was found in 107 cases (66%), with 76 cases (47%) suffering from severe leakage (more than 5 times a day and needs diaper). The prevalences of incontinence and severe leakage were 63% and 52% at geriatric hospitals, 59% and 29% at intermediate care centers and 78% and 63% at nursing homes, respectively. The risk factors for incontinence were consciousness disturbance, urinary urgency, impaired mobility and dementia, and those for severe leakage were apathy, loss of urinary sensation, dementia and impaired mobility. The type of incontinence was considered functional one in 81% of cases. The agreement of the incontinence type evaluated by urologists and that by nurses was found in 90% of incontinent cases. Incontinence was estimated "incurable" in 54% of cases by attending nurses. These observations indicate a high prevalence of severe and "incurable" incontinence in the institutionalized elderly, urgently warranting an effective remedy for the increasing aged society.

  5. Urinary incontinence in the aged, Part 2: Management strategies.

    PubMed

    Rousseau, P; Fuentevilla-Clifton, A

    1992-06-01

    Treatments for urge incontinence associated with uninhibited bladder contractions include medications with anticholinergic and smooth muscle relaxant properties as well as habit training, bladder retraining, contingency therapy, and biofeedback. Pelvic floor (Kegel) exercises improve stress incontinence in 60 to 90% of female patients. For patients who fail to improve with pelvic floor exercises, a combination of an alpha-adrenergic agent and conjugated estrogen is recommended. Surgery is particularly effective in elderly women with significant pelvic prolapse. Management of overflow incontinence requires surgery or intermittent/chronic catheterization. Functional incontinence may be improved with correction of the underlying disorder and availability of a motivated caregiver.

  6. The Challenge of Urinary Incontinence in the Elderly

    PubMed Central

    Worrall, Graham

    1989-01-01

    By 2021 Canada will have an enormous population older than 65 years of age. Before the wholesale introduction of programs for seniors with urinary incontinence, careful evaluation of present treatments and the extent to which they can usefully be applied in the community is necessary. We need more information about the diagnosis and treatment of urinary incontinence in the elderly and about both patient and caregiver compliance with treatment for urinary incontinence. There is a great need for research on the efficiency of programs targeted at the incontinent group and for community surveys to reassess the problem's long-term consequences. PMID:21249070

  7. Slings in iatrogenic male incontinence: Current status

    PubMed Central

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

    2010-01-01

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

  8. [Causes and diagnosis of female urinary incontinence].

    PubMed

    Schorsch, I; Soljanik, I; Stanislaus, P; Bauer, R; Mayer, M; Hocaoglu, Y; Becker, A; May, F

    2007-09-20

    The primary cause of stress incontinence is birth traumata. However, obesity, asthma, chronic constipation or hard physical work can also overtax the pelvic floor and lead to injury of the connective tissue and a slackening of the ligamentous apparatus. Pelvic floor defects are initially diagnosed simply through a thorough urogynaecological examination. To predict the success of a surgical treatment, the functions can be tested by performing simulated operations.

  9. Fecal Pellet Flux in the Mesopelagic Sargasso Sea

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

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

    ERIC Educational Resources Information Center

    Filce, Hollie Gabler; Bishop, John B.

    2014-01-01

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

  11. FECAL COLIFORM INCREASE AFTER CENTRIFUGATION

    EPA Science Inventory

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

  12. Women with Diabetes: Understanding Urinary Incontinence and Help Seeking Behavior

    PubMed Central

    Doshi, Ashmi M.; Van Den Eeden, Stephen K.; Morrill, Michelle Y.; Schembri, Michael; Thom, David H.; Brown, Jeanette S.

    2010-01-01

    Purpose To examine the association of urinary incontinence by diabetes status and race and evaluate beliefs and help-seeking around incontinence in a population-based cohort of women with and without diabetes. Materials and Methods We performed a cross-sectional analysis of 2,270 middle-aged and older racially/ethnically diverse women in Diabetes RRISK. Incontinence, help-seeking behavior, and beliefs were assessed by self-report questionnaires and in-person interviews. Incontinence characteristics of diabetics and non-diabetics were compared using univariate analysis and multivariate models. Results Women with diabetes reported weekly incontinence significantly more than women without diabetes (Weekly: 35.4% vs. 25.7%, respectively, p <0.001). Race prevalence patterns were similar (white and Latina women with the most prevalent incontinence and African-American and Asian women with the least) among women with and without diabetes. Less than 50% of women with diabetes discussed their incontinence with a doctor (42.2% vs. 55.5% (of women without diabetes) p <0.003). Women with diabetes were more likely than women without diabetes to report believing that incontinence is a rare condition (17% vs. 6%, respectively, p<0.001). Conclusions Incontinence is highly prevalent among women with diabetes. Race prevalence patterns are similar among women with and without diabetes. Understanding help-seeking behaviors are important to ensure appropriate care for patients. Physicians should be alert for urinary incontinence because it is often unrecognized and thereby under-treated among women with diabetes. PMID:20727547

  13. 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).

  14. Surgical management of pediatric urinary incontinence.

    PubMed

    Dave, Sumit; Salle, Joao Luiz Pippi

    2013-08-01

    The surgical management of pediatric urinary incontinence secondary to neurogenic bladder and congenital anomalies is challenging, and continues to evolve with new surgical innovations. The goal of these surgical procedures is to achieve complete and socially acceptable urinary dryness, while preserving volitional voiding where possible, without causing damage to the upper tracts. This review focuses on recent studies and highlights the pros and cons of these advances, based on our experience. The short-term success in achieving urinary continence has to be tempered with the long-term implications of these reconstructive procedures, about which our knowledge is limited.

  15. Promoting social continence using incontinence management products.

    PubMed

    Dingwall, Lindsay

    Urinary incontinence (UI) is a common problem which affects men and women for a variety of reasons. For some people with UI cure is not achievable. For others, time is required to accurately diagnose and treat their urinary symptoms. In order to improve quality of life for people with UI, health professionals require awareness of the products available to achieve social continence. Continence products and devices fall into three categories: collective devices, containment products and occlusive devices. This article provides a brief overview of the more common products available and discusses some of the common benefits and drawbacks to their use.

  16. [Urine incontinence referral criteria for primary care].

    PubMed

    Brenes Bermúdez, F J; Cozar Olmo, J M; Esteban Fuertes, M; Fernández-Pro Ledesma, A; Molero García, J M

    2013-01-01

    Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.

  17. [Urine incontinence referral criteria for primary care].

    PubMed

    Brenes Bermúdez, F J; Cozar Olmo, J M; Esteban Fuertes, M; Fernández-Pro Ledesma, A; Molero García, J M

    2013-05-01

    Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.

  18. Thermotolerant non-fecal source Klebsiella pneumoniae: validity of the fecal coliform test in recreational waters.

    PubMed Central

    Caplenas, N R; Kanarek, M S

    1984-01-01

    Wisconsin pulp and paper mill processing plants were evaluated for fecal coliform and total Klebsiella (i.e., thermotolerant and thermointolerant) bacterial concentrations. Using the standard fecal coliform test, up to 90 per cent of non-fecal source thermotolerant K. pneumoniae was falsely identified as fecal source bacteria. Since there is a lack of specificity in the currently used standard for fecal coliform evaluation, a more reliable health risk assessment for fecal coliform bacteria is recommended. PMID:6388365

  19. [Transobturator slings for female stress urinary incontinence].

    PubMed

    Sousa, Ana; Jesus, André; Carvalho, Maria; Carvalho, Giselda; Marques, João; Falcão, Francisco; Torgal, Isabel

    2014-01-01

    Introdução: A incontinência urinária de esforço afeta 20 a 40% das mulheres. Os slings colocados sob a uretra média, aplicados por via transobturadora, são a terapêutica consensualmente aceite na atualidade. O objetivo do estudo foi avaliar a eficácia e possíveis complicações associadas à aplicação dos slings colocados por via transobturadora no tratamento da incontinência urinária de esforço. Material e Métodos: Avaliaram-se retrospetivamente 363 doentes submetidas a cirurgia de incontinência urinária de esforço por via transobturadora, nos Hospitais da Universidade de Coimbra do Centro Hospitalar e Universitário de Coimbra, no período de 1 Janeiro de 2008 a 1 Julho de 2010. Resultados: A média das idades das doentes foi de 56 anos [28-86]. Além da correção da incontinência urinária de esforço, em 13,5% das mulheres foi associada outra cirurgia vaginal. A maioria (95,3%) das mulheres apresentou hipermobilidade da uretra. Ocorreram complicações per-operatórias em 0,8%, complicações pós-operatórias imediatas em 5,2% e complicações pós-operatórias tardias em 15,7%. A taxa de sucesso global foi de 93,7%. A taxa de sucesso nas doentes com uretra fixa foi 77,8%, verificando-se melhores resultados (94,5%) naquelas com hipermobilidade da uretra (p = 0,02). A taxa de sucesso foi comparável nas doentes com e sem cirurgias vaginais associadas. Discussão: As técnicas transobturadoras têm taxas de sucesso elevadas, tendo-se tornado o tratamento de primeira linha para as doentes com IUE, independentemente se tratadas pela técnica outside-in (TOT®) ou pela inside-out (TVT-O®). Ambas as técnicas foram concebidas com o intuito de evitar a passagem no espaço retropúbico, reduzindo assim o número de complicações. Conclusão: As taxas de cura para as abordagens transobturadoras oscilam entre 80 e 95%. A taxa de cura aumenta quando o mecanismo responsável pela incontinência urinária de esforço é a hipermobilidade da uretra

  20. Kegel's exercises with biofeedback therapy for treatment of stress incontinence.

    PubMed

    Burns, P A; Marecki, M A; Dittmar, S S; Bullough, B

    1985-02-01

    True stress incontinence due to a weakened pelvic floor is one of the most frequently cited urologic complaints of multiparous women past age 40. One treatment modality currently used to treat stress incontinence is exercising the pubococcygeus muscle. Combining biofeedback therapy with a vaginal probe (perineometer) helps patients identify the muscle, provides immediate feedback and assists the nurse and patient in assessing problem resolution. This article describes an intervention program using biofeedback, and measured Kegel's exercises on a small number of women with symptoms of stress incontinence. The lessening of symptoms became a major factor in continued compliance with the exercise program.

  1. 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

  2. Review of current technologies for urinary incontinence: strengths and limitations.

    PubMed

    Fader, M

    2003-01-01

    A wide range of continence products is available, and this paper focuses on products to prevent incontinence (such as urinals and commodes) and to contain or manage urinary incontinence (such as absorbent pads, penile sheaths and urethral catheters). Drawing on results from published clinical evaluations at the Continence Product Evaluation Network at UCL and at other centres, the strengths and limitations of the major categories of incontinence products currently on the market are reviewed. It is concluded that, although products for continence have improved considerably over the last 20 years, there is considerable scope for the designer and engineer to improve on current products.

  3. Vascular incontinence: incontinence in the elderly due to ischemic white matter changes

    PubMed Central

    Sakakibara, Ryuji; Panicker, Jalesh; Fowler, Clare J; Tateno, Fuyuki; Kishi, Masahiko; Tsuyuzaki, Yohei; Ogawa, Emina; Uchiyama, Tomoyuki; Yamamoto, Tatsuya

    2012-01-01

    This review article introduces the new concept of vascular incontinence, a disorder of bladder control resulting from cerebral white matter disease (WMD). The concept is based on the original observation in 1999 of a correlation between the severity of leukoareosis or WMD, urinary symptoms, gait disorder and cognitive impairment. Over the last 20 years, the realization that WMD is not a benign incidental finding in the elderly has become generally accepted and several studies have pointed to an association between geriatric syndromes and this type of pathology. The main brunt of WMD is in the frontal regions, a region recognized to be crucial for bladder control. Other disorders should be excluded, both neurological and urological, such as normal-pressure hydrocephalus, progressive supranuclear palsy, etc., and prostatic hyperplasia, physical stress incontinence, nocturnal polyuria, etc. Treatment involves management of small vessel disease risk factors and anticholinergic drugs that do not easily penetrate the blood brain barrier to improve bladder control. PMID:23139851

  4. 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— ... to slide 4 out of 4 Overview The vaginal opening lies just below the urethral opening, and ...

  5. Bladder Control Problems: Medications for Treating Urinary Incontinence

    MedlinePlus

    ... used correctly, topical estrogen therapy typically doesn't cause side effects. However, to treat incontinence, topical estrogen is usually paired with another medication or therapy — which may cause side effects. How it works Imipramine is a tricyclic antidepressant. ...

  6. Managing faecal incontinence or leakage: the Peristeen Anal Plug.

    PubMed

    Doherty, Willie

    Incontinence can be a devastating problem to many individuals. It is embarrassing and limiting socially, and prevents those with the problem from going about their day-to-day activities. People adopt coping strategies to manage the problem and those with urinary incontinence often look for containment products such as disposable pads or nappy-style products. These products have been developed using different absorbent materials and are accessible to sufferers in local supermarkets. Absorbency of the products has improved so that once wetted, they hold urine more easily. However, the same cannot be said for faecal incontinence management products and there are few that can be called upon to manage this devastating condition. The Peristeen Anal Plug, developed originally as the Conveen Anal Plug, stands alone in the search for a device to manage faecal incontinence or leakage.

  7. What's best--reusable or disposable incontinence products?

    PubMed

    Haeker, S

    1986-05-01

    To use paper or cloth? The director of nursing for a 72-bed intermediate care facility opted to continue using reusable incontinence products based on the results of a three-week study conducted by her staff.

  8. Olanzapine as a Cause of Urinary Incontinence: A Case Report

    PubMed Central

    Oluwole, Lateef Olutoyin; Adegun, Patrick T; Tareo, Peter O

    2012-01-01

    Olanzapine, an atypical antipsychotic, is one of the most commonly used antipsychotics. Though olanzapine is commonly associated with endocrine side effects, it is generally well tolerated by most patients and is rarely associated with urinary incontinence. This report highlights the case of a 23 -year old male patient with schizophrenia who developed severe urinary incontinence following the use of olanzapine. No medications were given to relieve the incontinence contrary to some other studies where ephedrine was used. Olanzapine was changed to trifluoperazine, and the patient's condition improved within two days. Urinary incontinence, though uncommon, is an embarrassing side effect of olanzapine which could negatively affect drug compliance. As such, clinicians should enquire about it in order to improve the patient's health. PMID:23139697

  9. 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

  10. Fecal microbiota transplantation: in perspective

    PubMed Central

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

    2016-01-01

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

  11. Effects of urinary incontinence on psychosocial outcomes in adolescence.

    PubMed

    Grzeda, Mariusz T; Heron, Jon; von Gontard, Alexander; Joinson, Carol

    2016-12-10

    To examine whether daytime wetting and bedwetting urinary incontinence (UI) in childhood and adolescence are associated with psychosocial problems in adolescence. We used data from the Avon Longitudinal Study of Parents and Children to examine the association between trajectories of UI from 4 to 9 years and self-reported psychosocial problems in adolescence (13-14 years) including depressive symptoms, peer victimisation, poor self-image and school experiences (negative perception of school and teachers, problems with peer relationships). Sample sizes ranged from 5162 (perception of teachers) to 5887 (self-image). We also examined associations between self-reported UI at 14 years and psychosocial problems. Relative to normative development, adolescents who experienced delayed development of bladder control had poorer self-image [standardised mean difference = 0.18 (95% CI 0.04, 0.32)], more negative perceptions of school [0.18 (0.02, 0.34)] and more problems with peer relationships at school [0.25 (0.10, 0.40)]. Persistent wetting (bedwetting with daytime wetting) in childhood was associated with increased problems with peer relationships in adolescence [0.19 (0.03, 0.34)]. The strongest associations between adolescent UI and psychosocial problems were found for daytime wetting (reference = no UI at 14 years): depressive symptoms [OR = 3.04 (95% CI 1.91-4.84)], peer victimisation [2.14 (1.48-3.10)], poor self-image (t = -8.49, p < 0.001) and problems with peer relationships (t = -4.69, p < 0.001). Children with delayed development of bladder control and persistent wetting have increased psychosocial problems in adolescence. Adolescents with UI reported a range of psychosocial problems and clinicians should be aware that they might require support from psychological services.

  12. [Neurogenic urinary incontinence. Value of surgical management].

    PubMed

    Kutzenberger, J

    2008-06-01

    Damage to the CNS, the cauda equina, and the pelvic nerval structures causes neurogenic bladder dysfunction with neurogenic urinary incontinence (NUI). The definitive diagnosis of NUI is made with urodynamic examination methods. The most frequent cause of NUI is neurogenic detrusor overactivity (NDO). The treatment concept must take into account the physical and emotional restrictions. The treatment of NUI due to NDO is a domain of conservative therapy, i.e., mostly antimuscarinics and intermittent catheterization (IC). In about 30%, there is a good chance for therapy failures. An advancement in therapy is the injection of BTX-A into the detrusor. The missing drug approval is a disadvantage.Operative treatments are considered if conservative and minimally invasive therapies are unsuccessful. Sacral deafferentation (SDAF) and sacral anterior root stimulator implantation (SARSI) are available as organ-preserving techniques only for paraplegics with NDO and reflex urinary incontinence and neuromodulation for the other forms of NDO provided that a successful percutaneous nerve evaluation (PNE) test has previously taken place. Augmentation cystoplasty is indicated if SDAF and neuromodulation cannot be used and the bladder wall is damaged irreversibly by fibrosis. Kidney function of at least 25% and acceptance of IC are prerequisites. Myectomy (autoaugmentation) has an indication similar to augmentation cystoplasty but there must not be any fibrosis. Bladder neck insufficiency (BNI) caused by paralysis or iatrogenically can be treated by the implantation of an alloplastic sphincter high at the bladder neck. A stable reservoir function is required. If not all methods are possible, the ileum conduit or the suprapubic bladder fistula can be the last resort.

  13. Informatics in radiology: dual-energy electronic cleansing for fecal-tagging CT colonography.

    PubMed

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

    2013-05-01

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

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

    PubMed Central

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

    2013-01-01

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

  15. Incontinence in Intellectual Disability: An Under Recognized Cause

    PubMed Central

    Sagayaraj, Benjamin; V.T.T., Rajan; Kumar, Radha

    2015-01-01

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

  16. [Urodynamic studies in the child with urinary incontinence].

    PubMed

    Schwöbel, M; Bodmer, C

    1998-01-01

    Voiding disorders in children are frequent. To establish an exact anamnesis, it has to be distinguished between enuresis and incontinence and this may consequently already have a therapeutical effect. Enuresis is defined as a normal void occurring at an inappropriate time or place. Incontinence is an involuntary loss of urine and a pathological voiding habit, often in combination with urinary infections. The causes of an enuresis are always functional, the causes for incontinence may be organic or functional. Organic causes are neurogenic bladder dysfunctions or structural anomalies of the lower urinary tract. The functional causes are divided in urge incontinence, dysfunctional voiding, lazy bladder syndrome and stress incontinence. The most important screening examination in each child with voiding disorders is the uroflowmetry, in combination with an electromyography (EMG) of pelvic floor and abdominal muscles. For registration of the muscle activity, surface electrodes are used that only show muscle groups, but do not hurt on application. Cystometry, an invasive method, is used as a second step. The therapy of functional incontinence consists in bladder training, physiotherapy of the pelvic floor and biofeedback. Medicaments are given in second priority. The therapy of functional voiding disorders is only successful in cooperation with the child and its parents.

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

    PubMed Central

    Bakuła, Stanisław

    2014-01-01

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

  18. Challenges of Conducting Multi-Center, Multi-Disciplinary Urinary Incontinence Clinical Trials: Experience of the Urinary Incontinence Treatment Network

    PubMed Central

    Steers, William; Richter, Holly; Nyberg, Leroy; Kusek, John; Kraus, Stephen; Dandrea, Kimberly; Chai, Toby; Brubaker, Linda

    2009-01-01

    Aims The Urinary Incontinence Treatment Network (UITN) was established in 2000 as a multi-disciplinary, multi-institutional network by the National Institute for Diabetes, Digestive, and Kidney Diseases (NIDDK) to investigate treatments for urinary incontinence in women. Methods Over 8 years this network composed of urologists, urogynecologists, geriatricians, behavioral psychologists, physical therapists, nurses, epidemiologists, social scientists and statisticians from nine academic sites and a Data Coordinating Center has been effective in designing and completing prospective randomized clinical trials for treatments of urinary incontinence in women. Results Two major clinical trials have been completed and a third has completed recruitment. The focus of the completed trials was a comparison of surgical methods to treat stress urinary incontinence whereas the third examined the potential benefit of combined behavioral intervention and antimuscarinic drug therapy to eliminate the need for long-term use of drug therapy alone to manage urge urinary incontinence. The scientific output of the network measured by abstracts, original papers and presentations demonstrates the productivity of the network. Conclusions Many unique challenges are posed by a multi-disciplinary team located at sites across the United States undertaking several clinical trials. This review presents some of the logistics, barriers, tactics, and strategies used to create this successful clinical trials network focused on urinary incontinence. PMID:19030190

  19. Ultrasound Imaging of the Pelvic Floor.

    PubMed

    Stone, Daniel E; Quiroz, Lieschen H

    2016-03-01

    This article discusses the background and appraisal of endoluminal ultrasound of the pelvic floor. It provides a detailed anatomic assessment of the muscles and surrounding organs of the pelvic floor. Different anatomic variability and pathology, such as prolapse, fecal incontinence, urinary incontinence, vaginal wall cysts, synthetic implanted material, and pelvic pain, are easily assessed with endoluminal vaginal ultrasound. With pelvic organ prolapse in particular, not only is the prolapse itself seen but the underlying cause related to the anatomic and functional abnormalities of the pelvic floor muscle structures are also visualized.

  20. Comparison of Perineal Sonographically Measured and Functional Urodynamic Urethral Length in Female Urinary Incontinence

    PubMed Central

    Janetzki, Nadine; Kennes, Lieven; Stickeler, Elmar; Serno, Julia; Behrendt, Julia

    2016-01-01

    Objectives. To detect the anatomical insufficiency of the urethra and to propose perineal ultrasound as a useful, noninvasive tool for the evaluation of incontinence, we compared the anatomical length of the urethra with the urodynamic functional urethral length. We also compared the urethral length between continent and incontinent females. Methods. 149 female patients were enrolled and divided into four groups (stress, urge, or mixed incontinence; control). Sonographically measured urethral length (SUL) and urodynamic functional urethral length (FUL) were analyzed statistically. Standardized and internationally validated incontinence questionnaire ICIQ-SF results were compared between each patient group. Results. Perineal SUL was significantly longer in incontinent compared to continent patients (p < 0.0001). Pairwise comparison of each incontinent type (stress, urge, or mixed incontinence) with the control group showed also a significant difference (p < 0.05). FUL was significantly shorter in incontinent patients than in the control group (p = 0.0112). But pairwise comparison showed only a significant difference for the stress incontinence group compared with the control group (p = 0.0084) and not for the urge or mixed incontinent group. No clear correlation between SUL, FUL, and ICIQ-SF score was found. Conclusions. SUL measured by noninvasive perineal ultrasound is a suitable parameter in the assessment of female incontinence, since incontinent women show a significantly elongated urethra as a sign of tissue insufficiency, independent of the type of incontinence. PMID:27819004

  1. 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.

  2. Incontinence, bladder neck mobility, and sphincter ruptures in primiparous women

    PubMed Central

    2010-01-01

    Objective To compare the function of the pelvic floor in primiparae before and during pregnancy with the status post partum concerning symptoms of incontinence, sphincter ruptures, bladder-neck mobility and the influence of the different modes of deliveries. Methods Questionnaire evaluating symptoms of urinary and anal incontinence in nulliparous women before and after delivery and correlating these symptoms with functional changes of the pelvic floor based on a careful gynaecologic examination as well as perineal and endoanal ultrasound. Results 112 women were included in our study and came for the first visit, 99 women returned for follow-up 6 months after childbirth. Stress and flatus incontinence significantly increased from before pregnancy (3 and 12%) to after childbirth (21 and 28%) in women with spontaneous delivery or vacuum extraction. No new symptoms occurred after c-section. There was no significant difference between the bladder neck position before and after delivery. The mobility of the bladder neck was significantly higher after vaginal delivery using a vacuum extraction compared to spontaneous delivery or c-section. The bladder neck in women with post partum urinary stress incontinence was significantly more mobile than in continent controls. The endoanal ultrasound detected seven occult sphincter defects without any correlation to symptoms of anal incontinence. Conclusion Several statistically significant changes of the pelvic floor after delivery were demonstrated. Spontaneous vaginal delivery or vacuum extraction increases the risk for stress or anal incontinence, delivery with vacuum extraction leads to higher bladder neck mobility and stress incontinent women have more mobile bladder necks than continent women. PMID:20696633

  3. Knowledge and understanding of urinary incontinence

    PubMed Central

    Nguyen, Katherina; Hunter, Kathleen F.; Wagg, Adrian

    2013-01-01

    Abstract Objective To investigate family physicians’ knowledge of, attitudes toward, and understanding of urinary incontinence (UI), as well as their perceptions of barriers to continence care, as a foundation for designing interventions to improve service provision for those in northern Alberta who suffer from UI. Design Descriptive survey using a standardized instrument. The survey instrument was completed either by telephone interview or on paper copy faxed back to the researchers, depending on participant preference. Setting Northern Alberta. Participants Random sample of family physicians (N = 158). Main outcome measures Physician knowledge of and attitudes toward UI, UI management practices, and barriers to providing UI care. Results Survey response rate was 10.6% (158 of 1488); 84.2% (133 of 158) of respondents practised in urban settings, 44.9% (71 of 158) had been in practice for fewer than 15 years, 24.1% (38 of 158) reported having no training in UI management since graduation, and 53.8% (85 of 158) reported that they proactively discussed UI with their patients. Overall, 70.0% of respondents felt fairly confident in managing UI. Most family physicians referred patients for specialist care, with few referrals to community services. Respondents thought that continence services were scarce, with long waiting times, and that such services were generally overstretched; they believed that although high-quality continence care was a personal priority, it was not a priority focus for their practice partnerships or networks. In terms of the highest ranked areas for improvement in UI management, increased awareness and understanding among physicians (ranked first by 28.5% of respondents), followed by dedicated incontinence clinics or nurses for referral (17.7%) and improving patient awareness and understanding (12.0%). Conclusion There continues to be considerable variation in knowledge about UI management and a relative overreliance on specialist care, despite

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

    MedlinePlus

    ... Non-surgical Treatment Options for Urinary Incontinence in Women What is UI? “Taking Control” (5-minute video) “ ... video in a new window) Are there other women like me? (8-minute video) Urinary incontinence happens ...

  5. Urinary Incontinence Symptoms and Impact on Quality of Life in Patients Seeking Outpatient Physical Therapy Services

    PubMed Central

    Alappattu, Meryl; Neville, Cynthia; Beneciuk, Jason; Bishop, Mark

    2016-01-01

    Objective The objective of this study was to examine the frequency and types of urinary incontinence (UI) in patients seeking outpatient physical therapy for neuro-musculoskeletal conditions. Design Retrospective cross-sectional analysis. Patients A convenience sample of patients that positively responded to a UI screening question were included in this study. Methods Data were collected for age, sex, and primary treatment condition classified into one of the following (i.e. urinary dysfunction; fecal dysfunction; pelvic pain; spine; neurological disorders; or extremity disorders); UI type (i.e. mixed, urge, stress, or insensible); UI symptom severity; and quality of life impact. Main Outcome Measures Frequency of UI type, symptom severity, health-related quality of life (HRQoL) impact, and pad use were compared between treatment groups. Results The mean age of the sample (n=599) was 49.8 years (SD=18.5) and 94.7% were female. The urinary dysfunction group comprised 44.2% of the total sample, followed by the spine group with 25.7%, and pelvic pain with 17.2%. The urinary dysfunction group scored significantly higher on UI symptom severity and impact on quality of life compared to the pelvic pain and spine groups, but not compared to the extremity disorders, fecal dysfunction, or neurological disorders group. Conclusion These preliminary data indicate that UI is a condition afflicting many individuals who present to outpatient physical therapy beyond those seeking care for UI. We recommend using a simple screening measure for UI and its impact on HRQoL as part of a routine initial evaluation in outpatient physical therapy settings. PMID:26863987

  6. Faecal incontinence: Current knowledges and perspectives

    PubMed Central

    Benezech, Alban; Bouvier, Michel; Vitton, Véronique

    2016-01-01

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

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

    PubMed

    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.

  8. Incontinence-associated dermatitis in patients with spinal cord injury.

    PubMed

    Foxley, Susan; Baadjies, Ruth

    Evidence-based patient care for those with urinary and faecal incontinence involves routine tasks that are integral to essential patient care. However, over the past few decades, researchers have demonstrated how ritualistic practice in this area has become. There is also a growing range of skin care products that can be used to prevent incontinence-associated dermatitis and for nurses, deciding which ones to use can be problematic Incontinent patients have a 22% higher risk of developing pressure ulcers - when immobile this risk increases to 30% - and the often indiscriminate use of various lotions, without a significant evidence base, is a growing cause of concern. Maintaining healthy skin for those patients who have a spinal cord injury and also experience urinary and faecal incontinence is a challenge faced by nurses in primary and secondary care. Research undertaken in secondary care demonstrates that standardization to an evidence-based skin care regime, to be used after incontinent episodes, improves patient care in this specialist area.

  9. Fecal transplant policy and legislation.

    PubMed

    Vyas, Dinesh; Aekka, Apoorva; Vyas, Arpita

    2015-01-07

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

  10. [Urinary stress incontinence in the female: comparison of incontinence theories and new tension-free surgical procedures].

    PubMed

    Perucchini, D; Fink, D

    2002-01-01

    Urethral sphincter competence involves a complicated inter action of many factors which act in concert. Stress incontinence occurs due to damage to the urethral support and loss or deterioration of urethral sphincter function as a consequence of delivery or aging. Recent research indicates that a more integrated, comprehensive view regarding the different structures, both inside and outside the urethra, is needed to explain the mechanism of incontinence. According to the theories of de Lancey, urinary stress incontinence is caused by defects in the supporting tissues that both actively and passively stabilize the urethra in its correct anatomical position. The integral theory of Petros and Ulmstein explains how laxity in the vagina or its supporting ligaments may cause stress incontinence favored by laxity in the ligamentous insertion points of the vagina. Colposuspension procedures have dominated incontinence surgery for the last 50 years. The introduction of the tension-free vaginal tape procedure was a real innovation that has challenged our understanding of the continence mechanism and taught us the importance of the midurethra. Different modifications of the tension-free procedures have been introduced recently and are discussed in this paper.

  11. 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

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

    PubMed Central

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

    2016-01-01

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

  14. Sexual function following surgery for urodynamic stress incontinence.

    PubMed

    Jha, Swati; Moran, Paul; Greenham, Helen; Ford, Caroline

    2007-08-01

    The objective of this study was to compare sexual function in women before and after surgery for urodynamic stress incontinence in the absence of pelvic organ prolapse. This was a prospective questionnaire survey. Fifty-four women undergoing surgery (tension-free vaginal tape/tension-free vaginal tape-obturator) for urodynamic stress incontinence with no evidence of detrusor overactivity or concomitant prolapse were assessed preoperatively and 6 months post operatively. Assessment was based on the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ), the International Consultation on Incontinence Questionnaire (ICIQ) and the Patient Global Impression of Improvement. Paired t-tests were used for comparing pre- and post-op scores and unpaired t-tests for comparing observations between groups. Spearman's rank correlation was used for testing whether two numerically scored items were related, and McNemar test was used to compare pre- and postoperative responses to individual questions. ICIQ scores showed significant improvement after surgery (p < 0.001). Women completing PISQ were significantly younger (mean = 54) than those who did not (mean = 65; p < 0.001). The total PISQ score was better postoperatively (preoperative = 87.2, postoperative = 92.7; p < 0.001), with improvements in both the physical (preoperative = 31.0, postoperative = 35.2; p < 0.001) and partner-related domains (preoperative = 18.8, postoperative = 19.9; p = 0.002) but no improvement in behaviour emotive domains (preoperative = 37.3, postoperative = 37.6; p = 0.70). There was a reduction in episodes of coital incontinence postoperatively (preoperatively = 16/54, postoperatively = 39/54; p < 0.002). Previous vaginal surgery, oestrogen status of respondents and hysterectomy status did not affect the PISQ. Surgical correction of stress incontinence is associated with an improvement in sexual function.

  15. [Update on current care guidelines: urinary incontinence (female)].

    PubMed

    2012-01-01

    Female urinary incontinence (UI) is divided into stress (SUI), urgency (UUI), mixed (MUI) and overflow incontinence (chronic retention). Advanced age, obesity and pregnancy are the most important risk factors. Standardised questionnaires are used in diagnosis. The pad test, cough stress test and bladder diary are objective tools. A gynaecological examination includes pelvic floor muscle palpation and residual urine measurement. Urodynamics, cystoscopy and ultrasonography are complementary tools. Guided pelvic floor-muscle training is the first-line therapy. UUI can be treated with anticholinergic medicines. If conservative treatments are ineffective, SUI and MUI can be treated surgically with mid-urethral slings (TVT TOT and TVT-0).

  16. A newly designed deodorant pad for urinary incontinence.

    PubMed

    Fukui, J; Sakai, Y; Hosaka, K; Yamashita, T; Ogawa, A; Shirai, H

    1990-08-01

    The authors designed a new pad for urinary incontinence. It is composed of a cloth of acrylonitrile copper sulfide and another cloth of iron-phthalocyanine. In vitro experiments showed that acrylonitrile copper sulfide cloth inhibited the growth of most bacteria causing urinary tract infection, and that iron-phthalocyanine cloth effectively eliminated bad-smelling gases. The use of this pad relieved diaper-dermatitis and diminished offensive smells from feces and urine. This pad was well received by nurses and helpers taking care of incontinent elderly people.

  17. [Enuresis and pediatric urinary incontinence : Diagnostics and therapy].

    PubMed

    Schultz-Lampel, D; Goepel, M; Reitz, A; Braun, P

    2016-12-01

    Differentiated non-invasive diagnostic procedures allow a discrimination between nocturnal enuresis and behavior-linked urinary incontinence in children with daytime symptoms, which are different entities of a pathological pediatric micturition syndrome. The article describes the diagnostic procedure as well as the therapeutic approach to all forms of micturition disorders in childhood. All behavioral, medical and biofeedback therapeutic methods according to the recently published S2k guidelines from the Association of the Scientific Medical Societies in Germany (AWMF) on enuresis and non-organic (functional) incontinence in children and adolescents are mentioned and discussed.

  18. The prevalence of stress urinary incontinence in women studying nursing and related quality of life.

    PubMed

    Opara, Józef; Czerwińska-Opara, Wioletta Ewa

    2014-03-01

    Urinary incontinence is a growing problem that affects millions of people worldwide. The purpose of this study was to assess the prevalence of stress urinary incontinence (SUI) in women studying nursing. Respondents completed a questionnaire assessing urinary incontinence, severity of symptoms and quality of life. Short forms to assess symptoms of distress for urinary incontinence and quality of life: UDI-6 and IIQ-7 have been used. The study's conclusions are as follows: 1) among the 113 interviewed women, stress urinary incontinence (SUI) was observed in 25% of respondents; this prevalence is similar to the age-matched population; 2) among the triggering factors mentioned in stress urinary incontinence the most frequent were: coughing, laughing and sneezing; 3) moderate impact of incontinence on quality of life has been shown, but this effect was not statistically significant.

  19. [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.

  20. 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

  1. The prevalence of stress urinary incontinence in women studying nursing and related quality of life

    PubMed Central

    Czerwińska-Opara, Wioletta Ewa

    2014-01-01

    Urinary incontinence is a growing problem that affects millions of people worldwide. The purpose of this study was to assess the prevalence of stress urinary incontinence (SUI) in women studying nursing. Respondents completed a questionnaire assessing urinary incontinence, severity of symptoms and quality of life. Short forms to assess symptoms of distress for urinary incontinence and quality of life: UDI-6 and IIQ-7 have been used. The study's conclusions are as follows: 1) among the 113 interviewed women, stress urinary incontinence (SUI) was observed in 25% of respondents; this prevalence is similar to the age-matched population; 2) among the triggering factors mentioned in stress urinary incontinence the most frequent were: coughing, laughing and sneezing; 3) moderate impact of incontinence on quality of life has been shown, but this effect was not statistically significant. PMID:26327826

  2. Urinary Incontinence Management Costs are Reduced Following Burch or Sling Surgery for Stress Incontinence

    PubMed Central

    Subak, Leslee L.; Goode, Patricia S.; Brubaker, Linda; Kusek, John W.; Schembri, Mr. Michael; Lukacz, Emily S.; Kraus, Stephen R.; Chai, Toby C.; Norton, Peggy; Tennstedt, Sharon L.

    2014-01-01

    Objective To estimate the effect of Burch and fascial sling surgery on out-of-pocket urinary incontinence (UI) management costs at 24 months post-operatively and identify predictors of change in cost among women enrolled in a randomized trial comparing these procedures. Methods Resources used for UI management (supplies, laundry, dry cleaning) were self-reported by 491 women at baseline and 24 months post-surgery and total out-of-pocket costs for UI management (in 2012 US dollars) were estimated. Data from the two surgical groups were combined to examine change in cost for UI management over 24 months. Univariate and bivariate changes in cost were analyzed using Wilcoxon signed rank test. Predictors of change in cost were examined using multivariate mixed models. Results At baseline mean (±SD) age of participants was 53±10 years, and frequency of weekly UI episodes was 23±21. Weekly UI episodes decreased by 86% at 24 months (P<0.001). Mean weekly cost was $16.60±$27 (median $9.39) at baseline and $4.57±$15 (median $0.10) at 24 months (P<0.001), a decrease of 72%. In multivariate analyses, cost decreased by $3.38±$0.77 per week for each decrease of 1 UI episode per day (P<0.001) and was strongly associated with greater improvement in UDI and IIQ scores (P<0.001) and decreased 24-hour pad weight (P<0.02). Conclusion Following Burch or fascial sling surgery, UI management cost at 24 months decreased by 72% ($625 per woman per year) and was strongly associated with decreasing UI frequency. Reduced out-of-pocket expenses may be a benefit of these established urinary incontinence procedures. PMID:24631433

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

    EPA Science Inventory

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

  4. Fecal Source Identification with Real-Time Quantitative PCR

    EPA Science Inventory

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

  5. Electrokinetic profiles of nonowoven cotton for absorbent incontinence material

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  6. Staying Trim, Strong May Cut Risk of Urinary Incontinence

    MedlinePlus

    ... in decreasing the odds of new or worsening stress type of urinary incontinence," she said. The study was published recently in the Journal of the American Geriatrics Society . SOURCES: Anne Suskind, M.D., assistant professor of urology, University of California, San Francisco; Megan Schimpf, M.D., ...

  7. [The defecation balloon proctogram in the study of idiopathic incontinence].

    PubMed

    Ciarelli, A; Ciarelli, F; Mascia, D; Tentarelli, M

    1991-01-01

    The authors report their findings in the study of idiopathic rectal incontinence using a defecatory balloon proctogram. The study provides a detailed anatomico-functional analysis of the sphincteric tract and, together with manometric and electromyographic studies, is useful in assessing the need for reconstructive surgery and for monitoring the results of ileoanal and coloanal anastomoses, sphincteric plastic surgery and posterior anal plastic surgery.

  8. Assessment of the female patient with urinary incontinence.

    PubMed

    Bates, Frankie

    2002-10-01

    Understanding the pelvic floor anatomy and all of its components is crucial when performing pelvic floor examination and assessing patients suffering from urinary incontinence. It is important for urology nurses to understand the pelvic floor, including the muscle, nerve, and fascia involved; external and internal examination of the vulva; and global assessment of the patient.

  9. Fecal bacterial diversity in a wild gorilla.

    PubMed

    Frey, Julie C; Rothman, Jessica M; Pell, Alice N; Nizeyi, John Bosco; Cranfield, Michael R; Angert, Esther R

    2006-05-01

    We describe the bacterial diversity in fecal samples of a wild gorilla by use of a 16S rRNA gene clone library and terminal-restriction fragment length polymorphism (T-RFLP). Clones were classified as Firmicutes, Verrucomicrobia, Actinobacteria, Lentisphaerae, Bacteroidetes, Spirochetes, and Planctomycetes. Our data suggest that fecal populations did not change temporally, as determined by T-RFLP.

  10. Incontinence and gait disturbance after intraventricular extension of intracerebral hemorrhage

    PubMed Central

    Kruger, Andrew J.; Sekar, Padmini; Haverbusch, Mary; Osborne, Jennifer; Moomaw, Charles J.; Martini, Sharyl; Hosseini, Shahla M.; Ferioli, Simona; Worrall, Bradford B.; Elkind, Mitchell S.V.; Sung, Gene; James, Michael L.; Testai, Fernando D.; Langefeld, Carl D.; Broderick, Joseph P.; Koch, Sebastian; Flaherty, Matthew L.

    2016-01-01

    Objective: We tested the hypothesis that intraventricular hemorrhage (IVH) is associated with incontinence and gait disturbance among survivors of intracerebral hemorrhage (ICH) at 3-month follow-ups. Methods: The Genetic and Environmental Risk Factors for Hemorrhagic Stroke study was used as the discovery set. The Ethnic/Racial Variations of Intracerebral Hemorrhage study served as a replication set. Both studies performed prospective hot-pursuit recruitment of ICH cases with 3-month follow-up. Multivariable logistic regression analyses were computed to identify risk factors for incontinence and gait dysmobility at 3 months after ICH. Results: The study population consisted of 307 ICH cases in the discovery set and 1,374 cases in the replication set. In the discovery set, we found that increasing IVH volume was associated with incontinence (odds ratio [OR] 1.50; 95% confidence interval [CI] 1.10–2.06) and dysmobility (OR 1.58; 95% CI 1.17–2.15) after controlling for ICH location, initial ICH volume, age, baseline modified Rankin Scale score, sex, and admission Glasgow Coma Scale score. In the replication set, increasing IVH volume was also associated with both incontinence (OR 1.42; 95% CI 1.27–1.60) and dysmobility (OR 1.40; 95% CI 1.24–1.57) after controlling for the same variables. Conclusion: ICH subjects with IVH extension are at an increased risk for developing incontinence and dysmobility after controlling for factors associated with severity and disability. This finding suggests a potential target to prevent or treat long-term disability after ICH with IVH. PMID:26850978

  11. Caffeine Intake and Risk of Urinary Incontinence Progression Among Women

    PubMed Central

    Townsend, Mary K.; Resnick, Neil M.; Grodstein, Francine

    2012-01-01

    Objective To estimate the association between long-term caffeine intake and risk of urinary incontinence (UI) progression over 2 years among women with moderate UI. Methods We conducted a prospective cohort study in 21,564 women with moderate UI enrolled in the Nurses’ Health Study and Nurses’ Health Study II. Incontinence progression was identified from questionnaires during 2 years of follow-up. Baseline caffeine intake (ie, average intake during the past year) and change in caffeine intake during the 4 years prior to baseline were measured using food frequency questionnaires. Odds ratios (ORs) for incontinence progression according to caffeine intake were calculated for each cohort separately, and then for both cohorts combined. Results The percentage of women with UI progression was similar across categories of baseline level of caffeine intake and change in caffeine intake prior to baseline. For example, percentages were 21% versus 22% comparing 450 mg or more to less than 150 mg of caffeine per day (adjusted OR 0.87, 95% confidence interval [CI] 0.70-1.08). Comparing women with increased caffeine intake to those with stable caffeine intake, percentages with progression were 22% versus 20% (OR 1.08, 95% CI 0.95-1.22). Results were similar in separate analyses of urgency and stress UI. Conclusion Long-term caffeine intake over one year was not associated with risk of UI progression over 2 years among women with moderate incontinence, although we could not examine acute effects of caffeine. Improved understanding of the effect of caffeine on the bladder is needed to better advise women with incontinence about caffeine intake. PMID:22525905

  12. Classification and treatment of functional incontinence in children.

    PubMed

    Nijman, R J

    2000-05-01

    Functional urinary incontinence in children may be caused by disturbances of the filling phase, the voiding phase or a combination of both. Detrusor overactivity may cause frequency and urgency, with or without urge incontinence. Girls present with symptoms of detrusor overactivity more often than boys, but sometimes other symptoms, e.g. urinary tract infections or constipation, prevail. Frequent contractions of the detrusor may cause the pelvic floor muscles to become overactive, resulting in staccato or fractionated voiding. When incontinence is the result of a voiding disorder the term 'dysfunctional voiding' is used. Bladder function in these children may be normal, but instability may be present. In children with a 'lazy' bladder, voiding occurs with no detrusor contractions, and postvoid residual volumes and overflow incontinence are the main characteristics. Diagnosis is based on the medical and voiding history, a physical examination, bladder diaries and uroflowmetry. The upper urinary tract should be evaluated in children with recurrent infections and dysfunctional voiding (reflux). Uroflowmetry can be combined with pelvic floor electromyography to detect overactivity of the pelvic floor muscles. Urodynamic studies are usually reserved for patients with dysfunctional voiding and those not responding to anticholinergic drugs. Treatment is usually a combination of 'standard therapy', behavioural therapy, bladder training, physiotherapy and medical treatment. The role of alpha-blockers needs to be evaluated further. Also, neuromodulation may have a place in treatment but the exact indications need to be defined. Clean intermittent self-catheterization is sometimes necessary in children with a lazy bladder and large residual volumes who do not respond to a more conservative approach. Future research needs to be directed towards improving understanding of the pathophysiology, epidemiology, classification and treatment modalities of functional incontinence in

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

    EPA Science Inventory

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

  14. Optimal optical filters of fluorescence excitation and emission for poultry fecal detection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Purpose: An analytic method to design excitation and emission filters of a multispectral fluorescence imaging system is proposed and was demonstrated in an application to poultry fecal inspection. Methods: A mathematical model of a multispectral imaging system is proposed and its system parameters, ...

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

    PubMed

    Muller, Nancy; McInnis, Elaine

    2013-09-01

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

  16. Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity

    PubMed Central

    Wolin, Kathleen Y.; Luly, Jason; Sutcliffe, Siobhan; Andriole, Gerald L.; Kibel, Adam S.

    2011-01-01

    Purpose Urinary incontinence is one of the most commonly reported and distressing side effects of radical prostatectomy for prostate carcinoma. Several studies have suggested that symptoms may be worse in obese men but to our knowledge no research has addressed the joint effects of obesity and a sedentary lifestyle. We evaluated the association of obesity and lack of physical activity with urinary incontinence in a sample of men who had undergone radical prostatectomy. Materials and Methods Height and weight were abstracted from charts, and obesity was defined as body mass index 30 kg/m2 or greater. Men completed a questionnaire before surgery that included self-report of vigorous physical activity. Men who reported 1 hour or more per week of vigorous activities were considered physically active. Men reported their incontinence to the surgeon at their urology visits. Information on incontinence was abstracted from charts at 6 and 58 weeks after surgery. Results At 6 weeks after surgery 59% (405) of men were incontinent, defined as any pad use. At 58 weeks after surgery 22% (165) of men were incontinent. At 58 weeks incontinence was more prevalent in men who were obese and physically inactive (59% incontinent). Physical activity may offset some of the negative consequences of being obese because the prevalence of incontinence at 58 weeks was similar in the obese and active (25% incontinent), and nonbese and inactive (24% incontinent) men. The best outcomes were in men who were nonobese and physically active (16% incontinent). Men who were not obese and were active were 26% less likely to be incontinent than men who were obese and inactive (RR 0.74, 95% CI 0.52–1.06). Conclusions Pre-prostatectomy physical activity and obesity may be important factors in post-prostatectomy continence levels. Interventions aimed at increasing physical activity and decreasing weight in patients with prostate cancer may improve quality of life by offsetting the negative side effects

  17. Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus

    PubMed Central

    Roe, Brenda; Flanagan, Lisa; Jack, Barbara; Barrett, James; Chung, Alan; Shaw, Christine; Williams, Kate

    2011-01-01

    Aim This is a review of descriptive studies with incontinence as the primary focus in older people in care homes. Background Incontinence is prevalent among residents of care home populations. Data sources MEDLINE and CINAHL were searched from 1996 to 2007 using the highly sensitive search strings of the Cochrane Incontinence Review Group for urinary and faecal incontinence including all research designs. Search strings were modified to enhance selectiveness for care homes and older people and exclude studies involving surgical or pharmacological interventions. Searching of reference sections from identified studies was also used to supplement electronic searches. The Cochrane Library was searched for relevant systematic reviews to locate relevant studies from those included or excluded from reviews. The search was limited to English-language publications. Methods A systematic review of studies on the management of incontinence, promotion of continence or maintenance of continence in care homes was conducted in 2007–2009. This is a report of descriptive studies. Results Ten studies were identified that reported on prevalence and incidence of incontinence (urinary with or without faecal), policies, assessment, documentation, management or economic evaluation of its management. Use of incontinence pads and toileting programmes comprised the most common management approaches used. No studies were identified that attempted to maintain continence of residents in care homes. Conclusions Studies on maintaining continence and identifying components of toileting programmes that are successful in managing or preventing incontinence and promoting continence in residents of care home populations along with their economic evaluation are warranted. PMID:21105895

  18. [Fecal transplantation the future therapy?].

    PubMed

    Rebizak, Ewelina; Sierant, Katarzyna; Łabuzek, Krzysztof; Okopień, Bogusław

    2015-08-01

    Intestinal bacteria play an important role in human physiology, taking part in the metabolism, absorption of nutrients and regulation of the immune system. In many illnesses the bacterial imbalance in the digestive tract occurs, and fecal transplantation is one method that allows you to restore the balance. The essence of the described method is to replace the pathogenesis, abnormal bacterial flora with the flora occurring in normal healthy individuals. So far, the main use of the method described in the article is resistant to antibiotics Clostridium difficile infection, which gives you a chance to avoid total colectomy. The article presents an accurate description of the same procedure to prepare the material, the selection of donor, recipient preparation and diseases, such as inflammatory bowel diseases, irritable bowel syndrome, diabetes and obesity, in which this method of treatment is currently practised.

  19. [Prevalence and risk factors of urinary incontinence in female workers of hotels].

    PubMed

    Fontana, L; Falconi, G; Di Martino, T; Iavicoli, I

    2007-01-01

    The International Continence Society defines urinary incontinence (UI) as "a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable". There are three different jorms of UI. stress urinary incontinence, urge urinary incontinence and mixed incontinence. The aim of this study was to investigate the prevalence of UI in a group of female workers in the hotel sector. The International Consultation on Incontinence Questionnaire Urinary Incontinence short form (ICIQ-UI Short Form) was administered to all female workers and data were collected about age, body mass index, number of vaginal and Caesarean delivery. Results showed a prevalence of UI widely bigger in the plans waitress than in video display terminal workers and suggest the hypothesis that manual handling of loads representing a possible occupational risk for UI.

  20. Urinary incontinence in women: a comprehensive review of the pathophysiology, diagnosis and treatment.

    PubMed

    Padmanabhan, P; Dmochowski, R

    2014-10-01

    Urinary incontinence (UI) or involuntary leakage of urine is a distressing and serious health problem. It has a significant psychosocial and economic burden leading to significant quality of life issues. UI is more prevalent than most chronic diseases yet largely underreported. Aging and age-related changes in the bladder play a significant role in the development of UI. This in combination with cognitive dysfunction, functional impairment, pharmacotherapy, smoking, childbearing, obesity and coexisiting comorbidities worsen the condition. Due to the burden UI places on the individual, their family and society, it is important for providers to diagnose and have ready treatment options available. The three most common types of UI are stress urinary incontinence (SUI), urge urinary incontinence (UUI), or a combination of both, mixed urinary incontinence (MUI). This review describes the pathophysiology of incontinence; and diagnosis and treatment (conservative, pharmacological, and surgical therapies) of incontinence in women.

  1. Moving fecal microbiota transplantation into the mainstream.

    PubMed

    Orenstein, Robert; Griesbach, Cheryl L; DiBaise, John K

    2013-10-01

    In recent years, fecal microbiota transplantation (aka fecal transplantation, fecal bacteriotherapy, FMT) has become increasing utilized to treat recurrent and refractory Clostridium difficile infection (CDI). Almost 600,000 cases of CDI occur each year in the United States. Of these, an estimated 15,000 patients have a recurrence. The management of recurrent disease has been challenging for patients and clinicians. Increasingly, FMT has been recognized as an effective option for these patients. This article explores why FMT has reemerged as a practical therapeutic modality. In the process, the logistics by which the procedure is performed and the factors that may affect quality, safety, and patient outcomes will be described.

  2. Teaching strategies for assessing and managing urinary incontinence in older adults.

    PubMed

    Bradway, Christine; Cacchione, Pamela

    2010-07-01

    Urinary incontinence is common and affects many aspects of older adults' lives; therefore, it is essential that nursing faculty include this content in classroom and clinical teaching situations. This article describes innovative strategies for teaching upper-level nursing students (e.g., junior and senior undergraduates) about urinary incontinence in older adults, specifically, the relevant anatomy and physiology of continence and associated pathophysiology of urinary incontinence, risk factors and consequences, definitions and types, and effective nursing assessment and management strategies.

  3. The Association between Urinary Incontinence and Low Back Pain and Radiculopathy in Women

    PubMed Central

    Kaptan, Hulagu; Kulaksızoğlu, Haluk; Kasımcan, Ömür; Seçkin, Bedreddin

    2016-01-01

    AIM: Urinary incontinence (UI) is a common dysfunction, affecting especially women of all ages. The terminology of low back pain (LBP) and radiculopathy (RP) may be misused interchangeably with each other. There are many reports of the association with LBP and incontinence but those involving compression of nerve root(as RP), has not been distinguished from isolated low back pain. This study was structured to analyse the association of UI, LBP and RP. METHODS: One hundred twenty patients were included in the study. Patients with spinal or urinary infection, tumour (spinal or others), cauda equine, pelvic operation, spinal trauma, spinal surgery, urogenital pathology were not accepted for this study. Age and weight of all patients were determined. Oswestry Disability Index (ODI) was utilised for assessment of loss of function and SEAPI incontinence index was used for urinary incontinence. All patients were examined for neurological pathology to differentiate between the LBP and RP by department of neurosurgery. Student t-test and Mann-Whitney-U tests were used for statistical significance. RESULTS: There was no statistical significance between low back pain with overall urinary incontinence (p = 0.131), urge (p = 0.103) or stress incontinence (p = 0.68), respectively. However; The statistical aspects were identified relationship between overall (p = 0.026) and urge (p = 0.001) urinary incontinence with radiculopathy. The association of urge incontinence and radiculopathy seems to show a more significant relationship. Yet there was no correlation between radiculopathy and stress incontinence (P = 0.062). CONCLUSION: Low back pain should not be regarded as a predisposing factor for urinary incontinence; however, radiculopathy has a statistically positive correlation between overall incontinence and urge incontinence. PMID:28028410

  4. Clinical profile of elderly urinary incontinence in Singapore: a community-based study.

    PubMed

    Lee, K S; Chan, C J; Merriman, A; Tan, E C; Osborn, V

    1991-11-01

    The prevalence of urinary incontinence in the elderly aged 65 years and above was found to be 4.6% (42 out of a total of 919 respondents), in a community-based study in Singapore. Urinary incontinence was defined as leakage of urine on at least two occasions in the previous one month. The clinical profile of 30 out of the 42 (71%) subjects were studied. There was equal distribution of male and female subjects. Eighteen (60%) of the subjects were below 75 years of age. Twenty-five (83.3%) subjects had severe incontinence. Twenty-four (80%) had the incontinence for more than one year. Despite the high percentage of patients with severe incontinence, only nine (30%) used some form of aid. Incontinence in our very old (75 years and above) was not related to frailty or physical dependence. Seven of the subjects (23.3%) were found to have functional incontinence associated with cognitive impairment. These patients were unable to indicate their toilet needs. They also had associated physical disability as well as double incontinence, and their carers were under stress. Ten of the subjects had pure urge incontinence. Seven of them had an underlying central nervous system disorder, suggesting that destrusor hyperreflexia may be the underlying cause for urinary incontinence in this group. All except one in this group had more than one possible precipitating factor for their incontinence. Eleven subjects had symptoms suggestive of outlet obstruction, although only two were found to have proven outlet obstruction. None of the female subjects had pure stress incontinence.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Hypnotherapy for incontinence caused by the unstable detrusor.

    PubMed Central

    Freeman, R M; Baxby, K

    1982-01-01

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

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

    PubMed

    Lian, Yaping

    2016-07-20

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

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

    PubMed

    Voegeli, David

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

  8. Promoting social continence: products and devices in the management of urinary incontinence.

    PubMed

    Lekan-Rutledge, Deborah; Doughty, Dorothy; Moore, Katherine N; Wooldridge, Leslie

    2003-12-01

    Urinary incontinence (UI) is a prevalent problem occurring in men and women across the lifespan. Technologic innovations have provided individuals with incontinence and caregivers with an array of options for achieving social continence. Even when UI cannot be completely cured, it can always be managed with products, skin care regimens, occlusive or drainage devices and toileting equipment to ensure optimal skin integrity, odorless urine containment, social independence, comfort, and freedom of movement. Various products, devices, and equipment available to help incontinent individuals preserve independence and quality of life and manage incontinence are described.

  9. Findings of universal cystoscopy at incontinence surgery and their sequelae

    PubMed Central

    Zyczynski, Halina M.; Sirls, Larry T.; Greer, W. Jerod; Rahn, David D.; Casiano, Elizabeth; Norton, Peggy; Kim, Hae-Young; Brubaker, Linda

    2014-01-01

    OBJECTIVE The purpose of this study was to report the frequency of abnormal cystoscopy at incontinence surgery and to identify risk factors and sequelae of injury. STUDY DESIGN Findings of cystoscopy were collected prospectively in 3 multicenter surgical trials. Clinical, demographic, and procedure characteristics and surgeon experience were analyzed for association with iatrogenic injury and noninjury abnormalities. Impact of abnormalities on continence outcomes and adverse events during 12 months after the procedure were assessed. RESULTS Abnormal findings in the bladder or urethra were identified in 95 of 1830 women (5.2%). Most injuries (75.8%) were iatrogenic. Lower urinary tract (LUT) injury was most common at retropubic urethropexy and retropubic midurethral sling procedures (MUS; 6.4% each), followed by autologous pubovaginal sling procedures (1.7%) and transobturator MUS (0.4%). Increasing age (56.9 vs 51.9 years; P = .04), vaginal deliveries (3.2 vs 2.6; P = .04), and blood loss (393 vs 218 mL; P=.01) were associated with LUT injury during retropubic urethropexy; however, only age (62.9 vs 51.4 years; P = .02) and smoking history (P = .04) were associated for pubovaginal sling procedures. No factors correlated with increased risk of injury at retropubic and transobturator MUS. Notably, previous incontinence surgery, concomitant procedures, anesthesia type, and trainee participation did not increase LUT injury frequency. Although discharge with an indwelling catheter was more common after trocar perforation compared with the noninjury group (55.6% vs 18.5%; P < .001), they did not differ in overall success, voiding dysfunction, recurrent urinary tract infections, or urge urinary incontinence. CONCLUSION Universal cystoscopy at incontinence surgery detects abnormalities in 1 in 20 women. Urinary trocar perforations that are addressed intraoperatively have no long-term adverse sequelae. PMID:24380742

  10. DEVELOPMENT OF QUALITY INDICATORS FOR WOMEN WITH URINARY INCONTINENCE

    PubMed Central

    Anger, Jennifer T.; Scott, Victoria C. S.; Kiyosaki, Krista; Khan, Aqsa A.; Weinberg, Avivah; Connor, Sarah E.; Roth, Carol P.; Wenger, Neil; Shekelle, Paul; Litwin, Mark S.

    2013-01-01

    AIMS To develop a means to measure the quality of care provided to women treated for urinary incontinence (UI) through the development of quality-of-care indicators (QIs). METHODS We performed an extensive literature review to develop a set of potential quality indicators for the management of urinary incontinence. QIs were modeled after those previously described in the Assessing the Care of Vulnerable Elders (ACOVE) project. Nine experts ranked the indicators on a nine-point scale for both validity and feasibility. We analyzed preliminary rankings of each indicator using the RAND Appropriateness Method. A forum was then held in which each indicator was thoroughly discussed by the panelists as a group, after which the indicators were rated a second time individually using the same nine-point scale. RESULTS QIs were developed that addressed screening, diagnosis, work-up, and both non-surgical and surgical management. Areas of controversy included whether routine screening for incontinence should be performed, whether urodynamics should be performed before non-surgical management is initiated, and whether cystoscopy should be part of the pre-operative work-up of uncomplicated stress incontinence. Following the expert panel discussion, 27 of 40 potential indicators were determined to be valid for UI with a median score of at least seven on a nine-point scale. CONCLUSIONS We identified 27 quality indicators for the care of women with UI. Once these QIs are pilot-tested for feasibility, they will be applied on a larger scale to measure the quality of care provided to women with UI in the United States. PMID:24105879

  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. Artificial urinary sphincter for post-prostatectomy incontinence: a review.

    PubMed

    James, Mary H; McCammon, Kurt A

    2014-06-01

    The artificial urinary sphincter remains the gold standard for treatment of post-prostatectomy urinary incontinence. The AMS 800 (American Medical Systems, Minnetonka, MN, USA) is the most commonly implanted artificial urinary sphincter. Having been on the market for almost 40 years, there is an abundance of literature regarding its use, but no recent review has been published. We reviewed the current literature regarding the indications, surgical principles, outcomes and complications of artificial urinary sphincter implantation for stress urinary incontinence after prostatectomy. A PubMed search was carried out for articles on the artificial urinary sphincter from 1995 to present. The review was centered on articles related to the use of the AMS 800 for stress urinary incontinence in males after prostatectomy. Relevant articles were reviewed. The majority of patients will achieve social continence (1 pad per day) after artificial urinary sphincter implantation; however, rates of total continence (no pad usage) are significantly lower. Patient satisfaction outcomes average greater than 80% in most series. Potential complications requiring reoperation include infection (0.5-10.6%) and urethral erosion (2.9-12%). Revision surgeries are most commonly as a result of urethral atrophy, which ranges from 1.6 to 11.4%. The 5-year Kaplan-Meier freedom from reoperation ranges from 50 to 79%, while the 10-year Kaplan-Meier freedom from mechanical failure is 64%. The artificial urinary sphincter is a reliable device with good outcomes. As expected with any prosthetic device, complications including mechanical failure, infection, erosion and recurrent incontinence remain significant concerns. Despite known complications, the patient satisfaction rates after artificial urinary sphincter implantation remain high. Appropriate patient counseling and adherence to surgical principles are imperative.

  13. CDC Study Finds Fecal Contamination in Pools

    MedlinePlus

    ... Electronic Media , Office of Communication (404) 639-3286 CDC study finds fecal contamination in pools A study ... Calendar Resources Resources Contact Us Frequently Asked Questions CDC Quick Links Data & Statistics Freedom of Information Act ...

  14. ANALYZING BIOSOLIDS FOR FECAL COLIFORM AND SALMONELLAE

    EPA Science Inventory

    Current federal regulations required monitoring for fecal coliforms or Salmonella in biosolids destined for land application. Standard protocols designed to quantify these organisms in water or wastewater were identified and specified in these regulations. However, proto...

  15. Fecal Microbiota Transplantation: Just a Fancy Trend?

    PubMed

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

    2015-07-01

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

  16. Fecal Transplant Shows Early Promise Against Autism

    MedlinePlus

    ... 163263.html Fecal Transplant Shows Early Promise Against Autism Small study found giving healthy gut bacteria to ... study suggests a novel treatment for kids with autism: Give these young patients a fresh supply of ...

  17. FECAL COLIFORM INCREASE AFTER CENTRIFUGATION: EPA PERSPECTIVE

    EPA Science Inventory

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

  18. The Impact of Stress Incontinence Surgery of Female Sexual Function

    PubMed Central

    BRUBAKER, Linda; CHIANG, Seing; ZYCZYNSKI, Halina; NORTON, Peggy; KALINOSKI, D. Lynn; STODDARD, Anne; KUSEK, John W.; STEERS, William

    2009-01-01

    Objective To describe change in sexual function 2 years after surgery to treat stress urinary incontinence. Methods This analysis included 655 women randomized to Burch colposuspension or sling surgery. Sexual activity was assessed by the PISQ-12 among those sexually active at baseline and two years after surgery. Results Mean PISQ-12 total score improved from baseline 32.23±6.85 to 36.85± 5.89. After surgery, fewer subjects reported incontinence (9% vs. 53%, p<0.0001), restriction of sexual activity due to fear of incontinence (10% vs. 52%, p<0.0001), avoidance of intercourse because of vaginal bulging (3% vs. 24%, p<0.0001) or negative emotional reactions during sex (9% vs. 35%, p<0.0001). Women with successful surgery had greater improvement PISQ-12 scores (5.77 vs. 3.79), p<0.006. Sexually active women were younger, thinner, and had lower MESA scores (total and urge subscale) than sexually inactive women. Conclusion Sexual function improves following successful surgery and did not differ between Burch or sling. PMID:19286143

  19. Quality of Life after Surgery for Stress Incontinence

    PubMed Central

    Tennstedt, S. L.; Litman, H. J.; Zimmern, P.; Ghetti, C.; Kusek, J. W.; Nager, C.W.; Mueller, E.R.; Kraus, S.R.; Varner, E.

    2008-01-01

    Introduction This study investigated changes in condition-specific quality of life (QOL) after surgery for stress urinary incontinence (SUI). Methods Data from 655 women in a clinical trial comparing the Burch and fascial sling were examined. Results Improvement in QOL, measured with the IIQ (mean decrease 133.1; s.d. 109.8), was observed 6 months after surgery and persisted at 24 months. Women for whom surgery was successful (regardless of surgery type) had greater improvement in QOL (mean decrease 160.0; s.d 103.9) than did women for whom surgery was not successful (mean decrease 113.6; s.d 110.9) (p<0.0001), although not statistically significant after adjusting for covariates. Multivariable analysis showed that QOL improvement was related to decreased UI symptom bother, greater improvement in UI severity, younger age, Hispanic ethnicity and receiving Burch surgery. Among sexually active women, worsening sexual function had a negative impact on QOL. Conclusion Improved QOL was explained most by UI symptom improvement. Brief Summary Improvements in quality of life after stress incontinence surgery are significant, durable over 24 months, and associated with improvement of incontinence symptoms and symptom bother. PMID:18682875

  20. [Female stress urinary incontinence during pregnancy. A bibliographical review].

    PubMed

    Navarro García, Miguel Angel; De Carlos Alegre, Vanessa

    2009-10-01

    The authors have prepared a brief bibliographical review on female stress urinary incontinence during pregnancy. The high degree of incidence this disorder has and the introduction of the latest sanitary techniques combine to make necessary a profound review which aids medical professionals to realize the magnitude of this problem, as well as to diagnose and treat it effectively. Female stress urinary incontinence during pregnancy is an involuntary urine loss associated to the physical effort which an increase in abdominal pressure provokes. A literary review of articles related to this disorder leaves no doubt that among the risk factors which make a woman be predisposed to suffer female stress urinary incontinence, obstetric trauma as a consequence of pregnancy and birth is a main risk factor. The authors describe a couple of diagnostic tools, a ICIQ-SF questionnaire, and therapeutic tools, the pelvic floor muscle exercise program, whose effectiveness has been sufficiently demonstrated and may prove to have very beneficial clinical uses which can be applied in a nurse's office.

  1. Urological disorders in men: urinary incontinence and benign prostatic hyperplasia.

    PubMed

    Miller, Susan W; Miller, Mindi S

    2011-08-01

    Urinary incontinence (UI) and benign prostatic hyperplasia (BPH) are 2 common urogenital problems in men. UI is associated with involuntary leakage of urine and lower urinary tract symptoms (LUTS) of urgency, frequency, and nocturia. Types of UI include functional, urge, stress, and overflow. Treatment for UI is based on the type of incontinence, patient-specific factors, and treatment preferences of both patients and health care providers. Options for the management of UI include environmental modifications, disposable incontinence products, pelvic floor exercises, pharmacotherapy, surgically implanted devices, and intermittent catheterization. BPH may be also associated with LUTS. Patient symptoms, assessed with a measurement tool such as the American Urological Association Symptom Index (AUASI), serve as the basis for determining treatment. Management approaches for BPH include pharmacotherapy, surgery, and minimally invasive procedures. Anticholinergic drugs as well as α-receptor antagonists and 5-α reductase inhibitors, either alone or in combination, are effective and useful for LUTS unresponsive to traditional pharmacotherapy. Transurethral resection of the prostate (TURP) can eliminate symptoms of BPH but is associated with relatively more complications than other available surgical and minimally invasive procedures.

  2. A warning detector for urinary incontinence for home health care.

    PubMed

    Tamura, T; Nakajima, K; Matsushita, T; Fujimoto, T; Shimooki, S; Nakano, T

    1995-01-01

    A telemetry system for monitoring urinary incontinence has been developed using two principles, temperature and impedance changes of a diaper. The system is composed of a pair of sensors, a transmitter, and a receiver. Temperature changes are monitored using thermistors, one in the center of the diaper and the other attached to the abdomen, and the temperature differences between them after urinary incontinence is detected. For the impedance method, two electroconductive cloths as electrodes placed in the diaper are used as sensors. Urine acts as a conductor to produce a current between the sensors. Clinical evaluation showed that both methods operate well; 13 of 17 incontinence episodes were detected using the temperature method and 32 of 35 with the impedance method. The misdetections were caused by faulty sensor arrangement for temperature measurement and by detection of exudates by the conductive sensors. These monitors may be used for the care of elderly people who use diapers for home health care, to save care time and help maintain hygiene.

  3. Fecal Coliform Removal by River Networks

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  4. Refractive index matching applied to fecal smear clearing.

    PubMed

    Ferreira, Claúdio S

    2005-01-01

    Thick smears of human feces can be made adequate for identification of helminth eggs by means of refractive index matching. Although this effect can be obtained by simply spreading a fleck of feces on a microscope slide, a glycerol solution has been routinely used to this end. Aiming at practicability, a new quantitative technique has been developed. To enhance both sharpness and contrast of the images, a sucrose solution (refractive index = 1.49) is used, which reduces the effect of light-scattering particulates. To each slide a template-measured (38.5 mm3) fecal sample is transferred. Thus, egg counts and sensitivity evaluations are easily made.

  5. Fecal calprotectin in coeliac disease.

    PubMed

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

    2014-01-14

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

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

    EPA Science Inventory

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

  7. Biomechanical properties of the pelvic floor muscles of continent and incontinent women using an inverse finite element analysis.

    PubMed

    Silva, M E T; Brandão, S; Parente, M P L; Mascarenhas, T; Natal Jorge, R M

    2017-03-17

    Pelvic disorders can be associated with changes in the biomechanical properties in the muscle, ligaments and/or connective tissue form fascia and ligaments. In this sense, the study of their mechanical behavior is important to understand the structure and function of these biological soft tissues. The aim of this study was to establish the biomechanical properties of the pelvic floor muscles of continent and incontinent women, using an inverse finite element analysis (FEA). The numerical models, including the pubovisceral muscle and pelvic bones were built from magnetic resonance (MR) images acquired at rest. The numerical simulation of Valsalva maneuver was based on the finite element method and the material constants were determined for different constitutive models (Neo-Hookean, Mooney-Rivlin and Yeoh) using an iterative process. The material constants (MPa) for Neo-Hookean (c1) were 0.039 ± 0.022 and 0.024 ± 0.004 for continent vs. incontinent women. For Mooney-Rivlin (c1) the values obtained were 0.026 ± 0.010 vs. 0.016 ± 0.003, and for Yeoh (c1) the values obtained were 0.031 ± 0.023 vs. 0.016 ± 0.002, (p < 0.05). Muscle displacements obtained in the numerical simulations of Valsalva maneuver were compared with the muscle displacements obtained through additional dynamic MRI. Incontinent women presented a higher antero-posterior displacement than the continent women. The results were also similar between MRI and numerical simulations (40.27% vs. 42.17% for Neo-Hookean, 39.87% for Mooney-Rivlin and 41.61% for Yeoh). Using an inverse FEA coupled with MR images allowed to obtain the in vivo biomechanical properties of the pelvic floor muscles, leading to a relationship between them for the continent and incontinent women in a non-invasive manner.

  8. [Treatment of urinary incontinence in epispadias at the beginning of the third millenium].

    PubMed

    Touili, Y; Chebil, M; Bacha, K; Hajri, M; Hassine, B; Ayed, M

    2002-01-01

    The treatment of urinary incontinence in epispadias is delicate. Urinary continence is generally obtained after onerous and repetitive surgery. Different publications show a variable results. After the study of the results of our series (nine cases) and the results published in the literature, we propose a clarification on the therapeutic modalities of urinary incontinence associated to this malformation.

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

    ERIC Educational Resources Information Center

    Simmons, Sandra F.; Ouslander, Joseph G.

    2005-01-01

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

  10. The incidence of urinary incontinence across Asian, black, and white women in the United States

    PubMed Central

    TOWNSEND, Mary K.; CURHAN, Gary C.; RESNICK, Neil M.; GRODSTEIN, Francine

    2009-01-01

    Objective We calculated incidence rates of urinary incontinence by incontinence frequency and type over 4 years in Asian, black, and white women in the United States. Study Design Prospective analyses included 76,724 participants aged 37–79 years in the Nurses’ Health Study cohorts with no incontinence at baseline. Results The 4-year incidence of incontinence at least monthly was higher in white women (7.3/100 person-years) compared with Asian (5.7/100 person-years, p=0.003) and black women (4.8/100 person-years, p<0.001). The incidence of at least weekly stress incontinence was significantly lower in black compared with white women (0.1 versus 0.8 per 100 person-years, p<0.001). The difference between black and white women in the incidence of any incontinence and stress incontinence remained significant after adjusting for known risk factors (p<0.001 for both). Conclusions Urinary incontinence incidence differs by race. Studies to confirm these results and better understand underlying mechanisms are needed. PMID:20042169

  11. Stigma and microaggressions experienced by older women with urinary incontinence: a literature review.

    PubMed

    Heintz, Phyllis A; DeMucha, Cheryl M; Deguzman, Maryann M; Softa, Ridhima

    2013-01-01

    This literature review investigated stigma and identified episodes of microaggressions experienced by women with urinary incontinence. Three significant themes were revealed: lack of disclosure from psychological distress, microaggressions resulting from stigma, and factors associated with the intersections of gender, race, and ethnicity. Nursing implications include earning and maintaining patient trust, and demonstrating sensitivity about urinary incontinence.

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

    PubMed

    Connery, Neil A; Spotswood, Tim

    2012-11-01

    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.

  13. 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…

  14. An Evaluation of the Effects of the Transobturator Tape Procedure on Sexual Satisfaction in Women with Stress Urinary Incontinence Using the Libido Scoring System

    PubMed Central

    Narin, Raziye; Nazik, Hakan; Narin, Mehmet Ali; Aytan, Hakan; Api, Murat

    2013-01-01

    Introduction and Hypothesis. Most women experience automatic urine leakage in their lifetimes. SUI is the most common type in women. Suburethral slings have become a standard surgical procedure for the treatment of stress urinary incontinence when conservative therapy failed. The treatment of stress urinary incontinence by suburethral sling may improve body image by reducing urinary leakage and may improve sexual satisfaction. Methods. A total of 59 sexually active patients were included in the study and underwent a TOT outside-in procedure. The LSS was applied in all patients by self-completion of questionnaires preoperatively and 6 months after the operation. General pleasure with the operation was measured by visual analogue score (VAS). Pre- and postoperative scores were recorded and analyzed using SPSS 11.5. Results. Two parameters of the LSS, orgasm and who starts the sexual activity, increased at a statistically significant rate. Conclusion. Sexual satisfaction and desire have partially improved after the TOT procedure. PMID:24288621

  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. Acupuncture for the treatment of urinary incontinence: A review of randomized controlled trials

    PubMed Central

    PAIK, SUN-HO; HAN, SU-RYUN; KWON, OH-JUN; AHN, YOUNG-MIN; LEE, BYUNG-CHEOL; AHN, SE-YOUNG

    2013-01-01

    The aim of this study was to examine the effects of acupuncture on urinary incontinence and to discuss why these acupoints were selected. Seven databases were searched for any randomized controlled trials (RCTs) that investigated the use of acupuncture or acupressure as a treatment for urinary incontinence, and the Cochrane risk of bias tool was utilized to evaluate the risk of bias in each study. Four RCTs met all the inclusion criteria. The results from the selected RCTs failed to demonstrate any statistically significant improvements in urinary incontinence, although acupuncture or acupressure did exhibit favorable effects on overactive bladder symptoms and quality of life, in comparison with other conventional therapies. There have been limited results supporting acupuncture or acupressure as an effective treatment method for urinary incontinence; therefore, further RCTs are required to confirm the effectiveness of acupuncture or acupressure in the treatment of urinary incontinence. PMID:24137264

  17. Abdominal obesity is associated with stress urinary incontinence in Korean women.

    PubMed

    Han, Myung Ok; Lee, Nan Young; Park, Hye Soon

    2006-01-01

    This study investigated the relationship between abdominal obesity and stress urinary incontinence in Korean women. Women aged 30 and over, who visited the Department of Family Medicine of Asan Medical Center were recruited to participate in this study. Anthropometric measurements including body mass index (BMI) and waist circumference were taken, and associated factors of stress urinary incontinence was assessed by questionnaire. Stress urinary incontinence was significantly associated with physical work, vaginal delivery, and high waist circumference. In comparison with women in the lowest quartile of waist circumference, the odds ratios (OR) for stress urinary incontinence in women in the second, third, and fourth quartiles were increased significantly (1.79, 95% CI 1.07-2.98; 3.50, 95% CI 2.02-6.07; and 6.07, 95% CI 3.23-11.40, respectively). Our results indicate that high waist circumference may be a risk factor associated with stress urinary incontinence in women.

  18. Recent developments in technology for the assessment and management of incontinence.

    PubMed

    Hillary, Christopher J; Slovak, Martin; McCarthy, Avril; Hashim, Hashim; Chapple, Christopher R

    2014-01-01

    Urinary incontinence, the leakage of urine, is a common condition, which can have a significant impact on a patient's quality-of-life. Incontinence may arise as a consequence of a weakness of the urinary sphincter or bladder dysfunction, usually over-activity. Incontinence therapies occupy a large proportion of the healthcare budget. As no single device to manage incontinence is appropriate for all situations, a diverse range of products are available on the market and the development of improved products based on fundamental designs has been slow. This review highlights some of the key issues of continence care and describes the current technology and recent developments involved in the diagnosis, assessment and treatment of incontinence, along with the strengths and limitations of these methods. These issues are imperative to address if improved technology is to be developed.

  19. Differential Decomposition of Bacterial and Viral Fecal ...

    EPA Pesticide Factsheets

    Understanding the decomposition of microorganisms associated with different human fecal pollution types is necessary for proper implementation of many water qualitymanagement practices, as well as predicting associated public health risks. Here, thedecomposition of select cultivated and molecular indicators of fecal pollution originating from fresh human feces, septage, and primary effluent sewage in a subtropical marine environment was assessed over a six day period with an emphasis on the influence of ambient sunlight and indigenous microbiota. Ambient water mixed with each fecal pollution type was placed in dialysis bags and incubated in situ in a submersible aquatic mesocosm. Genetic and cultivated fecal indicators including fecal indicator bacteria (enterococci, E. coli, and Bacteroidales), coliphage (somatic and F+), Bacteroides fragilis phage (GB-124), and human-associated geneticindicators (HF183/BacR287 and HumM2) were measured in each sample. Simple linearregression assessing treatment trends in each pollution type over time showed significant decay (p ≤ 0.05) in most treatments for feces and sewage (27/28 and 32/40, respectively), compared to septage (6/26). A two-way analysis of variance of log10 reduction values for sewage and feces experiments indicated that treatments differentially impact survival of cultivated bacteria, cultivated phage, and genetic indicators. Findings suggest that sunlight is critical for phage decay, and indigenous microbio

  20. Stress Urinary Incontinence in Women With Multiple Sclerosis

    PubMed Central

    2016-01-01

    Purpose To report the prevalence and risk factors of stress urinary incontinence (SUI) and the prevalence of intrinsic sphincter deficiency in women with multiple sclerosis (MS). Methods We conducted a retrospective study. Female patients with MS, followed for lower urinary tract symptoms (LUTS) during a 15-year period were included. Demographic data, MS history, expanded disability status scale (EDSS) score at the urodynamic visit, obstetrical past, birth weight, LUTS, and urodynamic findings were collected. SUI was defined as incontinence during cough, or any effort. A maximum urethral closure pressure less than 30 cm H2O defined intrinsic sphincter deficiency. Results We included 363 women with a mean age of 46.7±10.8 years and a mean disease duration of 12.9±8.7 years. The incidence of relapsing remitting MS, a secondary progressive form, and a primary progressive form was 60.6%, 32.8%, and 6.6%, respectively. The prevalence of SUI was 31.4%. The prevalence of intrinsic sphincter deficiency was 1.4% and 0.8% of these patients had a SUI (P=0.300). In a multivariate analysis, women with a SUI had significantly higher birth weight (P=0.030), a pelvic organ prolapse (P=0.021), urgent urinary incontinence (P=0.006), a lower EDSS score (P=0.019), and a weaker containing effort (P<0.001). Conclusions The prevalence of SUI in women with MS was 31.4%. This symptom could affect the quality of life of women with MS. PMID:27706005

  1. Markov chain decision model for urinary incontinence procedures.

    PubMed

    Kumar, Sameer; Ghildayal, Nidhi; Ghildayal, Neha

    2017-03-13

    Purpose Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective. Design/methodology/approach This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov chain decision model for examining which of these surgical interventions is more effective in treating women with stress UI based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis. Findings Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure. Originality/value This paper demonstrates the efficacy of a Markov chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov chain decision modeling process to analyze various strategies for treating UI.

  2. 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.

  3. Engineered structures for use in disposable incontinence products.

    PubMed

    White, C F

    2003-01-01

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

  4. Clostridium difficile Infection and Fecal Microbiota Transplant.

    PubMed

    Liubakka, Alyssa; Vaughn, Byron P

    2016-07-01

    Clostridium difficile infection (CDI) is a major source of morbidity and mortality for hospitalized patients. Although most patients have a clinical response to existing antimicrobial therapies, recurrent infection develops in up to 30% of patients. Fecal microbiota transplant is a novel approach to this complex problem, with an efficacy rate of nearly 90% in the setting of multiple recurrent CDI. This review covers the current epidemiology of CDI (including toxigenic and nontoxigenic strains, risk factors for infection, and recurrent infection), methods of diagnosis, existing first-line therapies in CDI, the role of fecal microbiota transplant for multiple recurrent CDIs, and the potential use of fecal microbial transplant for patients with severe or refractory infection.

  5. Fecal Fat Analyses in Chronic Pancreatitis Importance of Fat Ingestion before Stool Collection

    PubMed Central

    Engjom, Trond; Jurmy, Palwasha; Tjora, Erling; Gilja, Odd Helge; Dimcevski, Georg

    2017-01-01

    Objective Quantitative determination of fecal fat still is the gold standard for measuring malabsorption. We evaluated the importance of standardized food intake before and under the collection of feces. Material and Methods In a project, evaluating patients with suspected chronic pancreatitis (CP) and healthy volunteers (HC), stools were collected for 72 hours coupled to registration of nutritional intake over five consecutive days. Patient groups were created by a modified Layer score, which includes imaging findings, clinical parameters and pancreas function testing. Results We found 12 patients with CP, 11 patients without CP and 13 healthy individuals in our database. Median fecal fat in CP patients was 12 g/day, in non-CP patients 5 g/day and in healthy controls 5 g/day. Median fat absorption coefficient was 81% in those with chronic pancreatitis, 92% in those without CP and 92% in healthy controls. Corresponding median fat intake was 65 g/day, 68 g/day and 81 g/day in the respective groups. Spearman Rank Order Correlation between fecal fat (g/d) and fat absorption coefficient in all study subjects (n = 36) was good (-0.88 (p<0.001)). When we stratified groups according to fat intake, correlation between fecal fat and fat absorption was also good (-0.86 to -0.95). Conclusion In the diagnoses of fat malabsorption, calculating the ratio of fat absorption did not give additional information compared to fecal fat. PMID:28095460

  6. Bridging the Gap: Determinants of Undiagnosed or Untreated Urinary Incontinence in Women

    PubMed Central

    DURALDE, Erin R.; WALTER, Louise C.; VAN DEN EEDEN, Stephen K.; NAKAGAWA, Sanae; SUBAK, Leslee L.; BROWN, Jeanette S.; THOM, David H.; HUANG, Alison J.

    2016-01-01

    Background Over a third of middle-aged or older women suffer from urinary incontinence, but less than half undergo evaluation or treatment for this burdensome condition. With national organizations now including assessment of incontinence as a quality performance measure, providers and healthcare organizations have a growing incentive to identify and engage these women who are undiagnosed and untreated. Objective We sought to identify clinical and sociodemographic determinants of patient-provider discussion and treatment of incontinence among ethnically diverse, community-dwelling women. Study Design We conducted an observational cohort study from 2003-2012 of 969 women 40 years and older enrolled in a Northern California integrated healthcare delivery system, who reported at least weekly incontinence. Clinical severity, type, treatment, and discussion of incontinence were assessed by structured questionnaires. Multivariable regression evaluated predictors of discussion and treatment. Results Mean age of the 969 participants was 59.9 (±9.7) years, and 55% were racial/ethnic minorities (171 Black, 233 Latina, 133 Asian or Native American). Fifty-five percent reported discussing their incontinence with a healthcare provider, 36% within one year of symptom onset, and with only 3% indicating that their provider initiated the discussion. Over half (52%) reported being at least moderately bothered by their incontinence. Of these women, 324 (65%) discussed their incontinence with a clinician, with 200 (40%) doing so within 1 year of symptom onset. In multivariable analysis, women were less likely to have discussed their incontinence if they had a household income <$30,000/year versus ≥$120,000/year (AOR=0.49, CI=0.28-0.86), or were diabetic (AOR=0.71, CI=0.51-0.99). They were more likely to have discussed incontinence if they had clinically severe incontinence (AOR=3.09, CI=1.89-5.07), depression (AOR=1.71, CI=1.20-2.44), pelvic organ prolapse (AOR= 1.98, CI=1

  7. Fecal microbiota transplantation inducing remission in Crohn's colitis and the associated changes in fecal microbial profile.

    PubMed

    Kao, Dina; Hotte, Naomi; Gillevet, Patrick; Madsen, Karen

    2014-08-01

    Inflammatory bowel disease (IBD) is a chronic relapsing disorder of the intestine of unclear etiology. Increasing evidence has pointed to intestinal dysbiosis as a potential factor in a genetically susceptible individual. Fecal microbiota transplantation (FMT) has been used to treat inflammatory bowel disease with variable degrees of success. Herein, we report a patient with Crohn's colitis, previously failing an immunosuppressant, who achieved clinical, endoscopic, and histologic remission after a single fecal microbiota transplantation infusion. We have further characterized the changes in the fecal microbiota associated with this observation.

  8. Quantitative PCR for genetic markers of human fecal pollution

    EPA Science Inventory

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

  9. Quantitative PCR for Genetic Markers of Human Fecal Pollution

    EPA Science Inventory

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

  10. Addressing Uncertainty in Fecal Indicator Bacteria Dark Inactivation Rates

    EPA Science Inventory

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

  11. Incontinence after radical prostatectomy: Anything new in its management?

    PubMed Central

    Caremel, Romain; Corcos, Jacques

    2014-01-01

    Introduction: With the increasing number of radical prostatectomies (RP) performed, male stress urinary incontinence (SUI) has become common. The artificial urinary sphincter (AUS) is the gold standard to treat SUI post-RP, but new devices have recently been developed. We review the recent studies on the treatment of SUI post-RP; we also describe the surgical techniques, mechanisms of action and results of these new procedures. Methods: We conducted a literature review search in the PubMed/Medline and Embase databases. Our search was restricted to recent articles. We included studies even if the urinary incontinence was due to sphincter deficiency after RP in non-neurologic patients. Results: We found 8 cohort studies for the surgical procedure: 3 studies concerning slings, 1 involving balloons adjustable implant, and 4 involving new devices. The only randomized controlled trial (RCT) was a pharmacologic clinical trial comparing duloxetine to placebo. The social continence rates were analyzed for 6 studies and were up to 66%. Conclusion: New minimally invasive surgical procedures have emerged as the main alternative to AUS, with social continence rates up to 60% despite just 1 RCT studying the pharmacologic approach. There is an urgent need for well-designed clinical trials to clarify the role of new surgical alternatives in the management of SUI post-RP. New technologies should continue to be evaluated and compared with the AUS, which remains the gold standard. PMID:25024791

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

    PubMed

    Kottner, J; Beeckman, D

    2015-12-01

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

  13. Urinary Incontinence and Levels of Regular Physical Exercise in Young Women.

    PubMed

    Da Roza, T; Brandão, S; Mascarenhas, T; Jorge, R N; Duarte, J A

    2015-08-01

    The purpose of this study was to determine the influence of different levels of regular physical exercise on the frequency of urinary incontinence in young nulliparous women from the northern region of Portugal. Participants (n=386) self-reported demographic variables, frequency, and time spent practicing organized exercise per week, as well as completed the International Consultation on Incontinence Questionnaire-Short Form. The level of exercise was calculated based on the time (in minutes) usually spent per week in organized exercise. 19.9% of Portuguese nulliparous women reported incontinence symptoms. Considering the distribution of urinary incontinence among the different quartiles of organized exercise, women from the 4(th)quartile (those who train for competitive purposes) demonstrated highest relative frequency (p=0.000) and a 2.53 greater relative risk to develop (95% CIs,1.3-2.7) incontinence compared to women from the 1(st) quartile (inactive). Women who practice exercise for recreational purposes (2(nd) and 3(rd) quartiles) did not show significant differences in the urinary incontinence prevalence and relative risk of developing it compared to women from the 1(st) quartile. The results showed that women participating in organized exercise involving high volume training for competition are potentially at risk of developing urinary incontinence, although organized exercise undertaken without the intent to compete seems to be safe for maintaining urinary continence.

  14. [Guideline 'Incontinence urine and feces' of the Dutch Preventive Youth Health Care].

    PubMed

    Beltman, Maaike; Deurloo, Jacqueline A; van Leerdam, Frank J M; Wierenga-van der Hoeven, Catelijne J; Bulk-Bunschoten, Anneke M W; Kamphuis, Mascha

    2012-01-01

    Continence problems can occur during childhood. This guideline is for the Dutch Youth Health Care (JGZ) and gives recommendations for the prevention, early detection and treatment of these problems. As a preventative measure advices for potty training should be started in children aged 18-24 months. If incontinence is present, it is important to take a history and carry out physical examination. In children over the age of 5 who are incontinent of urine the following are recommended: taking child out of bed, calendar with reward system, bedwetting alarm or voiding diary; children over the age of 8 can follow dry bed training. Faecal incontinence is often associated with constipation. Incontinent children with constipation are given advice about normal eating and exercise patterns. If this is not successful then laxatives are prescribed. The JGZ should refer further if there are indications of an underlying condition; if children over the age of 5 are wet during the day; if children are incontinent of faeces at night; if children are incontinent of faeces but not constipated; if children persistently wet the bed; if there is faecal incontinence despite counselling, and if medication needs to be prescribed.

  15. A comparison of cost and efficacy of three incontinence skin barrier products.

    PubMed

    Zehrer, Cindy L; Lutz, James B; Hedblom, Edwin C; Ding, Li

    2004-12-01

    Maintaining healthy, intact perineal skin in nursing home residents with incontinence is a challenge. Their condition puts them at risk for developing incontinence dermatitis, possibly predisposing them to develop pressure ulcers. To examine the cost-effectiveness of three perineal skin barriers (a polymer-based barrier film and two petrolatum ointments) used to prevent incontinence dermatitis, a 6-month descriptive study was conducted among residents (N = 250) from four long-term care facilities (nursing homes) in the upper Midwestern US. All residents were incontinent and had intact perineal skin when they enrolled in the study. An economic analysis was performed using time-motion data from a convenience sample of enrolled residents and their caregivers. Residents had an average of 4.1 (+/-2.307) incontinent episodes per day, the occurrence of incontinence dermatitis was 3.3 % and not significantly different between the different protocols of care (P = 0.4448). Results of the economic analysis showed that daily barrier application costs ranged from $0.17 for the barrier film to $0.76 for the ointments evaluated. With labor included in the analysis, costs were also lower for the barrier film that required the least frequent application ($0.26) compared to ointments that required more frequent application ($1.40). Results of this study suggest that the daily or three times weekly barrier film protocols are affordable alternatives to using petrolatum ointments in the prevention of incontinence dermatitis.

  16. 78 FR 12763 - Fecal Microbiota for Transplantation; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

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

  17. Magnetic Resonance Imaging Analysis of Caudal Regression Syndrome and Concomitant Anomalies in Pediatric Patients

    PubMed Central

    Boruah, Deb K; Dhingani, Dhaval D; Achar, Sashidhar; Prakash, Arjun; Augustine, Antony; Sanyal, Shantiranjan; Gogoi, Manoj; Mahanta, Kangkana

    2016-01-01

    Objective: The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of caudal regression syndrome (CRS) and concomitant anomalies in pediatric patients. Materials and Methods: A hospital-based cross-sectional retrospective study was conducted. The study group comprised 21 pediatric patients presenting to the Departments of Radiodiagnosis and Pediatric Surgery in a tertiary care hospital from May 2011 to April 2016. All patients were initially evaluated clinically followed by MRI. Results: In our study, 21 pediatric patients were diagnosed with sacral agenesis/dysgenesis related to CRS. According to the Pang's classification, 2 (9.5%) patients were Type I, 5 (23.8%) patients were Type III, 7 (33.3%) patients were Type IV, and 7 (33.3%) patients were of Type V CRS. Clinically, 17 (81%) patients presented with urinary incontinence, 6 (28.6%) with fecal incontinence, 9 patients (42.9%) had poor gluteal musculatures and shallow intergluteal cleft, 7 (33.3%) patients had associated subcutaneous mass over spine, and 6 (28.6%) patients presented with distal leg muscle atrophy. MRI showed wedge-shaped conus termination in 5 (23.8%) patients and bulbous conus termination in 3 (14.3%) patients above the L1 vertebral level falling into Group 1 CRS while 7 (33.3%) patients had tethered cord and 6 (28.6%) patients had stretched conus falling into Group 2 CRS. Conclusion: MRI is the ideal modality for detailed evaluation of the status of the vertebra, spinal cord, intra- and extra-dural lesions and helps in early diagnosis, detailed preoperative MRI evaluation and assessing concomitant anomalies and guiding further management with early institution of treatment to maximize recovery. PMID:27833778

  18. Discovering new indicators of fecal pollution

    PubMed Central

    McLellan, Sandra L.; Eren, A. Murat

    2014-01-01

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

  19. Interaction of fecal coliforms with soil aggregates

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  20. Fecal microbiota transplantation and donor standardization.

    PubMed

    Owens, Casey; Broussard, Elizabeth; Surawicz, Christina

    2013-09-01

    Clostridium difficile diarrhea is a common and severe infectious disease. Antibiotics, which are standard initial treatment, are less effective for treating refractory or recurrent infection. Fecal microbiota transplantation, where healthy donor stool is transplanted into a patient, is an alternative to antibiotic therapy that requires standardization for donors and patients.

  1. Fecal Transplants: What Is Being Transferred?

    PubMed Central

    Bojanova, Diana P.

    2016-01-01

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

  2. 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.

  3. Fluorogenic selective and differential medium for isolation of fecal streptococci.

    PubMed Central

    Littel, K J; Hartman, P A

    1983-01-01

    Of 44 fluorogenic substrates tested for their ability to differentiate species of fecal streptococci, four yielded species-differentiating reactions. The remaining substrates either yielded uniformly positive, negative, or variable strain-dependent reactions. One substrate, 4-methylumbelliferone-alpha-D-galactoside, was hydrolyzed by Streptococcus bovis and S. faecium and its biotypes. 4-Methylumbelliferone-alpha-D-galactoside and a colorimetric starch substrate were incorporated into the fecal streptococcal selective medium of Donnelly and Hartman (Appl. Environ. Microbiol. 35:576-581, 1978). Three phenotypic groups were identifiable on the new fluorescent gentamicin-thallous-carbonate agar: (i) starch hydrolysis and fluorescence (S. bovis), (ii) no starch hydrolysis but fluorescence (S. faecium and its biotypes), and (iii) no starch hydrolysis or fluorescence (S. faecalis, S. avium, S. equinus, S. mitis, and S. salivarius). Of the presumptive identifications from sewage, swine, and bovine samples, 86% were confirmed as being correct. The new medium has potential application in water, food, environmental, and possibly clinical microbiology. Images PMID:6830220

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

    NASA Astrophysics Data System (ADS)

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

    2004-03-01

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

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

    PubMed Central

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

    2015-01-01

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

  6. Portrait representation of postmenopausal women's experiences of living with urinary incontinence.

    PubMed

    Pakgohar, Minoo; Hamid, Tengku-Aizan; Ibrahim, Rahimah; Vahid-Dastjerdi, Marzieh

    2015-01-01

    This study explored the meaning of the experiences of community-dwelling postmenopausal women who were born and grew up in a Muslim country when drawing a picture about their lived experiences of urinary incontinence. Hermeneutic phenomenology underpinned the study's interpretive research approach. In-depth, semistructured interviews were conducted in two sessions with nine postmenopausal women. The participants were asked to draw a picture about their lived experiences of urinary incontinence in a self-portrait. Three themes emerged to illuminate the meaning of urinary incontinence, including "disruption of normal functioning," "self-imposed restrictions," and "feeling of despair." Discussion of these themes was presented, and practice and research implications were suggested.

  7. Revisiting the O complex: urinary incontinence, delirium and polypharmacy in elderly patients

    PubMed Central

    Hogan, D B

    1997-01-01

    Urinary incontinence, delirium and polypharmacy are common, challenging problems encountered in elderly patients. Review of the literature shows that these conditions are interrelated. For example, polypharmacy can lead to delirium, which, in turn, can lead to urinary incontinence. The drugs prescribed for urinary incontinence can precipitate delirium or contribute to polypharmacy. The underlying causes for these problems in elderly patients are frequently complex, and management in turn must often be multifactorial. The occurrence of these problems should lead to careful evaluation followed by thoughtful, responsive treatment. Brief updates are given with recommendations for management directed at primary care physicians. PMID:9347778

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

    PubMed

    Santini, Sara; Andersson, Gunnel; Lamura, Giovanni

    2016-01-01

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

  9. Evaluating and managing urinary incontinence after prostatectomy: beyond pads and diapers.

    PubMed

    Atiemo, Humphrey O; Moy, Louis; Vasavada, Sandip; Rackley, Raymond

    2007-01-01

    Men who become persistently incontinent after undergoing prostatectomy have a variety of options for regaining control, ranging from behavioral changes to surgery. To determine the best therapy, one should define the problem with a thorough urologic evaluation.

  10. Urethral duplication: a rare cause of urinary incontinence in a female child

    PubMed Central

    Gupta, Sanjay; Tiwari, Rajesh; Kumar, Vijoy; Singh, Mahendra

    2012-01-01

    Female urethral duplication is a rare congenital anomaly. We report a case of complete urethral duplication along with horseshoe kidney in a four-years-old female child presenting with incontinence since childhood. PMID:24578937

  11. Incontinence pads: recommending the best product-based wetback performance and price.

    PubMed

    Erekson, Elisabeth A; Meyer, Sara A; Melick, Clifford; McLennan, Mary T

    2008-10-01

    Incontinence pads are available in the USA without a prescription and are commonly the first treatment option a patient with incontinence uses. The goal of this study was to examine the difference in the performance and cost of commercially available incontinence pads with the intention of providing recommendations to women. Ten different urinary incontinence products were selected. A modified wetback test was used to test product performance. For the small volume leaks, the Walgreen's Extra pad generally performed worse on the wetback test than the three other pads tested (p = 0.001-0.012), but four tests were not statistically significant. At larger leak volumes, the Walgreen's underwear generally performed worse than other products (p < or = 0.001-0.046), with some exceptions. Brand name products generally performed better than generic products, but cost more. Undergarments and underwear do the worst job of keeping moisture inside the pad.

  12. The Pathophysiology of Stress Urinary Incontinence: A Historical Perspective

    PubMed Central

    Cundiff, Geoffrey W

    2004-01-01

    This article provides a historical perspective on the evolution of theories regarding the pathophysiology of stress urinary incontinence (SUI). The progression of these theories has followed the development of the diagnostic technologies that have provided insight into different aspects of urethral dysfunction. The earliest theories tied SUI to anatomic failure of urethral support. Recognition that anatomic failure impacted the interplay of intra-abdominal pressure and the bladder and urethra led to theories focused on the dynamic interaction between the bladder and urethral pressures. Investigators then began to recognize the importance of urethral sphincteric dysfunction. More recently, investigators have attempted to combine the anatomic and functional etiologies into a consolidated theory. These efforts point to a multi-factorial etiology of SUI. Continuing research has provided new insight into the neurophysiology of urethral function, opening new avenues for tailoring therapy for SUI. PMID:16985860

  13. The science behind biomaterials in female stress urinary incontinence surgery.

    PubMed

    Amrute, Kaytan V; Badlani, Gopal H

    2009-01-18

    Female stress urinary incontinence, while not life threatening, can present with various social and economic implications. Biomaterials, primarily synthetic, are often utilized to augment surgical correction. Repair with biomaterials involves midurethral support to function against weakened connective tissue caused by injury, abnormal collagen metabolism, or genetic predisposition. Even though efficacy rates are high, the potential for complications, such as erosion, are great without comprehension of inherent characteristics of each graft material. Low-weight, macroporous, monofilament synthetic grafts and noncross-linked biologic grafts are examples of biomaterials that implant reasonably well with host tissue. This paper reviews the justification for biomaterial use, host reaction, and the various parameters of natural and synthetic grafts.

  14. Incontinence-associated dermatitis in the elderly: treatment options.

    PubMed

    Corcoran, Eleanor; Woodward, Sue

    Incontinence-associated dermatitis (IAD) is a common problem in older people. However, it is frequently misdiagnosed and poorly treated. There is often uncertainty about which product to use to prevent and treat IAD; the different types, brands and how to apply them. This literature review looks specifically at the use of barrier products in the prevention and treatment of IAD. A systematic search found six primary research papers that analysed the effectiveness of various barrier products; they will be compared and contrasted in this review. There is a lack of evidence to recommend any one barrier product over another for use in a standardised skin care protocol such as the regimen suggested by Gray et al (2012). More research needs to be conducted to establish the most effective barrier products on the market. More research is also needed on the efficacy of barrier products in the prevention and treatment solely of IAD rather than combined studies looking at IAD with pressure ulcers.

  15. New frontiers in the treatment of overactive bladder and incontinence.

    PubMed

    Chancellor, Michael B

    2002-01-01

    In this article the author tries to forecast how urologists will treat the overactive bladder (OAB) in the next decade. He reviews drugs currently under development and also logical and exciting pharmacological targets that would be suitable targets for treating OAB in the future. The author also discusses intravesical therapy and alternative drug delivery methods, such as intravesical capsaicin and botulinum toxin. There are many advantages to advanced drug delivery systems, including the achievement of long-term therapeutic efficacy, decreased incidence and severity of side effects, and improved patient compliance. Special emphasis is placed on approaches to modulating bladder afferent nerve function to prevent OAB. Speculation on future techniques such as gene therapy can also be considered for treating OAB, because they may make it possible to access all of the genitourinary organs via minimally invasive techniques. Traditional anticholinergic therapies are limited in their effectiveness. There is great hope for future research and therapy for OAB and urinary incontinence.

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

    PubMed Central

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

    2016-01-01

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

  17. [Epidemiology and treatment for urinary incontinence and pelvic organ prolapse in women].

    PubMed

    Starczewski, Andrzej; Brodowska, Agnieszka; Brodowski, Jacek

    2008-07-01

    Urinary incontinence (UI) is defined as uncontrolled urine leakage through an urethra. At present, the following types of UI can be specified: stress incontinence (SI), urge incontinence (UI), mixed incontinence (MI), overflow incontinence (OI) in which the bladder becomes too full because it cannot be fully emptied, and functional incontinence (FI). Incontinence is one of the most common chronic diseases in women and is found in 17-60% of the whole population. In most patients, SI is combined with pelvic organ prolapse. The basic risk factors mentioned as contributing to these two conditions are obstetrical past and gynaecological history and atrophic changes in the urogenital area. There are also a number of diseases related to the increase in intra-abdominal pressure, such as obesity chronic constipation and diseases associated with persistent cough. Other factors leading to pelvic organ prolapse include hard physical work, some professional sports, connective tissue disorders, neuropathy and disturbed innervation of the pelvic floor. To deal with stress incontinence (SI), conservative and surgical treatment is employed. In the first degree intensity, it is mainly physiotherapy, electrical stimulation of the pelvic floor muscles, lifestyle modification and reduction of body mass. When the SI symptoms are more severe, surgical treatment is usually preferred. From among many methods, these presently used are Burch and sling operations. On the other hand, surgical treatment for pelvic organ prolapse involves colpoperineoplasty with the use of polypropylene mesh (Prolift), colporrhaphy by double TOT approach method, median colporrhaphy, Cooper's ligament or sacrospinous ligament colpopexy, and attachment of the uterus to the sacrum. The results of surgical treatment depend on co-occurrence of risk factors, the surgical method chosen, the lapse of time from the surgery and the type of the applied biomedical material.

  18. Symptoms of Combined Prolapse and Urinary Incontinence in Large Surgical Cohorts

    PubMed Central

    Brubaker, L.; Rickey, L.; Xu, Y.; Markland, A.; Lemack, G.; Ghetti, C.; Kahn, M.; Nagaraju, P.; Norton, P.; Chang, T. D.; Stoddard, A.

    2011-01-01

    Objective To estimate whether prolapse severity is a major contributor to urinary incontinence severity, as measured by validated incontinence questionnaires. Methods We analyzed data from two large female stress urinary incontinence (SUI) surgical cohorts: the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) study (N=655) and the subsequent Trial of Mid-Urethral Slings (TOMUS) study (N=597). All participants completed a standardized baseline assessment including validated measures of symptom severity, quality of life, objective measures of urine loss [Urogenital Distress Inventory (UDI), Medical, Epidemiologic, and Social Aspects of Aging questionnaire (MESA), Incontinence Impact Questionnaire (IIQ) and pad test], as well as the Pelvic Organ Prolapse – Quantification (POP-Q) assessment. Groups were compared using the χ2 test (categorical measures) or the one-way analysis of variance (continuous measures). Statistical significance was defined at p-value <0.05. Results The SISTEr and TOMUS samples were similar for many variables including age (52 vs. 53 years, respectively), nulliparity (9 vs. 12%), prior UI surgery (14 vs. 13%), and prior hysterectomy (31 vs 28%), but other differences necessitated separate analysis of the two cohorts. There was not a statistically significant difference in UDI scores according to prolapse stage in either study population. Patients with prior surgery for POP and SUI had more incontinence symptoms and were more bothered by their UI, regardless of prolapse stage. Conclusions Prolapse stage is not strongly or consistently associated with incontinence severity in women who select surgical treatment of stress urinary incontinence. Prior POP and UI surgery is associated with worse UI severity and bother. Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00064662 and NCT00325039. PMID:20093904

  19. Prevalence and Trends of Urinary Incontinence in Adults in the United States, 2001 to 2008

    PubMed Central

    Markland, Alayne D.; Richter, Holly E.; Fwu, Chyng-Wen; Eggers, Paul; Kusek, John W.

    2011-01-01

    Purpose We estimate trends in the prevalence of urinary incontinence in the adult population of the United States from 2001 through 2008 before and after adjusting for other potential associated factors. Materials and Methods We analyzed data on 17,850 adults 20 years old or older who participated in the 2001 to 2008 cycles of the National Health and Nutrition Examination Survey. Any urinary incontinence was defined as a positive response to questions on urine leakage during physical activity, before reaching the toilet and during nonphysical activity. During this period changes in demographic and clinical factors associated with urinary incontinence included age, race/ethnicity, obesity, diabetes and chronic medical conditions (prostate disease in men). Age standardized prevalence estimates and prevalence ORs of urinary incontinence trends were determined using adjusted multivariate models with appropriate sampling weights. Results The age standardized prevalence of urinary incontinence in the combined surveys was 51.1% in women and 13.9% in men. Prevalence in women increased from 49.5% in 2001 to 2002, to 53.4% in 2007 to 2008 (Ptrend = 0.01) and in men from 11.5% to 15.1%, respectively (Ptrend = 0.01). In women increased prevalence was partially explained by differences in age, race/ethnicity, obesity, diabetes and select chronic diseases across the survey periods. After adjustment the prevalence OR for 2007 to 2008 vs 2001 to 2002 decreased from 1.22 (95% CI 1.03–1.45) to 1.16 (95% CI 0.99–1.37). in men adjustment for potentially associated factors did not explain the increasing prevalence of urinary incontinence. Conclusions The age standardized prevalence of urinary incontinence increased in men and women from 2001 through 2008. Decreasing obesity and diabetes may lessen the burden of urinary incontinence, especially in women. PMID:21684555

  20. Role of antimuscarinics in the treatment of nonneurogenic daytime urinary incontinence in children.

    PubMed

    Nijman, Rien J M

    2004-03-01

    Idiopathic or "functional" urinary incontinence in children--incontinence with no known neurologic or anatomic cause--may take the form of urge incontinence, the most common type of incontinence, which is characterized by detrusor overactivity during the filling phase, or dysfunctional voiding. The latter may be classified as staccato voiding (periodic bursts of pelvic floor activity with prolonged voiding and, in some cases, residual urine), interrupted voiding (insufficient bladder emptying, infrequent voiding with several phases of micturition), or "lazy bladder" syndrome (infrequent voiding and large bladder capacity). The etiology of functional incontinence is unknown. Theories include genetic predisposition, recurrent urinary tract infections, immaturity or too-early toilet training, and sexual abuse. A severe form of urge incontinence, nonneurogenic neurogenic (Hinman) bladder, may be the end stage of dysfunctional voiding, but an occult neurologic component should also be considered. Diagnostic procedures recommended for children with urinary incontinence include careful history taking, a voiding diary, and physical examination to identify symptoms and to minimize the need for invasive procedures. Treatments include behavioral modification, biofeedback, antibiotics, anticholinergics, counseling, and neuromodulation. The antimuscarinics oxybutynin and tolterodine are, at present, the most commonly used drugs to treat incontinence. Common side effects with these agents (ie, reduced saliva production and worsening constipation) can be severe and can cause up to 10% of children using oxybutynin to discontinue treatment. Current evidence suggests that tolterodine may have a more favorable safety profile than oxybutynin. In addition, new antimuscarinics in the pipeline, eg, darifenacin and solifenacin, are expected to possess more favorable safety and tolerability profiles and may therefore help to alleviate these limitations.

  1. New Fecal Method for Plutonium and Americium

    SciTech Connect

    Maxwell, S.L. III

    2000-06-27

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

  2. [Research progress of fecal microbiota transplantation].

    PubMed

    Dai, Ting; Tang, Tongyu

    2015-07-01

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

  3. Systematic screening for urinary incontinence in older women: Who could benefit from it?

    PubMed Central

    Visser, Els; de Bock, Geertruida H.; Kollen, Boudewijn J.; Meijerink, Marije; Berger, Marjolein Y.; Dekker, Janny H.

    2012-01-01

    Objective To identify women who are suffering from urinary incontinence but do not consult a physician and to identify reasons for this. Design Survey study as part of a randomized controlled trial that investigates the effects of a standardized assessment and evidence-based treatment on urinary incontinence in older women, the URINO project. Setting Female patients from general practices in the Northern part of the Netherlands. Patients A total of 225 women of 55 years and older suffering from urinary incontinence. Main outcome measures Number of patients with urinary incontinence who are not registered by their GP as suffering from this, factors associated with help-seeking behaviour, and reasons for not seeking help. Results Of the 225 patients, 143 (64%) were not registered by their GP as suffering from urinary incontinence. These women were more often younger and had lower levels of distress due to their urogynaecological symptoms. The most common reason for not consulting a GP was that patients considered their symptoms not to be serious enough. Conclusion The prevalence of older women with urinary incontinence who do not seek help is high. Help-seeking behaviour is associated with increasing age and higher levels of distress caused by the symptoms. Younger patients more often hesitate to consult their GP if they perceive their symptoms to be relatively mild. PMID:22324458

  4. Incontinence pad absorption and skin barrier creams: a non-patient study.

    PubMed

    Dykes, Peter; Bradbury, Sarah

    2016-12-08

    Exposure of the skin to excessive moisture, such as in cases of incontinence, can damage its natural barrier function and lead to tissue damage and breakdown. Common methods for managing incontinence and preventing related skin damage include the use of incontinence pads and the application of skin barrier creams to reduce exposure to moisture and irritants. Previous reports have indicated that barrier creams can transfer onto incontinence pads from the skin and reduce their absorbency, and thus the efficacy of both products. This study, using non-patient volunteers, investigated the effect on incontinence pad absorbency of Medi Derma-S and Medi Derma-Pro; two products from the Medi Skin Protection range, in comparison with other market-leading products. Results indicated that, while there was a small degree of product transfer onto the incontinence pads, this did not have a major impact on the absorption of synthetic urine. Medi Derma-S and Medi Derma-Pro performed consistently with other similar market-leading products.

  5. [Current diagnostics and therapy of the overactive bladder and urge incontinence].

    PubMed

    Badawi, J K; Langbein, S

    2005-06-17

    Urinary incontinence affects millions of people worldwide and also represents a social problem. Costs of urinary incontinence and overactive bladder are very high. Urge incontinence is the involuntary loss of urine associated with a strong desire or urge to urinate. There are two types of urge incontinence: One is associated with involuntary detrusor contractions leading to a loss of urine, the other is characterized by a hypersensitive bladder in which micturition reflexes are induced due to an increased afferent activity. It is important to distinguish between an idiopathic type of urge incontinence and a symptomatic type possibly caused by infections, tumours, bladder stones or foreign bodies. Diagnostics is based on a careful medical history, clinical examination and urodynamic evaluation. The use of a voiding diary is necessary. Current agents for drug therapy rely upon their anticholinergic properties. Their use is limited by side effects such as blurred vision, dizziness, constipation and dryness of the mouth. Additionally, patients refractory to anticholinergic medication can be treated by endoscopic direct injection of botulinum toxin into the detrusor muscle. These patients can also be treated by intravesical application of vanilloid derivatives in the bladder leading to a desensitization of bladder sensory fibers. In some cases of refractory urge incontinence, electrical neuromodulation is effective. Other pharmacological approaches could be selective b-adrenoceptor agonists, calcium antagonists and potassium channel openers, but these substances are not yet available for clinical use.

  6. Fecal microbiota transplantation for gastrointestinal diseases.

    PubMed

    Matsuoka, Katsuyoshi; Mizuno, Shinta; Hayashi, Atsushi; Hisamatsu, Tadakazu; Naganuma, Makoto; Kanai, Takanori

    2014-01-01

    Fecal microbiota transplantation (FMT) is a treatment to restore the normal microbial composition of the gut by introducing fecal microbiota obtained from a healthy donor into a diseased individual. There has been a growing interest in the use of FMT as a treatment of various diseases including Clostridium difficile infection (CDI), inflammatory bowel disease, and irritable bowel syndrome. Despite the increasing application of FMT, there are no standard protocols. Many aspects of FMT procedures vary regarding donor selection, preparation of fecal materials, recipient preparation, and route of administration. FMT is most successful in treating recurrent CDI. A randomized controlled trial reported a success rate of approximaetly 90%. Ulcerative colitis (UC) is a potentially good indication for FMT, although limited evidence is available on the use of FMT for the treatment of UC. Only several small case series have been reported, and the results in terms of efficacy are inconsistent. FMT can also be used to treat diseases other than gastrointestinal disorders in which the gut microbiota is disturbed, e.g., cardiovascular diseases, autoimmune diseases, and metabolic disorders. There remain many unanswered questions with regard to FMT, and more research is required in this field.

  7. Therapeutic potential of fecal microbiota transplantation.

    PubMed

    Smits, Loek P; Bouter, Kristien E C; de Vos, Willem M; Borody, Thomas J; Nieuwdorp, Max

    2013-11-01

    There has been growing interest in the use of fecal microbiota for the treatment of patients with chronic gastrointestinal infections and inflammatory bowel diseases. Lately, there has also been interest in its therapeutic potential for cardiometabolic, autoimmune, and other extraintestinal conditions that were not previously considered to be associated with the intestinal microbiota. Although it is not clear if changes in the microbiota cause these conditions, we review the most current and best methods for performing fecal microbiota transplantation and summarize clinical observations that have implicated the intestinal microbiota in various diseases. We also discuss case reports of fecal microbiota transplantations for different disorders, including Clostridium difficile infection, irritable bowel syndrome, inflammatory bowel diseases, insulin resistance, multiple sclerosis, and idiopathic thrombocytopenic purpura. There has been increasing focus on the interaction between the intestinal microbiome, obesity, and cardiometabolic diseases, and we explore these relationships and the potential roles of different microbial strains. We might someday be able to mine for intestinal bacterial strains that can be used in the diagnosis or treatment of these diseases.

  8. Fecal shedding of Salmonella in exotic felids.

    PubMed

    Clyde, V L; Ramsay, E C; Bemis, D A

    1997-06-01

    Two collections of exotic felids were screened for the presence of Salmonella by selective fecal culture utilizing selenite broth and Hektoen enteric agar. In > 90% of the samples, Salmonella was isolated from a single culture. A commercial horsemeat-based diet was fed in both collections, and one collection also was fed raw chicken. Salmonella was cultured from the raw chicken and the horsemeat diet for both collections. Multiple Salmonella serotypes were identified, with S. typhimurium and S. typhimurium (copenhagen) isolated most frequently. Approximately half of the Salmonella isolates demonstrated multiple antibiotic resistance. The ability to harbor Salmonella as normal nonpathogenic bacteria of the gastrointestinal tract may be a physiological adaptation to carnivory. The high rate of fecal shedding of Salmonella in healthy individuals clouds the interpretation of a positive fecal culture in an ill felid, or one with diarrhea. All zoo employees having contact with cat feces or raw diets have a high rate of occupational exposure to Salmonella and should exercise appropriate hygienic precautions.

  9. Emotional incontinence and executive function in ischemic stroke: a case-controlled study.

    PubMed

    Tang, W K; Chen, Yangkun; Lam, Wynnie W M; Mok, Vincent; Wong, Adrian; Ungvari, Gabor S; Xiang, Y T; Wong, Ka Sing

    2009-01-01

    Frontal and basal ganglia infarcts and executive dysfunction are thought to be involved in the pathophysiology of poststroke emotional incontinence (PSEI). The study examined whether patients with PSEI have more frontal and/or basal ganglia infarcts and impairment in executive function. A total of 516 Chinese patients with acute ischemic stroke consecutively admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong were screened for PSEI 3 months after the index stroke. According to Kim's criteria, 39 (7.6%) had PSEI. Thirty-nine stroke patients without PSEI served as matched control group. The PSEI group had significantly more frontal and/or basal ganglia infarcts, had lower Chinese Frontal Assessment Battery scores, required more time to complete the Stroop Test, and made more omission and commission errors in the Go-NoGo test. There was no significant correlation between frontal or basal ganglia infarcts and executive function. The correlation between frontal infarct and severity of PSEI was .420. Further follow-up and functional imaging studies are warranted to explore the relationship between PSEI, brain infarcts, and executive dysfunction. (JINS, 2009, 15, 62-68.).

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

    PubMed

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

    2015-01-01

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

  11. Fecal Sterol and Runoff Analysis for Nonpoint Source Tracking.

    PubMed

    Fahrenfeld, N L; Del Monaco, N; Coates, J T; Elzerman, A W

    2016-01-01

    Fecal pollution source identification is needed to quantify risk, target installation of source controls, and assess performance of best management practices in impaired surface waters. Sterol analysis is a chemical method for fecal source tracking that allows for differentiation between several fecal pollution sources. The objectives of this study were to use these chemical tracers for quantifying human fecal inputs in a mixed-land-use watershed without point sources of pollution and to determine the relationship between land use and sterol ratios. Fecal sterol analysis was performed on bed and suspended sediment from impaired streams. Human fecal signatures were found at sites with sewer overflow and septic inputs. Different sterol ratios used to indicate human fecal pollution varied in their sensitivity. Next, geospatial data was used to determine the runoff volumes associated with each land-use category in the watersheds. Fecal sterol ratios were compared between sampling locations and correlations were tested between ratio values and percentage of runoff for a given land-use category. Correlation was not observed between percentage of runoff from developed land and any of the five tested human-indicating sterol ratios in streambed sediments, confirming that human fecal inputs were not evenly distributed across the urban landscape. Several practical considerations for adopting this chemical method for microbial source tracking in small watersheds are discussed. Results indicate that sterol analysis is useful for identifying the location of human fecal nonpoint-source inputs.

  12. Behavior Therapy to Enable Drug Discontinuation in the Treatment of Urge Incontinence: A Randomized Controlled Trial

    PubMed Central

    Burgio, Kathryn L.; Kraus, Stephen R.; Menefee, Shawn; Borello-France, Diane; Corton, Marlene; Johnson, Harry W.; Mallett, Veronica; Norton, Peggy; FitzGerald, Mary P.; Dandreo, Kimberly J.; Richter, Holly E.; Rozanski, Thomas; Albo, Michael; Zyczynski, Halina M.; Lemack, Gary E.; Chai, Toby C.; Khandwala, Salil; Baker, Jan; Brubaker, Linda; Stoddard, Anne M.; Goode, Patricia S.; Nielsen-Omeis, Betsy; Nager, Charles W.; Kenton, Kimberly; Tennstedt, Sharon L.; Kusek, John W.; Chang, T. Debuene; Nyberg, Leroy M.; Steers, William

    2010-01-01

    Background Women with urge urinary incontinence are commonly treated with antimuscarinic medications, but many discontinue therapy. Objective To determine whether combining antimuscarinic drug therapy with supervised behavioral training, compared to drug therapy alone, improves the ability of women with urge incontinence to achieve clinically important reductions in incontinence episodes and to and sustain these improvements after discontinuing medication. Design Two-stage, multi-center, randomized clinical trial (BE-DRI trial) (July 2004 – January 2006). Setting Nine university-affiliated outpatient clinics. Patients 307 women with urge predominant incontinence. Interventions Ten weeks of open-label, extended-release tolterodine alone (N = 153) or combined with behavioral training (N = 154) (Stage 1), followed by discontinuation of therapy and follow-up at 8 months (Stage 2); 237 participants completed the trial. Measurements The primary outcome, measured at 8 months, was defined as not taking drug or receiving any other therapy for urge incontinence and ≥70% reduction in frequency of incontinence episodes. Secondary outcomes were reduction in incontinence, self-reported satisfaction and improvement, and scores on validated questionnaires measuring symptom distress/bother and health-related quality-of-life. Study staff who performed outcome evaluations were blinded to group assignment, but participants and interventionists were not. Results At 8 months, there was no difference in successful discontinuation of drug therapy between combined therapy and drug alone (41% in both groups, 95% confidence interval on difference: -12% to +12%). A higher proportion of patients in combined therapy achieved ≥70% reduction of incontinence than in drug therapy alone at 10 weeks (69% vs. 58%; difference = 11%; 95% confidence interval: -0.3 to +22.1). Combined therapy yielded better outcomes over time on the Urogenital Distress Inventory and Overactive Bladder Questionnaire

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

    PubMed Central

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

    2016-01-01

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

  14. 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

  15. 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

  16. Sexual function before and after non-surgical treatment for stress urinary incontinence

    PubMed Central

    Handa, Victoria L.; Whitcomb, Emily; Weidner, Alison C.; Nygaard, Ingrid; Brubaker, Linda; Bradley, Catherine S.; Paraiso, Marie Fidela R.; Schaffer, Joseph; Zyczynski, Halina M.; Zhang, Min; Richter, Holly E.

    2011-01-01

    Objectives (1) to describe sexual function in women seeking treatment of stress urinary incontinence (SUI); (2) to compare the impact on sexual function of three SUI treatments; and (3) to investigate whether non-surgical treatment of SUI is associated with improved sexual function. Methods Women with SUI were randomized to continence pessary, behavioral therapy (pelvic floor muscle training and continence strategies), or combination therapy. Sexual function was assessed at baseline and 3-months using short forms of the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ-12) and the Personal Experiences Questionnaire (SPEQ). Successful treatment of SUI was assessed with a patient global impression of improvement. ANOVA was used to compare scores between groups. Results At baseline, sexual function was worse among women with mixed incontinence compared to those with pure SUI. After therapy, successful treatment of SUI was associated with greater improvement in PISQ-12 score (2.26 ± 3.24 versus 0.48 ± 3.76, p=0.0007), greater improvement in incontinence with sexual activity (0.45 ± 0.84 versus 0.01 ± 0.71, p=0.0002), and greater reduction in restriction in sexual activity related to fear of incontinence (0.32 ± 0.76 versus −0.06 ± 0.78, p=0.0008). Among those successfully treated for SUI, improvement in continence during sexual activity was greater in both the combined therapy group (p=0.019) and the behavioral group (p=0.02) compared to the pessary group. Conclusions Successful non-surgical treatment of SUI is associated with improvements in incontinence-specific measures of sexual function. Behavioral therapy may be preferred to pessary for treatment of SUI among women whose incontinence interferes with sexual function. PMID:21572534

  17. Factors Associated With Quality Of Life In Women Undergoing Surgery For Stress Urinary Incontinence

    PubMed Central

    Sirls, Larry T.; Tennstedt, Sharon; Albo, Mike; Chai, Toby; Kenton, Kim; Huang, Liyuan; Stoddard, Anne M; Arisco, Amy; Gormley, E. Ann

    2014-01-01

    Purpose To determine the association of clinicodemographic factors with urinary incontinence (UI) related quality of life (QoL) in women having surgery for stress urinary incontinence (SUI) and to compare the incontinence-specific IIQ (Incontinence Impact Questionnaire) and the ICIQ (International Consultation on Incontinence Questionnaire). Secondary objectives evaluated the contributions of incontinence severity and sexual function to QoL. Materials and Methods Baseline data from 597 women in the Trial of Mid Urethral Slings (TOMUS). Correlates of QoL tested included health status and history, type, severity and bother of UI, and sexual function. Results Lower QoL by both the IIQ and ICIQ included younger age, higher BMI, more SUI symptoms, and more severe and bothersome UI symptoms. Each measure identified factors associated with lower QoL not identified by the other (IIQ; Hispanic ethnicity, poor health status and more urge UI symptoms, and ICIQ; prior UI treatment and more UI episodes per day). Sexually active women had similar QoL but also increased incontinence episodes (IIQ and ICIQ) and more sexual dysfunction (IIQ only). Conclusion In women planning SUI surgery, QoL is associated with non-UI factors as well as with the type, severity and degree of bother from UI symptoms. Many factors are associated with QoL as measured by both IIQ and ICIQ. However more non-UI factors were associated with QoL when measured by the IIQ than by the ICIQ. More than one scale may be needed to evaluate QoL after SUI treatment. PMID:20952014

  18. 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

  19. Improving diaper design to address incontinence associated dermatitis

    PubMed Central

    2010-01-01

    Background Incontinence associated dermatitis (IAD) is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the polyacrylate superabsorber. The intention was to minimize disturbance of the already weak acid mantle of aged skin. We also employed air-permeable side panels to minimize skin occlusion and swelling of the stratum corneum. Methods The surface pH of diapers was measured after repeated wetting with a urine substitute fluid at the level of the top sheet. Occlusive effects and hydration of the stratum corneum were measured after a 4 hour application of different side panel materials by corneometry on human volunteers. Finally, we evaluated skin symptoms in 12 patients with preexisting IAD for 21 days following the institutional switch to the optimized diaper design. Local skin care protocols remained in place unchanged. Results The improved design created a surface pH of 4.6 which was stable even after repeated wetting throughout a 5 hour period. The "standard design" briefs had values of 7.1, which is alkaline compared to the acidic surface of normal skin. Side panels made from non-woven material with an air-permeability of more than 1200 l/m2/s avoided excessive hydration of the stratum corneum when compared to the commonly employed air-impermeable plastic films. Resolution of pre-existing IAD skin lesions was noted in 8 out of 12 patients after the switch to the optimized brief design. Conclusions An improved design of adult-type briefs can create an acidic pH on the surface and breathable side panels avoid over-hydration of the stratum corneum and occlusion. This may support the

  20. Race and Ethnicity Do Not Contribute to Differences in Pre-operative Urinary Incontinence Severity or Symptom Bother In Women Undergoing Stress Incontinence Surgery

    PubMed Central

    Kraus, Stephen R.; Markland, Alayne; Chai, Toby C.; Stoddard, Anne; FitzGerald, Mary Pat; Leng, Wendy; Mallett, Veronica; Tennstedt, Sharon L.

    2007-01-01

    Aims To determine whether race/ethnicity affects urinary incontinence (UI) severity and bother, in women undergoing surgery for stress incontinence. Methods We used baseline data from participants in the Stress Incontinence Surgical Treatment Efficacy trial. UI severity was measured by the number of leakage episodes during a 3-day urinary diary and by urodynamic evaluation. UI bother was measured using the Urogenital Distress Inventory (UDI). Race/ethnicity classification was based on self report. Results Of the 654 women, 72(11%) were Hispanic, 480(73%) non-Hispanic White, 44 (6.7%) non-Hispanic Black and 58 (8.9%) ‘Other’. No differences were seen in any UI severity measures. Non-Hispanic Whites had lowest UDI scores on bivariate analysis, explained by socioeconomic status, BMI and age on multivariate analysis. Conclusion Factors other than racial/ethnic differences underlie variations in UI symptoms and bother in this group of women seeking surgery for stress incontinence. PMID:17618773

  1. Fecal microbiota in pouchitis and ulcerative colitis

    PubMed Central

    Li, Kai-Yu; Wang, Jian-Lin; Wei, Jiang-Peng; Gao, Sen-Yang; Zhang, Ying-Ying; Wang, Li-Tian; Liu, Gang

    2016-01-01

    AIM To investigate the changes in microbiota in feces of patients with ulcerative colitis (UC) and pouchitis using genomic technology. METHODS Fecal samples were obtained from UC patients with or without an ileal pouch-anal anastomosis (IPAA) procedure, as well as healthy controls. The touchdown polymerase chain reaction technique was used to amplify the whole V3 region of the 16S rRNA gene, which was transcribed from DNA extracted from fecal samples. Denaturing gradient gel electrophoresis was used to separate the amplicons. The band profiles and similarity indices were analyzed digitally. The predominant microbiota in different groups was confirmed by sequencing the 16S rRNA gene. RESULTS Microbial biodiversity in the healthy controls was significantly higher compared with the UC groups (P < 0.001) and IPAA groups (P < 0.001). Compared with healthy controls, the UC patients in remission and those in the mildly active stage, the predominant species in patients with moderately and severely active UC changed obviously. In addition, the proportion of the dominant microbiota, which was negatively correlated with the disease activity of UC (r = -6.591, P < 0.01), was decreased in pouchitis patients. The numbers of two types of bacteria, Faecalibacterium prausnitzii and Eubacterium rectale, were reduced in UC. Patients with pouchitis had an altered microbiota composition compared with UC patients. The microbiota from pouchitis patients was less diverse than that from severely active UC patients. Sequencing results showed that similar microbiota, such as Clostridium perfringens, were shared in both UC and pouchitis. CONCLUSION Less diverse fecal microbiota was present in patients with UC and pouchitis. Increased C. perfringens in feces suggest its role in the exacerbation of UC and pouchitis. PMID:27833384

  2. Evaluation of fecal contamination indicators (fecal coliforms, somatic phages, and helminth eggs) in ryegrass sward farming.

    PubMed

    Cárdenas, Martha; Moreno, Gerardo; Campos, Claudia

    2009-02-15

    The effect of soil supplementation with biosolids at various ratios on fecal-origin microorganism activity was evaluated in a ryegrass sward farm. Fifteen plots with 3 different soil and biosolid mixture ratios were assessed. Soil and grass were sampled over a period of 4 months (days 0, 30, 45, 60, 75, and 120) for soil and on days 75 and 120 for grass, corresponding to first and second grass harvest periods. We analyzed fecal coliforms, somatic phages, helminth eggs, and environmental factors, such as rainfall, temperature, and moisture. The fecal coliforms decreased by 2 logarithmic units (LU) in all soils containing biosolids and by 1 LU in the soil alone and in biosolid control plots alone. The concentration of somatic phages decreased to 2 to 3 LU in the soil containing biosolids and to 1 to 2 LU in the control plots. In contrast, however, there was a noticeable increase in helminth eggs on days 75 ad 120, but not in the soil control alone. Maximum concentrations (10(2) CFU/g TS; colony forming units per gram total solids) of fecal coliforms were found on the grass and in other samples, but the concentrations of phages and helminth eggs were below detection limits. Environmental factors did not significantly influence the results, and grass production increased from 35 to 50 Ton/Ha (tons per hectare) with biosolid supplementation, as compared with controls (14 Ton/Ha).

  3. Fecal biomarkers in inflammatory bowel disease.

    PubMed

    Lopez, Robert N; Leach, Steven T; Lemberg, Daniel A; Duvoisin, Gilles; Gearry, Richard B; Day, Andrew S

    2017-03-01

    Over the last two decades, knowledge on fecal biomarkers has substantially increased. Nowadays, these non-invasive markers of inflammation have significant clinical utility in the management of inflammatory bowel disease. Their use informs the decision to perform endoscopy before diagnosis is made right through to influencing therapeutic choices and the need for interval endoscopic assessment. In this review, the roles of two S100 proteins, calprotectin, and S100A12 are described along with that of lactoferrin, in the context of inflammatory bowel disease.

  4. The University of Michigan Incontinence Symptom Index (M-ISI): a Clinical Measure for Type, Severity, and Bother related to Urinary Incontinence

    PubMed Central

    Suskind, Anne M.; Dunn, Rodney L.; Morgan, Daniel M.; DeLancey, John O.L.; McGuire, Edward J.; Wei, John T.

    2013-01-01

    Aims To develop a clinically relevant, easy to use, and validated instrument for assessing severity and bother related to urinary incontinence. Methods Survey items were piloted and refined following psychometric principles in five separate patient cohorts. Patient and expert endorsement of items, factor analyses, Spearman rank correlations and response distributions were employed for item selection. Formal reliability and validity evaluation were conducted for the final questionnaire items. Results Expert physicians and patient focus groups confirmed face and content validity for the measure. A 10-item measure called the Michigan Incontinence Symptom Index (M-ISI) was developed with two domains: a Total M-ISI Domain consisting of subdomains for stress urinary incontinence, urgency urinary incontinence, and pad use, and a Bother Domain. High construct validity was demonstrated with a Cronbach’s alpha for the Total M-ISI Domain (items 1–8) of 0.90 and for the Bother Domain (items 9–10) of 0.82. Cronbach’s alpha for the subdomains were all > 0.85. Construct validity, convergent and divergent validity, internal discriminant validity, and predictive validity were all robust. The minimally important difference for the measure was determined to be 4 points (out of 32) for the Total M-ISI Severity Domain, and 1–2 points (out of 8–12) for the individual subdomains. Conclusions The M-ISI is a parsimonious measure that has established reliability and validity on several levels and complements current clinical evaluative methods for patients with urinary incontinence. PMID:23945994

  5. Determination of fecal contamination origin in reclaimed water open-air ponds using biochemical fingerprinting of enterococci and fecal coliforms.

    PubMed

    Casanovas-Massana, Arnau; Blanch, Anicet R

    2013-05-01

    Low levels of fecal indicator bacteria (FIB) were recently detected in two reclaimed water open-air ponds used to irrigate a golf course located in Northeastern Spain. The aim of this study was to evaluate the feasibility of a biochemical fingerprinting method to track the origin of fecal contamination in water with low FIB levels, as in the aforementioned ponds. We also aimed to determine whether FIB presence was due to regrowth of the reclaimed water populations or to a contribution of fecal matter whose source was in the golf facility. Three hundred and fifty enterococcal strains and 308 fecal coliform strains were isolated from the ponds and reclamation plant, and they were biochemically phenotyped. In addition, the inactivation of several microbial fecal pollution indicators (fecal coliforms, total bifidobacteria, sorbitol-fermenting bifidobacteria, somatic bacteriophages, and bacteriophages infecting Bacteroides thetaiotaomicron) was studied using a mesocosm in situ in order to obtain information about their decay rate. Although FIB concentration was low, the biochemical fingerprinting provided evidence that the origin of the fecal contamination in the ponds was not related to the reclaimed water. Biochemical fingerprinting thus proved to be a successful approach, since other microbial source-tracking methods perform poorly when dealing with low fecal load matrices. Furthermore, the mesocosm assays indicated that none of the microbial fecal indicators was able to regrow in the ponds. Finally, the study highlights the fact that reclaimed water may be recontaminated in open-air reservoirs, and therefore, its microbial quality should be monitored throughout its use.

  6. Treatment of stress urinary incontinence by ginsenoside Rh2.

    PubMed

    Chen, Yung-Hsiang; Lin, Yu-Ning; Chen, Wen-Chi; Hsieh, Wen-Tsong; Chen, Huey-Yi

    2014-01-01

    Stress urinary incontinence (SUI) is a common disorder in middle-aged women and the elderly. Although surgical treatment of SUI has progressed, there are no effective pharmacological therapies without a side effect. We studied the effect of ginsenoside Rh2 against SUI. Here, we studied the effect of ginsenoside Rh2 on the contractile force of the urethra and blood vessels in an ex vivo organ bath assay. We further investigated the mechanisms and effects of Rh2 in cell culture and animal models. Ginsenoside Rh2 dose-dependently reduced lipopolysaccharide (LPS)-induced nitric oxide (NO) production and inducible nitric oxide synthase (iNOS) expression in RAW 264.7 cells. In the vaginal distension (VD)-induced SUI mouse model, ginsenoside Rh2 significantly reversed the VD-induced SUI physical signs and reduced blood pressure. The modulation of several SUI-related proteins, including myosin, survival motor neuron (SMN) protein, α-adrenergic receptor 1a (AdR1a), and superoxide dismutase 3 (SOD3), may play some crucial roles in the therapeutic approaches against SUI. In conclusion, the ginsenoside Rh2 may offer therapeutic potential against SUI.

  7. 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.

  8. Urinary incontinence among patients with arthritis--a neglected disability.

    PubMed Central

    Turner-Stokes, L; Frank, A O

    1992-01-01

    Urinary tract pathology may be no more common in patients with arthritis than among the general population, but its impact may be enhanced by disability. In this survey of 247 patients, as many as 38% of patients with rheumatoid arthritis (RA), 47% of patients with osteoarthritis (OA) and even 34% of patients with soft tissue rheumatism (STR) reported difficulty controlling their urine, confirming that incontinence is a widespread and often under-reported problem. More detailed enquiry in a sample of 90 patients with OA or RA did not suggest specific urinary tract pathology related to the underlying arthritis. Those who reported problems with urinary control were more disabled, and took longer to get to the toilet in their own environment than those without control problems. Twenty-seven per cent of patients felt that their problems would be solved by provision of a downstairs toilet. Timing of tasks performed by patients within their home is suggested as a method for assessing functional ability which encompasses both patient disability and environmental factors. PMID:1629846

  9. A study of transobturator tape in stress urinary incontinence

    PubMed Central

    Mayekar, Rahul Vishwanath; Bhosale, Archana Anilkumar; Kandhari, Khushboo Vikram; Nandanwar, Yogeshwar Sadashiv; Shaikh, Sadaf Sadique

    2017-01-01

    Background: Stress urinary incontinence (SUI) is commonly encountered in gynecological practice. Nowadays, midurethral sling surgeries in the form of transobturator tape (TOT) surgery are recommended in its treatment. Aims and Objectives: To assess the outcome and patient satisfaction of TOT surgery in the treatment of SUI. Materials and Methods: A prospective study was undertaken for patients of SUI who underwent TOT surgery by the outside in method and followed up for 5 years. The patients were assessed clinically and by the Patient Global Impression of Improvement (PGI-I) preoperatively and at postoperative day 3, discharge and 3 months follow-up. Results: Successful surgical treatment with TOT was seen in all patients at the time of discharge. There was no recurrence of SUI seen up to 1 year, but at 5-year follow-up two patients had a recurrence of SUI on examination though they did not complain of SUI. Urinary retention, tape extrusion, and groin stitch infection were the commonly seen complications following surgery. On subjective assessment, 61 patients were completely satisfied at day 3, and all patients were completely satisfied at discharge and 3 months follow-up as per the PGI-I score. Conclusion: TOT gives an excellent outcome in the treatment of SUI. PMID:28216921

  10. 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.

  11. 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

  12. An evaluation of two incontinence skin care protocols in a long-term care setting.

    PubMed

    Lewis-Byers, Kari; Thayer, Debra

    2002-12-01

    Caring for the skin of patients with incontinence is an essential activity in long-term care. A prospective descriptive study to compare the effect of two skin care protocols on skin condition, pain, and caregiver time was conducted. Thirty-two (32) skilled nursing facility residents with incontinence participated in the 3-week study. Patients were randomly assigned to a standard care regimen (soap and water cleansing after each incontinence episode, followed by application of a moisturizing lotion) or study care protocol (no-rinse skin cleanser after each episode and application of a barrier cream with durable properties after the first incontinence episode of each shift). Number and type of incontinence episodes, skin condition, pain, and caregiver time spent were assessed. Skin integrity was maintained in the majority of control (69%) and study group (72%) patients and improvement occurred in 8% of control and 17% of the study group (NS). Study protocol procedures took less time to complete than control procedures (a savings of 79 minutes/patient/day). A positive correlation between pain intensity and level of skin impairment was observed (r = 0.88). The results of this study suggest that at this facility, use of soap, water, and a moisturizer may be less effective and more time-consuming than using a no-rinse cleanser and a durable barrier product.

  13. Association between urinary incontinence and depressive symptoms in overweight and obese women

    PubMed Central

    SUNG, Vivian W.; WEST, Delia S.; HERNANDEZ, Alexandra L.; WHEELER, Thomas L.; MYERS, Deborah L.; SUBAK, Leslee L.

    2009-01-01

    OBJECTIVE Determine the association between urinary incontinence (UI) and depressive symptoms. STUDY DESIGN Cross-sectional study of 338 incontinent and overweight women at baseline in the Program to Reduce Incontinence by Diet and Exercise trial. Depressive symptoms were defined as a Beck Depression Inventory score ≥ 10. UI frequency was determined by 7-day voiding diary. Symptom bother and quality of life were determined using the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Multivariable regression was used to estimate the association between UI and depressive symptoms. RESULTS Women with depressive symptoms (N=101) reported a higher mean number of UI episodes per week (28 vs. 23, P=.005) and higher (worse) mean scores on the UDI (176 vs. 162, P=.02) and IIQ (136 vs. 97, P<.001) compared to women without depressive symptoms. The risk of having depressive symptoms increased with each 7-episode increase in UI per week (AOR 1.10, 95% CI 1.01–1.21), each 50-point increase in UDI (AOR 1.27, 95% CI 1.01–1.60) and each 50-point increase in IIQ (AOR 1.44, 95% CI 1.22–1.71). CONCLUSIONS Urinary incontinence frequency, symptom bother, and quality of life are independently associated with depressive symptoms in overweight and obese women. PMID:19236869

  14. [Towards early functional treatment of urinary incontinence after prostatectomy (author's transl)].

    PubMed

    Moulonguet, A; Verges, J; Delmas, V

    1981-01-01

    The authors report their striking experience of the effectiveness of early functional treatment of urinary incontinence after prostatectomy. This experience is based upon 50 cases collected over a period of 10 years. Treatment is based upon stimulation of the perineal musculature by faradic current, ano-perineal exercises, and mictional rehabilitation. Results, in 50 cases, showed a marked improvement in 43 (86%), including 15 complete cures (30%). Such a favourable result was obtained with six weeks' treatment. It would appear that the result is all the better when treatment is started earlier, whether in a case of arrhythmic incontinence dominated by urgency, or isolated nocturnal incontinence. The results, once acquired, generally persist. A relapse of incontinence often responds adequately to a new series of sessions of functional treatment. It would appear that the mode of action of this functional therapy is based upon a decrease in bladder instability, and an increase in urethra resistance. The authors show that, with their treatment, improvements and cures in urinary incontinence after prostatectomy occur much earlier with the aid of functional treatment than spontaneously. Thus, treatment is worthwhile undertaking.

  15. Detection of intracellular bacteria in exfoliated urothelial cells from women with urge incontinence.

    PubMed

    Cheng, Ying; Chen, Zhuoran; Gawthorne, Jayde A; Mukerjee, Chinmoy; Varettas, Kerry; Mansfield, Kylie J; Schembri, Mark A; Moore, Kate H

    2016-10-01

    The role of subclinical infection in patients with urge incontinence has been largely ignored. The aim of this study was to test for the presence of intracellular bacteria in exfoliated urothelial cells obtained from the urine of patients with detrusor overactivity or mixed incontinence +/- a history of UTI, and compare this to a control group of patients with stress incontinence and no history of infection. Bacterial cystitis was assessed by routine microbiology and compared to microscopic analysis of urine by Wright staining. Subsequent analysis of urothelial cells by confocal microscopy was performed to determine the existence of intracellular bacteria. Bacterial cystitis was seen in 13% of patients based on routine microbiology. Wright staining of concentrated urothelial cells demonstrated the presence of bacteria in 72% of samples. Filamentous bacterial cells were observed in 51% of patients and were significantly more common in patients with detrusor overactivity. Intracellular Escherichia coli were observed by confocal microscopy. This study supports the possibility that a subset of patients with urge incontinence may have unrecognised chronic bacterial colonisation, maintained via an intracellular reservoir. In patients with negative routine microbiology, application of the techniques used in this study revealed evidence of infection, providing further insights into the aetiology of urge incontinence.

  16. Urinary incontinence in women treated by ischemic compression over the bladder area: a pilot study

    PubMed Central

    Hains, Guy; Hains, François; Descarreaux, Martin; Bussières, André

    2007-01-01

    Abstract Objective The purpose of this study was to determine if ischemic compression therapy over the bladder area results in clinically important changes among female patients with stress and mixed (stress and urge) incontinence. Methods One group of patients (n = 24) received ischemic compression therapy directed over the bladder area (experimental group). The control group (n = 9) received ischemic compression therapy directed toward structures of the hip joint. Changes in urinary incontinence symptoms were monitored using a 2-part questionnaire: the urogenital distress inventory and the incontinence impact questionnaire. Patients' perceived amelioration (improvement) was quantified using a scale divided from 0% to 100%. Results Mean scores for the first questionnaire (urogenital distress inventory + incontinence impact questionnaire, 19 questions) were 23.3 vs 25.3 at baseline and 10.2 vs 22.2 after 15 treatments for the experimental and control group, respectively. The experimental group scores were 6.9 at 30 days after the last treatment and 11.3 at the 6-month follow-up. The perceived percentages of amelioration after 15 treatments were 69% vs 32% for the experimental and control group, respectively. The experimental group scores were 73% at 30 days after the last treatment and 60% at the 6-month follow-up. Conclusions In this study, ischemic compression directed toward elicited trigger points over bladder area was found to be an effective treatment of patients presenting symptoms of urinary incontinence. Improvement in symptoms was still present in follow-up at 6 months. PMID:19674707

  17. Factors Influencing Fecal Contamination in Pond of Bangladesh

    NASA Astrophysics Data System (ADS)

    Knappett, P. S.; Escamilla, V.; Layton, A.; McKay, L. D.; Emch, M.; Mailloux, B. J.; Williams, D. E.; Huq, M. R.; Alam, M.; Farhana, L.; Ferguson, A. S.; Sayler, G. S.; Ahmed, K.; Serre, M. L.; Akita, Y.; Yunus, M.; van Geen, A.

    2010-12-01

    Occurrence of diarrheal disease in villages in rural Bangladesh remains relatively common, even though many households have switched to tubewell water for drinking and cooking. One factor contributing to this may be exposure to fecal contamination in ponds, which are often used for bathing and fishing. The objective of this study is to determine the dominant sources of fecal pollution in typical ponds and to explore the relationship between local population, latrine density, latrine quality and concentrations of fecal bacteria and pathogens in pond water. Forty-three ponds were sampled and analyzed for E. coli using culture-based methods and for E. coli, Bacteroides and adenovirus using quantitative PCR. Population and sanitation infrastructure were surveyed and compared to levels of pond fecal contamination. Molecular fecal source tracking using Bacteroides, determined that humans were the dominant source of fecal contamination in 79% of the ponds. Ponds directly receiving latrine effluent had the highest concentrations of fecal indicator bacteria. Concentrations of fecal indicator bacteria correlated with population surveyed within a distance of 30-70 m (p<0.01) and total latrines surveyed within 50-70 m (p<0.05). Unsanitary latrines with visible effluent within the pond drainage basin were also significantly correlated to fecal indicator concentrations (p<0.05). The vast majority of the surveyed ponds contained unsafe levels of fecal contamination primarily due to unsanitary latrines, and to lesser extent to sanitary latrines and cattle. Since the majority of fecal pollution is from humans, use of pond water could help explain the persistence of diarrheal disease in rural Bangladesh.

  18. Characterizing relationships among fecal indicator bacteria ...

    EPA Pesticide Factsheets

    Bed sediments of streams and rivers may store high concentrations of fecal indicator bacteria (FIB) and pathogens. Due to resuspension events, these contaminants can be mobilized into the water column and affect overall water quality. Other bacterial indicators such as microbial source tracking (MST) markers, developed to determine potential sources of fecal contamination, can also be resuspended from bed sediments. The primary objective of this study was to predict occurrence of waterborne pathogens in water and streambed sediments using a simple statistical model that includes traditionally measured FIB, environmental parameters and source allocation, using MST markers as predictor variables. Synoptic sampling events were conducted during baseflow conditions downstream from agricultural (AG), forested (FORS), and wastewater pollution control plant (WPCP) land uses. Concentrations of FIB and MST markers were measured in water and sediments, along with occurrences of the enteric pathogens Campylobacter, Listeria and Salmonella, and the virulence gene that carries Shiga toxin, stx2. Pathogens were detected in water more often than in underlying sediments. Shiga toxin was significantly related to land use, with concentrations of the ruminant marker selected as an independent variable that could correctly classify 76% and 64% of observed Shiga toxin occurrences in water and sediment, respectively. FIB concentrations and water quality parameters were also selected a

  19. Separation of strontium from fecal matter

    SciTech Connect

    Kester, D.K.

    1994-12-31

    The present invention relates to a method of separating strontium, and, more particularly, to a method of separating strontium from a sample of biomass potentially contaminated with various radionuclides. Radioactive strontium is a radionuclide which represents a hazard to man because of its long half-life and, if ingested, its tendency to be retained in the human body. In the event that radionuclides such as strontium or various actinides are ingested, it is desirable to monitor the discharge or release of these radionuclides from the human body through analysis of fecal matter. In laboratories and other facilities where potential for radionuclide contamination exists, fecal analysis for strontium is routinely conducted for individuals who are terminating from their position or are suspected of having been contaminated with radionuclides. Methods for separating and analyzing radioactive actinides from a biomass sample are well known and have been extensively developed for the US Department of Energy. These methods, described in the Department`s internal procedure, USDOE, RESL/ID, A-16, 1981, as well as in US Patent 5,190,881, involve the use of an iron phosphate precipitation step to separate actinides from a solution, or supernate. However, there are no established procedures for the separation of strontium from a biomass sample wherein an iron phosphate precipitation step is involved.

  20. Knowledge and Attitudes of Nursing Home Staff and Surveyors about the Revised Federal Guidance for Incontinence Care

    ERIC Educational Resources Information Center

    DuBeau, Catherine E.; Ouslander, Joseph G.; Palmer, Mary H.

    2007-01-01

    Purpose: We assessed nursing home staff and state nursing home surveyors regarding their knowledge and attitudes about urinary incontinence, its management, and the revised federal Tag F315 guidance for urinary incontinence. Design and Methods: We conducted a questionnaire survey of a convenience sample of nursing home staff and state nursing home…

  1. IDENTIFICATION OF SOURCES OF FECAL POLLUTION IN ENVIRONMENTAL WATERS

    EPA Science Inventory

    A number of Microbial Source Tracking (MST) methods are currently used to determine the origin of fecal pollution impacting environmental waters. MST is based on the assumption that given the appropriate method and indicator organism, the source of fecal microbial pollution can ...

  2. Global Inter-Laboratory Fecal Source Identification Methods Comparison Study

    EPA Science Inventory

    Source tracking is key to identifying sources of fecal contamination for remediation as well as risk assessment. Previous intra- and inter-lab studies have investigated the performance of human and cow-associated source tracking markers, as well as library-dependent fecal source ...

  3. CULTURE-INDEPENDENT MOLECULAR METHODS FOR FECAL SOURCE IDENTIFICATION

    EPA Science Inventory

    Fecal contamination is widespread in the waterways of the United States. Both to correct the problem, and to estimate public health risk, it is necessary to identify the source of the contamination. Several culture-independent molecular methods for fecal source identification hav...

  4. Distinguishing bovine fecal matter on spinach leaves using field spectroscopy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Detection of fecal contaminants on leafy greens in the field will allow for decreasing cross-contamination of produce during and post-harvest. Fecal contamination of leafy greens has been associated with E.coli O157:H7 outbreaks and foodbourne illnesses. In this study passive field spectroscopy, mea...

  5. Escherichia coli and fecal coliforms in freshwater and estuarine sediments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    It has been known for some time that substantial populations of fecal coliforms and E. coli are harbored in freshwater bottom sediments, bank soils, and beach sands. However, the relative importance of sediments as bacterial habitats and as a source of water-borne fecal coliforms and E. coli has not...

  6. Gracilis muscle transposition as a workhorse flap for anal incontinence: Quality of life and functional outcome in adults

    PubMed Central

    Kalra, Guru Dayal Singh; Sharma, Amit Kumar; Shende, Kaustubh Sharad

    2016-01-01

    Background/Purpose: Anal incontinence is one of the most psychologically and socially debilitating conditions in an otherwise healthy individual. It can lead to social isolation, loss of self-esteem, self-confidence and depression. This study is devoted to the problem of anal incontinence in the adult patients. The aim of our study is to analyse the results of gracilis muscle transposition for anal incontinence and improvement in quality of life (QOL) of patients. Materials and Methods: This was a retrospective study. A total of 18 patients with complaint of anal incontinence were enrolled in this study. All patients were treated with gracilis muscle transposition. Results: All patients are continent, and there is an improvement in their QOL. Conclusion: Gracilis muscle transposition is a good option for patients of anal incontinence who are not treated by non-surgical means. PMID:28216815

  7. Management of female urinary incontinence: A survey of urogynaecologists' view on the NICE guideline.

    PubMed

    Balachandran, A; Monga, A; Duckett, J

    2016-05-01

    We conducted a survey to obtain the opinions of urogynaecologists regarding the National Institute for Health and Care Excellence or NICE 2013 urinary incontinence guideline and whether it would change their current practice. A closed format questionnaire was sent electronically to all members of the British Society of Urogynaecology or BSUG between January and March 2014. There were three major areas of disagreement. First, 70.2% of respondents disagreed that a multidisciplinary team review was necessary before invasive treatment for urinary incontinence. Second, 53.8% of respondents disagreed that preoperative urodynamic studies were not required in stress urinary incontinence diagnosed clinically. Third, 58.6% of respondents disagreed that oxybutynin, tolterodine and darifenacin should be used as first-line drug therapy for overactive bladder. The questionnaire demonstrates that there are significant concerns leading to more than a third of respondents not altering their current practice in line with the entire guideline.

  8. Etiopathogenesis, diagnostics and history of surgical treatment of stress urinary incontinence.

    PubMed

    Jovan, Hadži-Djokić; Uroš, Babić; Aleksandar, Argirović; Miodrag, Aćimović; Milan, Radovanović; Bogomir, Milojević; Tomisla, Pejčić; Zoran, Džamić

    2014-01-01

    Urinary incontinence represents involuntary urine leakage into the urethra. This pathological condition represents a major medical, social and hygienic problem. The paper presents risk factors for development of the disorder, as well as diagnostic methods applied in evaluation of the female patients. Chronological review of diverse surgical techniques used in treatment of stress urinary incontinence reported in the published scientific papers is also presented. Review of the literature data was also performed. Sling procedures with application of suburethral loops have been used since the beginning of the last century in treatment of this disorder. Surgical treatment of stress urinary incontinence is applied when conservative treatment fails to give any effects according to strictly defined indications. During the last 100 years, surgical techniques have undergone different improvements and the results have also been significantly improved.

  9. Outcomes of Sacral Nerve Stimulation For Faecal Incontinence in Northern Ireland

    PubMed Central

    Irwin, GW; Dasari, BV; Irwin, R; Johnston, D

    2017-01-01

    Background Sacral nerve root stimulation (SNS) is an effective and developing therapy for faecal incontinence, a debilitating condition that can result in social and personal incapacitation. Objectives The objectives of this study are to assess the morbidity of the procedure, improvement in the incontinence scores and Quality of Life (QoL) following SNS. Materials and methods Patients were identified from the Northern Ireland regional SNS service from 2006 to 2012. Numbers of patients who had temporary placement and permanent placement were collated. Pre and postoperative assessment of severity of incontinence and QoL was performed using Cleveland Clinic Incontinence Score (CCIS) and Short Form-36 (SF-36) respectively. Statistical analysis was undertaken using Wilcoxon signed rank test. Morbidity was assessed by retrospective review of patient records. Results Seventy-five patients were considered for trial of a temporary SNS. Sixty-one proceeded to insertion of a temporary SNS and, of these, 40 elected to have a permanent SNS. There was a significant reduction in the pre-SNS and post-SNS Cleveland Clinic Incontinence Scores from median of 14 to 9 respectively (p=0.008). There was a significant improvement in Role Physical (p=0.017), General Health (p=0.02), Vitality (p=0.043), Social Functioning (p=0.004), Role Emotional (p=0.007), Mental Health (p=0.013) and Mental Health Summary (p=0.003). However, this is not reflected in the bodily pain and physical functional domains. Conclusion Permanent sacral nerve stimulation is effective and results in significant improvement of faecal incontinence scores and quality of life. PMID:28298708

  10. Urinary incontinence and risk of functional decline in older women: data from the Norwegian HUNT-study

    PubMed Central

    2013-01-01

    Background The main objective of the present study was to determine whether UI is an independent predictor of ADL decline and IADL decline in elderly women. We also aimed to find out whether incontinent subjects were at higher risk of needing help from formal home care or home nursing care during 11 year follow-up. Methods A prospective cohort study conducted as part of the North-Trøndelag Health Study 2 and 3. Women aged 70–80 years when participating in the HUNT 2 study, who also participated in the HUNT 3 study, were included in this study. Analyses on self-reported urinary incontinence at baseline and functional decline during a11-year period were performed for incontinent and continent subjects. Results Baseline prevalence of urinary incontinence was 24%. At on average eleven year follow up, logistic regression analysis showed a significant association between incontinence and decline in activities of daily living (ADL) (OR =2.37, 95% CI =1.01-5.58) (P=0.04). No association between urinary incontinence and instrumental activities of daily living (IADL) in incontinent women compared with continent women was found (OR=1.18, CI=.75-1.86) (P=.46). Data were adjusted for ADL, IADL and co morbid conditions at baseline. No significant differences in need of more help from formal home care and home nursing care between continent and incontinent women were found after 11 years of follow-up. Conclusions Urinary incontinence is an important factor associated with functional decline in women aged 70–80 years living in their own homes. At eleven years of follow up, no significant differences in need of more help from formal home care and home nursing care between continent and incontinent women were found. PMID:23678851

  11. Fecal pollution source tracking toolbox for identification, evaluation and characterization of fecal contamination in receiving urban surface waters and groundwater.

    PubMed

    Tran, Ngoc Han; Gin, Karina Yew-Hoong; Ngo, Huu Hao

    2015-12-15

    The quality of surface waters/groundwater of a geographical region can be affected by anthropogenic activities, land use patterns and fecal pollution sources from humans and animals. Therefore, the development of an efficient fecal pollution source tracking toolbox for identifying the origin of the fecal pollution sources in surface waters/groundwater is especially helpful for improving management efforts and remediation actions of water resources in a more cost-effective and efficient manner. This review summarizes the updated knowledge on the use of fecal pollution source tracking markers for detecting, evaluating and characterizing fecal pollution sources in receiving surface waters and groundwater. The suitability of using chemical markers (i.e. fecal sterols, fluorescent whitening agents, pharmaceuticals and personal care products, and artificial sweeteners) and/or microbial markers (e.g. F+RNA coliphages, enteric viruses, and host-specific anaerobic bacterial 16S rDNA genetic markers) for tracking fecal pollution sources in receiving water bodies is discussed. In addition, this review also provides a comprehensive approach, which is based on the detection ratios (DR), detection frequencies (DF), and fate of potential microbial and chemical markers. DR and DF are considered as the key criteria for selecting appropriate markers for identifying and evaluating the impacts of fecal contamination in surface waters/groundwater.

  12. Factorial validity and internal consistency of the PRAFAB questionnaire in women with stress urinary incontinence

    PubMed Central

    Hendriks, Erik JM; Bernards, Arnold TM; Staal, J Bart; de Vet, Henrica CW; de Bie, Rob A

    2008-01-01

    Background To investigate the factor structure, dimensionality and construct validity of the (5-item) PRAFAB questionnaire score in women with stress urinary incontinence (stress UI). Methods A cross validation study design was used in a cohort of 279 patients who were randomly divided into Sample A or B. Sample A was used for preliminary exploratory factor analyses with promax rotation. Sample B provided an independent sample for confirming the premeditated and proposed factor structure and item retention. Internal consistency, item-total and subscale correlations were determined to assess the dimensionality. Construct validity was assessed by comparing factor-based scale means by clinical characteristics based on known relationships. Results Factor analyses resulted in a two-factor structure or subscales: items related to 'leakage severity' (protection, amount and frequency) and items related to its 'perceived symptom impact' or consequences of stress UI on the patient's life (adjustment and body (or self) image). The patterns of the factor loadings were fairly identical for both study samples. The two constructed subscales demonstrated adequate internal consistency with Cronbach's alphas in a range of 0.78 and 0.84 respectively. Scale scores differed by clinical characteristics according to the expectations and supported the construct validity of the scales. Conclusion The findings suggest a two-factorial structure of the PRAFAB questionnaire. Furthermore the results confirmed the internal consistency and construct validity as demonstrated in our previous study. The best description of the factorial structure of the PRAFAB questionnaire was given by a two-factor solution, measuring the stress UI leakage severity items and the perceived symptom impact items. Future research will be necessary to replicate these findings in different settings, type of UI and non-white women and men. PMID:18218110

  13. Urinary incontinence: economic burden and new choices in pharmaceutical treatment.

    PubMed

    Levy, Richard; Muller, Nancy

    2006-01-01

    In the year 2000, an estimated 17 million community-dwelling adults in the United States had daily urinary incontinence (UI), and an additional 33 million suffered from the overlapping condition, overactive bladder. Estimates of the total annual cost of these conditions range up to 32 billion US dollar; the largest components are management costs and the expenses associated with nursing home admissions attributable to UI. In most cases, patients with UI can be treated with pharmaceutical agents, in addition to behavioral therapy. Until recently, pharmaceutical therapy for UI has been limited, especially because the adverse effects of available agents resulted in poor adherence to treatment regimens. Recent innovations in molecular design and new dosage forms of UI medications offer the promise of fewer and less severe adverse effects and, thus, better treatment outcomes for patients. Additionally, the availability of multiple agents within a therapeutic class offers health care providers a spectrum of choices with which to personalize treatment for each individual patient. New pharmacologic treatment options for UI have the potential to allow greater independence for older persons who reside at home and to delay or avoid the costs of admission to long-term care facilities. Alternate dosage forms, which include patches and sustained-release formulations, may benefit patients who have difficulty chewing, swallowing, or remembering to take medications. Although these newer products are generally more expensive than older forms of therapy, they typically have more favorable cost-effectiveness ratios. Access to these new medications for patients enrolled in public and private health care plans may help to reduce the economic and social burden of UI care.

  14. Macular posterior pigmentary incontinence: its relation to macular amyloidosis and notalgia paresthetica.

    PubMed

    Westermark, P; Ridderström, E; Vahlquist, A

    1996-07-01

    Patients with clinical features of dorsal macular amyloidosis but without subepidermal amyloid deposits were followed for 2-11 years. The clinical appearance was fairly stable during this period of time, with little tendency of healing. Only 2 of the patients developed typical macular amyloidosis during the follow-up. It is concluded that a condition strongly resembling macular amyloidosis but without amyloid is an entity, and the designation "macular posterior pigmentary incontinence" is proposed. The relationship between macular posterior pigmentary incontinence and the two conditions macular amyloidosis and notalgia paresthetica is discussed.

  15. Gastrointestinal transit and prolonged ambulatory colonic motility in health and faecal incontinence

    PubMed Central

    Herbst, F; Kamm, M; Morris, G; Britton, K; Woloszko, J; Nicholls, R

    1997-01-01

    Background—Colonic motor function has not been studied in the ambulatory setting over a prolonged period in the unprepared state. Furthermore, the disturbance of this function in patients with faecal incontinence is unknown. 
Aim—To study colonic function over two to three days in the ambulatory, unprepared state in health and in patients with idiopathic faecal incontinence. 
Methods—Six healthy women and six women with faecal incontinence and a structurally intact anal sphincter ingested a dual radioisotope meal, and had a six sensor, solid state manometric probe colonoscopically inserted into the left colon. Scanning was performed until radioisotope left the gut and pressure was recorded for a median of 44hours. 
Results—Three of six patients showed abnormal gastric emptying. Patients showed no disturbance of colonic radioisotope transit. Controls had a median of 12, whereas patients had a median of 16, high amplitude propagated waves per 24 hours. In three patients urge incontinence was associated with high amplitude (up to 500 cm water) propagated waves which often reached the rectum. These high pressure waves were identical to those occuring in healthy subjects, the only difference being the lack of adequate sphincter response. Passive incontinence was not associated with colonic motor activity. Defaecation in all subjects was associated with identical propagated waves, and distal movement of 13% (median) of right colonic content and excretion of 32% from the left colon and rectum. The urge to defaecate was associated with either propagated waves (45%) or non-propagated contractions (55%). Rectal motor complexes were recorded in both groups of subjects, but similar rhythmic activity was also recorded in the sigmoid and descending colon. 
Conclusions—Normal colonic function consists of frequent high pressure propagated waves. Rhythmic activity occurs both proximal to and in the rectum. Defaecation is characterised by high pressure propagated

  16. 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

  17. The Role of Geriatricians and Family Practitioners in the Treatment of Overactive Bladder and Incontinence

    PubMed Central

    Voytas, John

    2002-01-01

    Although the prevalence of overactive bladder (OAB) and that of its symptoms (urinary urge incontinence, urgency, and frequency) increase with age, these conditions are not necessarily normal consequences of aging. Patients who present with urinary symptoms should be evaluated and treated, whether they are living on their own or in a residential, assisted-care, or long-term-care environment. Effective treatment for OAB and urinary incontinence (UI) is available and improves quality of life for the elderly. The primary care physician and geriatrician can accomplish a basic evaluation for UI using a systematic approach, as detailed in the following pages. PMID:16986021

  18. Management of tissue excoriation in older patients with urinary or faecal incontinence.

    PubMed

    Copson, Dale

    This article discusses good skin care in relation to the management of incontinence. It outlines the structure and functions of the skin and describes how the skin changes as we age. It examines how incontinence can damage the skin and provides an overview of the current management methods that are used to prevent tissue excoriation. It also suggests an effective alternative that could be used if previous strategies have failed and the skin begins to breakdown, that is, the use of a silver regimen.

  19. Prevalence of urinary incontinence among community-dwelling adults receiving home care.

    PubMed

    Du Moulin, M F M T; Hamers, J P H; Ambergen, A W; Janssen, M A P; Halfens, R J G

    2008-12-01

    We conducted a cross-sectional survey in 2005 to determine the prevalence of and factors associated with urinary incontinence (UI) in adults receiving home care. Of the 2,866 patients surveyed, 46% suffered from UI; 6.5% had stress, 16.6% had urge, 9% had mixed, and 17.6% had functional incontinence. No diagnosis regarding type of UI had been established in 50.2%. Factors associated with UI were advanced age, higher body mass index, and impaired mobility. UI is prevalent in older persons receiving home care, but the lack of diagnosis of type of UI in half of the participants surveyed impedes management of UI.

  20. Fecal Microbial Transplant Effect on Clinical Outcomes and Fecal Microbiome in Active Crohn’s disease

    PubMed Central

    Suskind, David L.; Brittnacher, Mitchell J.; Wahbeh, Ghassan; Shaffer, Michele L.; Hayden, Hillary S.; Qin, Xuan; Singh, Namita; Damman, Christopher J.; Hager, Kyle R.; Nielson, Heather; Miller, Samuel I.

    2014-01-01

    Objective Crohn’s disease (CD) is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Fecal Microbial Transplant (FMT) is a potential therapeutic option for individuals with CD based on the hypothesis that changing the fecal dysbiosis could promote less intestinal inflammation. Design Nine patients, ages 12–19 years, with mild to moderate symptoms defined by Pediatric Crohn’s disease activity index (PCDAI of 10–29) were enrolled into a prospective open label study of FMT in CD (FDA IND 14942). Patients received FMT by nasogastric tube with follow up evaluations at 2, 6, and 12 weeks. PCDAI, C-reactive protein (CRP), and fecal calprotectin were evaluated at each study visit. Results All reported adverse events (AE) were graded as mild except for one individual who reported moderate abdominal pain after FMT. All AE were self limiting. Metagenomic evaluation of stool microbiome indicated evidence of FMT engraftment in seven out of nine patients. The mean PCDAI score improved with patients having a baseline of 19.7 ± 7.2, with improvement at 2 weeks to 6.4 ± 6.6, and at 6 weeks to 8.6 ± 4.9. Based upon PCDAI, 7/9 patients were in remission at 2 weeks, and 5/9 patients who did not receive additional medical therapy were in remission at week 6 and 12 weeks. No or modest improvement were seen in the patients who did not engraft or whose microbiome was most similar to their donor. Conclusion This is the first study to demonstrate that FMT for CD may be a possible therapeutic option for Crohn’s disease. Further prospective studies are required to fully assess the safety and efficacy of the FMT in patients with Crohn’s disease. PMID:25647155

  1. Mortality of fecal bacteria in seawater

    SciTech Connect

    Garcia-Lara, J.; Menon, P.; Servais, P.; Billen, G. )

    1991-03-01

    The authors propose a method for determining the mortality rate for allochthonous bacteria released in aquatic environments without interference due to the loss of culturability in specific culture media. This method consists of following the disappearance of radioactivity from the trichloracetic acid-insoluble fraction in water samples to which ({sup 3}H)thymidine-prelabeled allochthonous bacteria have been added. In coastal seawater, they found that the actual rate of disappearance of fecal bacteria was 1 order of magnitude lower than the rate of loss of culturability on specific media. Minor adaptation of the procedure may facilitate assessment of the effect of protozoan grazing and bacteriophage lysis on the overall bacterial mortality rate.

  2. Further studies on fecal parasites in antiquity.

    PubMed

    Allison, M J; Bergman, T; Gerszten, E

    1999-11-01

    This is a continuation study of the survival of antigenic material over the centuries using mummified human remains from the Andean area of South America. The fluorescent antibody kit from Meridian Diagnostics (Cincinnati, OH) was used to identify some Cryptosporidium species and Giardia species found in feces from the intestines of mummies 500 to 3,000 years old. The specimens that were positive by direct visualization using fluorescent antibody were then tested with an enzyme-linked immunosorbent assay reaction using a Meridian kit just released on the market. Since all of the feces used were formed, it would seem that the organisms found were from carriers rather than active cases of disease. Similar fecal specimens were shown to harbor antigens from Helicobacter pylori almost 3,000 years old.

  3. Determining Sources of Fecal Pollution in a Rural Virginia Watershed with Antibiotic Resistance Patterns in Fecal Streptococci

    PubMed Central

    Hagedorn, Charles; Robinson, Sandra L.; Filtz, Jennifer R.; Grubbs, Sarah M.; Angier, Theresa A.; Reneau, Raymond B.

    1999-01-01

    Nonpoint sources of pollution that contribute fecal bacteria to surface waters have proven difficult to identify. Knowledge of pollution sources could aid in restoration of the water quality, reduce the amounts of nutrients leaving watersheds, and reduce the danger of infectious disease resulting from exposure to contaminated waters. Patterns of antibiotic resistance in fecal streptococci were analyzed by discriminant and cluster analysis and used to identify sources of fecal pollution in a rural Virginia watershed. A database consisting of patterns from 7,058 fecal streptococcus isolates was first established from known human, livestock, and wildlife sources in Montgomery County, Va. Correct fecal streptococcus source identification averaged 87% for the entire database and ranged from 84% for deer isolates to 93% for human isolates. To field test the method and the database, a watershed improvement project (Page Brook) in Clarke County, Va., was initiated in 1996. Comparison of 892 known-source isolates from that watershed against the database resulted in an average correct classification rate of 88%. Combining all animal isolates increased correct classification rates to ≥95% for separations between animal and human sources. Stream samples from three collection sites were highly contaminated, and fecal streptococci from these sites were classified as being predominantly from cattle (>78% of isolates), with small proportions from waterfowl, deer, and unidentified sources (≈7% each). Based on these results, cattle access to the stream was restricted by installation of fencing and in-pasture watering stations. Fecal coliforms were reduced at the three sites by an average of 94%, from prefencing average populations of 15,900 per 100 ml to postfencing average populations of 960 per 100 ml. After fencing, <45% of fecal streptococcus isolates were classified as being from cattle. These results demonstrate that antibiotic resistance profiles in fecal streptococci can

  4. Fecal immunochemical test as a biomarker for inflammatory bowel diseases: can it rival fecal calprotectin?

    PubMed Central

    Hiraoka, Sakiko; Nakarai, Asuka; Takashima, Shiho; Inokuchi, Toshihiro; Ichinose, Masao

    2016-01-01

    Accurate evaluation of disease activity is essential for choosing an appropriate treatment and follow-up plan for patients with inflammatory bowel disease (IBD). Endoscopy is required for accurately evaluating disease activity, but the procedures are sometimes invasive and burdensome to patients. Therefore, alternative non-invasive methods for evaluating or predicting disease activity including mucosal status are desirable. Fecal calprotectin (Fcal) is the most widely used fecal marker for IBD, and many articles have described the performance of the marker in predicting disease activity, mucosal healing (MH), treatment efficacy, and risk of relapse. Fecal immunochemical test (FIT) can quantify the concentration of hemoglobin in stool and was originally used for the screening of colorectal cancer. We recently reported that FIT is also a useful biomarker for IBD. A direct comparison between the use of Fcal and FIT showed that both methods predicted MH in ulcerative colitis equally well. However, in the case of Crohn's disease, FIT was less sensitive to lesions in the small intestine, compared to Fcal. FIT holds several advantages over Fcal in regards to user-friendliness, including a lower cost, easy and clean handling, and the ability to make rapid measurements by using an automated measurement system. However, there is insufficient data to support the application of FIT in IBD. Further studies into the use of FIT for evaluating the inflammatory status of IBD are warranted. PMID:26884729

  5. A Prospective, Descriptive, Quality Improvement Study to Decrease Incontinence-Associated Dermatitis and Hospital-Acquired Pressure Ulcers.

    PubMed

    Hall, Kimberly D; Clark, Rebecca C

    2015-07-01

    Incontinence is a common problem among hospitalized patients and has been associated with multiple health complications, including incontinence-associated dermatitis (IAD) and hospital-acquired pressure ulcers (HAPUs). A prospective, descriptive study was conducted in 2 acute care neurology units to 1) assess the prevalence of incontinence and incidence of IAD and HAPUs among incontinent patients, and 2) evaluate the effect of caregiver education and use of a 1-step cleanser, moisturizer, barrier product on the development of IAD and HAPUs among patients with incontinence. During a period of 1 month, the incontinence status of admitted patients was recorded and skin was assessed for the presence/absence of IAD and HAPUs twice per day. After the 1-month data collection, all clinicians on the study units completed a facility-based online education program about IAD, HAPUs, and skin care followed by the implementation of a 1-step cleanser/barrier product for skin care of all patients with incontinence. Data collection procedures remained the same. Data were collected using a paper/pencil instrument and entered into a spreadsheet for analysis. Descriptive statistics were calculated and prevalence and incidence rates were compared between the pre-intervention and post-intervention phase using Fisher's exact analysis. During the first phase of the study, 17 of 40 admitted patients (42.5%) were incontinent. Of those, 5 (29.4%) developed IAD and all of these patients developed HAPUs (5 of 40 admitted, 29.4%) during an average length of stay of 7.3 (range: 2-14) days. In the intervention phase of the study, 25 of 46 (54.3%) patients were incontinent and none developed IAD or a HAPU during an average length of stay of 7.4 (range: 2-14) days. The average Braden scale score was 14.14 in the pre-intervention group of patients with incontinence and 12.74 in the intervention group. The prevalence of incontinence among patients admitted to acute care neurology units and the rate

  6. What is the best surgical intervention for stress urinary incontinence in the very young and very old? An International Consultation on Incontinence Research Society update.

    PubMed

    Robinson, Dudley; Castro-Diaz, David; Giarenis, Ilias; Toozs-Hobson, Philip; Anding, Ralf; Burton, Claire; Cardozo, Linda

    2015-11-01

    An increasing number of continence procedures are being performed in women of all ages. An overview of the existing literature and consensus regarding surgery for stress urinary incontinence (SUI) in the young and the old was presented and discussed at the International Consultation on Incontinence Research Society Think Tank. This manuscript reflects the Think Tank's summary and opinion. Despite the increasing number of continence procedures, there are relatively few data to guide management in the very young and the very old. When considering continence surgery in the young, long-term efficacy and safety are paramount, and the future effects of pregnancy and childbirth need to be carefully considered. Conversely, in the elderly, minimally invasive procedures with low morbidity are important, especially in the frail elderly who may have significant co-morbidities. Further research including prospective randomised trials, cohort studies and national registries, should help guide our management in these two challenging groups of patients.

  7. Profiling Living Bacteria Informs Preparation of Fecal Microbiota Transplantations.

    PubMed

    Chu, Nathaniel D; Smith, Mark B; Perrotta, Allison R; Kassam, Zain; Alm, Eric J

    2017-01-01

    Fecal microbiota transplantation is a compelling treatment for recurrent Clostridium difficile infections, with potential applications against other diseases associated with changes in gut microbiota. But variability in fecal bacterial communities-believed to be the therapeutic agent-can complicate or undermine treatment efficacy. To understand the effects of transplant preparation methods on living fecal microbial communities, we applied a DNA-sequencing method (PMA-seq) that uses propidium monoazide (PMA) to differentiate between living and dead fecal microbes, and we created an analysis pipeline to identify individual bacteria that change in abundance between samples. We found that oxygen exposure degraded fecal bacterial communities, whereas freeze-thaw cycles and lag time between donor defecation and transplant preparation had much smaller effects. Notably, the abundance of Faecalibacterium prausnitzii-an anti-inflammatory commensal bacterium whose absence is linked to inflammatory bowel disease-decreased with oxygen exposure. Our results indicate that some current practices for preparing microbiota transplant material adversely affect living fecal microbial content and highlight PMA-seq as a valuable tool to inform best practices and evaluate the suitability of clinical fecal material.

  8. Using fecal glucocorticoids for stress assessment in Mourning Doves

    USGS Publications Warehouse

    Washburn, Brian E.; Millspaugh, Joshua J.; Schulz, John H.; Jones, Susan B.; Mong, T.

    2003-01-01

    Fecal glucocorticoid assays provide a potentially useful, noninvasive means to study physiological responses of wildlife to various stressors. The objective of our study was to validate a method for measuring glucocorticoid metabolites in Mourning Dove (Zenaida macroura) feces. We validated the assay using standard procedures (e.g., parallelism, recovery of exogenous corticosterone) to demonstrate that the assay accurately and precisely measured glucocorticoid metabolites in Mourning Dove fecal extracts. We conducted adrenocorticotropin (ACTH) challenge experiments to validate the assay's ability to determine biologically important changes in fecal glucocorticoids. Fecal glucocorticoid levels increased significantly approximately 2-3 hr after administration of ACTH at 50 IU per kg body mass to wild Mourning Doves held in captivity. In contrast, fecal glucocorticoid metabolites did not increase in control birds, birds that received saline injections, or a lower dose of ACTH (1 IU per kg body mass). Variation in overall fecal glucocorticoid metabolite levels may have been influenced by season and the length of time birds were held in captivity. Non-invasive fecal glucocorticoid metabolite analyses, in combination with demographic information, may have considerable utility for monitoring the effects of natural and anthropogenic disturbances on Mourning Dove populations.

  9. Profiling Living Bacteria Informs Preparation of Fecal Microbiota Transplantations

    PubMed Central

    Chu, Nathaniel D.; Smith, Mark B.; Perrotta, Allison R.; Kassam, Zain; Alm, Eric J.

    2017-01-01

    Fecal microbiota transplantation is a compelling treatment for recurrent Clostridium difficile infections, with potential applications against other diseases associated with changes in gut microbiota. But variability in fecal bacterial communities—believed to be the therapeutic agent—can complicate or undermine treatment efficacy. To understand the effects of transplant preparation methods on living fecal microbial communities, we applied a DNA-sequencing method (PMA-seq) that uses propidium monoazide (PMA) to differentiate between living and dead fecal microbes, and we created an analysis pipeline to identify individual bacteria that change in abundance between samples. We found that oxygen exposure degraded fecal bacterial communities, whereas freeze-thaw cycles and lag time between donor defecation and transplant preparation had much smaller effects. Notably, the abundance of Faecalibacterium prausnitzii—an anti-inflammatory commensal bacterium whose absence is linked to inflammatory bowel disease—decreased with oxygen exposure. Our results indicate that some current practices for preparing microbiota transplant material adversely affect living fecal microbial content and highlight PMA-seq as a valuable tool to inform best practices and evaluate the suitability of clinical fecal material. PMID:28125667

  10. Fecal corticoid monitoring in whooping cranes (Grus americana) undergoing reintroduction

    USGS Publications Warehouse

    Hartup, Barry K.; Olsen, Glenn H.; Czekala, Nancy M.

    2005-01-01

    We used radioimmunoassay to determine fecal corticoid concentrations and assess potential stress in 10 endangered whooping cranes (Grus americana) undergoing reintroduction to the wild. Fecal samples were collected shortly after hatching at a captive facility in Maryland, during field training in Wisconsin, and throughout a human-led migration to Florida. After a 14-day decline following hatching, fecal corticoid concentrations stabilized at baseline levels for the duration of the captive period, despite exposure to potentially stressful stimuli. Shipment of the cranes to the field training site was correlated with an eight- to 34-fold increase in fecal corticoid concentrations, which returned to baseline levels within 1 week. Increases were positively correlated with age but not body weight at the time of shipping. Fecal corticoid concentrations during the training period increased slightly and exhibited greater variation than levels observed at the captive facility, but were well within expected norms based on previous studies. Fecal corticoid concentrations increased twofold following premigration physical examinations and placement of radiotransmitters, and persisted for up to 4 days before they returned to baseline levels. Though fecal corticoid concentrations and variation during the migration period were similar to training levels, there was an overall decline in fecal corticoid concentrations during the artificial migration. Acute stressors, such as capture, restraint, and severe storms, were associated with stress responses by the cranes that varied in accordance with lasting physical or psychological stimuli. The overall reintroduction process of costume-rearing, ultralight aircraft habituation, training, and artificial migration was not associated with elevations in fecal corticoid concentrations suggestive of chronic stress.

  11. Incontinence-associated dermatitis: a cross-sectional prevalence study in the Australian acute care hospital setting.

    PubMed

    Campbell, Jill L; Coyer, Fiona M; Osborne, Sonya R

    2016-06-01

    The purpose of this cross-sectional study was to identify the prevalence of incontinence and incontinence-associated dermatitis (IAD) in Australian acute care patients and to describe the products worn to manage incontinence, and those provided at the bedside for perineal skin care. Data on 376 inpatients were collected over 2 days at a major Australian teaching hospital. The mean age of the sample group was 62 years and 52% of the patients were male. The prevalence rate of incontinence was 24% (91/376). Urinary incontinence was significantly more prevalent in females (10%) than males (6%) (χ(2)  = 4·458, df = 1, P = 0·035). IAD occurred in 10% (38/376) of the sample group, with 42% (38/91) of incontinent patients having IAD. Semi-formed and liquid stool were associated with IAD (χ(2)  = 5·520, df = 1, P = 0·027). Clinical indication of fungal infection was present in 32% (12/38) of patients with IAD. Absorbent disposable briefs were the most common incontinence aids used (80%, 70/91), with soap/water and disposable washcloths being the clean-up products most commonly available (60%, 55/91) at the bedside. Further data are needed to validate this high prevalence. Studies that address prevention of IAD and the effectiveness of management strategies are also needed.

  12. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    PubMed Central

    Barbosa, Angélica Mércia Pascon; Dias, Adriano; Marini, Gabriela; Calderon, Iracema Mattos Paranhos; Witkin, Steven; Rudge, Marilza Vieira Cunha

    2011-01-01

    OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes. RESULTS: The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6%) and two years after a cesarean (44.8% vs. 18.4%). Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%). Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence. CONCLUSIONS: The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies. PMID:21915481

  13. Prevalence of commonly prescribed medications potentially contributing to urinary symptoms in a cohort of older patients seeking care for incontinence

    PubMed Central

    2013-01-01

    Background Several medication classes may contribute to urinary symptoms in older adults. The purpose of this study was to determine the prevalence of use of these medications in a clinical cohort of incontinent patients. Methods A cross-sectional study was conducted among 390 new patients aged 60 years and older seeking care for incontinence in specialized outpatient geriatric incontinence clinics in Quebec, Canada. The use of oral estrogens, alpha-blocking agents, benzodiazepines, antidepressants, antipsychotics, ACE inhibitors, loop diuretics, NSAIDs, narcotics and calcium channel blockers was recorded from each patient’s medication profile. Lower urinary tract symptoms and the severity of incontinence were measured using standardized questionnaires including the International Consultation on Incontinence Questionnaire. The type of incontinence was determined clinically by a physician specialized in incontinence. Co-morbidities were ascertained by self-report. Logistic regression analyses were used to detect factors associated with medication use, as well as relationships between specific medication classes and the type and severity of urinary symptoms. Results The prevalence of medications potentially contributing to lower urinary tract symptoms was 60.5%. Calcium channel blockers (21.8%), benzodiazepines (17.4%), other centrally active agents (16.4%), ACE inhibitors (14.4%) and estrogens (12.8%) were most frequently consumed. Only polypharmacy (OR = 4.9, 95% CI = 3.1-7.9), was associated with medication use contributing to incontinence in analyses adjusted for age, sex, and multimorbidity. No associations were detected between specific medication classes and the type or severity of urinary symptoms in this cohort. Conclusion The prevalence of use of medications potentially causing urinary symptoms is high among incontinent older adults. More research is needed to determine whether de-prescribing these medications results in improved urinary symptoms

  14. Comparison of Fecal Coliform Agar and Violet Red Bile Lactose Agar for Fecal Coliform Enumeration in Foods

    PubMed Central

    Leclercq, A.; Wanegue, C.; Baylac, P.

    2002-01-01

    A 24-h direct plating method for fecal coliform enumeration with a resuscitation step (preincubation for 2 h at 37 ± 1°C and transfer to 44 ± 1°C for 22 h) using fecal coliform agar (FCA) was compared with the 24-h standardized violet red bile lactose agar (VRBL) method. FCA and VRBL have equivalent specificities and sensitivities, except for lactose-positive non-fecal coliforms such as Hafnia alvei, which could form typical colonies on FCA and VRBL. Recovery of cold-stressed Escherichia coli in mashed potatoes on FCA was about 1 log unit lower than that with VRBL. When the FCA method was compared with standard VRBL for enumeration of fecal coliforms, based on counting carried out on 170 different food samples, results were not significantly different (P > 0.05). Based on 203 typical identified colonies selected as found on VRBL and FCA, the latter medium appears to allow the enumeration of more true fecal coliforms and has higher performance in certain ways (specificity, sensitivity, and negative and positive predictive values) than VRBL. Most colonies clearly identified on both media were E. coli and H. alvei, a non-fecal coliform. Therefore, the replacement of fecal coliform enumeration by E. coli enumeration to estimate food sanitary quality should be recommended. PMID:11916678

  15. Cost effectiveness of training incontinent elderly in nursing homes: a randomized clinical trial.

    PubMed Central

    Hu, T W; Kaltreider, D L; Igou, J F; Yu, L C; Rohner, T J

    1990-01-01

    This study used a randomized clinical trial with 133 incontinent elderly in seven nursing homes to evaluate the effectiveness of a behavioral training therapy and its cost implications. The training program lasted three months, and a 22-week follow-up period examined the durability of the treatment effect. The therapy became effective after six weeks of training. By the final months of training, the treatment participants' wet episodes had been reduced by 0.6 episode per day, or a 26 percent reduction over baseline, and improvement was maintained during the follow-up period. Trainees with a high frequency of incontinence during baseline, relatively more cognitive residents, and residents with a normal bladder capacity responded better to this behavioral program. The cost of training was the equivalent of about one hour of nursing aide time per patient day. The reduction in incontinence during the follow-up period resulted in some small savings in laundry costs and supplies used, and some quantitatively unmeasurable but detectable improvement in psychosocial well-being among the trainees. Since the central figure in implementing this training protocol is the nursing aide, it is important to find an organizational management scheme that will stimulate nursing aides to reduce incontinence among nursing home residents. PMID:2116385

  16. Impact of anal incontinence on psychosocial function and health-related quality of life.

    PubMed

    Crowell, Michael D; Schettler, V Ann; Lacy, Brian E; Lunsford, Tisha N; Harris, Lucinda A; DiBaise, John K; Jones, Michael P

    2007-07-01

    The relationship among the frequency of anal incontinence (AI), psychosocial factors, and health-related quality of life (HRQOL) was evaluated. Consecutive patients (n=280) completed a bowel symptom questionnaire, the Symptom Checklist 90 -- Revised (SCL 90-R), and an assessment of HRQOL. Group 1 had no incontinence, Group 2 had AI less than once per week, and Group 3 experienced AI more than once per week. Multivariate analyses were used to evaluate the relationship among symptoms, the SCL-90-R subscales, and HRQOL. Group 3 reported more frequent stools than the other groups. Significant psychological distress was present in both incontinent groups compared to Group 1 (P=0.002). A reduction in overall HRQOL was also seen in the incontinent groups. Depression was inversely correlated with QOL-Satisfaction and QOL-Ratings and positively correlated with QOL-Interference. AI was associated with impaired psychosocial function and decreased HRQOL. The frequency of AI was associated with increased HRQOL-Interference, but minimally with the degree of psychosocial impairment.

  17. Evaluation of a patient education tool to reduce the incidence of incontinence post-prostate surgery.

    PubMed

    Ip, Virginia

    2004-10-01

    A pelvic floor muscle exercise program can reduce the incidence of incontinence post-prostate surgery. The purpose of this study was to validate a new education tool, a refrigerator magnet, in comparison to a paper copy with the same information, to determine if patient compliance with the exercises increased.

  18. In Search of Dignity: One Family Caring for Their Child's Incontinence

    ERIC Educational Resources Information Center

    Coelho, Amy

    2009-01-01

    This article shares a story of a family with a child who has a spastic quadriplegia cerebral palsy, a form of cerebral palsy (CP) that affects all four limbs and torso with debilitating muscle dysfunction. It describes how the family cares for their child's incontinence. It also shares the experience of the child's mother, Kathy, who attributes…

  19. Assessment of sexual functions in partners of women with complaints of urinary incontinence

    PubMed Central

    Keles, Muzaffer Oguz; Caliskan, Selahattin; Gokce, Ali Murat; Gunes, Mustafa

    2016-01-01

    ABSTRACT Aim: Investigation of the erectile functions in partners of women with urinary incontinence problems. Materials and Methods: Sexually active female patients over the age of 18 years with complaints of urinary incontinence (n=30) (Group-1), and without urinary incontinence (n=30) (Group-2, controls) were included this study. Evaluation of the patients were done at Erzincan Mengücek Gazi Training and Research Hospital's urology outpatient clinic between June 2012 and January 2013. Partners of group-1 and group-2 were asked to fill in the 5-item International Index of Erectile Function (IIEF-5) questionnaire, and then the scores of the two groups were compared for statistically significant differences. Results: Among the partners of the group-1 patients, 15 (50%) had mild erectile dysfunction (ED), 11 (36.6%) had moderate ED, 1 (3.4%) had severe ED, and erectile function was normal in the remaining 3 (10%). Among the partners of group-2 patients, 15 (50%) had mild ED, 7 had moderate ED, 1 (3.4%) had severe ED, and 7 (23.3%) had normal erectile function. Compared to the spouses of group-2 patients, ED was more prevalent among the spouses of group-1 patients. Conclusion: Erectile function in the partners of women with urinary incontinence may be adversely affected by the UI of their partners. PMID:27532113

  20. Stress urinary incontinence and overactive bladder syndrome: current options and new targets for management.

    PubMed

    Elser, Denise M

    2012-05-01

    In the United States, office visits for women seeking treatment for urinary incontinence more than doubled between 1994 and 2000, from 1845 per 100 000 women. This review article addresses treatment options for 2 common types of incontinence in women: stress urinary incontinence (SUI) and detrusor overactivity (DO), commonly referred to as urge urinary incontinence (UUI). In the past, those with SUI typically faced limited treatment options, such as Kegel exercises, pessaries, or major surgery (Burch or Marshall-Marchetti-Krantz operations). However, treatment options for women also included anticholinergic medications, behavioral therapy, and implantable neuromodulation. In recent years, more options have become available. For women with SUI, a variety of minimally invasive synthetic midurethral sling approaches (eg, retropubic, transobturator, and single incision) and office-based procedures (eg, periurethral injection of bulking agents and radiofrequency collagen denaturation [Renessa®; Novasys Medical]) are now offered. More outpatient options will hopefully be available soon, including an inflatable, free-floating balloon to act as a shock absorber, and injection of muscle-derived stem cells into the periurethral tissue. Women with UUI now have targeted options, such as posterior tibial nerve stimulation (PTNS) and intravesical injections of onabotulinumtoxinA (Botox®; Allergan, Inc.), in addition to nonoral systemic medications.

  1. 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

  2. Urethro-urethral fistula: A rare cause of post-TURP incontinence

    PubMed Central

    Moorthy, H. Krishna; Pillai, Biju S.

    2014-01-01

    Prostatic abscess rarely follows acute prostatitis and can sometimes lead to a fistula by breaking into the prostatic urethra, peri-rectal tissues, the perineum, or the rectum. We report a case of a prostatic abscess tracking into the bulbar urethra after a transurethral resection of the prostate. This created a fistula, mimicking a urethral duplication and leading to urinary incontinence. PMID:25553167

  3. Absenteeism, Educational Plans, and Anxiety among Children with Incontinence and Their Parents

    ERIC Educational Resources Information Center

    Filce, Hollie G.; LaVergne, Leslie

    2015-01-01

    Background: Children with incontinence have more absenteeism, poorer academic performance, and potential social difficulties during the school years. These children and their parents are at risk for illness-related anxiety. Whereas educational plans are designed to remediate educational, medical, and social-emotional barriers at school, little…

  4. 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

  5. Outcomes of Surgery for Stress Urinary Incontinence in the Older Woman

    PubMed Central

    Ellington, David R.; Erekson, Elisabeth A.; Richter, Holly E.

    2015-01-01

    Synopsis As population demographics continue to evolve, specifics on age-related outcomes of stress urinary incontinence interventions will be critical to patient counseling and management planning. Understanding medical factors unique to older woman and their lower urinary tract condition will allow caregivers to optimize surgical outcomes, both physical and functional, and minimize complications within this population. PMID:26476111

  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. Beyond "diaper rash": Incontinence-associated dermatitis: does it have you seeing red?

    PubMed

    Junkin, Joan; Selekof, Joan Lerner

    2008-11-01

    Incontinence-associated dermatitis (IAD) results from frequent exposure to urine or feces. Consistent preventive skin care or treatment may reduce the incidence of IAD. The authors propose using an IAD classification and intervention tool (IADIT) to make detecting and treating IAD easier and more consistent.

  8. 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…

  9. Distance Learning: A Strategy for Improving Incontinence Care in Nursing Homes

    ERIC Educational Resources Information Center

    Rahman, Anna N.; Schnelle, John F.; Yamashita, Takashi; Patry, Gail; Prasauskas, Ruta

    2010-01-01

    Purpose: This article describes a distance learning model designed to help nursing homes implement incontinence management best practices. A basic premise is that translating research into practice requires both a feasible intervention and a dissemination strategy responsive to the target audience's needs. Design and Methods: Over 8 months, nurse…

  10. Managing therapeutic competition in patients with heart failure, lower urinary tract symptoms and incontinence.

    PubMed

    Tannenbaum, Cara; Johnell, Kristina

    2014-02-01

    Up to 50% of heart failure patients suffer from lower urinary tract symptoms. Urinary incontinence has been associated with worse functional status in patients with heart failure, occurring three times more frequently in patients with New York Heart Association Class III and IV symptoms compared with those with milder disease. The association between heart failure and urinary symptoms may be directly attributable to worsening heart failure pathophysiology; however, medications used to treat heart failure may also indirectly provoke or exacerbate urinary symptoms. This type of drug-disease interaction, in which the treatment for heart failure precipitates incontinence, and removal of medications to relieve incontinence worsens heart failure, can be termed therapeutic competition. The mechanisms by which heart failure medication such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and β-blockers aggravate lower urinary tract symptoms are discussed. Initiation of a prescribing cascade, whereby antimuscarinic agents or β3-agonists are added to treat symptoms of urinary urgency and incontinence, is best avoided. Recommendations and practical tips are provided that outline more judicious management of heart failure patients with lower urinary tract symptoms. Compelling strategies to improve urinary outcomes include titrating diuretics, switching ACE inhibitors, treating lower urinary tract infections, appropriate fluid management, daily weighing, and uptake of pelvic floor muscle exercises.

  11. IDENTIFICATION OF CHICKEN-SPECIFIC FECAL MICROBIAL SEQUENCES USING A METAGENOMIC APPROACH

    EPA Science Inventory

    In this study, we applied a genome fragment enrichment (GFE) method to select for genomic regions that differ between different fecal metagenomes. Competitive DNA hybridizations were performed between chicken fecal DNA and pig fecal DNA (C-P) and between chicken fecal DNA and an ...

  12. Contact with beach sand, concentrations of fecal indicators, and enteric illness risk

    EPA Science Inventory

    Recent studies ofbeach sand fecal contamination have triggered interest among scientists and in the media. Although evidence shows that beach sand can harbor fecal indicator organisms as well as fecal pathogens, illness risk associated with beach sand contact and fecal indicators...

  13. Assessment of symptoms of urinary incontinence in women with polycystic ovary syndrome

    PubMed Central

    Montezuma, Thais; Antônio, Flávia Ignácio; de Sá Rosa e Silva, Ana Carolina Japur; de Sá, Marcos Felipe Silva; Ferriani, Rui Alberto; Ferreira, Cristine Homsi Jorge

    2011-01-01

    OBJECTIVES: The pelvic floor muscles are sensitive to androgens, and due to hyperandrogenism, women with polycystic ovary syndrome can have increased mass in these muscles compared to controls. The aim of this study is to compare reports of urine leakage and quality of life between women with and without polycystic ovary syndrome. METHODS: One hundred thirteen 18- to 40-year-old nulliparous women with polycystic ovary syndrome or without the disease (controls) were recruited at the University Hospital of School Medicine of São Paulo University at Ribeirão Preto City, Brazil. The subjects were not taking any hormonal medication, had not undergone previous pelvic surgery and did not exercise their pelvic floor muscles. The women were divided into the following four groups: I- polycystic ovary syndrome with normal body mass index (n = 18), II- polycystic ovary syndrome with body mass index ≥25 (n = 32), III- controls with normal body mass index (n = 29), and IV- controls with Body Mass Index ≥25 (n = 34). Quality of life was evaluated using the SF-36 questionnaire, and the subjects with urinary complaints also completed the International Consultation on Incontinence Questionnaire Short Form to evaluate the severity of their urinary incontinence. RESULTS: The replies to the International Consultation on Incontinence Questionnaire Short Form revealed a significant difference in urinary function between groups, with 24% of the subjects in group IV reporting urinary incontinence. The mean scores for the SF-36 questionnaire revealed that group II had the lowest quality of life. CONCLUSIONS: The control obese group (IV) reported a higher prevalence of urinary incontinence. There was no difference in the reported frequency of urine loss between the polycystic ovary syndrome and control groups with normal body mass index or between the polycystic ovary syndrome and control groups with body mass index ≥25. PMID:22086521

  14. FECAL POLLUTION, PUBLIC HEALTH AND MICROBIAL SOURCE TRACKING

    EPA Science Inventory

    Microbial source tracking (MST) seeks to provide information about sources of fecal water contamination. Without knowledge of sources, it is difficult to accurately model risk assessments, choose effective remediation strategies, or bring chronically polluted waters into complian...

  15. Study Questions 'Fecal Transplant' Treatment for Gut Infection

    MedlinePlus

    ... the gut's natural mix of microbes (known as microbiota). Traditionally, doctors prescribe another antibiotic -- oral vancomycin -- to ... from our clinical experience, in which FMT [fecal microbiota transplantation] is effective for 85 to 90 percent ...

  16. Changes of Cattle Fecal Microbiome Under Field Conditions

    EPA Science Inventory

    Next generation sequencing (NGS) has been applied to study the microbiome in wastewater, sewage sludge, and feces. Previous microbial survival studies have shown different fecal-associated microbes have different decay rates and regrowth behaviors.

  17. Methods of targeting animal sources of fecal pollution in water

    EPA Science Inventory

    In this chapter, proposed chemical and biological MST indicators for the determination of animal fecal sources are discussed. The biological indicators are grouped based on the phylogenetic description of the proposed target (eukarya, bacteria, and virus). A comprehensive descrip...

  18. Fecal Indicator Bacteria and Environmental Observations: Validation of Virtual Beach

    EPA Science Inventory

    Contamination of recreational waters by fecal material is often assessed using indicator bacteria such as enterococci. Enumeration based on culturing methods can take up to 48 hours to complete, limiting the accuracy of water quality evaluations. Molecular microbial techniques em...

  19. Changes of Cattle Fecal Microbiome Under Field Conditions.

    EPA Science Inventory

    Next generation sequencing (NGS) has been applied to study the microbiome in wastewater, sewage sludge, and feces. Previous microbial survival studies have shown different fecal-associated microbes have different decay rates and regrowth behaviors.

  20. Saccharomyces cerevisiae colonization associated with fecal microbiota treatment failure

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Fecal microbiota therapy (FMT) has emerged as the gold standard for treatment of persistent, symptomatic Clostridium difficile infection (CDI) that does not respond to conventional antimicrobial treatment. Probiotics are commonly recommended in addition to antimicrobial treatment for CD...

  1. Repeated fecal microbiota transplantation in a child with ulcerative colitis.

    PubMed

    Shimizu, Hirotaka; Arai, Katsuhiro; Abe, Jun; Nakabayashi, Kazuhiko; Yoshioka, Takako; Hosoi, Kenji; Kuroda, Makoto

    2016-08-01

    We report the case of an 11-year-old girl with ulcerative colitis refractory to conventional therapy, who was subsequently treated successfully with repeated fecal microbiota transplantation (FMT). The patient was steroid dependent despite several infliximab treatments, and colectomy was proposed to improve quality of life. After repeated FMT, she was able to maintain remission with on minimal dose of steroid. Although her fecal microbiota was dysbiotic before FMT, it was restored to a similar pattern as the donor after repeated FMT.

  2. Fecal Microbiota Transplantation for Inflammatory Bowel Disease

    PubMed Central

    Lopez, Joanna

    2016-01-01

    The gut bacterial microbiome, particularly its role in disease and inflammation, has gained international attention with the successful use of fecal microbiota transplantation (FMT) in the treatment of Clostridium difficile infection. This success has led to studies exploring the role of FMT in other conditions, including inflammatory bowel disease (IBD). Both Crohn’s disease and ulcerative colitis are chronic inflammatory conditions of the gastrointestinal system that have multifactorial etiologies. A shift in gut microbial composition in genetically susceptible individuals, an altered immune system, and environmental factors are all hypothesized to have a role in the pathogenesis of IBD. While numerous case reports and cohort studies have described the use of FMT in patients with IBD over the last 2 decades, the development of new sequencing techniques and results from 2 recent randomized, controlled trials have allowed for a better understanding of the relationship between the microbiome and the human host. However, despite these efforts, knowledge remains limited and the role of FMT in the management of IBD remains uncertain. Further investigation is necessary before FMT joins the current armamentarium of treatment options in clinical practice. PMID:27493597

  3. Performance of PCR-based assays targeting Bacteroidales genetic markers of human fecal pollution in sewage and fecal samples

    EPA Science Inventory

    There are numerous PCR-based methods available to characterize human fecal pollution in ambient waters. Each assay employs distinct oligonucleotides and many target different genes and microorganisms leading to potential variations in method performance. Laboratory comparisons ...

  4. The Toileting Habit Profile Questionnaire: Screening for Sensory-Based Toileting Difficulties in Young Children with Constipation and Retentive Fecal Incontinence

    ERIC Educational Resources Information Center

    Beaudry-Bellefeuille, Isabelle; Lane, Shelly J.; Ramos-Polo, Eduardo

    2016-01-01

    This study examined the face and preliminary content validity of the Toileting Habit Profile Questionnaire, a tool designed to screen for sensory-based defecation difficulties in children. A panel of experts reviewed a pilot version of the questionnaire and responded to probe questions. Two reviewers conducted direct content analysis of responses;…

  5. Loss of Vancomycin-Resistant Enterococcus Fecal Dominance in an Organ Transplant Patient With Clostridium difficile Colitis After Fecal Microbiota Transplant

    PubMed Central

    Stripling, Joshua; Kumar, Ranjit; Baddley, John W.; Nellore, Anoma; Dixon, Paula; Howard, Donna; Ptacek, Travis; Lefkowitz, Elliot J.; Tallaj, Jose A.; Benjamin, William H.; Morrow, Casey D.; Rodriguez, J. Martin

    2015-01-01

    We report the use of fecal microbiota transplantation in a single heart-kidney transplant recipient with recurrent Clostridium difficile, vancomycin-resistant Enterococcus (VRE) fecal dominance, and recurrent VRE infections. Fecal microbiota transplantation resulted in the reconstruction of a diverse microbiota with (1) reduced relative abundance of C difficile and VRE and (2) positive clinical outcome. PMID:26180828

  6. Sacral neuromodulation and peripheral nerve stimulation in patients with anal incontinence: an overview of techniques, complications and troubleshooting

    PubMed Central

    Zbar, Andrew P.

    2014-01-01

    Sacral neuromodulation (SNM) therapy has revolutionized the management of many forms of anal incontinence, with an expanded use and a medium-term efficacy of 75% overall. This review discusses the technique of SNM therapy, along with its complications and troubleshooting and a discussion of the early data pertaining to peripheral posterior tibial nerve stimulation in incontinent patients. Future work needs to define the predictive factors for neurostimulatory success, along with the likely mechanisms of action of their therapeutic action. PMID:24759349

  7. Elective cesarean section to prevent anal incontinence and brachial plexus injuries associated with macrosomia--a decision analysis.

    PubMed

    Culligan, Patrick J; Myers, John A; Goldberg, Roger P; Blackwell, Linda; Gohmann, Stephan F; Abell, Troy D

    2005-01-01

    Our aim was to determine the cost-effectiveness of a policy of elective C-section for macrosomic infants to prevent maternal anal incontinence, urinary incontinence, and newborn brachial plexus injuries. We used a decision analytic model to compare the standard of care with a policy whereby all primigravid patients in the United States would undergo an ultrasound at 39 weeks gestation, followed by an elective C-section for any fetus estimated at > or =4500 g. The following clinical consequences were considered crucial to the analysis: brachial plexus injury to the newborn; maternal anal and urinary incontinence; emergency hysterectomy; hemorrhage requiring blood transfusion; and maternal mortality. Our outcome measures included (1) number of brachial plexus injuries or cases of incontinence averted, (2) incremental monetary cost per 100,000 deliveries, (3) expected quality of life of the mother and her child, and (4) "quality-adjusted life years" (QALY) associated with the two policies. For every 100,000 deliveries, the policy of elective C-section resulted in 16.6 fewer permanent brachial plexus injuries, 185.7 fewer cases of anal incontinence, and cost savings of $3,211,000. Therefore, this policy would prevent one case of anal incontinence for every 539 elective C-sections performed. The expected quality of life associated with the elective C-section policy was also greater (quality of life score 0.923 vs 0.917 on a scale from 0.0 to 1.0 and 53.6 QALY vs 53.2). A policy whereby primigravid patients in the United States have a 39 week ultrasound-estimated fetal weight followed by C-section for any fetuses > or =4500 g appears cost effective. However, the monetary costs in our analysis were sensitive to the probability estimates of urinary incontinence following C-section and vaginal delivery and the cost estimates for urinary incontinence, vaginal delivery, and C-section.

  8. The Burden of Urinary Incontinence and Urinary Bother Among Elderly Prostate Cancer Survivors

    PubMed Central

    Kopp, Ryan P.; Marshall, Lynn M.; Wang, Patty Y.; Bauer, Douglas C.; Barrett-Connor, Elizabeth; Parsons, J. Kellogg

    2014-01-01

    Background Data describing urinary health in elderly, community-dwelling prostate cancer (PCa) survivors are limited. Objective To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa. Design, setting, and participants A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ≥65 yr. Outcome measurements and statistical analysis We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs). Results and limitations At baseline, 706 men (12%) reported a history of PCa, with a median time since diagnosis of 6.3 yr. Of these men, 426 (60%) reported urinary incontinence. In adjusted analyses, observation (PR: 1.92; 95% confidence interval [CI], 1.15–3.21; p = 0.01), surgery (PR: 4.68; 95% CI, 4.11–5.32; p < 0.0001), radiation therapy (PR: 1.64; 95% CI, 1.20– 2.23; p = 0.002), and androgen-deprivation therapy (ADT) (PR: 2.01; 95% CI, 1.35–2.99; p = 0.0006) were each associated with daily incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95% CI, 1.00–1.78; p = 0.05), surgery (PR: 1.25; 95% CI, 1.10–1.42; p = 0.0008), and ADT (PR: 1.50; 95% CI, 1.26–1.79; p < 0.0001) were associated with increased AUA-SI bother scores. Cancer stage and use of adjuvant or salvage therapies were not available for analysis. Conclusions Compared with their peers without PCa, elderly PCa survivors had a two-fold to five-fold greater prevalence of urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with

  9. Fecal Microbiota Transplantation in Inflammatory Bowel Disease.

    PubMed

    Reinisch, Walter

    2017-01-01

    The etiology of inflammatory bowel disease (IBD) is unknown, but it is thought to arise from an aberrant immune response to a change in colonic environment in a genetically susceptible individual. The intestinal microbiota are located at the complex interface of the epithelial barrier and are sensitive to changes in environmental factors, such as diets, drugs or smoking and signals derived from the intestinal immune system and the gut-brain axis. In patients with IBD, an imbalance in the structural and/or functional configuration of the intestinal microbiota leading to the disruption of the host-microorganism homeostasis (dysbiosis) has been reproducibly reported. As animal models of IBD require gut bacteria to induce inflammation, it is hypothesized that the dysbiosis observed in patients is not only a surrogate of changes at the intestinal barrier but also a potential cause or at least enhancer of the mucosal inflammatory process. That burgeoning notion has stimulated thoughts to modify the intestinal microbiota and rekindled interest in previous work on the efficacy of antibiotics in patients with IBD. The feasibility and tremendous success of fecal microbiota transplantation (FMT) to treat antibiotic resistant Clostridium difficile has finally paved the way to embark into the unchartered territory of IBD using FMT. Different routes and number of administrations, choices of donors, disease status and permitted therapies might have contributed to mixed results, particularly from the so far published randomized controlled trials. However, microbiome analysis suggests that a durable transplantation of donor bacteria to the host appears feasible and might be associated with a higher likelihood of response. On the other hand, this raises the concern of transplanting not only anti-inflammatory active bacteria and their products, but also not-yet-known dispositions for other diseases including cancer. Attempts are being made to better characterize those components of

  10. Fecal Microbiota Transplant: Respice, Adspice, Prospice.

    PubMed

    Brandt, Lawrence J

    2015-01-01

    Respice, Adspice, Prospice, look to the past, look to the present, look to the future, is one of life's valuable axioms; for it is only if one knows where one has been can one intelligently prepare for the future. I have used this approach here to review fecal microbiota transplant (FMT). First used in fourth-century China to treat an assortment of gastrointestinal (GI) symptoms, today FMT is primarily used for recurrent Clostridium difficile infection (RCDI). In the future, however, it is likely that microbiotic therapy will be extended beyond treatment of RCDI. Early on, fresh feces from patient-identified donors was used and administered by several routes. FMT cure rates for RCDI remain approximately 82% and 91% when fresh stool is given by the upper GI and lower GI routes, respectively, but now we are moving in the direction of using carefully vetted volunteers whose stool is processed into a variety of formulations including lyophilized material and even capsules. It is very likely that an array of products derived from feces or based on specific microbiotic profiles and commercially prepared in a controlled environment will be available to restore eubiosis to a dysbiotic intestinal microbial community, and thereby correct a variety of GI and non-GI disorders. We are witnessing a paradigm shift in therapeutics. Previously, bacteria were thought of only as potential pathogens, whereas now we appreciate that a diverse community of bacteria is crucial to the health of the host. We are now learning that to restore such diversity once it has been interrupted can result in miraculous cure. The future of microbiotic therapy is bright.

  11. Does menopausal status impact urinary continence outcomes following abdominal sacrocolpopexy without anti-incontinence procedures in continent women?

    PubMed Central

    Inan, Abdurrahman Hamdi; Toz, Emrah; Beyan, Emrah; Gurbuz, Tutku; Ozcan, Aykut; Oner, Oznur

    2016-01-01

    Objective: We investigated the impact of menopausal status on urinary continence following abdominal sacrocolpopexy (ASC) without an anti-incontinence procedure in continent women. Methods: We conducted a clinical follow-up study of 137 patients diagnosed with stage 3 or higher pelvic organ prolapse (POP) without urinary incontinence between January 2012 and December 2014. Patients were provided with detailed a priori information pertaining to the abdominal sacrocolpopexy procedure and were invited to attend follow-up visits at 1, 3, 12, and 24 months. Follow-up visits included a gynecological examination, cough test, and validated Urinary Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) questionnaires. Results: The mean follow-up time for the cohort was 16.5±3.45 months. The study group was divided according to menopausal status: premenopausal (Group-1) and postmenopausal women (Group-II). Anatomical recurrence was not detected during the follow-up period in either group, but de novo stress urinary incontinence was seen in 15 of 53 (28.3%) Group-I patients and in 6 of 84 (7.1%; p < 0.01) Group-II patients. Conclusions: The risk of de novo stress urinary incontinence in postmenopausal women after ASC is low. However, premenopausal patients have a higher incidence of de novo stress incontinence which affect quality of life. PMID:27648027

  12. Effect of belly dancing on urinary incontinence-related muscles and vaginal pressure in middle-aged women

    PubMed Central

    An, So-Young; Kim, Seung-Suk; Han, Gunsoo

    2017-01-01

    [Purpose] This study examined the effect of belly dancing on the urinary incontinence-related muscles and vaginal pressure in middle-aged women to provide fundamental data for establishing an effective training program focusing on mitigating and preventing urinary incontinence. [Subjects and Methods] The subjects included 24 middle-aged women, who have been diagnosed with urinary incontinence. The subjects were randomly divided into two groups, viz. the experimental group (N=12) and control group (N=12). The experimental group underwent a belly dancing program focusing on pelvis moves. [Results] In the experimental group, the urinary incontinence-related muscle strength and vaginal pressure were increased, while the control group showed no significant change. [Conclusion] Belly dancing focusing on pelvis moves had a positive effect on the urinary incontinence-related muscle strength and vaginal pressure, suggesting that a recreational dance program focusing on pelvic exercise can be used to prevent and relieve the symptoms of urinary incontinence as a non-surgical treatment. PMID:28356615

  13. Human-Induced Trophic Cascades along the Fecal Detritus Pathway

    PubMed Central

    Nichols, Elizabeth; Uriarte, María; Peres, Carlos A.; Louzada, Julio; Braga, Rodrigo Fagundes; Schiffler, Gustavo; Endo, Whaldener; Spector, Sacha H.

    2013-01-01

    Human presence and activity in tropical forest is thought to exert top-down regulation over the various ‘green-world’ pathways of plant-based foodwebs. However, these effects have never been explored for the ‘brown-world’ pathways of fecal-detritus webs. The strong effects of humans on tropical game mammals are likely to indirectly influence fecal detritivores (including Scarabaeine dung beetles), with subsequent indirect impacts on detrivore-mediated and plant-facilitating detrital processes. Across a 380-km gradient of human influence in the western Brazilian Amazon, we conducted the first landscape-level assessment of human-induced cascade effects on the fecal detritus pathway, by coupling data on human impact, game mammal and detritivore community structure, and rate measurements of a key detritus process (i.e. dung beetle-mediated secondary seed dispersal). We found evidence that human impact indirectly influences both the diversity and biomass of fecal detritivores, but not detritivore-mediated processes. Cascade strength varied across detritivore groups defined by species' traits. We found smaller-bodied dung beetles were at higher risk of local decline in areas of human presence, and that body size was a better predictor of cascade structure than fecal resource manipulation strategy. Cascade strength was also stronger in upland, unflooded forests, than in seasonally flooded forests. Our results suggest that the impact of human activity in tropical forest on fecal-detritus food web structure is mediated by both species' traits and habitat type. Further research will be required to determine the conditions under which these cascade effects influence fecal-detritus web function. PMID:24146780

  14. The pathogenesis of genitourinary prolapse and stress incontinence of urine. A histological and histochemical study.

    PubMed

    Gilpin, S A; Gosling, J A; Smith, A R; Warrell, D W

    1989-01-01

    Histological and histochemical analysis of biopsy samples of pubococcygeus muscle obtained from asymptomatic women and from women with stress incontinence of urine, with or without genitourinary prolapse, have been compared. In the asymptomatic women both age and parity appeared to be related to the morphological features of the samples and in particular those obtained from the posterior part of the pubococcygeus. In the symptomatic women there was a significant increase in the number of muscle fibres showing pathological damage which were obtained from the posterior part of the pelvic floor. The range of diameters of both Type I and Type II fibres obtained from this region was significantly different between symptomatic and asymptomatic women. These findings may be attributable to partial denervation of the pelvic floor in patients with urinary stress incontinence with or without genital tract prolapse.

  15. Prevention and management of incontinence-associated dermatitis using a barrier cream.

    PubMed

    Holroyd, Sharon; Graham, Katriona

    2014-12-01

    Incontinence-associated dermatitis (IAD) is a common skin disorder affecting patients with urinary and/or faecal incontinence. Maintaining the skin's integrity is a challenge, particularly in the elderly and individuals with medical or surgical comorbidities. It is widely reported that the issue is complex and recognition is inconsistent, with symptoms often being confused with those of pressure ulcers. This article explores the causes of IAD, looking at the structure of healthy skin and the pathology that occurs during skin breakdown. It identifies risk factors and prevention and management strategies, including the use of barrier creams. The article then presents the results of a large product evaluation that took place with Cavilon Durable Barrier Cream (3M). The barrier cream was shown to be more effective in treating and managing patients with IAD than the previous product that patients had been using. A case study is also included to demonstrate the efficacy of the newest version of Cavilon Durable Barrier Cream.

  16. Distributions of Fecal Markers in Wastewater from Different Climatic Zones for Human Fecal Pollution Tracking in Australian Surface Waters.

    PubMed

    Ahmed, W; Sidhu, J P S; Smith, K; Beale, D J; Gyawali, P; Toze, S

    2015-12-18

    Recreational and potable water supplies polluted with human wastewater can pose a direct health risk to humans. Therefore, sensitive detection of human fecal pollution in environmental waters is very important to water quality authorities around the globe. Microbial source tracking (MST) utilizes human fecal markers (HFMs) to detect human wastewater pollution in environmental waters. The concentrations of these markers in raw wastewater are considered important because it is likely that a marker whose concentration is high in wastewater will be more frequently detected in polluted waters. In this study, quantitative PCR (qPCR) assays were used to determine the concentrations of fecal indicator bacteria (FIB) Escherichia coli and Enterococcus spp., HFMs Bacteroides HF183, human adenoviruses (HAdVs), and polyomaviruses (HPyVs) in raw municipal wastewater influent from various climatic zones in Australia. E. coli mean concentrations in pooled human wastewater data sets (from various climatic zones) were the highest (3.2 × 10(6) gene copies per ml), followed by those of HF183 (8.0 × 10(5) gene copies per ml) and Enterococcus spp. (3.6 × 10(5) gene copies per ml). HAdV and HPyV concentrations were 2 to 3 orders of magnitude lower than those of FIB and HF183. Strong positive and negative correlations were observed between the FIB and HFM concentrations within and across wastewater treatment plants (WWTPs). To identify the most sensitive marker of human fecal pollution, environmental water samples were seeded with raw human wastewater. The results from the seeding experiments indicated that Bacteroides HF183 was more sensitive for detecting human fecal pollution than HAdVs and HPyVs. Since the HF183 marker can occasionally be present in nontarget animal fecal samples, it is recommended that HF183 along with a viral marker (HAdVs or HPyVs) be used for tracking human fecal pollution in Australian environmental waters.

  17. Fecal indicator bacteria variability in samples pumped from monitoring wells.

    PubMed

    Kozuskanich, J; Novakowski, K S; Anderson, B C

    2011-01-01

    The detection of microbiological contamination in drinking water from groundwater wells is often made with a limited number of samples that are collected using traditional geochemical sampling protocols. The objective of this study is to examine the variability of fecal indicator bacteria, as observed using discrete samples, due to pumping. Two wells were instrumented as multilevel piezometers in a bedrock aquifer, and bacterial enumeration was conducted on a total of 166 samples (for total coliform, fecal coliform, Escherichia coli, and fecal streptococci) using standard membrane filtration methods. Five tests were conducted using pumping rates ranging from 0.3 to 17 L/min in a variety of purging scenarios, which included constant and variable (incremental increase and decrease) flow. The results clearly show a rapid and reproducible, 1 to 2 log-unit decrease in fecal indicator bacteria at the onset of pumping to stabilized, low-level concentrations prior to the removal of three to five well volumes. The pumping rate was not found to be correlated with the magnitude of observed bacterial counts. Based on the results, we suggest sampling protocols for fecal indicator bacteria that include multiple collections during the course of pumping, including early-time samples, and consider other techniques such as microscopic enumeration when assessing the source of bacteria from the well-aquifer system.

  18. Longitudinal fecal steroid excretion in maned wolves (Chrysocyon brachyurus).

    PubMed

    Velloso, A L; Wasser, S K; Monfort, S L; Dietz, J M

    1998-10-01

    This study used a fecal steroid monitoring technique to evaluate reproductive cycles in male (4) and female (15) maned wolves, endangered South American canids. A radiolabeled testosterone infusion on a male revealed a fast and predominantly fecal route of excretion for this steroid. Testosterone was also excreted as eight unidentified metabolites, which was not the primary form of this steroid quantified in our assays. Fecal steroid concentrations (estradiol, E2; progestins, P; testosterone, T) in males and acyclic, nonpregnant (pseudo-pregnant), and pregnant females were monitored over four breeding seasons (October-January). Significant differences were detected between longitudinal P profiles of cyclic and acyclic females during estrus, luteal phase, and after birth/end of pseudo-pregnancy. Concentrations of P were also significantly higher in pregnant, compared to nonpregnant females, from proestrus to the end of the pregnant luteal phase. Although levels of T were higher in males than in females throughout the breeding season, no cyclicity in male fecal T concentrations was detected. Values of fecal P, T, and the ratio P/T were useful for differentiating gender and detecting pregnancy in females. Similarities to available data on other canids and the management and conservation implications of these findings were discussed.

  19. Gas-liquid chromatography of fecal neutral steriods.

    PubMed

    Gerhardt, K O; Gehrke, C W; Rogers, I T; Flynn, M A; Hentges, D J

    1977-05-21

    A method is described for the analysis of fecal neutral steriods with a dual-column gas-liquid chromatography (GLC) system. After saponification of the fecal slurry, the neutral steroids were extracted with hexane. The GLC separation of the compounds and quantitation were achieved by simultaneous injection of the derivatized and derivatized aliquots of the extract onto dual colmuns under identical conditions. The neutral steroids of interest were than identified by matching the retention times with those of known standards, and identification was confirmed by use of an interfaced GLC high-resolution mass spectrometry system. The detection limit was 0.003 mg of steroid/g of fecal slurry. The pricision of the method is illustrated by a relative standard diviation of 2-10% and a recovery of neutral steroids from 73-96%. The method was applied to the determination of fecal neutral steroids in a "High protein diet in colon cancer study". A considerably larger level of coprostanone than of coprostanol was observed. Data on neutral steroids in fecal samples from subjects on different diets are the subject of a separate publication.

  20. Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders

    PubMed Central

    Evrensel, Alper; Ceylan, Mehmet Emin

    2016-01-01

    Fecal microbiota transplantation has a 1700-year history. This forgotten treatment method has been put into use again during the last 50 years. The interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. New evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. There is a large number of experimental and clinical researches in the field of gut-brain axis. There is limited information on fecal microbiota transplantation. Despite this, initial results are promising. It is commonly used in the treatment of gastrointestinal diseases such as Clostridium difficile infection, Crohn’s disease, ulcerative colitis. It is also experimentally used in the treatment of metabolic and autoimmune diseases. There are case reports that it is effective in the treatment of autism, Parkinson’s disease, multiple sclerosis, chronic fatigue syndrome and irritable bowel syndrome. Its implementation is easy, and it is a cheap and reliable treatment method. However, the long-term risks are unknown. Additionally, standard application protocols have not yet been established. There are a lot of questions to be answered. A university in Turkey has got official permission this year, and started to apply fecal microbiota transplantation. In this review, neuropsychiatric areas of use of fecal microbiota transplantation have been discussed in the light of the current information. PMID:27489376

  1. Proceedings of the National Institute of Diabetes and Digestive and Kidney Diseases International Symposium on Epidemiologic Issues in Urinary Incontinence in Women.

    PubMed

    Brown, Jeanette S; Nyberg, Leroy M; Kusek, John W; Burgio, Kathryn L; Diokno, Ananias C; Foldspang, Anders; Fultz, Nancy H; Herzog, A Regula; Hunskaar, Steinar; Milsom, Ian; Nygaard, Ingrid; Subak, Leslee L; Thom, David H

    2003-06-01

    The Epidemiologic Issues in Urinary Incontinence: Current Databases and Future Collaborations Symposium included an international group of 29 investigators from 10 countries. The purpose of the symposium was to discuss the current understanding and knowledge gaps of prevalence, incidence, associated risk factors, and treatment outcomes for incontinence in women. During the symposium, investigators identified existing large databases and ongoing studies that provide substantive information on specific incontinence research questions. The investigators were able to form an international collaborative research working group and identify potential collaborative projects to further research on the epidemiology of urinary incontinence and bladder dysfunction.

  2. 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.

  3. A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

    PubMed

    Rogers, Rebecca G; Coates, Kimberly W; Kammerer-Doak, Dorothy; Khalsa, Satkirin; Qualls, Clifford

    2003-08-01

    The aim of this study was to develop the short form of a condition-specific, reliable, validated and self-administered instrument to evaluate sexual function in women with pelvic organ prolapse and/or urinary incontinence. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire -12 (PISQ-12) was developed from the data of 99 of 182 women surveyed to create the long form (PISQ-31). An additional 46 patients were recruited for further validation. All subsets regression analysis identified 12 items likely to predict PISQ-31 scores. Short form scores underwent correlation analysis with long form, Incontinence Impact Questionnaire - 7 (IIQ-7), Sexual History Form -12 (SHF-12) and Symptom Questionnaire (SQ) scores. Test-retest reliability was checked with a subset of 20 patients. All subsets regression analysis with R>0.92 identified 12 items that predicted PISQ-31 scores. Short form scores were highly correlated with long form scores ( R=0.75-0.95). Correlations of the PISQ-12 with SHF-12 ( R=-0.66 and -0.68) and IIQ-7 ( R=-0.38 and -0.54) scores were similar to correlation of the PISQ-31 with these other measures. Reliability was moderate to high, with weighted kappa values from 0.56 to 0.93. PISQ-12 scores were lower in patients with low sexual function as measured on the SHF-12 ( P <0.001), and lower in women with depression as measured on the SQ ( P <0.001). The PISQ-12 is a validated and reliable short form that evaluates sexual function in women with urinary incontinence and/or pelvic organ prolapse and predicts PISQ-31 scores. It is able to distinguish women with poor sexual function as measured on the SHF-12.

  4. [Guidelines for rehabilitation management of non-neurological urinary incontinence in women].

    PubMed

    Leriche, B; Conquy, S

    2010-02-01

    Pelvic floor rehabilitation is prescribed as first-line treatment for women with stress urinary incontinence, particularly in cases of urinary incontinence with no first-degree uterine prolapse, with poor-quality perineal testing results or inverted perineal command. Prescription of 15 sessions should suffice to evaluate the possibilities of improving the incontinence. The sessions can be continued if the patient feels she is progressing but has not reached sufficient results. With no progression despite properly conducted rehabilitation, the question of whether to continue the physical therapy arises. Currently, therapists determine the number of sessions. They are better apt to know whether sessions should be pursued and should relay a report to the prescribing physician. This type of rehabilitation is within the domain of physical therapists. Midwives can be responsible for postpartum rehabilitation. On the other hand, the importance of the patient's role in the results and their maintenance is well known. Occasionally a few sessions some time after the initial sessions can serve to verify the acquisitions and motivate the patient in her personal contribution to this rehabilitation. The work of the physical therapist cannot be substituted with Keat-type home electrostimulation. The physical therapist plays an important role in the overall management of this condition. Currently, in absence of demonstrated efficacy, self-administration of electrostimulation is not recommended. In urge incontinence, the rehabilitation approach will be used concomitantly with prescription of anticholergics with behavioral therapy and bladder biofeedback work. In addition, low-frequency electrostimulation can be done during the session. Starting with 10-12 sessions is sufficient. In all cases, rehabilitation should take a multidisciplinary approach and be integrated into a medical and/or surgical management plan.

  5. Artificial urinary sphincter for urinary incontinence after radical prostatectomy: a historical cohort from 2004 to 2015

    PubMed Central

    dos Santos, Augusto Cesar Soares; Rodrigues, Luíza de Oliveira; Azevedo, Daniela Castelo; Carvalho, Lélia Maria de Almeida; Fernandes, Mariana Ribeiro; Avelar, Sandra de Oliveira Sapori; Horta, Maria da Glória Cruvinel; Kelles, Silvana Márcia Bruschi

    2017-01-01

    ABSTRACT This study aimed to retrospectively evaluate a cohort of patients with prostate cancer and persistent urinary incontinence after radical prostatectomy. From January 2004 to December 2015, eighty-six individuals were identified to have received an AUS implant, provided by a private nonprofit HMO operating in Belo Horizonte, Brazil. On total, there were 91 AUS implants, with a median interval between radical prostatectomy and AUS implant of 3.6 years (IQR 1.9 to 5.5). The rate of AUS cumulative survival, after a median follow-up of 4.1 years (IQR 1.7-7.2 years), was 44% (n=40). The median survival of AUS implants was 2.9 years (IQR 0.5-7.9 years). Thirty-seven AUS implants (40.7%) resulted in grade III surgical complications. There were 5 deaths at 2.1, 4.7, 5.7, 5.7 and 6.5 years of follow-up, but none due to causes directly associated to the AUS implant. Persistent severe incontinence was documented in 14 (15.3%) additional patients. From the 51 AUS implants which resulted in grade III surgical complications or persistent severe incontinence, 24 (47.1%) underwent surgical revisions. Explantation of the sphincter or its components was observed in 6 cases (25.0%). Mechanical failure, described as fluid loss and/or inability to recycle the AUS device, was observed in 4 devices (16.7%). In conclusion, although AUS implants are recommended as the gold-standard treatment of severe urinary incontinence after prostatectomy, the observed high rates of malfunction and grade III adverse events are a matter of concern warranting further assessment on the safety and efficacy of these devices. PMID:28124538

  6. Artificial urinary sphincter for urinary incontinence after radical prostatectomy: a historical cohort from 2004 to 2015.

    PubMed

    Santos, Augusto Cesar Soares Dos; Rodrigues, Luíza de Oliveira; Azevedo, Daniela Castelo; Carvalho, Lélia Maria de Almeida; Fernandes, Mariana Ribeiro; Avelar, Sandra de Oliveira Sapori; Horta, Maria Glória Cruvinel; Kelles, Silvana Márcia Bruschi

    2017-01-01

    This study aimed to retrospectively evaluate a cohort of patients with prostate cancer and persistent urinary incontinence after radical prostatectomy. From January 2004 to December 2015, eighty-six individuals were identified to have received an AUS implant, provided by a private nonprofit HMO operating in Belo Horizonte, Brazil. On total, there were 91 AUS implants, with a median interval between radical prostatectomy and AUS implant of 3.6 years (IQR 1.9 to 5.5). The rate of AUS cumulative survival, after a median follow-up of 4.1 years (IQR 1.7-7.2 years), was 44% (n=40). The median survival of AUS implants was 2.9 years (IQR 0.5-7.9 years). Thirty-seven AUS implants (40.7%) resulted in grade III surgical complications. There were 5 deaths at 2.1, 4.7, 5.7, 5.7 and 6.5 years of follow-up, but none due to causes directly associated to the AUS implant. Persistent severe incontinence was documented in 14 (15.3%) additional patients. From the 51 AUS implants which resulted in grade III surgical complications or persistent severe incontinence, 24 (47.1%) underwent surgical revisions. Explantation of the sphincter or its components was observed in 6 cases (25.0%). Mechanical failure, described as fluid loss and/or inability to recycle the AUS device, was observed in 4 devices (16.7%). In conclusion, although AUS implants are recommended as the gold-standard treatment of severe urinary incontinence after prostatectomy, the observed high rates of malfunction and grade III adverse events are a matter of concern warranting further assessment on the safety and efficacy of these devices.

  7. [Delayed necrotizing fasciitis: a complication of stress incontinence surgery by suburethral sling].

    PubMed

    Tholozan, A-S; Delapparent, T; Terzibachian, J-J; Leung, F; Govyadovskiy, A; Maillet, R; Riethmuller, D

    2014-06-01

    We report a 50-year-old woman case with an extensive necrotizing fasciitis (NF). The NF appeared 10 years after a tension free vaginal tape procedure for urinary stress incontinence. Vital prognosis was engaged due to the initial sepsis severity. This kind of complication is rare and could be under estimated. NF usually appear soon after surgery, whatever within the year following implantation. Anyway, NF are always related to a vaginal erosion of the tape.

  8. Predictors of Success and Satisfaction of Nonsurgical Therapy for Stress Urinary Incontinence

    PubMed Central

    Schaffer, Joseph; Nager, Charles W.; Xiang, Fang; Borello-France, Diane; Bradley, Catherine S.; Wu, Jennifer M.; Mueller, Elizabeth; Norton, Peggy; Paraiso, Marie Fidela R.; Zyczynski, Halina; Richter, Holly E.

    2012-01-01

    Objective To identify factors that may predict success and satisfaction in women undergoing nonsurgical therapy for stress urinary incontinence (SUI). Methods Baseline demographic and clinical characteristics of women participating in a multicenter randomized trial of pessary, behavioral, or combined therapy for SUI were evaluated for potential predictors of success and satisfaction. Success and satisfaction outcomes were assessed at 3 months and included the Patient Global Impression of Improvement (PGI-I), stress incontinence subscale of the Pelvic Floor Distress Inventory (PFDI), and Patient Satisfaction Questionnaire (PSQ). Logistic regression was performed to identify predictors, adjusting for treatment and other important clinical covariates. Adjusted odds ratios (AOR), 95% confidence intervals (CI), and associated P-values are presented. Results Four hundred forty-six women were randomized. College education or higher and no previous UI surgery predicted success based on the stress subscale of the PFDI (AOR=1.61, 95% CI 1.01 to 2.55; p=0.04; AOR=3.15, 95% CI 1.04 to 9.53; p=0.04, respectively). Menopausal status predicted success using the PGI-I (AOR=2.52 postmenopausal vs premenopausal, 95% CI 1.29 to 4.95; AOR=1.32 unsure menopausal status vs pre-menopausal, 95% CI 0.65 to 2.66; p=0.03 across all three groups). Less than 14 incontinence episodes per week predicted satisfaction with the PSQ (AOR=1.97, 1.21 to 3.19; p=0.01). These predictors did not differ across the three treatment groups. Conclusions Menopause, higher education, no previous UI surgery and lower incontinence frequency were found to be predictors of success and satisfaction with nonsurgical therapy for SUI. This information may help better align provider and patient expectations with nonsurgical treatment outcomes. Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT00270998. PMID:22914396

  9. [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.

  10. Delirium following fesoterodine treatment for urgency incontinence in an 89-year old man

    PubMed Central

    Charbonneau, Jeannie Medeiros; Bisset, Rania; Nguyen, Patrick Viet-Quoc

    2016-01-01

    We describe the case of an 89-year-old man who developed delirium following the introduction of fesoterodine to treat his urgency incontinence. The patient started experiencing visual hallucinations approximately five days after starting fesoterodine 4 mg once daily. Delirium resolved after fesoterodine was stopped. Despite the apparent safe cognitive profile due to its pharmacodynamic properties, fesoterodine should be used with caution in the elderly, frail population. PMID:28255419

  11. Jacquet erosive diaper dermatitis in a young girl with urinary incontinence.

    PubMed

    Hara, M; Watanabe, M; Tagami, H

    1991-06-01

    We report a case of Jacquet erosive diaper dermatitis (dermatitis syphiloides posterosiva) in a 9-year-old girl suffering from urinary incontinence due to an ectopic opening of a left double ureter into the vaginal vestibule. The toilet paper that she used as an absorbent was thought to be one of the factors causing the eruption. The lesions cleared with topical application of a nonsteroidal antiinflammatory ointment and zinc oxide ointment, in conjunction with the use of sanitary napkins.

  12. Erbium: YAG Laser Incision of Urethral Structures for Treatment of Urinary Incontinence After Prostate Cancer Spray

    DTIC Science & Technology

    2006-02-01

    devoted to in vivo animal studies comparing the wound healingafter Erbium and Holmium laser incision of the urethra and bladder neck. Further...urinary incontinence. Conventional treatments for stricture (including balloon dilation, cold knife incision, electrocautery, and Holmium laser incision...urethral tissue with a thermal damage zone of only 10-20 µm. This thermal damage zone was much less than that of the Holmium laser which produced 300 µm of

  13. Low-dose dual-energy electronic cleansing for fecal-tagging CT Colonography

    NASA Astrophysics Data System (ADS)

    Cai, Wenli; Zhang, Da; Lee, June-Goo; Yoshida, Hiroyuki

    2013-03-01

    Dual-energy electronic cleansing (DE-EC) provides a promising means for cleansing the tagged fecal materials in fecaltagging CT colonography (CTC). However, the increased radiation dose due to the double exposures in dual-energy CTC (DE-CTC) scanning is a major limitation for the use of DE-EC in clinical practice. The purpose of this study was to develop and evaluate a low-dose DE-EC scheme in fecal-tagging DE-CTC. In this study, a custom-made anthropomorphic colon phantom, which was filled with simulated tagged materials by non-ionic iodinated contrast agent (Omnipaque iohexol, GE Healthcare), was scanned by a dual-source CT scanner (SOMATON Definition Flash, Siemens Healthcare) at two photon energies: 80 kVp and 140 kVp with nine different tube current settings ranging from 12 to 74 mAs for 140 kVp, and then reconstructed by soft-tissue reconstruction kernel (B30f). The DE-CTC images were subjected to a low-dose DE-EC scheme. First, our image-space DE-CTC denoising filter was applied for reduction of image noise. Then, the noise-reduced images were processed by a virtual lumen tagging method for reduction of partial volume effect and tagging inhomogeneity. The results were compared with the registered CTC images of native phantom without fillings. Preliminary results showed that our low-dose DE-EC scheme achieved the cleansing ratios, defined by the proportion of the cleansed voxels in the tagging mask, between 93.18% (12 mAs) and 96.62% (74 mAs). Also, the soft-tissue preservation ratios, defined by the proportion of the persevered voxels in the soft-tissue mask, were maintained in the range between 94.67% and 96.41%.

  14. Two-Year Outcomes After Sacrocolpopexy With and Without Burch to Prevent Stress Urinary Incontinence

    PubMed Central

    Brubaker, Linda; Nygaard, Ingrid; Richter, Holly E.; Visco, Anthony; Weber, Anne M.; Cundiff, Geoffrey W.; Fine, Paul; Ghetti, Chiara; Brown, Morton B.

    2008-01-01

    OBJECTIVES To report anatomic and functional outcomes 2 years after sacrocolpopexy in stress-continent women with or without prophylactic Burch colposuspension. METHODS In the Colpopexy and Urinary Reduction Efforts (CARE) trial, stress-continent women undergoing sacrocolpopexy were randomized to receive or not receive a Burch colposuspension. Outcomes included urinary symptoms, other pelvic symptoms, and pelvic support. Standardized pelvic organ prolapse quantification examinations and validated outcome measures including the Pelvic Floor Distress Inventory and the Pelvic Floor Impact Questionnaire were completed before surgery and at several postoperative intervals, including at 2 years. RESULTS This analysis is based on 302 of 322 randomized participants. Most were Caucasian (94%), with a mean age of 62±10 years (mean±standard deviation). Two years after surgery, 32.0% and 45.2% of women in the Burch and control groups, respectively, met the stress incontinence endpoint (presence of symptoms or positive cough stress test or interval treatment for stress incontinence, P=.026). The apex was well supported (point C within 2 cm of total vaginal length) in 95% of women, and this was not affected by concomitant Burch (P=.18). There was a trend toward fewer urgency symptoms in the Burch group (32.0% versus 44.5% no Burch, P=.085). Twenty participants experienced mesh or suture erosions. CONCLUSION The early advantage of prophylactic Burch colposuspension for stress incontinence that was seen at 3 months remains at 2 years. Apical anatomic success rates are high and not affected by concomitant Burch. PMID:18591307

  15. Nursing Home Work Environment and the Risk of Pressure Ulcers and Incontinence

    PubMed Central

    Temkin-Greener, Helena; Cai, Shubing; Zheng, Nan Tracy; Zhao, Hongwei; Mukamel, Dana B

    2012-01-01

    Objective To examine the association between nursing home (NH) work environment attributes such as teams, consistent assignment and staff cohesion, and the risk of pressure ulcers and incontinence. Data Sources/Setting Minimum dataset for 46,044 residents in 162 facilities in New York State, for June 2006–July 2007, and survey responses from 7,418 workers in the same facilities. Study Design For each individual and facility, primary and secondary data were linked. Random effects logistic models were used to develop/validate outcome measures. Generalized estimating equation models with robust standard errors and probability weights were employed to examine the association between outcomes and work environment attributes. Key independent variables were staff cohesion, percent staff in daily care teams, and percent staff with consistent assignment. Other facility factors were also included. Principal Findings Residents in facilities with worse staff cohesion had significantly greater odds of pressure ulcers and incontinence, compared with residents in facilities with better cohesion scores. Residents in facilities with greater penetration of self-managed teams had lower risk of pressure ulcers, but not of incontinence. Prevalence of consistent assignment was not significantly associated with the outcome measures. Conclusions NH environments and management practices influence residents’ health outcomes. These findings provide important lessons for administrators and regulators interested in promoting NH quality improvement. PMID:22098384

  16. PATIENT EXPECTATIONS DID NOT PREDICT OUTCOME OF DRUG AND BEHAVIORAL TREATMENT OF URGENCY URINARY INCONTINENCE

    PubMed Central

    FitzGerald, Mary P; DuBeau, Catherine E.; Kraus, Stephen R.; Johnson, Harry W.; Rahn, David D.; Mallett, Veronica; Stoddard, Anne M.; Zyczynski, Halina M.

    2012-01-01

    Objectives To determine whether expectations of treatment outcomes in women participating in a drug and behavioral treatment trial for urge urinary incontinence are related to patient factors, demographics, health-related locus of control and treatment outcomes. Methods Baseline assessments included expectations (improvement in bladder condition, time to improvement in bladder condition, and duration of improvement) and the multidimensional health locus of control (MHLC) scale. Outcomes were measured by patient global impression of improvement (PGI-I) at the end of active treatment (10 weeks) and 8 months after trial start. Results At baseline among 173 subjects, 114 (66%) believed their incontinence would get ‘very much better,’ 94 (55%) expected improvement by one month, and 111 (66%) expected improvement would last the rest of their lives.. There were no significant associations between baseline expectations or MHLC with PGI-I at 10 weeks or 8 months. Conclusions Expectations of treatment outcome and MHLC did not predict eventual patient-reported treatment outcome in this sample of women with urge-predominant urinary incontinence participating in a trial of drug and behavioral therapy. PMID:22453106

  17. Urodynamic Characterization of Obese Women with Urinary Incontinence Undergoing a Weight Loss Program

    PubMed Central

    Richter, Holly E.; Creasman, Jennifer M.; Myers, Deborah L.; Wheeler, Thomas L.; Burgio, Kathryn L.; Subak, Leslee L.

    2008-01-01

    Introduction The purpose of this study was to describe urodynamic characteristics of overweight or obese women with urinary incontinence and explore the relationship between urodynamic parameters, body mass index (BMI), and abdominal circumference (AC). Materials & Methods One hundred ten women underwent a standardized cough stress test and urodynamic study. Results 86% of women had urodynamic stress incontinence and 15% detrusor overactivity. Intraabdominal pressure (Pabd) at maximum cystometric capacity (MCC) increased 0.4 cm H2O per kg/m2 unit of BMI (95% confidence interval (CI): 0.0,0.7, p=0.04) and 0.4 cm H2O per 2 cm increase in AC (CI: 0.2, 0.7, p<0.01). Intravesical pressure (Pves) at MCC increased 0.4 cm H2O per 2 cm increase in AC (CI: 0.0, 0.8, p=0.05), but was not associated with BMI (p=0.18). Conclusion BMI and AC had a stronger association with Pabd than with Pves, suggesting a possible mechanism for the association between obesity and urinary incontinence. PMID:18679560

  18. 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

  19. Path analysis for adherence to pelvic floor muscle exercise among women with urinary incontinence.

    PubMed

    Chen, Shu-Yueh; Tzeng, Ya-Ling

    2009-06-01

    This study developed and tested the accuracy of a model designed to predict adherence to a pelvic floor muscle exercise regimen by Taiwanese women with urinary incontinence. The sample was composed of 106 women treated for urinary incontinence at urban hospitals in central and northern Taiwan from April 2000 to March 2003. All participants had practiced prescribed pelvic floor muscle exercises for at least 6 weeks at the time they completed study measures, which included adherence to pelvic floor muscle exercise, self-efficacy for the exercise, knowledge of the exercise, attitudes toward the exercise, dyadic cohesion, perceived benefits of the exercise, and severity of urine loss. After stepwise multiple regression analysis, a path analysis was conducted, with significant paths retained as modifiers. Self-efficacy for pelvic floor muscle exercise strongly and directly affected adherence to the exercise regimen. Attitudes toward the exercise, dyadic cohesion, and perceived benefits of the exercise affected adherence when mediated by self-efficacy for pelvic floor muscle exercise. Severity of urine loss also directly affected adherence. Exercise knowledge affected neither self-efficacy nor adherence. The model fit the data and accounted for 40% of adherence variance. Findings affirm the significant role of self-efficacy in predicting adherence to pelvic floor muscle exercise. Thus, self-efficacy for exercise can be an indicator for nurses to tailor exercise-training programs for women with urinary incontinence. Nurses can use the study findings to develop interventions to increase women's adherence to the exercise.

  20. Female Functional Constipation Is Associated with Overactive Bladder Symptoms and Urinary Incontinence

    PubMed Central

    Tomita, Masuomi; Sakai, Gen; Funakoshi, Shinsuke; Komatsuda, Akari; Ito, Yujiro; Nagata, Hirohiko; Tsukada, Nobuhiro; Nakamura, So

    2017-01-01

    This noninterventional cross-sectional study aims to assess the association between functional constipation (FC) and urinary symptoms in female patients with no treatment for urination and defecation. The Rome III criteria for evaluation of defecation, Overactive Bladder Symptom Score (OABSS) for evaluation of urinary symptoms, and clinical features were investigated in 145 female patients. Latent FC and moderate to severe overactive bladder (OAB) were defined on the basis of positivity for two or more of the Rome III criteria and an OABSS ≥ 6 with OABSS Q3 ≥ 2, respectively. In 60 latent FC patients, the OABSS was higher (5.0 versus 3.2, p = 0.001), and concurrent moderate to severe OAB symptoms and OAB with urinary incontinence were more frequent than those in 85 nonlatent FC patients (33.3 versus 10.6%, p = 0.001, and 31.7 versus 7.1%, p < 0.001). Multivariate analysis demonstrated that moderate to severe OAB symptoms were a significant associated factor of latent FC (odds ratio (OR) = 4.125, p = 0.005), while latent FC was the only associated factor of moderate to severe OAB and OAB with urinary incontinence (OR = 4.227, p = 0.005 and OR = 4.753, p = 0.004). In conclusion, moderate to severe OAB symptoms are correlated with FC. Moreover, FC is related to moderate to severe OAB symptoms and to OAB with urinary incontinence. PMID:28337444

  1. Treatment of Stress Urinary Incontinence in Neurological Patients With an Injectable Elastomer Prosthesis: Preliminary Results

    PubMed Central

    Citeri, Marco; Zanollo, Lucia; Guerrer, Chiara; Rizzato, Luigi; Frediani, Luca; Iselin, Christophe; Spinelli, Michele

    2017-01-01

    Many treatment options for stress urinary incontinence are difficult to apply to neurological patients. Urolastic is a new agent that is primarily indicated for women with mild stress urinary incontinence or men after prostate surgery. In this report, we present a series of 5 cases describing the first use of Urolastic to treat neurological patients. All patients were evaluated with a voiding diary and the use of auxiliary devices as the main indicators of continence. The median operative time was 30.8 minutes, and no complications were observed. Of the 5 patients, 4 reported improved incontinence: 2 switched from diapers to small pads, while the other 2 patients were able to discontinue urinary condom use. The only instance of treatment failure occurred in a patient with a low-compliance bladder. The advantages of this procedure appear to include a soft-cuff effect, reversibility, and minimal invasiveness. However, a future randomized study would be necessary to validate this treatment option. PMID:28361514

  2. Selected determinants of quality of life in women with urinary incontinence

    PubMed Central

    Szymona-Pałkowska, Katarzyna; Kraczkowski, Janusz J.; Janowski, Konrad; Steuden, Stanisława; Adamczuk, Jolanta; Robak, Jacek M.; Bakalczuk, Grzegorz

    2014-01-01

    Urinary incontinence (UI) is one of the most common diseases in women. It involves uncontrolled leaking of urine through the urethra. UI incidence depends on age and in certain age groups it can affect up to 60% of the female population. The symptoms can be persistent and due to their embarrassing nature they can lead to significant deterioration of quality of life and psychological functioning. The aim of this study was to investigate the relationship between the quality of life and selected aspects of functioning. Seventy female outpatients of a public clinic in Nałęczów, Poland, were examined, and the following methods were used: the Urinary Incontinence Life Quality Scale (Szymona-Pałkowska, Kraczkowski), Disease-Related Appraisal Scale (Janowski, Steuden), Coping Inventory for Stressful Situations (Endler, Parker), Disease-Related Social Support Scale (Brachowicz, Janowski, Sadowska), and the Knowledge Appraisal Scale for Urinary Incontinence (Szymona-Pałkowska, Kraczkowski). The obtained results suggest that the strongest predictors for the quality of life with UI would be: perception of the disease as an injustice and a challenge (a reverse relationship) and an avoidance-oriented style of coping with stress through companionship seeking (a positive relationship). The duration of the disease and the level of related knowledge proved to be crucial in the analysis of one dimension, i.e. distance to the symptoms. PMID:26327835

  3. The impact of pelvic organ prolapse on sexual function in women with urinary incontinence.

    PubMed

    Ozel, Begüm; White, Terry; Urwitz-Lane, Rebecca; Minaglia, Steven

    2006-01-01

    The aim of the study is to evaluate the impact of pelvic organ prolapse (POP) on sexual function in women with urinary incontinence (UI). In this retrospective, case-cohort study, we reviewed the medical records of all women evaluated for UI between March and November 2003. All patients completed the short forms of the Urogenital Distress Inventory, Incontinence Impact Questionnaire, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. Women with stage two or greater POP, as determined by the pelvic organ prolapse quantification (POPQ) system, were compared to women with stage 0 or 1 POP. Sixty-nine women with POP and 47 women without POP were included. Patient demographics did not differ between the two groups. Women with POP were significantly more likely to report absence of libido (53% versus 30%, P=0.02), lack of sexual excitement during intercourse (46% versus 27%, P=0.05), and that they rarely experienced orgasm during intercourse (49% versus 30%, P=0.05). In conclusion, women with POP in addition to UI are more likely to report decreased libido, decreased sexual excitement, and difficulty achieving orgasm during intercourse when compared to women with UI alone.

  4. Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse.

    PubMed

    Rogers, G R; Villarreal, A; Kammerer-Doak, D; Qualls, C

    2001-01-01

    The sexual function of women with and without urinary incontinence and/or pelvic organ prolapse (UI/POP) was compared using a condition-specific validated questionnaire, the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). Eighty-three women with UI/POP and 56 without agreed to participate. PISQ scores were significantly lower among women with UI/POP than in those without (P = 0.003). No differences in the stages of sexual excitement were noted between groups. The frequency of intercourse was less with UI/POP than without (P= 0.04). Women with UI/POP restricted sexual activity for fear of losing urine more frequently than did those without (P = 0.005). No differences were reported in patients' or partners' sexual satisfaction. This study found that women with UI/POP have poorer sexual functioning than those without, as measured by the PISQ, and report less frequent sexual activity. In addition, women with UI/POP are more likely to restrict sexual activity for fear of incontinence, although they report similar levels of satisfaction with their sexual relationships as do women without UI/POP.

  5. Urodynamic Changes Associated with Successful Stress Urinary Incontinence Surgery: Is a Little Tension a Good Thing?

    PubMed Central

    Kraus, Stephen R.; Lemack, Gary E.; Sirls, Larry; Chai, Toby C.; Brubaker, Linda; Albo, Michael; Leng, Wendy W.; Lloyd, L. Keith; Norton, Peggy; Litman, Heather

    2011-01-01

    Objectives The aim of this study is to identify urodynamic changes that correlate with successful outcomes after stress urinary incontinence (SUI) surgery. Methods 655 women were randomized to Burch colposuspension or autologous fascial sling as part of the multi-center Stress Incontinence Surgical Treatment Efficacy Trial. Preoperatively and 24 months after surgery, participants underwent standardized urodynamic testing which included non-invasive uroflowmetry, cystometrogram and pressure flow studies. Changes in urodynamic parameters were correlated to a successful outcome, defined a priori as: 1) negative pad test, 2) no urinary incontinence on 3-day diary, 3) negative cough and valsalva stress test, 4) no self-reported SUI symptoms on the Medical, Epidemiological and Social Aspects of Aging Questionnaire and 5) no retreatment for SUI. Results Subjects who met criteria for surgical success showed a greater relative increase in mean Pdet@Qmax (baseline vs 24 months) than women who were considered surgical failures (p = 0.008). While a trend suggested an association between greater increases in bladder outlet obstruction index and outcome success, this was not statistically significant. Other urodynamic variables such as maximum uroflow, bladder compliance, and the presence of preoperative or de novo detrusor overactivity did not differ with respect to outcome status. Conclusions Successful outcomes in both surgical groups (Burch and sling) were associated with higher voiding pressures relative to preoperative baseline values. However, concomitant changes in other urodynamic voiding parameters were not significantly associated with outcome. PMID:21996108

  6. Breaking the cycle: the etiology of incontinence dermatitis and evaluating and using skin care products.

    PubMed

    Fiers, S A

    1996-04-01

    Dermatitis is a common problem for incontinent patients; a cycle of moisture, friction, bacteria and breakdown can be established. To break this cycle, the clinician must understand the etiology of incontinence dermatitis and choose appropriate skin care products. Healthy skin has a mean acid mantle of 5.5 pH. This natural acidity discourages bacterial colonization and provides a moisture barrier. Aging skin experiences increased dryness (allowing cracks in which bacteria colonizes) and slower recovery from the effects of alkaline substances. Incontinence results in elevated friction coefficient, exposure to moisture, bacteria and ammonia (leading to alkaline conditions), and increased enzymatic activity. When choosing products to protect the skin, clinicians should check that the product's pH level is within the desirable range (4 to 7), that ingredients are appropriate and not contraindicated for particular patients, and that the product has been tested for dermal irritation and antimicrobial efficacy. Three basic product types are cleansers, moisturizers and barriers. Skin should be cleansed gently without high alkalinity (as in some bar soaps) or rubbing (which denudes fragile skin), patted or air dried, moisturized after bathing, and protected with a barrier. Using the appropriate products can reduce the risk for breakdown and enhance the skin health of your patients.

  7. Behavioural treatment of urinary incontinence and encopresis in children with learning disabilities: transfer of stimulus control.

    PubMed

    Smith, L; Smith, P; Lee, S K

    2000-04-01

    Urinary and faecal incontinence present a considerable problem in people with learning disabilities, despite the general effectiveness of behavioural techniques in continence training. Children with learning disabilities and obsessional behaviour may be particularly resistant to toilet training, even where relatively cognitively able, and often despite a substantial degree of control over their eliminatory functions. Their resistance may be more appropriately regarded as a challenging behaviour and their incontinence better explained by factors other than a simple failure to learn. A 'stimulus-control' hypothesis proposes that the child's nappy (diaper)/potty/underwear has developed strong stimulus control over the elimination response. This report describes three case studies in which treatment-resistant children, aged between 8 and 12 years, with mild or moderate learning disabilities, were successfully treated for nappy-dependent nocturnal encopresis or diurnal urinary incontinence. The children were routine case referrals for whom previous attempts to train bowel or bladder control had failed. Behavioural techniques, such as 'shaping' (gradually increasing the proximity to the toilet), 'fading' (reducing the presence of the nappy), and rewards for eliminating, effected successful transfer of stimulus control over elimination from nappy to toilet. Treatment times varied, depending on the degree of the child's obsession and resistance to change.

  8. Dietary marker effects on fecal microbial ecology, fecal VFA, nutrient digestibility coefficients, and growth performance in finishing pigs.

    PubMed

    Kerr, B J; Weber, T E; Ziemer, C J

    2015-05-01

    Use of indigestible markers such as Cr2O3, Fe2O3, and TiO2 are commonly used in animal studies to evaluate digesta rate of passage and nutrient digestibility. Yet, the potential impact of indigestible markers on fecal microbial ecology and subsequent VFA generation is not known. Two experiments utilizing a total of 72 individually fed finishing pigs were conducted to describe the impact of dietary markers on fecal microbial ecology, fecal ammonia and VFA concentrations, nutrient digestibility, and pig performance. All pigs were fed a common diet with no marker or with 0.5% Cr2O3, Fe2O3, or TiO2. In Exp. 1, after 33 d of feeding, fresh fecal samples were collected for evaluation of microbial ecology, fecal ammonia and VFA concentrations, and nutrient digestibility, along with measures of animal performance. No differences were noted in total microbes or bacterial counts in pig feces obtained from pigs fed the different dietary markers while Archaea counts were decreased (P = 0.07) in feces obtained from pigs fed the diet containing Fe2O 3compared to pigs fed the control diet. Feeding Cr2O3, Fe2O3, or TiO2 increased fecal bacterial richness (P = 0.03, 0.01, and 0.10; respectively) when compared to pigs fed diets containing no marker, but no dietary marker effects were noted on fecal microbial evenness or the Shannon-Wiener index. Analysis of denaturing gradient gel electrophoresis gels did not reveal band pattern alterations due to inclusion of dietary markers in pig diets. There was no effect of dietary marker on fecal DM, ammonia, or VFA concentrations. Pigs fed diets containing Cr2O3 had greater Ca, Cu, Fe, and P (P ≤ 0.02), but lower Ti ( P= 0.08) digestibility compared to pigs fed the control diet. Pigs fed diets containing Fe2O3 had greater Ca (P = 0.08) but lower Ti (P = 0.01) digestibility compared to pigs fed the control diet. Pigs fed diets containing TiO2 had greater Fe and Zn (P ≤ 0.09), but lower Ti ( P= 0.01) digestibility compared to pigs fed the

  9. Fecal microbiota transplantation via colonoscopy for recurrent C. difficile Infection.

    PubMed

    Allegretti, Jessica R; Korzenik, Joshua R; Hamilton, Matthew J

    2014-12-08

    Fecal Microbiota Transplantation (FMT) is a safe and highly effective treatment for recurrent and refractory C. difficile infection (CDI). Various methods of FMT administration have been reported in the literature including nasogastric tube, upper endoscopy, enema and colonoscopy. FMT via colonoscopy yields excellent cure rates and is also well tolerated. We have found that patients find this an acceptable and tolerable mode of delivery. At our Center, we have initiated a fecal transplant program for patients with recurrent or refractory CDI. We have developed a protocol using an iterative process of revision and have performed 24 fecal transplants on 22 patients with success rates comparable to the current published literature. A systematic approach to patient and donor screening, preparation of stool, and delivery of the stool maximizes therapeutic success. Here we detail each step of the FMT protocol that can be carried out at any endoscopy center with a high degree of safety and success.

  10. Media Discourse on the Social Acceptability of Fecal Transplants.

    PubMed

    Chuong, Kim H; O'Doherty, Kieran C; Secko, David M

    2015-10-01

    Advances in human microbiome research have generated considerable interest in elucidating the role of bacteria in health and the application of microbial ecosystem therapies and probiotics. Fecal transplants involve the introduction of gut microbes from a healthy donor's stool to the patient and have been documented as effective for treating Clostridium difficile infections (CDIs) and some other gastrointestinal disorders. However, the treatment has encountered regulatory hurdles preventing widespread uptake. We examined dominant representations of fecal transplants in Canadian media and found that fecal transplants are often represented as being inherently disgusting or distasteful (the "ick factor"). This "ick factor" is used to construct different messages about the treatment's social acceptability and legitimacy. We conclude that an over-emphasis on the "ick factor" constrains public discourse from a more nuanced discussion of the social challenges, scientific concerns, and regulatory issues surrounding the treatment.

  11. [The usefulness of fecal tests in colorectal cancer screening].

    PubMed

    Castells, Antoni

    2014-09-01

    Colorectal cancer is a paradigm of neoplasms that are amenable to preventative measures, especially screening. Currently, to carry this out, there are various strategies that have proven effective and efficient. In countries that have organized population-level screening programs, the most common strategy is fecal occult blood testing. In recent years, new methods have appeared that could constitute viable alternatives in the near future, among which the detection of changes in fecal DNA is emphasized. In this article, we review the most relevant papers on colorectal cancer screening presented at the annual meeting of the American Gastroenterological Association held in Chicago in May 2014, with special emphasis on the medium and long-term performance of strategies to detect occult blood in feces and the first results obtained with fecal DNA testing.

  12. Fecal bile acids of black-footed ferrets

    USGS Publications Warehouse

    Richardson, Louise; Johnson, M.K.; Clark, T.W.; Schroder, M.H.

    1986-01-01

    Fecal bile acid characteristics have been used to identify scats to species of origin. Fecal bile acids in scats from 20 known black-footed ferrets ( Mustela nigripes ), 7 other known small carnivores, and 72 of unknown origin were analyzed to determine if this procedure could be used as a tool to verify ferret presence in an area. Seventeen ferret scats were suitable for analysis and had a mean fecal bile acid index of 156 ± 9. This was significantly different from mean indices for the other carnivores; however, substantial overlap among confidence intervals occurred for badgers, kit foxes, and especially long-tailed weasels. We conclude this method is not useful for making positive identifications if individual ferret scats and suggest that we may be able to definitively identify individual scats with reasonable confidence by using gas-liquid chromatography.

  13. Fecal Impaction Causing Pelvic Venous Compression and Edema

    PubMed Central

    Naramore, Sara; Aziz, Faisal; Alexander, Chandran Paul; Methratta, Sosamma; Cilley, Robert; Rocourt, Dorothy

    2015-01-01

    Chronic constipation is a common condition which may result in fecal impaction. A 13-year-old male with chronic constipation and encopresis presented with fecal impaction for three weeks. The impaction caused abdominal pain, distension, encopresis, and decreased oral intake. He was found in severe distress with non-pitting edema of his feet and ankles along with perineal edema. The pedal edema worsened after receiving a fluid bolus, so concern arose for venous compression or a thrombus. A Duplex Ultrasound demonstrated changes in the venous waveforms of the bilateral external iliac and common femoral veins without thrombosis. Manual disimpaction and polyethylene glycol 3350 with electrolytes resolved the pedal and perineal edema. Four months later, he had soft bowel movements without recurrence of the edema. A repeat Duplex Ultrasound was normal. We present a child in whom severe fecal impaction caused pelvic venous compression resulting in bilateral pedal and perineal edema. PMID:26500749

  14. Fecal sodium and potassium losses in low birth weight infants.

    PubMed

    Verma, R P; John, E; Fornell, L; Vidyasagar, D

    1993-01-01

    We measured 24-hour fecal losses of sodium (Na) and potassium (K) in immediate post natal period of preterm neonates to determine the role of this route in the electrolyte imbalances seen in such infants. The values from preterm infants were compared to a group of age matched term infants. Eleven studies were done on unfed extremely low birth weight infants (group I, birth weight < 1200 gms), seven on fed preterm infants (group II, birth weight 1201-2500 gms) and nine on fed term infants (group III, birth weight 2501-4000 gms). Measured and derived variables compared between the groups were 24 hour fecal volume, total fecal electrolyte contents, Na or K lost per kg of body weight and per gm. of stool and Na or K losses as percent of intake. Although 24 hour fecal volume was lowest in group I, none of the variables related to Na differed between groups I and II whereas all of them were significantly lower in group I when compared with group III. Groups II and III differed only in terms of Na loss/gm stool which was lower in the previous group. Conversely K loss/gm of stool was significantly higher in group I when compared with both groups II and III and the only variable that differed between groups II and III was a higher fecal K content as fraction of intake. Fecal K/Na ratio was highest in group I, and decreased progressively with advancing gestational age, whereas creatinine clearance was lowest in group I and increased along with gestational age.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Fecal pellets: role in sedimentation of pelagic diatoms.

    PubMed

    Schrader, H J

    1971-10-01

    Membrane-enclosed fecal pellets of planktonic herbivores were sampled at several depths in the Baltic Sea (459 meters deep) and off Portugal (4000 meters deep) by means of a Simonsen multinet. Pellets contained mainly empty shells of planktonic diatoms and silicoflagellates. Two kinds of fecal pellets were found, those with the remains of one species (for example, Thalassiosira baltica) and those with the remains of several species (for example, Chaetoceros, Achnanthes, and Thalassiosira). Siliceous skeletons were protected from dissolution during settling by a membrane around the pellet.

  16. Chapter A7. Section 7.1. Fecal Indicator Bacteria

    USGS Publications Warehouse

    Myers, Donna N.; Sylvester, Marc A.

    1997-01-01

    Fecal indicator bacteria are used to assess the microbiological quality of water because, although not typically disease causing, they are correlated with the presence of several waterborne disease-causing organisms. The concentration of indicator bacteria is a measure of water safety for body-contact recreation or for consumption. This report provides information on the equipment, sampling protocols, and identification, enumeration, and calculation procedures that are in standard use by U.S. Geological Survey (USGS) personnel for the collection of data on fecal indicator bacteria.

  17. Prevalence of functional bowel disorders and faecal incontinence: an Australian primary care survey

    PubMed Central

    Ng, K-S; Nassar, N; Hamd, K; Nagarajah, A; Gladman, M A

    2015-01-01

    Aim Interest in functional bowel disorders (FBDs) and faecal incontinence (FI) has increased amongst coloproctologists. The study aimed to assess the prevalence of FBDs and FI (including its severity) among Australian primary healthcare seekers using objective criteria. Method A cross-sectional survey was conducted in a primary care setting in Sydney, Australia. A self-administered questionnaire was used to collect demographic information and diagnose FBDs (irritable bowel syndrome, constipation, functional bloating and functional diarrhoea) based on Rome III criteria. The severity of FI was determined using the Vaizey incontinence score. Associations with medical/surgical history and healthcare utilization were assessed. Results Of 596 subjects approached, 396 (66.4%) agreed to participate. Overall, 33% had FBD and/or FI. Irritable bowel syndrome was present in 11.1% and these participants were more likely to report anxiety/depression (P < 0.01) and to have had a previous colonoscopy (P < 0.001) or cholecystectomy (P = 0.02). Functional constipation was present in 8.1%, and functional bloating and functional diarrhoea were diagnosed in 6.1%, and 1.5%, respectively. FI was present in 12.1% with the majority (52%) reporting moderate/severe incontinence (Vaizey score > 8). Participants with FI were more likely to have irritable bowel syndrome, urinary incontinence and previous anal surgery (P < 0.01). Conclusion FBDs and FI are prevalent conditions amongst primary healthcare seekers and the needs of those affected appear to be complex given their coexisting symptoms and conditions. Currently, the majority do not reach colorectal services, although increased awareness by primary care providers could lead to sufferers being referred for specialist management. What does this paper add to the literature? This paper is the first to establish the prevalence of functional bowel disorders and faecal incontinence using explicit, standardized criteria amongst healthcare

  18. Two-Year Outcomes After Surgery for Stress Urinary Incontinence in Older Compared to Younger Women

    PubMed Central

    Goode, Patricia S.; Brubaker, Linda; Zyczynski, Halina; Stoddard, Anne M.; Dandreo, Kimberly J.; Norton, Peggy A.

    2008-01-01

    Precis Women 65 years and older have similar perioperative adverse events and length of stay, but lower subjective and objective cure rates after stress incontinence surgery than younger women. Objective To estimate if perioperative and postoperative outcomes after Burch colposuspension or pubovaginal sling for stress urinary incontinence (SUI) differed with age. Methods This study was a prospective secondary analysis of the Stress Incontinence Surgical Treatment Efficacy Trial. Baseline characteristics, adverse events, and 2-year outcomes of women at least 65 years old were compared to those younger than 65 utilizing chi-square and t-tests. Multivariable analyses were performed, including age and outcomes that differed between age groups on univariable analysis, adjusting for variables that differed by age group at baseline and by surgical treatment group. Results Six-hundred fifty-five women were included in analyses of perioperative events and 520 for 2-year outcomes. Mean age (±SD) was 69.7(±3.7) years in the older group and 49.4(±8.2) in the younger group. Older women had slightly longer time to normal activities (50 versus 42 days, p=0.05), but there was no difference in time to normal voiding (14 versus 11 days, p=0.42). Older women were more likely to have a positive stress test at follow-up (OR 3.7, 95% CI 1.70-7.97, p=.001), less subjective improvement in stress (8 point lesser decrease, 95%CI: 1.5-14.1, p=0.02), and urge incontinence (7 point lesser decrease, 95% CI 1.5-12.2, p=0.01) by the Medical and Epidemiologic Social Aspects of Aging questionnaire, and were more likely to undergo surgical retreatment for SUI (OR 3.9, 95% CI 1.30-11.48). Perioperative adverse events and length of stay did not differ between groups. Conclusion Older women undergoing surgery for stress incontinence can expect to do as well as younger women with respect to perioperative outcomes, but experience 2-year outcomes that are worse. Clinical Trial Registration Clinical

  19. Minimum important difference for validated instruments in women with urge incontinence

    PubMed Central

    Xu, Yan; Brubaker, Linda; Nygaard, Ingrid; Markland, Alayne; Rahn, David; Chai, Toby C.; Stoddard, Ann; Lukacz, Emily

    2017-01-01

    Aims Minimum important difference (MID) estimates the minimum degree of change in an instrument’s score that correlates with subjective sense of improvement. The aim of this study was to estimate the MID for the Urogenital Distress Inventory(UDI), Incontinence Impact Questionnaire(IIQ) and Overactive Bladder Questionnaire(OAB-q) using anchor and distribution-based approaches in patients with urge-predominant incontinence and whether MID changes over time. Methods This was a sub-analysis of a multi-center trial of 307 women with pure urge (11) or urge-predominant (296) incontinence who completed condition-specific instruments 10 weeks and 8 months after randomization to anticholinergic medication with or without behavioral therapy. We applied anchor-based methods only when the Kendall’s rank correlations between the anchors (Global Perception of Improvement(GPI), Patient Satisfaction Questionnaire(PSQ) and incontinence episodes(IE)) and the incontinence instruments (UDI, UDI irritative subscale, IIQ and OAB-q subscales) were ≥0.3. We applied 3 distribution-based methods to all instruments: effect sizes of ±0.2 SD (small) and ±0.5 SD (medium) and standard error of measurement (SEM) of ±1. Analyses were performed at both time points. Results Anchor-based MIDs for the UDI ranged from -35 to -45 and -15 to -25 for the irritative subscale Distribution-based methods MIDs for UDI and IIQ ranged between -10 to -25 and -19 to -49 respectively, reflective of a reduction in bother and symptom severity. OAB-q subscale MIDs ranged from +5 to +12, denoting improved quality of life (HRQL) and -13 to -25, consistent with a reduction in symptom severity (SS). Conclusions The MID in women with urge-predominant UI for the UDI and UDI irritative are -35 and -15. Our findings are consistent with previously reported MIDs for the OAB-q subscales. Distribution-based method MIDs are lower values than anchor-based values. The MID did not typically change over the time. PMID:21563210

  20. Magnetic resonance imaging of female urethral and periurethral disorders.

    PubMed

    Surabhi, Venkateswar Rao; Menias, Christine O; George, Verghese; Siegel, Cary Lynn; Prasad, Srinivasa R

    2013-11-01

    This article reviews the normal anatomy of the female urethra, magnetic resonance (MR) imaging techniques, and the role of MR imaging in the evaluation of diverse urethral and periurethral diseases. Salient MR imaging findings of common and uncommon cystic urethral lesions (urethral diverticulum, Skene cyst, and vaginal cysts), and masses (urethral carcinoma, leiomyoma, melanoma, fibroepithelial polyp, caruncle, and mucosal prolapse) are presented. The evolving role of dynamic MR in the evaluation of stress urinary incontinence is reviewed.