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1.
Br J Community Nurs ; 29(Sup5): S38-S40, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38728167

RESUMO

Urinary leakage is prevalent in men. To contain and manage this leakage, men are often advised about urinary devices. However, sometimes this advice does not include penile sheaths. Penile sheaths are a good way of managing urinary leakage if an individual is suitable for sheaths. This article will explore this suitability, advantages to using a sheath, reasons why sheaths may not be suitable, and will discuss optimum fitting to ensure the sheath is a secure drainage device.


Assuntos
Incontinência Urinária , Humanos , Masculino , Incontinência Urinária/enfermagem , Incontinência Urinária/terapia , Cateterismo Urinário/enfermagem , Cateterismo Urinário/instrumentação , Cateterismo Urinário/efeitos adversos , Pênis , Cateteres Urinários/efeitos adversos
2.
Investig Clin Urol ; 65(3): 230-239, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38714513

RESUMO

PURPOSE: Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions. MATERIALS AND METHODS: A systematic literature search was performed on 20 May 2023 using Scopus, PubMed, and Embase. Only English and adult papers were included. Meeting abstracts and preclinical studies were excluded. RESULTS: Twenty-one papers were accepted, revealing significant findings in the field. The study identified four primary sites of pudendal nerve entrapment (PNE), with the most prevalent location likely being at the level of the Alcock canal. Voiding symptoms are commonly exhibited in patients with PNE. PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. Regarding sexual function, the recovery of the somatic afferent pathway results in an improvement in erectile function early after neurolysis. Complete relief of persistent genital arousal disorder occurs in women, although bilateral PNN is necessary to achieve the efficacy. PNN is associated with low-grade complications. CONCLUSIONS: PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity.


Assuntos
Nervo Pudendo , Neuralgia do Pudendo , Humanos , Neuralgia do Pudendo/complicações , Incontinência Fecal/etiologia , Incontinência Fecal/terapia , Resultado do Tratamento , Disfunções Sexuais Fisiológicas/etiologia , Bloqueio Nervoso/métodos , Doenças Urogenitais Masculinas , Doenças Urogenitais Femininas/complicações , Doenças Urogenitais Femininas/cirurgia , Incontinência Urinária/etiologia , Incontinência Urinária/terapia
3.
Medicine (Baltimore) ; 103(15): e37671, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38608094

RESUMO

BACKGROUND: Urinary incontinence (UI) is a great problem of public health, especially for women's quality of life. UI afflicts at least 21.6% of the global population, and more than half of the UI is related to female stress urinary incontinence (SUI). Mawangdui Guidance plays an important role in preventing diseases and maintaining health. METHODS: Sixty female patients with SUI were randomly divided into a control group (n = 30) and an experimental group (n = 30). Patients in both groups were treated with basic rehabilitation therapy under the guidance of rehabilitation therapists who were trained in Mawangdui Guidance, based on the former, the experimental group was taught to exercise Mawangdui Guidance(including selected movements: "Qishi," "Longdeng," "Chishi," and "Yinyao"), while the control group performed Kegel exercise with a procedure of 20 min, six times per week for 6 weeks. The function was mainly evaluated by the 1 h pad-test, incontinence quality of life questionnaire (I-QOL), and international consultation on incontinence questionnaire urinary incontinence short form (ICI-Q-SF). In addition, evaluation of pelvic floor muscle function was also included in our assessment. RESULTS: The leakage of urine in the 1 h pad-test was significantly decreased in both two groups after treatment (P < .05), and the urine leakage in the experimental group was significantly less than that in the control group (P < .05). The muscle strength of type I and II muscle fibers of the pelvic floor, intravaginal pressure, and I-QOL score in both two groups were increased after treatment; moreover, the experimental group was more significant than the control group (P <.05). The fatigue degree of type I and type II muscle fibers of the pelvic floor, and the ICI-Q-SF score in both groups were significantly improved after treatment (P < .05); however, there were no differences between these two groups. The total effective rate of the experimental group was 90.00%, and 76.67% in the control group (P <.05). CONCLUSION: Mawangdui Guidance can effectively improve the function of pelvic floor muscle, improve the ability of urine storage and control, and alleviate the symptoms of female patients with SUI. However, the international research on Mawangdui Guidance is very limited, and more in-depth research is needed.


Assuntos
Qigong , Incontinência Urinária por Estresse , Incontinência Urinária , Feminino , Humanos , Incontinência Urinária por Estresse/terapia , Diafragma da Pelve , Qualidade de Vida , Projetos Piloto , Incontinência Urinária/terapia , Saúde Pública
4.
Rev Assoc Med Bras (1992) ; 70(3): e20231073, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38656000

RESUMO

OBJECTIVE: The objective of this study was to evaluate the effects of home-based pelvic floor muscle training in women with urinary incontinence, addressing the difficulties arising from social isolation due to the coronavirus disease 2019 pandemic by utilizing a specialized mobile app. METHODS: This randomized, single-group clinical trial aimed to assess the efficacy of pelvic floor muscle training guided by a mobile app (Diario Saúde) in women with stress urinary incontinence. Participants were instructed via telephone to engage in pelvic floor muscle training exercises twice a day for 30 days. Pre- and post-treatment, participants completed validated questionnaires regarding urinary symptoms and quality of life through telephone interviews. Additionally, treatment adherence was evaluated. RESULTS: A total of 156 women were enrolled in the study, with a mean age of 49.3±14.2 years. Significant improvements in urinary incontinence symptoms and quality of life were observed following pelvic floor muscle training guided by the mobile app (p<0.001). Notably, 74.3% of the participants reported performing the exercises with appropriate frequency. Of the participants, 62% reported either complete or substantial improvement in urinary symptoms post-treatment. CONCLUSION: This study revealed notable enhancements in stress urinary incontinence, urinary storage, and overall quality of life subsequent to pelvic floor muscle training guided by a mobile app, particularly during the coronavirus disease 2019 pandemic. The mobile app demonstrated robust acceptance and adherence among women experiencing urinary incontinence.


Assuntos
COVID-19 , Terapia por Exercício , Aplicativos Móveis , Diafragma da Pelve , Qualidade de Vida , Humanos , Feminino , Pessoa de Meia-Idade , Terapia por Exercício/métodos , Adulto , Resultado do Tratamento , Incontinência Urinária por Estresse/reabilitação , Incontinência Urinária por Estresse/terapia , Incontinência Urinária/terapia , Incontinência Urinária/reabilitação , SARS-CoV-2 , Inquéritos e Questionários , Pandemias , Idoso
5.
Trials ; 25(1): 285, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38671503

RESUMO

BACKGROUND: Urinary incontinence is highly prevalent in women while pelvic floor muscle training is recommended as the first-line therapy. However, the exact treatment regimen is poorly understood. Also, patients with pelvic floor muscle damage may have decreased muscle proprioception and cannot contract their muscles properly. Other conservative treatments including electromagnetic stimulation are suggested by several guidelines. Thus, the present study aims to compare the effectiveness of electromagnetic stimulation combined with pelvic floor muscle training as a conjunct treatment for urinary incontinence and different treatment frequencies will be investigated. METHODS/DESIGN: This is a randomized, controlled clinical trial. We will include 165 patients with urinary incontinence from the outpatient center. Participants who meet the inclusion criteria will be randomly allocated to three groups: the pelvic floor muscle training group (active control group), the low-frequency electromagnetic stimulation group (group 1), and the high-frequency electromagnetic stimulation group (group 2). Both group 1 and group 2 will receive ten sessions of electromagnetic stimulation. Group 1 will be treated twice per week for 5 weeks while group 2 will receive 10 days of continuous treatment. The primary outcome is the change in International Consultation on Incontinence Questionnaire-Short Form cores after the ten sessions of the treatment, while the secondary outcomes include a 3-day bladder diary, pelvic floor muscle function, pelvic organ prolapse quantification, and quality of life assessed by SF-12. All the measurements will be assessed at baseline, after the intervention, and after 3 months of follow-up. DISCUSSION: The present trial is designed to investigate the effects of a conjunct physiotherapy program for urinary incontinence in women. We hypothesize that this strategy is more effective than pelvic floor muscle training alone, and high-frequency electromagnetic stimulation will be superior to the low-frequency magnetic stimulation group.


Assuntos
Magnetoterapia , Diafragma da Pelve , Incontinência Urinária , Humanos , Feminino , Incontinência Urinária/terapia , Incontinência Urinária/fisiopatologia , Magnetoterapia/métodos , Diafragma da Pelve/fisiopatologia , Resultado do Tratamento , Pessoa de Meia-Idade , Fatores de Tempo , Adulto , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia por Exercício/métodos , Inquéritos e Questionários , Recuperação de Função Fisiológica , Idoso , Qualidade de Vida
6.
BMC Med Res Methodol ; 24(1): 60, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38459428

RESUMO

BACKGROUND: The minimal important difference is a valuable metric in ascertaining the clinical relevance of a treatment, offering valuable guidance in patient management. There is a lack of available evidence concerning this metric in the context of outcomes related to female urinary incontinence, which might negatively impact clinical decision-making. OBJECTIVES: To summarize the minimal important difference of patient-reported outcome measures associated with urinary incontinence, calculated according to both distribution- and anchor-based methods. METHODS: This is a systematic review conducted according to the PRISMA guidelines. The search strategy including the main terms for urinary incontinence and minimal important difference were used in five different databases (Medline, Embase, CINAHL, Web of Science, and Scopus) in 09 June 2021 and were updated in January 09, 2024 with no limits for date, language or publication status. Studies that provided minimal important difference (distribution- or anchor-based methods) for patient-reported outcome measures related to female urinary incontinence outcomes were included. The study selection and data extraction were performed independently by two different researchers. Only studies that reported the minimal important difference according to anchor-based methods were assessed by credibility and certainty of the evidence. When possible, absolute minimal important differences were calculated for each study separately according to the mean change of the group of participants that slightly improved. RESULTS: Twelve studies were included. Thirteen questionnaires with their respective minimal important differences reported according to distribution (effect size, standard error of measurement, standardized response mean) and anchor-based methods were found. Most of the measures for anchor methods did not consider the smallest difference identified by the participants to calculate the minimal important difference. All reports related to anchor-based methods presented low credibility and very low certainty of the evidence. We pooled 20 different estimates of minimal important differences using data from primary studies, considering different anchors and questionnaires. CONCLUSIONS: There is a high variability around the minimal important difference related to patient-reported outcome measures for urinary incontinence outcomes according to the method of analysis, questionnaires, and anchors used, however, the credibility and certainty of the evidence to support these is still limited.


Assuntos
Incontinência Urinária , Humanos , Feminino , Incontinência Urinária/diagnóstico , Incontinência Urinária/terapia , Inquéritos e Questionários , Medidas de Resultados Relatados pelo Paciente
7.
BMC Urol ; 24(1): 50, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38431583

RESUMO

INTRODUCTION: Urinary incontinence (UI) is a common but frequently neglected problem in females, significantly impacting their psychosocial health. The available estimates are an underestimation of a bigger problem. Thus, the study aimed to estimate the prevalence of UI, its associated risk factors, its impact on the Quality of life (QoL), and barriers to treatment-seeking behaviour in women attending tertiary healthcare centres. METHODS: We conducted a cross-sectional study using an opportunistic screening among women visiting a tertiary care hospital in Punjab recruited using multi-stage systematic random sampling. UI was classified as Stress (SUI), Urge (UUI), mixed (MUI), and No Incontinence (UI less than once a week or a month or no complaints) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Bivariate analyses were done using the chi-square test to test the association between the dependent and independent variables. The predictors of UI were explored using univariable and multivariable binary logistic regression and depicted using Odds ratio with 95% confidence intervals. The impact of UI on Quality of Life (QoL) was assessed using the Incontinence Impact Questionnaire-Short Form (IIQ-7), and compared among the three UI types using One-Way ANOVA. Treatment barriers were explored using open-ended questions. RESULTS: Of the 601 women, 19.6% reported UI (stress UI: 10.1%, mixed UI: 6.0%, and urge UI: 3.5%). There were significant clinical-social factors that predicted different types of UI. The UI depicted a significant effect on QoL across all domains of the IIQ-7 (total mean score: 50.8 ± 21.9) compared to women with no incontinence (0.1 + 1.9). The score was highest in women with MUI, followed by SUI and UUI. About two-thirds of the affected women never consulted a doctor and considered it a non-serious condition or a normal ageing process. CONCLUSIONS: The present study found a high prevalence of UI through opportunistic screening across all the women's age groups with different conditions. Due to the associated stigma, clinicians should make every attempt to talk more about this, especially in women with medical conditions that can precipitate UI. Furthermore, the results call for generating more robust estimates through community-based screening studies.


Assuntos
Incontinência Urinária por Estresse , Incontinência Urinária , Feminino , Humanos , Qualidade de Vida , Centros de Atenção Terciária , Estudos Transversais , Atenção Terciária à Saúde , Incontinência Urinária/diagnóstico , Incontinência Urinária/epidemiologia , Incontinência Urinária/terapia , Incontinência Urinária por Estresse/epidemiologia , Inquéritos e Questionários
8.
PLoS One ; 19(3): e0299721, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38452135

RESUMO

This study aimed to identify differences in caregiver burden related to toileting assistance, and examine the factors associated with the most burdensome aspects of providing toileting assistance. In 2019, a self-administered postal survey was conducted with 743 caregivers of older adults who received subsidies for continence products in Komatsu City, Japan. Both family caregivers and nursing home staff answered questions regarding older adults' urinary/fecal symptoms, toileting assistance, and perceived caregiver burden. Older adults living at home had less need for toileting assistance than those in nursing homes. However, family caregivers experienced more burden than nursing home staff. The most frequent physical burden associated with toileting assistance for family caregivers was urinary/fecal leakage from absorbent incontinence products. This burden was linked to family caregivers providing care at home, using a combination of urinary pads and diapers, and symptoms that caused burdens on caregivers including urinary/fecal incontinence, nocturia, and no desire to urinate. These results suggest that leakage caused by the inappropriate use of urinary pads combined with diapers is a source of caregiver burden. Continence care experts should provide guidance to family caregivers of older adults, particularly those who are underweight and frail, regarding the selection and fitting of absorbent incontinence products.


Assuntos
Sobrecarga do Cuidador , Incontinência Urinária , Humanos , Idoso , Estudos Transversais , Casas de Saúde , Instituições de Cuidados Especializados de Enfermagem , Incontinência Urinária/terapia , Cuidadores
9.
BMJ Open ; 14(3): e081731, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38553066

RESUMO

INTRODUCTION: Urinary incontinence (UI) is one of the most common chronic diseases among women, which can endanger their physical and mental health and incur a heavy financial burden on both individuals and society. Web-based interventions (WBIs) have been applied to manage women's UI, but their effectiveness has remained inconclusive. This systematic review and meta-analysis aims to explore the effectiveness of WBIs on self-reported symptom severity, condition-specific quality of life, adherence to pelvic floor muscle training (primary outcomes) and other extensive secondary outcomes among women with UI. We also aimed to investigate whether intervention characteristics (format, interactivity and main technology) have impacts on the effectiveness of primary outcomes. METHODS AND ANALYSIS: This systematic review protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. 10 electronic databases will be comprehensively searched from their inception to 1 May 2024, along with grey literature searches and manual reviews of relevant reference lists to identify eligible randomised controlled trials. The methodological quality of the included studies will be assessed by two reviewers based on the Cochrane Risk of Bias Tool. Meta-analyses will be conducted via Stata V.12.0. Leave-one-out sensitivity analyses will be performed, and publication bias will be evaluated using funnel plots and Egger's test. Subgroup analyses regarding intervention format, interactivity and main technology will be carried out. ETHICS AND DISSEMINATION: No ethics approval is needed for this review since no primary data are to be collected. The results of this review will help develop an optimal WBI for women with UI, thereby providing them with maximum benefits. The findings will be disseminated via a peer-reviewed journal or conference presentation. PROSPERO REGISTRATION NUMBER: CRD42023435047.


Assuntos
Intervenção Baseada em Internet , Incontinência Urinária , Feminino , Humanos , Qualidade de Vida , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Incontinência Urinária/terapia , Literatura de Revisão como Assunto
11.
Rev Prat ; 74(2): 179-184, 2024 Feb.
Artigo em Francês | MEDLINE | ID: mdl-38415424

RESUMO

URINARY INCONTINENCE IN CHILDREN. Urinary incontinence in children and adolescents is most often of functional origin. Questioning and clinical examination with a bladder diary should look for underlying urological or neurological causes. The type of incontinence, daytime or nocturnal, must be specified to adapt treatments. Renal and bladder ultrasound is recommended, and urodynamic studies are not routinely used. Lifestyle advice and bowel management are prerequisites for treatment. Depending on the type of symptoms, drug treatment, pelvic floor treatment, behavioral measures or stimulation of the posterior tibial nerve can be proposed. The evolution can sometimes be slow with a significant impact on quality of life, and neurocognitive aspects need to be considered.


INCONTINENCE URINAIRE DE L'ENFANT. L'incontinence urinaire de l'enfant et de l'adolescent est le plus souvent d'origine dite fonctionnelle. L'interrogatoire et l'examen clinique, comprenant un catalogue mictionnel, doivent rechercher des causes urologiques ou neurologiques sous-jacentes. Le type d'incontinence, diurne ou nocturne, doit être précisé car les traitements en dépendent. L'échographie rénale et vésicale est recommandée, et le bilan urodynamique n'est pas systématique. Les mesures hygiéno-diététiques et le traitement de la constipation constituent la première étape de la prise en charge. Selon le type de symptômes, un traitement médicamenteux, la rééducation périnéale, des mesures comportementales ou la stimulation du nerf tibial postérieur peuvent être proposés. L'évolution peut être parfois lente, avec un retentissement important sur la qualité de vie, et les aspects neurocognitifs nécessitent d'être pris en compte.


Assuntos
Qualidade de Vida , Incontinência Urinária , Criança , Adolescente , Humanos , Incontinência Urinária/diagnóstico , Incontinência Urinária/etiologia , Incontinência Urinária/terapia , Diafragma da Pelve , Exame Físico , Estilo de Vida
12.
BMC Womens Health ; 24(1): 118, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38355503

RESUMO

BACKGROUND: This study aimed to evaluate clinically relevant improvement after conservative self-management of urinary incontinence via a mobile app. It further aimed to establish Minimum Important Differences (MIDs) based on the severity and type of urinary incontinence. METHODS: Data was collected in a prospective cohort study that evaluated the freely available app Tät®. The app provided pelvic floor muscle training (PFMT) and life-style advice. Non-pregnant, non-postpartum women (≥ 18 years) who downloaded the app to treat urinary incontinence were included, if they completed the Patient Global Impression of Improvement (PGI-I) question at the 3-month follow-up (n = 1,733). Participants answered the International Consultation on Incontinence Questionnaire (ICIQ-UI SF) at baseline and after 3 months. The score change was analysed for correlation (Spearman) with the PGI-I. We then analysed one-way ANOVAs to determine whether there were significant differences between the groups based on the answers to the PGI-I. The MID was set to the mean change of the group that selected the answer "a little better" to the PGI-I question. RESULTS: The one-way ANOVA showed significant differences between PGI-I groups (p < 0.001). The MID for the general group was set to 1.46 (95% Confidence Interval [CI] 1.26-1.67). In the sub-group analyses, a MID for the group with slight incontinence could not be determined. For the group with moderate severity the MID was determined to be 1.33 (95% CI 1.10-1.57) and for the severe/very severe group it was 3.58 (95% CI 3.08-4.09). Analysis of different types of incontinence showed no difference in MIDs. CONCLUSIONS: The MID for self-management via a mobile app was lower than previously established MIDs, but differed depending on baseline severity. This study shows that MIDs need adjustment for baseline severity and treatment intensity when interpreting clinical trial results. If using MIDs as exact numbers, the study population and the treatment must be comparable.


Assuntos
Autogestão , Incontinência Urinária por Estresse , Incontinência Urinária , Humanos , Feminino , Incontinência Urinária por Estresse/terapia , Resultado do Tratamento , Estudos Prospectivos , Incontinência Urinária/terapia , Terapia por Exercício/métodos , Inquéritos e Questionários , Diafragma da Pelve , Qualidade de Vida
13.
Br J Nurs ; 33(4): 168-174, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38386533

RESUMO

BACKGROUND: One in four women experience urinary incontinence. A woman's medical history, a physical examination and certain tests can guide specialists in diagnosing and offering treatment. Despite the high prevalence, little is known about women's experience of urinary incontinence assessment. AIM: To explore the experience of a group of women undergoing an assessment for urinary incontinence. METHODS: Individual semi-structured interviews were conducted with 10 women who had been assessed for urinary incontinence. A thematic reflective analysis method was used. FINDINGS: The women experienced a lot of shame and worry related to their urinary incontinence and the assessment. Having a safe relationship with the urotherapist was very important, and being given information about treatment options gave hope for a better life. CONCLUSION: Urinary incontinence and its assessment are associated with shame and anxiety. A good patient-urotherapist relationship is paramount and learning that treatments are available made women feel more optimistic about the future.


Assuntos
Incontinência Urinária , Humanos , Feminino , Incontinência Urinária/diagnóstico , Incontinência Urinária/terapia , Pesquisa Qualitativa , Ansiedade/diagnóstico , Aprendizagem , Prevalência
14.
BMC Geriatr ; 24(1): 169, 2024 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-38368318

RESUMO

BACKGROUND: Urinary incontinence (UI) is a common geriatric syndrome with high health and socio-economic impacts in nursing home (NH) residents. OBJECTIVES: To estimate the prevalence and types of UI and its associated factors in older people living in NHs in Central Catalonia (Spain). We also determined the proportion of residents who were receiving behavioural strategies to prevent/manage UI. DESIGN AND SETTING: Cross-sectional study in 5 NHs conducted from January to March 2020. METHODS: We included consenting residents aged 65 + permanently living in the NHs. Residents who were hospitalized, in a coma or palliative care were excluded. UI was assessed using Section H of the Minimum Data Set. Sociodemographic and health-related variables were examined. Descriptive, bivariate, and multivariate (logistic regression) analyses were performed. RESULTS: We included 132 subjects (82.6% women), mean age of 85.2 (SD = 7.4) years. The prevalence of UI was 76.5% (95% CI: 68.60-82.93). The most common type was functional UI (45.5%), followed by urgency UI (11.4%). Only 46.2% of residents received at least one behavioural strategy to manage UI. Most sedentary behaviour (SB) variables presented a p-value lower than 0.001 in the bivariate analyses, but none remained in the final model. Moderate-severe cognitive impairment (OR = 4.44, p =.003), anticholinergic activity (OR = 3.50, p =.004) and risk of sarcopenia using SARC-F (OR = 2.75, p =.041) were associated with UI. CONCLUSIONS: The prevalence of UI was high in this sample of NH residents compared to the literature, yet less than half received prompted voiding as a strategy to prevent/reduce UI.UI was associated with cognitive impairment, anticholinergic activity, and risk of sarcopenia.


Assuntos
Sarcopenia , Incontinência Urinária , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Estudos Transversais , Prevalência , Casas de Saúde , Incontinência Urinária/diagnóstico , Incontinência Urinária/epidemiologia , Incontinência Urinária/terapia , Antagonistas Colinérgicos
15.
Int Urogynecol J ; 35(4): 811-822, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38315227

RESUMO

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is prevalent among older women, but conservative treatment rates remain low due to limited accessibility, despite evidence supporting pelvic floor muscle training (PFMT) efficacy. Group-based approaches, including online options, could offer cost-effective alternatives. Recent evidence supports the feasibility of online group-based PFMT for treating UI in older women. This pilot study now evaluated the clinical effects of this program on the number of leakage episodes per day, additional UI-specific outcomes, and other symptoms and indicators. METHODS: Community-dwelling women aged 65 and over, with stress or mixed UI, were recruited. Eligibility was assessed through in-person evaluations conducted by pelvic floor physiotherapists, who instructed participants on pelvic floor muscle contraction using digital palpation. Participants engaged in a 12-week group-based PFMT program with weekly 1-h sessions. Data were collected at three time points: recruitment (PRE1), before the first session (PRE2), and after the program (POST). Participants recorded UI symptoms using 7-day bladder diaries and standardized questionnaires on UI symptoms, quality of life (QoL), UI self-efficacy, and perceived costs. After the program (POST), participants provided feedback on their impression of improvement and satisfaction. RESULTS: Participants reported a significant reduction in their number of leakage episodes per day. Standardized questionnaire scores also supported the positive effects of the program on UI symptoms and QoL, self-efficacy in avoiding leakage and performing PFMT exercises, and monthly costs for continence products. Older women expressed high satisfaction with symptom improvement and the program. CONCLUSIONS: Online group-based PFMT improved UI symptoms, QoL, UI self-efficacy, and perceived UI costs among older women. Pragmatic randomized controlled trials are necessary for further validation.


Assuntos
Terapia por Exercício , Diafragma da Pelve , Qualidade de Vida , Incontinência Urinária , Humanos , Feminino , Projetos Piloto , Idoso , Diafragma da Pelve/fisiopatologia , Terapia por Exercício/métodos , Incontinência Urinária/terapia , Incontinência Urinária/fisiopatologia , Resultado do Tratamento , Idoso de 80 Anos ou mais , Autoeficácia , Inquéritos e Questionários
16.
J Wound Ostomy Continence Nurs ; 51(1): 61-65, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38215299

RESUMO

PURPOSE: The purpose of this study was to evaluate the effects of a urinary incontinence (UI) self-management program on UI symptoms, knowledge, and self-efficacy in community-dwelling older women. DESIGN: A 1-group pretest-posttest design. SUBJECTS AND SETTING: Participants were recruited from 14 primary healthcare posts (PHCPs) in South Chungcheong Province, rural South Korea. A total of 163 women participated in a 5-session UI self-management program. METHODS: The UI self-management program was sequentially conducted across 14 PHCPs between May and November 2016. In each PHCP, 6 to 22 women participated in the program. The program consisted of weekly 90-minute sessions that were conducted across 5 weeks. Each session included a lecture on UI, reflective discussion, pelvic floor muscle training, and the assignment of homework (exercises and a daily bladder diary). Main outcome variables were measured using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Urinary Incontinence Knowledge Scale (UIKS), and Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI), which were administered before and after the intervention. Descriptive statistics were computed, and Wilcoxon signed-rank tests analyzed the data. RESULTS: The intervention resulted in a significant decrease in the ICIQ-SF scores, which was indicative of improvement in UI severity (pretest: 6.64 [SD 6.15], posttest: 4.76 [SD 5.08], P = .001), significant increases in the UIKS (pretest: 15.69 [SD 6.36], posttest: 23.14 [SD 5.54], P = .001] and GSE-UI (pretest: 75.34 [SD 31.80], [posttest: 86.20 [SD 27.06], P = .001) scores. CONCLUSIONS: The UI self-management program improved UI symptoms, knowledge, and self-efficacy among community-dwelling older women.


Assuntos
Autogestão , Incontinência Urinária , Idoso , Feminino , Humanos , Terapia por Exercício/métodos , Vida Independente , Qualidade de Vida , República da Coreia , Inquéritos e Questionários , Resultado do Tratamento , Incontinência Urinária/terapia
17.
Int Urogynecol J ; 35(2): 291-301, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38252279

RESUMO

INTRODUCTION AND HYPOTHESIS: Mixed urinary incontinence (MUI) is defined by the International Urogynecology Association (IUGA) and International Continence Society as the complaint of involuntary leakage of urine associated with urgency and also with exertion, effort, sneezing or coughing. It therefore implies the coexistence of both stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). MUI is a heterogeneous diagnosis that requires an assessment of its individual components of SUI and UUI. Management requires an individualised approach to the symptom components. The aim of this review is to identify the assessment/investigations and management options for MUI. METHODS: A working subcommittee from the IUGA Research & Development (R&D) Committee was created and volunteers invited from the IUGA membership. A literature review was performed to provide guidance focused on the recommended assessment and management of MUI. The document was then evaluated by the entire IUGA R&D Committee and IUGA Board of Directors and revisions made. The final document represents the IUGA R&D Committee Opinion. RESULTS: The R&D Committee MUI opinion paper provides guidance on the assessment and management of women with MUI and summarises the evidence-based recommendations. CONCLUSIONS: Mixed urinary incontinence is a complex problem and successful management requires alleviation of both the stress and urge components. Care should be individualised based on patient preferences. Further research is needed to guide patients in setting goals and to determine which component of MUI to treat first. The evidence for many of the surgical/procedural treatment options for MUI are limited and needs to be explored in more detail.


Assuntos
Incontinência Urinária por Estresse , Incontinência Urinária , Humanos , Feminino , Incontinência Urinária por Estresse/complicações , Incontinência Urinária de Urgência/diagnóstico , Incontinência Urinária de Urgência/terapia , Incontinência Urinária/diagnóstico , Incontinência Urinária/terapia , Incontinência Urinária/complicações , Tosse/complicações
18.
J Vet Intern Med ; 38(2): 878-903, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38217372

RESUMO

Urinary incontinence (UI) is a disorder of micturition that can occur in dogs of any age, sex, and breed depending on the underlying cause and time of onset. Diagnosis and treatment for various causes of UI in dogs have been described by multiple comprehensive single author review articles, but large prospective clinical trials comparing treatment outcomes in veterinary medicine are lacking. The objectives of this consensus statement therefore are to provide guidelines on both recommended diagnostic testing and treatment for various causes of UI in dogs. Specifically, pathophysiology directly related to the canine urinary system will be reviewed and diagnostic and therapeutic challenges will be addressed. A panel of 12 experts in the field (8 small animal internists [L. Adams, J. Bartges, A. Berent, J. Byron, J. Foster, A. Kendall, S. Vaden, J. Westropp], 2 neurologists [J. Coates, N. Olby], 1 radiologist [G. Oetelaar], and 1 surgeon [C. Adin]) was formed to assess and summarize evidence in the peer-reviewed literature and to complement it with consensus recommendations using the Delphi method. Some statements were not voted on by all panelists. This consensus statement aims to provide guidance for management of both male and female dogs with underlying storage or voiding disorders resulting in UI.


Assuntos
Doenças do Cão , Incontinência Urinária , Masculino , Cães , Animais , Feminino , Estudos Prospectivos , Incontinência Urinária/diagnóstico , Incontinência Urinária/terapia , Incontinência Urinária/veterinária , Consenso , Doenças do Cão/terapia , Doenças do Cão/tratamento farmacológico
19.
Int Urogynecol J ; 35(3): 561-569, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38206341

RESUMO

INTRODUCTION AND HYPOTHESIS: This study is aimed at comparing the effectiveness of pelvic floor muscle training (PFMT) and Pilates on the improvement of urinary incontinence (UI), strength, and endurance of the pelvic floor muscles (PFMs), and the impact of UI on the quality of life in postmenopausal women. METHODS: Forty postmenopausal women were randomly divided in to two groups: PFMT (n = 20) and Pilates (n = 20). The participants were followed for 12 weeks, three times a week on nonconsecutive days. UI was assessed using the pad test and the voiding diary, PFM strength and resistance using bidigital assessment and manometry, and the impact of UI on quality of life using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), before and after the 3-month treatment. RESULTS: There was a significant intra-group improvement in both groups for the pad test, mean daily urinary loss, and ICIQ-SF. The strength was significantly improved only in the PFMT group, and the endurance in both groups. Peak strength manometry was significantly improved only in the Pilates group, and the mean strength manometry in both groups. There was also an improvement in both groups for peak endurance manometry and mean endurance manometry. In the inter-group comparison, there was a significant improvement only in muscle strength, which was positive for group. CONCLUSIONS: There was no difference between Pilates and PFMT for the management of women in post-menopause with stress urinary incontinence, provided that voluntary contraction of the PFMs is performed. However, further randomized clinical trials need to be carried out.


Assuntos
Incontinência Urinária por Estresse , Incontinência Urinária , Feminino , Humanos , Terapia por Exercício , Diafragma da Pelve/fisiologia , Qualidade de Vida , Pós-Menopausa , Incontinência Urinária/terapia , Incontinência Urinária por Estresse/terapia , Resultado do Tratamento
20.
Int Urogynecol J ; 35(3): 571-578, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38206337

RESUMO

INTRODUCTION AND HYPOTHESIS: The aim of this study is to compare the effectiveness of transcutaneous tibial nerve stimulation (TTNS) on quality of life (QoL) and clinical parameters related to incontinence in pharmacological agents (PhAs) naive and refractory women with idiopathic overactive bladder (iOAB). METHODS: In this prospective nonrandomized clinical trial, women with resistance to PhAs were included in the first group (n=21), PhA-naive women were included in the second group (n=21). TTNS was performed 2 days a week, a total of 12 sessions for 6 weeks. Every session lasted 30 min. Women were evaluated for the severity of incontinence (Pad test), 3-day voiding diary (voiding frequency, nocturia, incontinence episodes, and number of pads), symptom severity (Overactive Bladder Questionnaire-V8), quality of life (Incontinence Impact Questionnaire-7), treatment satisfaction, positive response, and cure-improvement rates. RESULTS: A statistically significant improvement was found in all parameters for each group at the 6th week compared with the baseline values (p<0.05). It was found that the severity of incontinence, incontinence episodes, symptom severity, treatment satisfaction, and QoL parameters were significantly improved in PhA-naive group compared with the PhA-resistant group at the 6th week (p<0.05). There were no statistically significant differences in the frequency of voiding, nocturia, and number of pads between the two groups (p>0.05). Positive response rates, the primary outcome measure, were statistically significantly higher in the PhA-naive group than in the PhA-resistant group. CONCLUSIONS: Although TTNS is more effective in PhA-naive women with iOAB, it appears to be an effective therapy that can also be used in the management of PhA-resistant women with iOAB.


Assuntos
Noctúria , Estimulação Elétrica Nervosa Transcutânea , Bexiga Urinária Hiperativa , Incontinência Urinária , Humanos , Feminino , Bexiga Urinária Hiperativa/tratamento farmacológico , Qualidade de Vida , Estudos Prospectivos , Resultado do Tratamento , Nervo Tibial , Incontinência Urinária/terapia
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