Pelvic floor training for lower urinary tract dysfunction in MS.

The aim of this study was to determine if pelvic floor muscle training (PFMT) improves lower urinary tract function in people with multiple sclerosis (MS). The authors found that a nine-week PFMT programme improved the function of the PFM, reduced the symptoms associated with lower urinary tract dysfunction and increased the quality of life in people with MS.

Five year follow-up comparing tension-free vaginal tape and colposuspension.

Burch colposuspension has been the procedure of choice for stress urinary incontinence, more recently the tension-free vaginal tape (TVT) has been used. A retrospective study on all TVT's and colposupensions was performed. The present clinical condition was assessed using the Bristol Female Lower Urinary Tract Symptoms and Short-Form 12 questionnaires. The median operating time was 50-59 minutes for TVT and 70-79 minutes for colposupension. The median number of day's hospitalization was 3 and 10 respectively. The overall success rate was 88.5% and 92% respectively. No significant difference in subjective outcome was noted at more than 5 years after surgery between the two procedures for either the BFLUTS or SF-12.

Substance abuse in pregnancy: opioid substitution in a northern Ireland maternity unit.

An increase in illicit drug use in Northern Ireland may well have links to the resolution of political conflict, which started in the mid 1990s. Social issues, heretofore hidden, have emerged into the limelight and may be worsened by paramilitary involvement. Registered addicts in the four Health Board areas have shown an increase from 1997 with the greatest number resident within the Northern Board Area. As the prevalence of heroin use in Northern Ireland increased, the Department of Health and Social Services and Public Safety (DHSSPS) commissioned a report, to recommend the development of substitute prescribing services. A case series of pregnancies was reviewed, within the Northern Board Area, where the mother was taking opioid substitution therapy. This resulted in baseline data of outcome for both mother and baby specific to a Northern Ireland population. The different medications for opioid substitution are also assessed. This information will guide a co-ordinated approach that involves obstetrician, anaesthetist, psychiatrist, midwife and social worker to the care of these high-risk pregnancies. Eighteen pregnancies were identified in the study period. Sixteen of these had viable outcomes. One was a twin pregnancy. Outcome data was therefore available for 17 infants. Information was obtained regarding patients' social and demographic background, drug taking behaviour and substitution regimen. Antenatal and intrapartum care was assessed and infants were followed up to the time of hospital discharge.

A study of quality of life in primigravidae with urinary incontinence.

This study aimed to establish the prevalence and effect of urinary incontinence on quality of life during pregnancy and after parturition. A prospective cohort of primigravidae was recruited. The Kings Health Questionnaire (KHQ) was self-administered antenatally (34 weeks to term) and postnatally (3 months after delivery). Four hundred ninety-two primigravidae were recruited. The prevalence of urinary incontinence was reported as: pre-pregnancy 3.5% (17/492), antenatal 35.6% (175/492), 3-5 days postpartum 13.7% (51/370) and 3 months postnatal 13.0% (47/362). Most women with urinary incontinence experienced an impact on quality of life antenatally (54.3%) and postnatally (71.1%), although those experiencing an impact usually reported it as 'a little' (75.8 and 87.5%). There was a higher prevalence of urinary incontinence after forceps delivery ( p<0.05) but not of greater impairment in quality of life ( p>0.05). Personal and general health deteriorated postnatally ( p<0.05). During pregnancy most women with urinary incontinence experience minimal impact on quality of life. Postnatally, other causes of morbidity may contribute to worsening of general and personal health.