The role of trans obturator tape as a surgical procedure for female stress urinary incontinence and its impact on quality of life in Jammu region

Background: Stress incontinence is one of the most common but debilitating health issue among women. It has a detrimental effect on overall health and quality of life of women. Trans obturator tape (TOT) has emerged as a promising treatment modality. The aim of present study was to assess the usefulness of TOT in terms of change in quality of life of stress incontinence patients.Methods: The study was performed at Department of Obstetrics and Gynecology, Acharya Shri Chandler of Medical Sciences (ASCOMS), Jammu. A total of 50 symptomatic women were enrolled in the study and underwent TOT procedure using outside-in technique. The quality of life of women was assessed at enrolment and 12 months after the procedure using King’s Health Questionnaire (KHQ). Change in QOL was assessed using paired ‘t’-test.Results: After 12 months follow-up, a total of 27 (54%) patients were entirely symptom free. As compared to pre-treatment QOL assessment on KHQ for general health/incontinence impact, quality of life and symptom scores a % decline of 73.2%, 79.8% and 78.4% was observed. For all the three parts, the change in scores was significant statistically. No other complications and side effects were reported.Conclusions: TOT is a useful procedure which provided symptomatic relief as well as QOL enhancement.

Pelvic floor muscle training with and without biofeedback in treatment of overactive bladder

Background: Overactive bladder (OAB) is a commonly encountered problem in gynaecological practice. It has profound effect on quality of life (QOL), affecting simple daily activities as well. Prevalence rates of OAB in Asians are 53.1%. The first line management of OAB is behaviour modification and pelvic floor muscle training (PFMT). Objective of this study was to comparative assessment of biofeedback assisted PFMT (BAPFMT) versus PFMT alone in treatment of OAB using strength of pelvic floor muscle and QOL before and after treatment.Methods: A prospective comparative randomized controlled trial was conducted to compare the effect of PFMT versus BAPFMT on OAB symptoms over period of 12 weeks. Total of 100 patients fulfilling inclusion and exclusion criteria were selected. Randomization of patients was done into two groups of 50 patients each; half of them were subjected to PFMT and other half to BAPFMT. Appropriate statistical test were applied.Results: At the end of 12 weeks of intervention, there was a significant improvement in pelvic floor muscle strength and QOL in both groups (p<0.001). The improvement in pelvic floor muscle strength was more with BAPFMT; however there was no difference in improvement of QOL between the groups.Conclusions: Addition of biofeedback to PFMT may be a useful adjunct in OAB patients.

Effect of Long-term Exercise on Voiding Functions in Obese Elderly Women / 대한배뇨장애요실금학회지

PURPOSE: An overactive bladder (OAB) may be defined as urgency that is a sudden, compelling, difficult to defer desire to pass urine that is usually accompanied by frequency and nocturia and possibly by incontinence. Obesity and old age are two factors in various causes of OAB. Several epidemiologic studies have identified positive associations among obesity, old age, urinary incontinence, and OAB. However, although exercise has been known to improve obesity and reduce incontinent urine loss, little research has been done in elderly women. Therefore, we investigated the effects of exercise on obesity-related metabolic factors, blood lipid factors, and OAB symptoms in elderly Korean women. METHODS: Twenty-one women aged between 69 and 72 years were recruited from the Seoul senior towers in Korea. All subjects worked out on a motorized treadmill and stationary cycle for 40 minutes, respectively, and performed resistance exercise for 30 minutes once a day for 52 weeks. Body composition, blood pressure, blood lipids, OAB symptom score, and King's health questionnaire were investigated and analyzed. RESULTS: Before performing physical exercise, all subjects showed increased OAB symptoms in association with enhanced body mass index (BMI), percentage fat, and blood lipid profiles. However, physical exercise for 52 weeks suppressed BMI, percentage fat, and blood lipid profiles and thus improved OAB symptoms. CONCLUSIONS: We suggest that long-term physical exercise can be a valuable tool for remarkable improvement of OAB.

Reliability and validity of the Chinese version of the King health questionnaire in patients with overactive bladder / 中华泌尿外科杂志

Objective To evaluate the reliability and validity of the Chinese version of the King's Health Questionnaire (KHQ) in patients with overactive bladder(OAB).Methods The original English KHQ was translated into Chinese and linguistically validated following the Cross-cultural adaptation of health-related quality of life measures. Patients recruited randomly from urology clinics were scheduled for two visits with 2 weeks apart, and they were surveyed through the Chinese version of the KHQ. Internal consistency reliability was assessed by Cronbach's α test;Test-retest reliability was examined among stable patients using Intraclass correlation coefficient (ICC) and Spearman's rank correlation statistical analyses. Content validity was estimated by Spearman's rank correlation statistical analyses. A factor analysis was conducted to validate the underlying factor structure of the Chinese version of the KHQ. Results A total of 48 OAB patients who met the criteria participated the study, and 40 patients (7 men, 33 women) completed the questionnaires twice. All the subscales and domains of the KHQ showed high levels of internal consistency (Cronbach's a: 0.718-0. 924) , moderate to excellent test-retest reliability (ICC:0.551-0.923,P<0.01) and acceptable construct validity. The content validity was moderate to excellent except for the Social Limitations domain. Conclusion Psychometric testing supports the reliability and validity of the Chinese version of the KHQ as an OAB-specific measure of HR QOL.

Impacto da incontinência urinária na qualidade de vida em um grupo de mulheres de 40 a 70 anos / Impact of urinary incontinence on quality of life in 40 to 70 year old sample of women

Objetivo: analisar os malefícios da incontinência urinária (IU) na qualidade de vida (QV) em mulheres de 40 a 70 anos em Belém-PA. Método: estudo transversal envolvendo 90 mulheres na faixa etária de 40 a 70 anos com queixas de IU, que assinaram o Termo de Consentimento Livre Esclarecido (TCLE), avaliadas, individualmente, por meio do King?s Health Questionnaire (KHQ), no ambulatório da Clínica Escola de Fisioterapia da Universidade da Amazônia, entre janeiro e março de 2009. Para o teste estatístico, utilizada a Correlação Linear de Pearson para variáveis dependentes (domínios do KHQ) e independentes (domínios do KHQ). Foi, previamente, estabelecido 95% como nível de significância e nível alfa = 0,05 como nível de decisão para rejeição da hipótese de nulidade. Resultados: destacaram-se as correlações com os domínios: emoções com limitações da atividade diária (0,62); limitações físicas com limitações sociais (0,56); medidas de gravidade com limitação da atividade diária (0,54) e com emoções (0,66), bem como limitações sociais com emoções (0,54). Conclusão: a IU apresentou grande influência sobre a QV das participantes, demonstrando que o impacto da IU foi o fator mais importante e os domínios emoções e medidas de gravidade apresentaram as correlações mais intensas nas pacientes analisadas.

Objective: to examine the impact of urinary incontinence (UI) on quality of life (QOL) in sample of women 40 to 70 years in the city of Belém-Pa. Method: cross-sectional observational survey inquiry, in an intentional sample, involving 90 women aged 40 to 70 years with complaints of urinary incontinence, evaluated individually by the questionnaire of QOL in the UI, King's Health Questionnaire (KHQ), (have figures which are combined and evaluated in areas, whose scores range from 0 to 100), held in the form of interviews by researchers in the outpatient in the clinical School of Physiotherapy (Fisioclínica), where he signed as volunteers to participate, through the Free and Informed Consent Term (FICT). We used the statistical package BioEstat 6.0 and Microsoft Office Excel spreadsheet. For the statistical test, we used the linear correlation of Pearson for variables (domains of KHQ) and independent (domains of KHQ). Getting 95% as previously established level of significance alpha = 0.05 and level of decision as to rejection of the null hypothesis. Results: stood out more strongly correlated with the domains: emotions with limitations of daily activity (0.62), physical limitations (0.67) and social constraints (0.54); measures of severity of limitation with daily activity (0, 54), physical limitations (0.54), social limitations (0.51) and emotion (0.66). Conclusion: the UI showed great influence on the QOL of the participants, demonstrating the impact of UI was the most important factor , and measures of severity and emotions was showed more intense correlations in these women.

Avaliação da qualidade de vida em mulheres com perda urinária: atendimento no Ambulatório de Gineco-Obstetrícia e Urologia da UCB / Assessment of quality of life in women with urinary loss: ambulatory care in obstetrics-gynecology and urology at UCB

A incontinência urinária é a perda involuntária de urina que leva a limitações sociais, físicas e higiênicas, influenciando na qualidade de vida. O estudo objetivou avaliar a qualidade de vida em mulheres com queixa de perda urinária, utilizando o King's Health Questionnaire (KHQ). Sessenta e quatro pacientes constituíram a amostra do estudo e responderam ao questionário. A idade média da amostra foi de 67,1 anos (+- 5,2); 24 mulheres com queixa de perda urinária aos esforços, 21 com premência urinária e 19 com sintomas associados. Estas últimas apresentaram um escore médio de 25,1, maior do que o das demais, indicando pior qualidade de vida. A incontinência urinária mostrou maior impacto na qualidade de vida, principalmente de mulheres com sintomas associados.

The urinary incontinence is the loss of urine, leading to social, physical, and hygienical limitations, characterizing a worsening in the quality of life. The study it had as objective to evaluate the quality of life in women with complaint of urine loss being using the King's Health Questionnaire (KHQ). Sixty-four women were carried through analyzing clinics. The sample was constituted by women with average age of 67.1 years (+- 5.2); 24 with complaint of urine loss when there are some bind of effort being done, 21 with complaint of urge-incontinence and 19 women with mixing urinary incontinence. The results had shown that the women with mixing urinary incontinence had presented a greater score in the domain of the questionnaire than the lost, indicating a worsening in the quality of life. Urinary incontinence showed greater impact on the quality of life mainly of women with symptoms.