Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes.

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.

Patterns of sedentary behavior among older women with urinary incontinence and urinary symptoms: a scoping review.

BACKGROUND: Independent of physical activity, sedentary behavior has emerged as a significant risk factor for health. Particularly, older adults spent as high as 13 h daily on sedentary activities, which account for 98% of their awake times. Although there is growing evidence revealing the potential association between sedentary behavior and urinary incontinence (UI) across populations of different ages, the relationship between sedentary behavior and urinary symptoms in older women, who are twice as likely to have UI than older men, has not been reviewed. This scoping review aimed to synthesize available evidence of the relationship between sedentary behavior and urinary symptoms in noninstitutionalized older women. METHODS: Six electronic databases (PubMed, Web of Science, SPORTDiscus, Ovid Nursing Database, EMBASE, and MEDLINE) were searched from their inception to April 2023. Observational and experimental studies that measured sedentary behavior using objective and/or self-reported methods in older women aged 60 + years having any type of UI, with English full texts available, were included. Relevant data, including sedentary patterns (types, definitions, measurements, and daily patterns) and UI types were tabulated. A narrative synthesis of the findings was also conducted. RESULTS: A total of seven studies (n = 1,822) were included for review and reporting. Objective measurement showed that older women with UI were engaged in > 8 h sedentary activities daily (493.3-509.4 min/day), which accounted for 73% of their awake times. The duration of self-reported sedentary behavior was lower than the time measured objectively, and the average weekday sitting time was 300-380 min/day. With or without adjustment for confounding factors (e.g., age and number of vaginal deliveries), the daily proportion of sedentary time and average duration of sedentary bouts were positively associated with the prevalence of urgency UI. Notably, sedentary patients with UI were more likely to have lower urinary tract symptoms, including bothersome incontinence, to use incontinence products, and to have nocturia episodes, than their age-matched counterparts who were less sedentary. CONCLUSION: Our findings suggest a potential relationship between sedentary behavior and UI in older women, but the causality of the relationship remains unclear. To further inform the clinical role of sedentary behavior in the context of UI, a greater number of rigorous studies with a prospective study design is urgently needed.

Impacts of Perioperative Comprehensive Nursing Intervention on Postoperative Urinary Incontinence and Quality of Life of Patients Undergoing Laparoscopic Radical Prostatectomy.

To evaluate the impact of perioperative comprehensive nursing intervention on postoperative urinary incontinence, various aspects of patient well-being were assessed. The comprehensive group, that received the nursing intervention, demonstrated significant improvements in self-care skills, health knowledge level, self-care responsibility, and self-concept compared to the standard group. The findings indicate that perioperative comprehensive nursing intervention has a remarkable effect on patients undergoing laparoscopic radical prostatectomy. This nursing intervention not only effectively improves postoperative urinary incontinence and alleviates negative emotions, such as anxiety and depression. Therefore, the implementation of this nursing intervention model is highly recommended for clinical practice and wider application.

Perceived usefulness of the nurse-patient therapeutic relationship in the rehabilitation journey of people with urinary incontinence: A mixed-method study.

INTRODUCTION: Despite various studies on the impact of incontinence on patients' lives, the existing literature has not investigated the contribution of nursing care during rehabilitation in terms of quality of life. Fewer data, therefore, exist on the characteristics and perceived impact of the therapeutic relationship as part of the rehabilitation program. AIMS: To investigate the characteristics of the nurse-patient therapeutic relationship and its impact throughout the rehabilitation program; to describe the levels of patient burden on everyday activities. MATERIALS AND METHODS: A monocentric, retrospective, multimethod descriptive study was conducted in the nurse-led continence clinic of a major teaching hospital in Northern Italy. A phenomenological approach with semistructured interviews was adopted after 6 weeks of rehabilitation, following the method of phenomenological enquiry by Giorgi. The short form 12 questionnaire was administered upon admission of patients to the clinic, after 6 weeks, and during the last consultation to investigate the impact of urinary incontinence (UI) on daily activities and physical and psychological quality of life. RESULTS: Ninety-one adult patients of both genders presenting for nonneurogenic nonpostpartum UI were consecutively enrolled. Physical scores (PCS-12) and MCS-12 scores significantly increased over time. Psychological scores showed great variability upon admission, which was reduced halfway through the rehabilitation program. The thematic analysis highlighted four categories based on data saturation: the impact of UI on daily activities, strategies to face the problem, feelings, and the role of nurses. CONCLUSIONS: This mixed-method investigation suggests the importance of therapeutic nursing relationships, clinical expertise, and rehabilitative skills. Quality of life is arguably related to the positive results of the rehabilitation program but also to the environment, patients perceive in terms of support, honesty, and trust.

Mental health problems, stressful life events and new-onset urinary incontinence in primary school-age children: a prospective cohort study.

Emotional/behaviour problems and exposure to stressful life events are thought to contribute to new onset of urinary incontinence (UI) amongst children who have attained bladder control. However, very few prospective studies have examined these associations. We assessed whether mental health problems and stressful life events were associated with subsequent new onset in UI using multivariable logistic regression in a prospective UK cohort (n = 6408). Mothers provided information on their child's symptoms of common mental disorders (Development and Wellbeing Assessment, 7 years), stressful life events (7-8 years) and wetting (day and night, 9 years). There was strong evidence that separation anxiety symptoms were associated with new-onset UI in the fully adjusted model (OR (95% CI) = 2.08 (1.39, 3.13), p < 0.001). Social anxiety, attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms were associated with new-onset UI, but these associations attenuated following adjustment for child developmental level and earlier emotional/behaviour problems. There was weak evidence for a sex interaction with stressful life events (p = 0.065), such that females experiencing more stressful life events were at higher risk of new-onset UI (fully adjusted model OR (95% CI) = 1.66 (1.05, 2.61), p = 0.029), but there was no association in males (fully adjusted model OR (95% CI) = 0.87 (0.52, 1.47), p = 0.608). These results suggest that separation anxiety and stressful life events in girls may lead to an increase in UI.

Prevalence and predictors of help-seeking behavior among post-partum women with urinary incontinence in China and Indonesia: A cross-sectional survey based on Andersen Help-Seeking Model.

INTRODUCTION: Urinary incontinence (UI) is a prevalent condition among post-partum women, and it can significantly affect their physical and psychosocial well-being. Therefore, it's crucial for post-partum women to discuss any UI symptoms they may be experiencing with their healthcare provider and seek appropriate treatment. PURPOSE: To investigate what leads post-partum women with UI to seek help in China and Indonesia based on the Andersen Help-Seeking Model. METHODS: A cross-sectional digital survey among post-partum women (6 weeks to 1 year) was conducted from May to November 2021 in China and Indonesia. The survey contents included: (1) demographic characteristics, (2) social support, (3) health care needs, (4) capacity and resources. For analysis, descriptive statistics, independent sample t-tests and chi-square tests were used to determine the differences between help-seeking and non-help-seeking women with UI, and logistic regression analysis and the receiver operating characteristic curve (ROC) was used to determine the predictors of heal-seeking behavior in post-partum women with UI. RESULTS: The prevalence of UI was 25 % (215/868) and 31 % (187/605) among post-partum women in China and Indonesia. Among post-partum women with UI, the help-seeking rate was 46 % (98/215) and 52 % (98/187) in China and Indonesia. Incontinence quality of Life, support from women of the family (Yes), knowing the available department for UI (Yes), current knowledge of UI and the current status of UI were independent risk factors for China (P<0.05). Support from husband (Yes), being asked about UI by a doctor (Yes) and the current status of UI were independent risk factors for Indonesia. The obtained area under ROC curve (AUC) for the model were 0.884 and 0.935 in China and Indonesia. CONCLUSIONS: The prevalence of UI and the rate of seeking help for UI in Indonesia were higher than those in China. Social support, needs and the availability of resources and organizational support to assist patients in their help-seeking efforts, were the main predictors affecting help-seeking behavior among post-partum women with UI.

Monitoring the relationship between overactive bladder and mobility disorders in women with multiple sclerosis.

BACKGROUND: Currently, there is a lack of studies monitoring the relationship between lower urinary tract symptoms and mobility disorders in women with multiple sclerosis. The aim of this study was to monitor the relationship between overactive bladder and mobility impairments in women with multiple sclerosis. METHODS: A number of 106 female patients with multiple sclerosis (MS) with relapsing-remitting (RR) form, disability stage: EDSS ≤ 6.5, from the specialized outpatient clinic of the Department of Neurology, Faculty of Medicine, University of Medical Sciences in Kosice. Urinary leakage symptoms were assessed by the modified International Consultation on Incontinence Questionnaire (ICIQ UI-SF), and overactive bladder symptoms were assessed by the Short Overactive Bladder Symptoms Questionnaire (OAB-q). The Multiple Sclerosis Impact Scale (MSIS-29) and the Rivermead Mobility Index (RMI) were used. CONCLUSION: In MS patients, we found the following correlations: a significant positive mean correlation between the severity of OAB and UI symptoms and physical attributes. We found a significant positive moderate correlation between severity of OAB and UI symptoms and psychological attributes. We found a negative significant moderate correlation between OAB and UI symptom severity and mobility. It was confirmed that the more severe the symptoms of UI and OAB, the greater the difficulty of mobility in performing physical activities, and thus the negative impact of SM disease on patients' psychological health increases.

Psychosocial functioning of women suffering from stress and mixed form of urinary incontinence depending on the severity of the symptoms.

INTRODUCTION: Urinary incontinence is a troublesome symptom that negatively affects many aspects of life among woman suffering from this disease. It disturbs social, professional and intimate relations, and thus contributes to a negative self-image, loss of self-confidence, withdrawal of a woman from social and family life, and consequently promotes negative state of mind and depression. AIM: The aim of the study was to analyse the influence of urinary incontinence on the psychosocial functioning of women suffering from this disease. MATERIAL AND METHODS: The study included a group of 202 women aged 40.1 ± 13.9 years. A proprietary questionnaire was used, aimed at all women who had an episode of urinary incontinence at any time in their life. RESULTS: The impact and perception of the urinary incontinence symptoms depended on its form and severity. Comparing stress urinary incontinence with the mixed form, a greater severity of symptoms in women with the mixed form were observed, respectively 13.6% vs. 53.9%. Taking into account the aspects of life affected by urinary incontinence, it was found that the greatest impact UI had on the social (52.5%), then on the professional (28.7%), and the least impact on the family aspect of life (21.8%). CONCLUSIONS: Research has shown that urinary incontinence has the greatest impact on the social aspect of the surveyed women's life. The reported impact largely depended on the form and severity of urinary incontinence. In over 40% of women, symptoms related to urinary incontinence caused a deterioration of wellbeing and body acceptance. The mixed form was by far the most problematic and had the greatest impact on the daily functioning of women compared to, for example, the stress form.

Effect of a Mobile App-Based Urinary Incontinence Self-Management Intervention Among Pregnant Women in China: Pragmatic Randomized Controlled Trial.

BACKGROUND: Urinary incontinence (UI) is a highly prevalent health concern commonly observed during and after pregnancy that can substantially impact women's physical and psychological well-being and quality of life. Owing to its numerous advantages, mobile health may be a promising solution; however, it is unclear whether the app-based intervention can effectively improve UI symptoms during and after pregnancy. OBJECTIVE: This study aimed to evaluate the effectiveness of the Urinary Incontinence for Women (UIW) app-based intervention for UI symptom improvement among pregnant women in China. METHODS: Singleton pregnant women without incontinence before pregnancy who were aged ≥18 years and between 24 and 28 weeks of gestation were recruited from a tertiary public hospital in China and were randomly allocated (1:1) to either an experimental group (n=63) or a control group (n=63). The experimental group received the UIW app intervention and oral pelvic floor muscle training (PFMT) instructions, whereas the control group received oral PFMT instructions alone. Neither the participants nor the researchers were blinded to the intervention. The primary outcome was UI severity. The secondary outcomes included quality of life, self-efficacy with PFMT, and knowledge of UI. All data were collected at baseline, 2 months after randomization, and 6 weeks post partum through electronic questionnaires or by checking the electronic medical record system. Data analysis followed the intention-to-treat principle. A linear mixed model was used to examine the intervention effect on primary and secondary outcomes. RESULTS: Participants in the experimental and control groups were comparable at baseline. Of the 126 overall participants, 117 (92.9%) and 103 (81.7%) women completed follow-up visits at 2 months after randomization and 6 weeks after delivery, respectively. A statistically significant difference in UI symptom severity was observed between the experimental group and control group (2 months after randomization: mean difference -2.86, 95% CI -4.09 to -1.64, P<.001; 6 weeks post partum: mean difference -2.68, 95% CI -3.87 to -1.49, P<.001). For the secondary outcomes, a statistically significant intervention effect on the quality of life, self-efficacy, and UI knowledge was found at the 2-month follow-up (all P<.05) and 6 weeks post partum (all P<.001). CONCLUSIONS: The app-based UI self-management intervention (UIW) effectively improved UI symptom severity, quality of life, self-efficacy with PFMT, and knowledge of UI during the late pregnancy and early postnatal periods. Larger multicenter studies with a longer postpartum follow-up are required to further extend these findings. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800016171; http://www.chictr.org.cn/showproj.aspx?proj=27455. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/22771.

The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review.

INTRODUCTION: Urinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups. METHODOLOGY: A systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. RESULTS: Four themes emerged from this review: the perceived origin of UI, the physical, psychological, and social impact of UI, the impact of culture and religion on UI, and vice versa, and the interaction of women with health services. DISCUSSION: Social determinants of health, such as religion and culture, need to be considered by professionals providing care if women from underrepresented groups experiencing UI are to receive optimal care.

Characteristics, scope of activity, and negative emotions in elderly women with urinary incontinence: Based on a longitudinal follow-up in Shanghai, China.

We conducted a study to assess the characteristics, scope of activity, and negative emotions in elderly women with urinary incontinence (UI) based on a longitudinal follow-up conducted in Shanghai, China from 2013 to 2019. A total of 3,531 elderly women were included in the final analysis, and 697 women who experienced UI during follow-up were included in the UI group. Subjects with UI were subdivided into those with partial UI (UI once a day or less) and UI (frequent UI). Two thousand eight hundred and thirty-four women who did not have UI during the same period served as the control group. The prevalence of UI was 19.74% in this study. Logistic regression analysis revealed that being older (> 80 years of age), having a high level of education (> 12 years; elderly people with a high level of education may pay more attention to their health and notice UI more readily), a low personal monthly income (≤ 3,000 RMB), more gravidity/parity, and having a chronic disease (chronic obstructive pulmonary disease (COPD), dementia, or Parkinson's disease) were risk factors for UI (p < 0.05). About 60% of women in the partial UI group engaged in daily activities outdoors, while this number decreased sharply to 3.6% in the UI group. Women in the UI group were more likely to have negative emotions, such as depression, anxiety, irritability, or feeling worthless (p < 0.001). Among elderly women with dementia, those with UI had defects in terms of judgment in everyday life, the ability of convey information, and the ability to understand information (p < 0.05). More attention needs to be paid to the adverse effects of UI on activities of daily living (ADL) and mental health in the future.

Lower urinary tract symptoms are elevated with depression in Japanese women.

OBJECTIVES: Depression might worsen lower urinary tract symptoms (LUTS), but the correlation is still disputed. This study examined the influence of depression on LUTS in Japanese women. METHODS: This study used a web-based questionnaire to evaluate the mental status of depression and LUTS. The mental status of depression was evaluated using the Quick Inventory of Depressive Symptomatology-Japanese version (QIDS-J), and LUTS was assessed based on the Overactive Bladder Symptom Score (OABSS) and responses to the International Consultation on Incontinence Questionnaire-Short Form. RESULTS: A total of 4151 of 5400 (76.9%) women responded to the questionnaire. The mean age was 48.3 ± 13.8 years. The OABSS gradually increased with the QIDS-J score. The incidence of overactive bladder (OAB) and urgency urinary incontinence (UUI) also increased along with the QIDS-J score. In the younger age group (20-39 years old), the risks of OAB and UUI were higher than in the elderly group (7.42 for OAB and 7.44 for UUI). CONCLUSIONS: This study revealed that worsening of LUTS was correlated with depression.

The effect of perceived social support levels on coping methods for urinary incontinence in elderly men.

OBJECTIVE: This study aimed to determine the effect of the perceived social support level on coping methods for urinary incontinence among men aged 65 years and over with urinary incontinence. METHODS: A total of 92 male patients over the age of 65 years with urinary incontinence and adequate cognitive levels were included in the study. The coping methods, the environmental support, and the Multidimensional Scale of Perceived Social Support were used to collect data. RESULTS: The most common method of coping was changing clothes (64 [69.6%]). The Multidimensional Scale of Perceived Social Support total mean score was 55.83±14.8, which was considered above the medium-level support. The perception level of social support caused significant differences in coping methods in individuals with urinary incontinence. CONCLUSION: The view that urinary incontinence is a problem related to aging is regarded as an obstacle to seeking healthcare. Society should be made aware that urinary incontinence is not a normal condition related to aging and that it is not an insoluble problem that the elderly must endure.

Urinary Incontinence in Turkish Women: A Qualitative Study on Daily Life and Sexual Health.

PURPOSE: The study was performed to determine how urinary incontinence (UI) affects women's daily lives and sexual health and how UI is perceived. DESIGN: Qualitative descriptive phenomenological design was used. SUBJECTS AND SETTING: The study was conducted in a family health center in Konya, Turkey, with official permission of the ministry of health. Study participants comprised 101 women with UI, but data from 12 women were excluded because they refused to respond to questions; therefore, data analysis is based on responses from 89 respondents. METHODS: Data were compiled via in-depth interviews using a semistructured questionnaire. Data collection and analysis processes were carried out simultaneously. Study data were examined using phenomenological content and thematic analyses. Document portraits and a code map of data were created using qualitative data analysis software. RESULTS: Participants' mean age was 46.25 (SD: 11.68) years. Thirty-three codes were identified to detect the effects of UI on women's daily lives. These codes were reviewed and combined into 5 main themes: religious issues, sexual problems, feeling restricted, psychological exposure, and internalization. CONCLUSIONS: Urinary incontinence causes women to experience environmental, psychological, and religious challenges during daily life. Healthcare professionals should give counsel and assistance by determining the issues for women with UI to promote coping with problems and offer referral for specialist care when necessary.

Multimorbidity increased the risk of urinary incontinence in community-dwelling adults: Results from the English Longitudinal Study On Ageing.

Multimorbidity (MM) is common in older people. Recent evidence, largely from cross-sectional studies, suggests that MM could be a risk factor for urinary incontinence (UI). For this reason, we aimed to explore the association between MM at baseline and incident UI, and which individual chronic medical conditions/factors might explain the association between MM and UI, using data from the English Longitudinal Study on Ageing, during ten years of follow-up. MM was defined as having two or more chronic medical conditions; the presence of UI was assessed using self-reported information. A logistic regression analysis, adjusted for baseline potential confounders, was used to assess the association between MM and UI, reporting the data as odds ratios (ORs) with their 95 % confidence intervals (CIs). Of 9432 initial participants, 6742 (mean age: 64.8 years; 53.2 % females) without UI at baseline were included in the analysis. MM was present at baseline in 48.8 % of the participants. People with MM had a significantly higher cumulative incidence of UI than their counterparts, leading to a significantly higher risk of UI also after adjusting for potential confounders at baseline (OR = 1.30; 95 % CI: 1.14-1.48). Among the medical conditions, only three were significantly associated with incident UI, namely asthma, Parkinson's disease, and psychiatric disorders. In conclusion, MM at baseline was associated with an increased risk of UI during ten years of follow-up, suggesting that UI is more likely to be present in people with several chronic medical conditions.

Lower urinary tract symptom severity, urinary bother, and incident life-space mobility restriction among older men.

BACKGROUND: Life-space mobility represents the distance, frequency, and independence of mobility, ranging from one's bedroom to beyond their town. Older men with lower urinary tract symptoms (LUTS) may limit their life-space to stay close to a bathroom. However, it's unknown whether LUTS severity or urinary bother are associated with risk of life-space mobility restriction. METHODS: We analyzed data from 3025 community-dwelling men age ≥71 years without life-space mobility restriction at analytic baseline (Year 7) of the Osteoporotic Fractures in Men (MrOS) study. The American Urologic Association Symptom Index (AUASI) was assessed at baseline and includes one question assessing urinary bother ("If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?"; score 0-1,2,3,4-6) and seven items to classify LUTS severity as none/mild (score 0-7), moderate (8-19), or severe (20-35). The University of Alabama Life-space Assessment was used to define life-space mobility restriction (≤60) at baseline and follow-up (Year 9). We used log-binomial regression with robust variance estimators to model adjusted risk ratios (ARR) for LUTS severity and urinary bother with incident life-space mobility restriction, controlling for age, site, health-related factors, and comorbidities. We then mutually adjusted for urinary bother and LUTS severity. RESULTS: Overall, the 2-year risk of life-space mobility restrictions was 9.9%. Compared to men without urinary bother (scores 0-1), the risk of life-space mobility restriction was significantly higher among men with bother scores of 4-6 (ARR = 2.20, 95% CI: 1.52, 3.19), independent of LUTS severity and confounders. Conversely, LUTS severity was not independently associated with the risk of life-space mobility restriction. CONCLUSIONS: Urinary bother, but not LUTS severity, is independently associated with incident life-space mobility restriction among older men. To maintain life-space mobility in older men with LUTS, future studies should identify shared mechanisms and interventions that minimize urinary bother.

URINARY INCONTINENCE - FROM CHILDHOOD ONWARDS.

Urinary incontinence (UI) is a condition that affects patients of all ages, starting with childhood. There are two peaks in its incidence, i.e., in childhood and another one in patients over 40 years of age, which increases continuously with patient age. It is a condition recognized by the World Health Organization as a set of diseases (International Classification of Diseases, ICD-10), and the International Classification of Functionality recognizes the associated extreme disablement. UI is a major health problem affecting the lives of an estimated 400 million persons worldwide. The global aging of the population will cause rise in the incidence of UI in the future. It is expected that UI itself will become a serious health and social burden for both patients and health service providers. UI can be an isolated problem, or it can be associated and/or aggravated by any associated disorder affecting the nervous system such as myelomeningoceles, Parkinson's disease or stroke. UI often affects the patient daily life, and it can have repercussions on their physical, financial, social, and emotional well-being. At last, it has a negative influence on their sexual health.

Mediating role of functional limitations in the association of urinary incontinence with depressive symptoms among middle-aged and older adults: The English Longitudinal Study of Aging.

OBJECTIVE: To investigate the association of urinary incontinence with depressive symptoms, and to explore the mediating effect of functional limitations on this association. METHODS: This cross-sectional study included 7039 adults aged 50 and over from the English Longitudinal Study of Aging (Wave 8). Urinary incontinence was defined as whether the participants experienced urinary incontinence in the past 12 months. Depressive symptoms were assessed based on the Center for Epidemiologic Studies-Depression Scale. Functional limitations included disability of activities of daily living, instrumental activities of daily living, mobility and large muscle groups limitation of the participants. Logistic regression based on Karlson/Holm/Breen (KHB) method was applied to estimate the association of urinary incontinence with depressive symptoms and explore the mediating effect of functional limitations. RESULTS: Urinary incontinence was significantly associated with increased risk of depressive symptoms after controlling covariates (odds ratio = 1.75, 95 % confidence interval: 1.45-2.11). Functional limitations explained 36.96 % of this association. CONCLUSION: Urinary incontinence might be associated with an increased risk of depressive symptoms among middle-aged and older adults and functional limitations partially mediate this association. Improving physically functional capacity might play an important role in preventing and managing depressive symptoms in elderly people with urinary incontinence.

Instruments for assessing sexual dysfunction in Arabic: A systematic literature review.

Sexual health is relevant throughout a person's life; however, studying human sexuality is complex and requires particular care when working with individuals from different cultural and social backgrounds. Much of the research addressing this subject has been conducted in Western countries, and that in non-Western countries is generally based on small sample sizes. The biopsychosocial nature of sexuality and its dysfunctions should be taken into consideration given that it is indispensable when conducting and assessing sexual studies in different countries and cultures. Therefore, culturally sensitive studies that consider cultural contexts and determinants as well as social markers are needed. The topic of sexuality in Arab culture is still enigmatic. This enigma has impacted the advancement of sexual science and limited researchers, health care practitioners, and patients. Thus, the aim of this systematic literature review was to find and assemble all scales and questionnaires regarding human sexual health that have been translated into Arabic and validated in order to promote a critical analysis of the methods used in each instrument and to inform readers and researchers of the limits and potential of each scale. Electronic databases were systematically searched, and eight instruments were selected for inclusion: the Arabic Index of Premature Ejaculation (AIPE), the Sexual Health Inventory for Men (SHIM), the Arabic Female Sexual Function Index (ArFSFI), the Female Genital Self-Image Scale (AVFGSIS), the Arabic Arizona Sexual Experiences Scale (ASEX), the Egyptian Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), the Saudi Arabian Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire in Arabic (PSIQ-IR), and the Arabic Female Sexual Distress Scale (FSDS). All included instruments showed good validity and reliability for the target population. Future studies are needed to develop culturally sensitive instruments.