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Klahsen O, Thibault-Gagnon S, McLean L. A theoretical model for brisk walking- and running-induced lower urinary tract symptoms (BRUTS) and the development of the BRUTS-questionnaire (BRUTS-Q): A focus group and Delphi study. Neurourol Urodyn 2024. [PMID: 39032104 DOI: 10.1002/nau.25523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 02/06/2024] [Accepted: 05/28/2024] [Indexed: 07/22/2024]
Abstract
AIMS Existing questionnaires provide limited information on the nature, severity and context surrounding lower urinary tract symptoms (LUTS) experienced during running, jogging and brisk walking. The aims of this study were to develop a theoretical model of the experience of LUTS by females participating in gait-based exercise activities and to use this model to generate a questionnaire to evaluate the presence, symptoms and bother associated with LUTS experienced by females during gait-based activities. METHODS A theoretical model was developed through a review of the literature and refined through a focus group consultation including pelvic health physiotherapists, females who experienced leakage during exercise and academic researchers who studied female LUTS. A draft questionnaire was developed using key constructs identified in the model by the focus group. A new expert panel was recruited, which included physiotherapists, women with self-reported gait-induced LUTS and urogynecologists. This panel followed a DELPHI process to evaluate the relevance and completeness of the constructs within the questionnaire. RESULTS Two rounds of consultation were required to reach consensus on the completeness of included constructs as well as the inclusion and wording of questions. The resulting questionnaire contains questions related to five key constructs: physical activity characteristics, symptoms of urgency, urgency urinary incontinence, stress urinary incontinence experienced during exercise and management/mitigation strategies adopted by respondents. CONCLUSIONS The content validity of the brisk walking- and running-induced lower urinary tracts symptoms questionnaire has been established. The next steps are to ensure that the questionnaire has adequate comprehensibility, followed by adequate measurement properties.
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Affiliation(s)
- Olena Klahsen
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Linda McLean
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Waeckel T, Ait Said K, Menahem B, Briant A, Doerfler A, Alves A, Tillou X. Urinary Continence Resolution after Bariatric Surgery: Long-Term Results after Six-Year Follow-Up. J Clin Med 2023; 12:jcm12062109. [PMID: 36983112 PMCID: PMC10051985 DOI: 10.3390/jcm12062109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
Background: Bariatric surgery is known to improve stress urinary incontinence (SUI) and overactive bladder disorders (OAB). However, there is little long-term follow-up in the literature. Objective: To determine the long-term effect of bariatric procedures on SUI and OAB and their impact on quality of life, we applied the ICIQ and USP questionnaires. Setting: The research was conducted at a French university hospital with expertise in bariatric surgery. Methods: We performed an updated follow-up at 6 years of a prospective cohort of 83 women who underwent a bariatric procedure between September 2013 and September 2014. The women completed the USP and ICIQ questionnaires before surgery, 1 year and 6 years after the surgery. Results: Of the 83 patients, 67 responded (80.7%) in full. SUI remained improved at 6 years: the USP score decreased from 3 [1; 7] before surgery to 0 [0; 1] (p = 0.0010) at 1 year after surgery and remained at 0 [0; 0] (p = 0.0253) at 6 years. The decrease in the OAB symptom score remained statistically significant: 3 [1; 7] before the surgery vs. 2 [0; 5] at 6 years (p = 0.0150). However, this improvement was significantly less pronounced than at 1 year: 0 [0; 1] (p = 0.002). Conclusions: Bariatric surgery seems to be effective at treating SUI and OAB with a long-lasting effects, still noted at 6 years.
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Affiliation(s)
- Thibaut Waeckel
- Urology and Transplantation Department, University Hospital of Caen, 14000 Caen, France
| | - Khelifa Ait Said
- Urology and Transplantation Department, University Hospital of Caen, 14000 Caen, France
| | - Benjamin Menahem
- Department of Digestive Surgery, University Hospital of Caen, 14000 Caen, France
- Registre des Tumeurs Digestives, INSERM UMR 1086 ANTICIPE, 14032 Caen, France
- Correspondence:
| | - Anais Briant
- Department of Biostatistics, University Hospital of Caen, 14000 Caen, France
| | - Arnaud Doerfler
- Urology and Transplantation Department, University Hospital of Caen, 14000 Caen, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, 14000 Caen, France
- Registre des Tumeurs Digestives, INSERM UMR 1086 ANTICIPE, 14032 Caen, France
- Pôle de Formation et de Recherche en Santé, 2 rue des Rochambelles, 14033 Caen, France
| | - Xavier Tillou
- Urology and Transplantation Department, University Hospital of Caen, 14000 Caen, France
- Pôle de Formation et de Recherche en Santé, 2 rue des Rochambelles, 14033 Caen, France
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Kokanalı MK, Ersak B, Tugrul D, Elmas B, Doganay M, Caglar AT. The neglected secret: Association of abdominal striae with stress urinary incontinence in primigravid pregnant women. Eur J Obstet Gynecol Reprod Biol 2022; 275:37-40. [PMID: 35717746 DOI: 10.1016/j.ejogrb.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/26/2022] [Accepted: 06/11/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE(S) To compare the presence and severity of striae gravidarum in pregnant women with and without stress urinary incontinence and to evaluate whether there is a relationship between the severity of striae gravidarum and the severity of incontinence in pregnant women with stress urinary incontinence. STUDY DESIGN Healthy primigravid pregnant women with an uneventful singleton pregnancy at 36-37 weeks of gestation were included. All women were asked two questions to assess the presence of urinary incontinence. Women who answered 'yes' to the question 'Do you have any involuntary urinary leakage during coughing/laughing/sneezing/running/jumping?' and 'no' to the question 'Do you have any involuntary urinary leakage accompanied by a strong urge to void?' were classified as women with stress urinary incontinence, and women who answered 'no' to both questions were classified as women without stress urinary incontinence. The presence and severity of striae gravidarum of these two groups were evaluated with the Davey score, and the severity of incontinence of women with stress urinary incontinence was evaluated with the Incontinence severity index questionnaire. RESULTS The Davey score of pregnant women with stress urinary incontinence was significantly higher than the score of women without stress urinary incontinence and the presence of severe striae gravidarum was more common in women with stress urinary incontinence. There was a positive, significant correlation between Incontinence severity index and Davey scores in women with stress urinary incontinence, and this was the only independent correlation that was significant in linear regression analysis. CONCLUSION(S) Presence and severity of striae gravidarum is correlated with the presence and severity of stress urinary incontinence in primigravid pregnant women. Evaluation of striae gravidarum may be useful in predicting the development of stress urinary incontinence and taking necessary precautions against it. This issue should be evaluated with good quality studies.
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Affiliation(s)
| | - Burak Ersak
- University of Health Sciences, Ankara City Hospital, Turkey
| | - Duygu Tugrul
- University of Health Sciences, Ankara City Hospital, Turkey
| | - Burak Elmas
- University of Health Sciences, Ankara City Hospital, Turkey
| | - Melike Doganay
- University of Health Sciences, Ankara City Hospital, Turkey
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Brandt F, Solomayer EF, Sklavounos P. Correlation between the Incontinence Severity Index (ISI) and the quality of life dimensions of the King's Health Questionnaire (KHQ) in German-speaking urinary incontinent women. J Gynecol Obstet Hum Reprod 2021; 51:102288. [PMID: 34902634 DOI: 10.1016/j.jogoh.2021.102288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Incontinence Severity Index (ISI) is a patient questionnaire to ascertain severity of urinary incontinence (UI) via two items. The aim of this study was to translate the ISI into German, to compare it with the German-language King's Health Questionnaire (KHQ), an already validated German-language questionnaire within the scope of UI to measure condition-specific quality of life (QoL), and to gain more insights into association between symptom severity and QoL in German-speaking women affected. METHODS A total of 161 urinary incontinent women completed the ISI and the KHQ. Mean scores of the KHQ domains were computed and separated into severity-groups ascertained by the ISI (slight, moderate, severe, and very severe). Differences between severity-groups were examined using Kruskal-Wallis and Mann-Whitney U test. Correlation between ISI and KHQ were computed using Spearman's correlation coefficient to investigate construct validity of the ISI as well as association between symptom severity and QoL. RESULTS Overall, mean scores of the KHQ domains increased with increasing severity level. A consistent significant increase was found in role, physical, and social limitations (p < 0.05). Furthermore, the ISI showed moderate to strong correlations with related domains (convergent validity) and weak correlations with non-related domains of the KHQ (discriminant validity). CONCLUSIONS Construct validity of the German-language ISI is acceptable. Therefore this study supports its use in German-speaking women but further studies have to be done to gain more comprehensive insights into its psychometric properties. Moreover, increasing symptom severity is associated with decreasing QoL, especially concerning role, physical, and social limitations. TRIAL REGISTRATION NUMBER DRKS00018777.
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Affiliation(s)
- Florian Brandt
- Clinic for Gynecology, Obstetrics and Reproductive Medicine at Saarland University Hospital and Medical Faculty of Saarland University, Homburg, Germany; IKK Südwest, Saarbrücken, Germany.
| | - Erich-Franz Solomayer
- Clinic for Gynecology, Obstetrics and Reproductive Medicine at Saarland University Hospital and Medical Faculty of Saarland University, Homburg, Germany
| | - Panagiotis Sklavounos
- Clinic for Gynecology, Obstetrics and Reproductive Medicine at Saarland University Hospital and Medical Faculty of Saarland University, Homburg, Germany
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Wikander L, Kirshbaum MN, Waheed N, Gahreman DE. Urinary Incontinence in Competitive Women Powerlifters: A Cross-Sectional Survey. SPORTS MEDICINE - OPEN 2021; 7:89. [PMID: 34874496 PMCID: PMC8651931 DOI: 10.1186/s40798-021-00387-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/22/2021] [Indexed: 12/30/2022]
Abstract
Background Urinary incontinence (UI) can negatively affect a woman’s quality of life, participation in sport and athletic performance. The objectives of this study were to determine the prevalence of UI in competitive women powerlifters; identify possible risk factors and activities likely to provoke UI; and establish self-care practices. Methods This international cross-sectional study was conducted using an online survey completed by 480 competitive women powerlifters aged between 20 and 71 years. The Incontinence Severity Index (ISI) was used to determine the severity of UI. Results We found that 43.9% of women had experienced UI within the three months prior to this study. The deadlift was the most likely, and the bench-press the least likely exercise to provoke UI. ISI scores were positively correlated with parity (τ = 0.227, p < 0.001), age (τ = 0.179, p < 0.001), competition total (τ = 0.105, p = 0.002) and body mass index score (τ = 0.089, p = 0.009). There was no significant correlation between ISI and years strength training (τ = − 0.052, p = 0.147) or years powerlifting (τ = 0.041, p = 0.275). There was a negative correlation between ISI score with having a pelvic floor assessment (η = 0.197), and the ability to correctly perform pelvic floor exercises (η = 0.172). Conclusion The prevalence of UI in this cohort was at the upper limit experienced by women in the general population. Women who had undergone a pelvic floor examination or were confident in correctly performing pelvic floor exercises experienced less severe UI. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00387-7.
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Affiliation(s)
- Lolita Wikander
- College of Health and Human Sciences, Charles Darwin University, Casuarina, NT, Australia.
| | | | - Nasreena Waheed
- College of Nursing and Midwifery, Charles Darwin University, Casuarina, NT, Australia
| | - Daniel E Gahreman
- College of Health and Human Sciences, Charles Darwin University, Casuarina, NT, Australia
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Cross-Sectional Study of the Prevalence and Symptoms of Urinary Incontinence among Japanese Older Adults: Associations with Physical Activity, Health-Related Quality of Life, and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020360. [PMID: 33418845 PMCID: PMC7824891 DOI: 10.3390/ijerph18020360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 11/16/2022]
Abstract
Urinary incontinence (UI) is a major social problem for older adults and leads to a decline in health-related quality of life (HRQoL), mental health, and physical activity. This study assessed the prevalence and symptoms of UI among older adults discharged from the hospital in Japan and investigated the association of UI symptoms with physical activity, HRQoL, and subjective well-being (SWB). By an international consultation, the Incontinence Questionnaire Short Form (ICIQ-SF) that assesses UI severity, was developed. Self-administered questionnaires were used to assess physical activity, HRQoL, SWB, and social demographic characteristics of the participants. In total, 145 participants (valid response rate, 48%; mean age, 78.6 ± 7.6 years) were included in the analysis. Multivariate logistic regression analysis was performed to identify significant factors associated with the presence of UI. Significant decreases in physical activity, HRQoL, and SWB were observed in patients with UI compared with those without UI (p < 0.05). Multivariate analysis revealed that age, number of reported conditions, and decreased SWB were associated with UI (p < 0.05). UI was associated with less physical activity and decreased mental health status in older adults (especially decreased SWB). Health-promoting measures for older adults with UI are essential for maintaining their well-being and extending healthy life expectancy.
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Prospective observational study of abdominal wall reconstruction with THT technique in primary midline defects with diastasis recti: clinical and functional outcomes in 110 consecutive patients. Surg Endosc 2020; 35:5104-5114. [PMID: 32964305 DOI: 10.1007/s00464-020-07997-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Surgical treatment of diastasis recti is still a matter of debate. Open approaches such as abdominoplasty, which offer the possibility to combine reparation of the diastasis with abdominal cosmetic surgery, are challenged by the emerging less-invasive laparoscopic or robotic techniques that offer shorter recovery for patients. However, evidence in favour of one of the two approaches concerning both short- and long-term complications and functional results is still lacking. In this paper, we analysed clinical and functional results of a new endo-laparoscopic technique for midline reconstruction (THT technique) in patients with primary abdominal wall defects associated with diastasis recti. METHODS Prospective observational study on 110 consecutive patients was submitted to endo-laparoscopic reconstruction of the abdominal wall with linear staplers. Morbidity and relapse rates with clinical and radiological follow-up were recorded at 1, 6, 12, and 24 months after the operation. Data regarding the impact of surgery on patients' quality of life (EuraHSQol) on chronic low back pain (Oswestry Disability Index, ODI) and urinary stress incontinence (Incontinence Severity Index, ISI) were gathered. RESULTS After a mean follow-up of 14 months, the morbidity rate was 9.1% and no recurrences were recorded. 6-month follow-up ultrasound showed a rectus muscles mean distance of 6.7 mm; EuraHSQol, ODI, and ISI scores significantly improved in 93%, 77%, and 63% of the cases, respectively. CONCLUSIONS The THT technique proved to be a feasible, safe, and effective alternative for corrective surgery of primary midline hernias associated with diastasis recti. Short- and mid-term results are encouraging but need to be confirmed by further studies with longer follow-up. The achieved midline reconstruction offers a significant improvement of patients' perceived quality of life through reduction of abdominal wall pain, bulging, low back pain, and urinary stress incontinence.
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Multidimensional outcomes of suburethral synthetic midurethral sling removal. World J Urol 2019; 38:2005-2012. [PMID: 31696257 DOI: 10.1007/s00345-019-02987-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/13/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To report multidimensional outcomes encompassing pain, dyspareunia, and recurrent urinary tract infections (UTIs), following suburethral sling removal (SSR) of synthetic midurethral slings (MUS) placed for female stress urinary incontinence. METHODS We reviewed a prospectively maintained, IRB-approved database of women undergoing SSR at our institution. Demographic data, type of sling, and symptoms along with Urogenital Distress Inventory-Short Form (UDI-6) scores both before and after SSR were analyzed. Success was defined using several modalities including patient-reported symptoms (ideal outcome) and UDI-6 questionnaire. RESULTS From 3/2006-2/2017, 443 women underwent SSR of which 230 met study criteria with median overall follow-up of 23 months (mean 30 months). 180/230 (78%) patients reported 3 or more symptoms at presentation. Median most recent post-SSR total UDI-6 score was 38 vs. 50 at baseline (p < 0.0001). By UDI-6, 53% of patients achieved success post-SSR. An ideal outcome was attained in 22/230 (10%) patients. A modified outcome allowing for one minimally invasive anti-incontinence procedure and excluding sexual activity classified 112/230 (49%) patients as successes. CONCLUSIONS While patients with MUS present with multiple symptoms, following SSR, there is sustained improvement in multiple symptom domains, including pain and urinary incontinence. Allowing for minimally invasive anti-incontinence procedures (not inclusive of subsequent suburethral sling), the rate of success was 49%, which was comparable to that derived from UDI-6 scores (53%).
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Prevalence of urinary incontinence in women powerlifters: a pilot study. Int Urogynecol J 2019; 30:2031-2039. [PMID: 30666426 DOI: 10.1007/s00192-019-03870-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Increased intra-abdominal pressure is associated with urinary incontinence (UI) as is increasing age, obesity, and participating in sport at an elite level. We aimed to determine the prevalence of UI in competitive women powerlifters and establish if commonly cited risk factors affect the incidence of UI. METHODS The authors developed a 17-item questionnaire to investigate the prevalence of UI and the relationship of UI with age, body mass, resistance training experience, and competition grade in competitive women powerlifters. The questionnaire was distributed through three major powerlifting federations in Australia for 16 months. The data of 134 competitive women powerlifters were collected anonymously using Qualtrics, and were analysed using multivariate analysis. RESULTS In combination, the age of lifters, resistance training experience, body weight categories, and competition grade accounted for a significant 28% of the variability in the Incontinence Severity Index (ISI) (p < 0.01). However, the ISI was not significantly different among age groups, body weight categories, or competition grade. Approximately, 41% of women powerlifters had experienced UI at some stage in life, and 37% of women powerlifters currently experienced UI during training, competition, or maximum effort lifts. However, the rate of UI experienced during daily life activities was approximately 11%. CONCLUSIONS This study showed that competitive women powerlifters experience a higher rate of UI during lifting-related activities than in daily life and that the rate of UI correlates positively with age, body weight categories, resistance training experience, and competition grade.
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Shakir NA, Wang C, Singla N, Alhalabi F, Christie A, Lemack GE, Zimmern PE. Challenges of Multidimensional Outcome Reporting after Suburethral Mid Urethral Sling Removal. J Urol 2018; 199:1577-1583. [PMID: 29307687 DOI: 10.1016/j.juro.2017.12.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE We sought to determine the types and frequency of presenting symptoms in women undergoing suburethral mid urethral sling removal to improve outcome reporting after removal. MATERIALS AND METHODS Following institutional review board approval women who underwent suburethral mid urethral sling removal of 1 mid urethral sling were evaluated for their presenting symptoms and correlation with the UDI-6 (Urogenital Distress Inventory-Short Form) questionnaire. Demographic data were recorded. Patient reported presenting symptoms were categorized into 5 domains, including storage symptoms, voiding symptoms, pain, recurrent urinary tract infections or urinary incontinence. The UDI-6 was reviewed preoperatively and 6 to 12 months postoperatively. We also calculated an ideal outcome, defined as resolution of incontinence, pain, resumption of sexual activity and no need for further anti-incontinence procedures. RESULTS A total of 230 women from 2006 to 2017 met study inclusion criteria, including 116 who completed the UDI-6 postoperatively. Of the women 80% had 3 or more presenting symptoms with pain as the most common symptom. The most common combination of symptoms was all 5 domains, which was noted in 46 of the 230 women (20%). An increasing number of symptoms correlated with the total preoperative UDI-6 score. Symptom domains were associated with the corresponding UDI-6 subdomain questions. Domains not covered by the UDI-6, ie recurrent urinary tract infections and dyspareunia, accounted for 27% of reported symptoms. Due to limited data on sexual activity an ideal outcome was reached in 10% of patients but this rate was 40% after sexual activity information was excluded. CONCLUSIONS In this series the presenting symptoms were manifold in women undergoing suburethral mid urethral sling removal. The UDI-6 questionnaire correlated with many of these complaints. It may be used in outcome analysis in conjunction with self-reported symptoms.
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Affiliation(s)
- Nabeel A Shakir
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Connie Wang
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Nirmish Singla
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Feras Alhalabi
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alana Christie
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gary E Lemack
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Philippe E Zimmern
- Department of Urology and Division of Biostatistics, Simmons Comprehensive Cancer Center (AC), University of Texas Southwestern Medical Center, Dallas, Texas.
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Pakgohar M, Sabetghadam S, Rahimparvar SFV, Kazemnejad A. Sexual function and help seeking for urinary incontinence in postmenopausal women. J Women Aging 2016; 28:2-8. [PMID: 26882204 DOI: 10.1080/08952841.2014.950546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Urinary incontinence (UI) is a common condition, especially in middle-aged and older women. UI is known to affect sexual function. Many women with UI do not consult a doctor about their condition. The aim of this study was to determine the relationship of sexual function and help seeking in postmenopausal women with urinary incontinence. This cross-sectional correlation study took place from March to May 2012. The subjects were selected by a clustered sampling method from various zones of Rasht (North of Iran). The data were collected using personal data forms, Questionnaire for Urinary Incontinence Diagnosis, Incontinence Severity Index, and Incontinence Quality of Life questionnaire. Data were analyzed by SPSS17 at the significant level of P < .05 and then were compared by parametric and nonparametric tests. A total of 313 menopausal women aged 45 to 60 years (mean 52.9) were recruited for the study. The mean sexual function score was 31.07 ± 7.52. Only 27.3% of subjects seek care for urinary incontinence. There was a significant correlation between sexual function and help seeking. The results of this study indicate that there is a significant correlation between sexual function and help seeking in postmenopausal women who participated in the present study. Health-care professionals should pay more attention to sexual symptoms of UI and make patients aware of available treatments.
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Affiliation(s)
- Minoo Pakgohar
- a Gerontological Nursing Department , Tehran University of Medical Sciences , Tehran , Iran
| | - Shadi Sabetghadam
- b Alzahra Hospital , Guilan University of Medical Sciences , Rasht , Iran
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Xu D, Wang X, Li J, Wang K. The mediating effect of 'bothersome' urinary incontinence on help-seeking intentions among community-dwelling women. J Adv Nurs 2014; 71:315-25. [PMID: 25212267 DOI: 10.1111/jan.12514] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 11/29/2022]
Abstract
AIM To explore the mediating effect of bother of urinary incontinence between urinary incontinence severity and help-seeking intentions and detect whether the International Consultation on Incontinence Questionnaire-UI Short Form could be a valid measure to delineate bothersome urinary incontinence. BACKGROUND Urinary incontinence is a common condition among women, which has a profound adverse effect on quality of life. However, many of them experiencing significant clinical symptoms do not seek medical help. DESIGN A cross-sectional survey design. METHODS Women with urinary incontinence (N = 620) from three randomized selected community health service centres from May-October 2011 participated in the study. Data were collected using a pencil-and-paper questionnaire. Multivariate regression models were used to test the role of bother as a mediator in the relation between urinary incontinence severity and help-seeking intentions. Receiver operating characteristic analysis was used to find the best cut-off International Consultation on Incontinence Questionnaire-UI Short Form score (range: 0-21) to delineate the bother of urinary incontinence. RESULTS Bothersome urinary incontinence mediated the relationship between urinary incontinence severity and help-seeking intentions. Age and duration of urine leakage had a negative association on help-seeking intentions, while educational level and previous help-seeking behaviours had a positive association. CONCLUSIONS Bother was a mediator in the relation between urinary incontinence severity and help-seeking intentions. The International Consultation on Incontinence Questionnaire-UI Short Form was a discriminative measure to delineate the bothersome urinary incontinence.
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Affiliation(s)
- Dongjuan Xu
- School of Nursing, Shandong University, Jinan, China; School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Pakgohar M, Sabetghadam S, Vasegh Rahimparvar SF, Kazemnejad A. Quality of life (QoL) and help-seeking in postmenopausal women with urinary incontinence (UI): A population based study. Arch Gerontol Geriatr 2014; 59:403-7. [PMID: 25067833 DOI: 10.1016/j.archger.2014.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE UI is a common condition among women. UI adversely impacts upon QoL and participation in everyday activities. The aim of this study was to determine the relationship of QoL and help-seeking in postmenopausal women with UI. DESIGN This cross-sectional correlation study took place from March to May 2012; the subjects were selected by multi stage sampling method from various zones of Rasht City (North of Iran). The data were collected using personal data form, Questionnaire for Urinary Incontinence Diagnose (QUID), Incontinence Severity Index (ISI) and Incontinence QoL questionnaire (I-QoL), data were analyzed by SPSS at the significant level of P<0.05 and then were compared by parametric and non-parametric tests. RESULT Three hundred and thirteen menopause women aged 45-60 years (mean 52.9) were recruited in the study. Mean QoL score was 46.18 ± 19.91. Only 27.3% of subjects seek care for UI. There was no significant correlation between the QoL and help-seeking. CONCLUSION According to the findings although QoL was impaired in women with UI, their help-seeking was low. Most of them did not consider UI an important problem; health professionals should educate patients and aware patients of available treatments.
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Affiliation(s)
- Minoo Pakgohar
- Gerontological Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Urinary incontinence: its assessment and relationship to depression among community-dwelling multiethnic older women. ScientificWorldJournal 2014; 2014:708564. [PMID: 24982981 PMCID: PMC3984862 DOI: 10.1155/2014/708564] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/11/2013] [Indexed: 11/18/2022] Open
Abstract
Urinary Incontinence (UI) affects many older adults. Some of its deleterious consequences include stress, major depression, diminished quality of life, sexual dysfunction, and familial discord. Of the various mental health problems identified in the literature as being comorbid with UI, the most notable one continues to be depression. Despite a wealth of research contributions on this topic, the available literature is underrepresentative of ethnic minority older women. Culture has been shown to have a significant impact on a woman's perception of her own UI symptoms; this demonstrates the necessity for the recruitment of ethnically and culturally diverse samples when studying UI. In the present study, we determined the prevalence of UI among 140 community-dwelling, ethnically diverse older women (28.2%), discovered that our new UI screener is reliable, and did not find the UI-depression link to be significant. The clinical and research implications of our findings are discussed.
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Aguilar-Navarro S, Navarrete-Reyes AP, Grados-Chavarría BH, García-Lara JMA, Amieva H, Avila-Funes JA. The severity of urinary incontinence decreases health-related quality of life among community-dwelling elderly. J Gerontol A Biol Sci Med Sci 2012; 67:1266-71. [PMID: 22879454 DOI: 10.1093/gerona/gls152] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Urinary incontinence (UI) is an important geriatric syndrome that has been associated with a wide range of health-related outcomes. However, UI severity has rarely been examined in the context of a comprehensive geriatric assessment. Therefore, the aim of this study is to examine the association between UI severity and health-related quality of life (QoL) when frequent geriatric issues are taken into account. METHODS We performed a cross-sectional study of 1,124 participants aged 70 y and older. UI was diagnosed when difficulty with urinary continence was reported, and its severity was assessed through a modified version of the Sandvik Index. Health-related QoL was measured using the SF-36, including its physical and mental component summaries. Multivariate linear regression was performed to determine the association between UI severity and health-related QoL. RESULTS Prevalence of UI was 18%, and it was severe in 29.3% of cases. Severely incontinent subjects were older and had worse self-perceived health status, greater disability, and more depressive symptoms in comparison with continent participants or with those affected to a lesser degree. Multivariate regression analysis showed a significant inverse association between the physical component summaries and moderate (B = -4.54) as well as severe UI (B = -6.72). The mental component summaries showed similar results (B = -1.44 and -4.43, respectively). CONCLUSIONS UI severity is associated with lower QoL scores in both its components. This association appears to be more important as severity increases. UI severity must be evaluated thoroughly in the elderly because of its potential adverse effects on physical and mental health.
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Affiliation(s)
- Sara Aguilar-Navarro
- Department of Geriatrics Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Abstract
BACKGROUND Morbidly obese women have markedly high rates of urinary and fecal incontinence. Weight loss reduces prevalence and severity of urinary incontinence; however, the effect of weight loss on fecal incontinence is unknown. AIMS The aim of this study was to document the prevalence of urinary and fecal incontinence in subjects who underwent bariatric surgery and associated weight loss. METHODS We mailed a detailed survey to all 404 adults who underwent bariatric surgery at the University of Wisconsin prior to May 2006. Type and severity of urinary and fecal incontinence was obtained using previously validated questionnaires. Perceived effect of surgery on bowel and bladder function was also assessed. RESULTS Forty-eight percent (193) of the surveys were returned. Urinary incontinence was reported in 72% of the women, 39% of whom perceived improvement after surgery. Only 21% of the men reported urinary incontinence. In contrast, fecal incontinence was common in both men and women; 48% of the women and 42% of the men reported liquid stool incontinence and 21% of the women and 30% of the men reported solid stool incontinence. Fifty-five percent of the women and 31% of the men with fecal incontinence perceived worsening after surgery. Women with diarrhea were four times more likely to report fecal incontinence (P<0.0001). Furthermore, women who perceived worsening of diarrhea after surgery were significantly more likely to have fecal incontinence (P=0.003). CONCLUSIONS Both fecal and urinary incontinence were common after bariatric surgery. Risk factors for fecal incontinence in women after bariatric surgery include diarrhea and worsening of diarrhea; we suggest that such surgery may uncover prior weaknesses in the continence mechanism.
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Gil KM, Somerville AM, Cichowski S, Savitski JL. Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence. Health Qual Life Outcomes 2009; 7:8. [PMID: 19196462 PMCID: PMC2645374 DOI: 10.1186/1477-7525-7-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 02/05/2009] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Current research focuses on three variables in evaluating the impact of stress urinary incontinence (SUI) on daily living: severity of incontinence, distress or bother resulting from incontinence, and effect on health related quality of life (HRQoL). Understanding the impact of these variables is important as they are the driving force behind women seeking surgical treatment. Given the importance of HRQoL in determining need for treatment, as well as evaluating treatment success, this review provides an assessment of the degree to which HRQoL is impaired in women seeking surgical treatment. METHODS PubMed searches for the terms "quality of life and distress and urinary incontinence" and "quality of life and bother and urinary incontinence" were performed with limits of English, human and female subjects through May 2008. All studies using validated instruments were included. No time limit was placed on the search. RESULTS Of 178 articles retrieved, 21 met the inclusion criteria, and 17 reported methods of scoring. The studies used the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Wide ranges of mean and individual levels of severity of symptoms, UDI and IIQ scores were seen among women seeking surgical treatment. Fourteen studies reported baseline and post-surgical treatment distress and QoL data. Statistically significant improvements between baseline and post-surgical UDI and IIQ scores were reported in 12 studies. Reported cure rates ranged from 46% to 97%. Satisfaction with the procedure was reported in 4 studies and ranged from 84% to 91%. A minority of studies reported the relationship between reduction in symptoms and change in HRQoL. CONCLUSION HRQoL is the main reason women seek surgical treatment for incontinence and surgical treatment leads to a significant improvement in mean HRQoL scores. Assessment of HRQoL has proved less useful in identifying why individual women seek treatment for incontinence. Preliminary work has begun to characterize the interaction between severity of symptoms, distress or bother resulting from these urinary symptoms, impact on HRQoL, and treatment seeking behavior, but further research is needed. Greater standardization in the reporting of results of distress or bother and HRQoL would allow for comparison across studies.
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Affiliation(s)
- Karen M Gil
- Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, OH, USA
- Northeastern Ohio Universities College of Medicine and Pharmacy, Rootstown, OH, USA
| | - Amber M Somerville
- Northeastern Ohio Universities College of Medicine and Pharmacy, Rootstown, OH, USA
| | - Sara Cichowski
- Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, OH, USA
| | - Jennifer L Savitski
- Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, OH, USA
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Stoffel JT, Morgan D, Dunn R, Hsu Y, Fenner D, DeLancey J, McGuire EJ, Wei JT. Urinary Incontinence After Stress Incontinence Surgery: A Risk Factor for Depression. Urology 2009; 73:41-6. [DOI: 10.1016/j.urology.2008.08.478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Revised: 08/12/2008] [Accepted: 08/13/2008] [Indexed: 11/24/2022]
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