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Li J, Zhao X, Li J, Liu Y, Li T. Knowledge of urinary incontinence among women 6 weeks to 1 year after delivery. Neurourol Urodyn 2024; 43:1655-1664. [PMID: 38624008 DOI: 10.1002/nau.25472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/11/2024] [Accepted: 04/04/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Urinary incontinence (UI) is common among postpartum women, but many do not seek medical help due to limited knowledge. Understanding the level of knowledge about UI in this population is essential for improving care-seeking behaviors and implementing targeted interventions. OBJECTIVE The objective was to examine knowledge regarding UI among postpartum women with UI within 6 weeks to 1 year after delivery. METHODS A cross-sectional study was conducted at obstetric clinic in two level-three grade A hospitals in Shenzhen, China, from January 2023 to June 2023. Women in their 6 weeks to 1 year after delivery with UI were asked to complete a questionnaire comprising three sections: (1) demographic variable; (2) International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF); and (3) The Urinary Incontinence Quiz (UIQ). RESULTS A total of 1228 women completed the questionnaire. Their mean UIQ score was 6.63 ± 3.51 (minimum = 2, maximum = 15), indicating the deficiency of UI knowledge among Chinese postpartum women. A total of 86.4% of participants experienced slight or moderate postpartum UI. The results of multivariate linear regression models for UIQ reveal significant independent associations between questionnaire scores and two variables: experience in pelvic floor muscle training (PFMT) (p < 0.001) and UI treatment in the past (p < 0.001). The overall model fit was R2 = 0.559 (p < 0.001). The regression coefficients for the experience in PFMT and UI treatment in the past were 2.301 and 4.916, respectively. However, no other discernible factors were identified to distinguish between those with and without adequate knowledge. CONCLUSIONS Postpartum women with UI within 6 weeks to 1 year after delivery had poor knowledge of UI. Targeted educational interventions focusing on PFMT and early treatment for UI are essential.
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Affiliation(s)
- Jie Li
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoling Zhao
- Obstetrics and Gynecology Reproductive Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Juanhua Li
- Department of Obstetrics, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuanwen Liu
- Department of Obstetrics, Bao'an District Maternal and Child Health Care Hospital, Shenzhen, Guangdong, China
| | - Tiantian Li
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
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Walgren LA, Wade C, Dessaulles M, Martin Ginis K, Locke J. A review of the role for pelvic floor physiotherapy in postmenopausal women with urinary incontinence. Post Reprod Health 2024:20533691241272830. [PMID: 39129175 DOI: 10.1177/20533691241272830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Urinary incontinence is a prevalent condition affecting women. Pelvic floor physiotherapy is a specialized field of physiotherapy dedicated to assessing and treating pelvic floor muscles. This therapy has demonstrated benefits in addressing stress urinary incontinence in premenopausal women, with numerous studies supporting its efficacy in this population. However, pelvic floor physiotherapy in the treatment of postmenopausal women is less well-established, and furthermore, the types of urinary incontinence in postmenopausal women are much broader. We provide a comprehensive review of recent literature investigating the effectiveness of pelvic floor physiotherapy therapy for various conditions in postmenopausal women, including urinary incontinence, urgency urinary incontinence, pelvic organ prolapse, genitourinary syndrome of menopause, sexual dysfunction, and urinary incontinence in the context of obesity, frailty, mobility, and dementia. After evaluating the current literature, it is evident that there is insufficient data to definitively endorse or dismiss the utilization of Pelvic floor physiotherapy for treating urinary incontinence in postmenopausal women. Nevertheless, considering the low associated risks of pelvic floor physiotherapy, we advocate for the initiation of comprehensive, large-scale randomized studies aimed at evaluating its effectiveness in addressing urinary incontinence in postmenopausal women with special attention to vulnerable subgroups, including individuals who are obese, frail or experiencing cognitive impairment.
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Affiliation(s)
- Lauren A Walgren
- Department of Medicine, University of British Columbia Southern Medical Program, Kelowna, BC, Canada
- Division of Urology, Kelowna General Hospital, Kelowna, BC, Canada
| | | | | | | | - Jennifer Locke
- Department of Medicine, University of British Columbia Southern Medical Program, Kelowna, BC, Canada
- Division of Urology, Kelowna General Hospital, Kelowna, BC, Canada
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Kilic BB, Yildiz Ozer A, Ozarpaci C, Polat MG. The Comparison of Individual and Group Hybrid Telerehabilitation Methods in Women with Urinary Incontinence. Int Urogynecol J 2024; 35:1299-1315. [PMID: 38761232 DOI: 10.1007/s00192-024-05808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/08/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The aim is to compare the effects of the progressive training program (PTP), a new protocol, with two different hybrid telerehabilitation methods, on the parameters related to urinary incontinence in women with urinary incontinence. METHODS A total of 50 participants with stress or mixed urinary incontinence participated in this two-arm, parallel-group, randomized, non-inferiority trial. Individual hybrid training (IHT) or group hybrid training (GHT) was given to women for 8 weeks. The Power, Endurance, Repetitions, Fast contractions, and Every Contraction Timed (PERFECT) scheme and surface electromyography were used to assess pelvic floor muscle function, whereas quality of life, exercise adherence, and symptoms were assessed by questionnaires and a 3-day bladder diary. An intention-to-treat analysis was performed. Linear mixed model analysis with the factors "time" and "group" was used to determine the effects of IHT and GHT. RESULTS The primary outcome was changes in pelvic floor muscle function as evaluated using the PERFECT scheme and surface electromyography at the 4th and 8th weeks relative to baseline. No statistical difference was found between the groups except for "power" of the PERFECT scheme and "nocturnal urination frequency" (p > 0.05). The GHT showed significant improvement in P and nocturnal urination frequency at the end of the 8th week (p < 0.05). From baseline to week 8, the effect size for the P value was found to be small (Cohen's d = 0.33). CONCLUSION Eight weeks of PTP did not lead to different results in incontinence-related parameters in either of the training methods. It may be better to conduct GHT in terms of implementing PTP in incontinence and training programs in terms of time, staff workload, and applicability.
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Affiliation(s)
- Berivan Beril Kilic
- Faculty of Health Sciences, Department of Physiotherapy Rehabilitation, Marmara University, Istanbul, Turkey.
| | - Aysel Yildiz Ozer
- Faculty of Health Sciences, Department of Physiotherapy Rehabilitation, Marmara University, Istanbul, Turkey
| | - Cemalettin Ozarpaci
- Gynecology and Obstetrics Clinic, Goztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Mine Gulden Polat
- Faculty of Health Sciences, Department of Physiotherapy Rehabilitation, Marmara University, Istanbul, Turkey
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Zhang Y, Engberg SJ, Courtney KL, Kariuki JK, Matthews JT. Effect of a Bladder Control Self-Management Program Delivered Through a Health Kiosk. J Wound Ostomy Continence Nurs 2024; 51:213-220. [PMID: 38820219 PMCID: PMC11147162 DOI: 10.1097/won.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE The purpose of this study was to examine the feasibility of delivering a bladder control self-management program through a multiuser health kiosk and to evaluate the program's effect on urinary incontinence (UI) and incontinence-specific quality of life (QoL). DESIGN Secondary analysis of data collected during participants' interactions with the Bladder Control Module (BCM) from the parent study. SUBJECTS AND SETTING One hundred eleven participants from the parent study were eligible to be included in this secondary analysis. Their mean age was 72.8 years, and most were female (n = 95, 85.6%); 81 (75.7%) identified themselves as Caucasian. Each participant could access the BCM at a health kiosk situated at one of several sites: senior centers, subsidized senior housing, retirement communities, and a public library. METHODS The BCM comprised 6 sessions self-administered at least 1 week apart. The content focused on lifestyle modification, pelvic floor muscle training, and bladder (habit) retraining, with encouragement of behavioral self-monitoring between sessions. The feasibility of delivering the intervention was measured by the proportion of participants completing each session. The effect of the BCM on incontinence episodes and incontinence-specific QoL was measured, respectively, by a 7-day bladder diary and the Incontinence Impact Questionnaire Short Form. RESULTS Sixty-one of the 111 eligible participants accessed the BCM. Participants recording incontinence episodes in their baseline bladder diary and completing at least 3 BCM sessions experienced significant decreases in median total UI (P = .01), urge UI (P < .001), and stress UI (P = .02) episodes per day. Incontinence-related QoL significantly improved (P = .03). CONCLUSIONS Our findings support the potential effectiveness of providing community-based, kiosk-enabled access to a conservative behavioral intervention designed to improve incontinence-related outcomes among older adults with UI. Additional research with a larger sample is warranted.
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Affiliation(s)
- Yuchen Zhang
- Yuchen Zhang, BSN-H, RN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Sandra J. Engberg, PhD, RN, CRNP, FAAN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Karen L. Courtney, PhD, MSN, RN , School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
- Jacob K. Kariuki, PhD, AGNP-BC , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Judith Tabolt Matthews, PhD, MPH , University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sandra J Engberg
- Yuchen Zhang, BSN-H, RN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Sandra J. Engberg, PhD, RN, CRNP, FAAN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Karen L. Courtney, PhD, MSN, RN , School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
- Jacob K. Kariuki, PhD, AGNP-BC , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Judith Tabolt Matthews, PhD, MPH , University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Karen L Courtney
- Yuchen Zhang, BSN-H, RN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Sandra J. Engberg, PhD, RN, CRNP, FAAN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Karen L. Courtney, PhD, MSN, RN , School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
- Jacob K. Kariuki, PhD, AGNP-BC , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Judith Tabolt Matthews, PhD, MPH , University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacob K Kariuki
- Yuchen Zhang, BSN-H, RN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Sandra J. Engberg, PhD, RN, CRNP, FAAN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Karen L. Courtney, PhD, MSN, RN , School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
- Jacob K. Kariuki, PhD, AGNP-BC , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Judith Tabolt Matthews, PhD, MPH , University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Judith Tabolt Matthews
- Yuchen Zhang, BSN-H, RN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Sandra J. Engberg, PhD, RN, CRNP, FAAN , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Karen L. Courtney, PhD, MSN, RN , School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
- Jacob K. Kariuki, PhD, AGNP-BC , School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- Judith Tabolt Matthews, PhD, MPH , University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, Pennsylvania
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Ter Haar CM, Class QA, Kobak WH, Pandya LK. Telehealth in a Pelvic Floor Physical Therapy Clinic: A Retrospective Cohort Study. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024:02273501-990000000-00207. [PMID: 38621420 DOI: 10.1097/spv.0000000000001510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
IMPORTANCE Telehealth offers advantages to patients with pelvic floor disorders because they face unique barriers to care; however, attendance of telehealth appointments is unknown. OBJECTIVE The objective of this study was to examine the attendance of telehealth appointments in urogynecology patients receiving pelvic floor physical therapy as compared with in-person visits before and during the COVID-19 pandemic. STUDY DESIGN We retrospectively collected electronic medical record data from patients engaging in pelvic floor physical therapy from 2019, and pre- and post-COVID-19 in 2020. Information included appointment type, attendance, age, primary diagnoses, insurance status, and zip code. Cohort differences were examined using the χ2 test and analyses of variance. RESULTS Our sample included 359 individuals scheduled for in-person visits in 2019, 57 for telehealth visits in 2020, and 283 for in-person visits in 2020. Patients scheduled for telehealth appointments were younger (39 ± 13 years) than patients in 2019 (45 ± 14 years) or 2020 (42 ± 14 years) in-person cohorts (χ2 (2, 696) = 6.8, P < 0.001). Patients attended telehealth appointments at higher rates (73.7%) than in-person visits in 2019 (56.8%) and 2020 (45.6%; χ2 (2, 699) = 26.2, P < 0.001). Attendance did not differ across primary diagnoses. Proximity based on zip code was not associated with attendance. CONCLUSIONS Pelvic floor physical therapy attendance rates were highest for patients with telehealth visits as compared with in-person visits. Our findings encourage health care providers to continue or begin to offer telehealth visits for pelvic floor physical therapy for the urogynecology patient population.
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Affiliation(s)
- Charlotte M Ter Haar
- From the Department of Obstetrics and Gynecology, University of California Irvine, Irvine, CA
| | - Quetzal A Class
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL
| | - William H Kobak
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL
| | - Lopa K Pandya
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL
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Yung KK, Cheung RYK, Wan OYK, Lee LLL, Choy KW, Chan SSC. Treatment outcome of women with urodynamic mixed urinary incontinence: an observational study. Int Urogynecol J 2023; 34:665-673. [PMID: 35445809 DOI: 10.1007/s00192-022-05097-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Mixed urinary incontinence (MUI) is a common yet understudied condition. It remains a therapeutic challenge, with the presence of both stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). There is limited information on the optimal management for women with urodynamic MUI (urodynamic stress incontinence and detrusor overactivity). We assessed the treatment outcome of pelvic floor muscle training (PFMT), medical treatment and surgery for women who were diagnosed with urodynamic MUI. METHODS A prospective observational study was carried out on women with urodynamic MUI from 2010 to 2018. All women underwent clinical assessment and standardised urodynamic evaluation. All women received PFMT from a specialised continence advisor as initial management. Antimuscarinics and/or continence surgery were considered according to the woman's response and symptoms after PFMT. Subjective outcome after each treatment modality was analysed. RESULTS A total of 198 women were included for analysis. All women received PFMT, 104 (52.5%) showing improvement in urinary incontinence. Eighty-seven (43.9%) women were offered antimuscarinics, of whom 58 (29.3%) showed subjective improvement in both SUI and UUI, and 10 (5%) reported a reduction in UUI but persistent SUI. A total of 55 (27.7%) women received surgical treatment, with 20 receiving continence procedures. Sixteen out of twenty (80%) of them reported improvement in both SUI and UUI. None reported worsening of urgency or UUI. Overall, across all treatment modalities, 73.8% of women showed improvement in both SUI and UUI. CONCLUSION Future analyses can help to inform which patients will have a higher success rate after each treatment modality and help focus treatment effort on those with a high risk of persistent symptoms. This will provide relevant data in counselling women, giving reasonable expectations and directing the management of women with urodynamic MUI.
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Affiliation(s)
- Kar Kei Yung
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
| | - Rachel Y K Cheung
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Osanna Y K Wan
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Loreta L L Lee
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kwong W Choy
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Symphorosa S C Chan
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Baran B, Kozłowski E, Majerek D, Rymarczyk T, Soleimani M, Wójcik D. Application of Machine Learning Algorithms to the Discretization Problem in Wearable Electrical Tomography Imaging for Bladder Tracking. SENSORS (BASEL, SWITZERLAND) 2023; 23:1553. [PMID: 36772593 PMCID: PMC9918926 DOI: 10.3390/s23031553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
The article presents the implementation of artificial intelligence algorithms for the problem of discretization in Electrical Impedance Tomography (EIT) adapted for urinary tract monitoring. The primary objective of discretization is to create a finite element mesh (FEM) classifier that will separate the inclusion elements from the background. In general, the classifier is designed to detect the area of elements belonging to an inclusion revealing the shape of that object. We show the adaptation of supervised learning methods such as logistic regression, decision trees, linear and quadratic discriminant analysis to the problem of tracking the urinary bladder using EIT. Our study focuses on developing and comparing various algorithms for discretization, which perfectly supplement methods for an inverse problem. The innovation of the presented solutions lies in the originally adapted algorithms for EIT allowing for the tracking of the bladder. We claim that a robust measurement solution with sensors and statistical methods can track the placement and shape change of the bladder, leading to effective information about the studied object. This article also shows the developed device, its functions and working principle. The development of such a device and accompanying information technology came about in response to particularly strong market demand for modern technical solutions for urinary tract rehabilitation.
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Affiliation(s)
- Bartłomiej Baran
- Research & Development Centre Netrix S.A., 20-704 Lublin, Poland
| | - Edward Kozłowski
- Faculty of Management, Lublin University of Technology, 20-618 Lublin, Poland
| | - Dariusz Majerek
- Faculty of Fundamentals of Technology, Lublin University of Technology, 20-618 Lublin, Poland
| | - Tomasz Rymarczyk
- Research & Development Centre Netrix S.A., 20-704 Lublin, Poland
- WSEI University, 20-209 Lublin, Poland
| | - Manuchehr Soleimani
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK
| | - Dariusz Wójcik
- Research & Development Centre Netrix S.A., 20-704 Lublin, Poland
- WSEI University, 20-209 Lublin, Poland
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Kinouchi K, Ohashi K. Assessing Engagement With Patient-Generated Health Data Recording and Its Impact on Health Behavior Changes in Multicomponent Interventions: Supplementary Analysis. JMIR Form Res 2022; 6:e35471. [PMID: 35503411 PMCID: PMC9115657 DOI: 10.2196/35471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/15/2022] [Accepted: 03/30/2022] [Indexed: 11/15/2022] Open
Abstract
Background The use and sharing of patient-generated health data (PGHD) by clinicians or researchers is expected to enhance the remote monitoring of specific behaviors that affect patient health. In addition, PGHD use could support patients’ decision-making on preventive care management, resulting in reduced medical expenses. However, sufficient evidence on the use and sharing of PGHD is lacking, and the impact of PGHD recording on patients’ health behavior changes remains unclear. Objective This study aimed to assess patients’ engagement with PGHD recording and to examine the impact of PGHD recording on their health behavior changes. Methods This supplementary analysis used the data of 47 postpartum women who had been assigned to the intervention group of our previous study for managing urinary incontinence. To assess the patients’ engagement with PGHD recording during the intervention period (8 weeks), the fluctuation in the number of patients who record their PGHD (ie, PGHD recorders) was evaluated by an approximate curve. In addition, to assess adherence to the pelvic floor muscle training (PFMT), the weekly mean number of pelvic floor muscle contractions performed per day among 17 PGHD recorders was examined by latent class growth modeling (LCGM). Results The fluctuation in the number of PGHD recorders was evaluated using the sigmoid curve formula (R2=0.91). During the first week of the intervention, the percentage of PGHD recorders was around 64% (30/47) and then decreased rapidly from the second to the third week. After the fourth week, the percentage of PGHD recorders was 36% (17/47), which remained constant until the end of the intervention. When analyzing the data of these 17 PGHD recorders, PFMT adherence was categorized into 3 classes by LCGM: high (7/17, 41%), moderate (3/17, 18%), and low (7/17, 41%). Conclusions The number of PGHD recorders declined over time in a sigmoid curve. A small number of users recorded PGHD continuously; therefore, patients’ engagement with PGHD recording was low. In addition, more than half of the PGHD recorders (moderate- and low-level classes combined: 10/17, 59%) had poor PFMT adherence. These results suggest that PGHD recording does not always promote health behavior changes.
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Affiliation(s)
- Kaori Kinouchi
- Department of Children and Women's Health, Area of integrated Health and Nursing Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Comparison of Pelvic Floor Physical Therapy Attendance Based on Referring Provider Specialty. Female Pelvic Med Reconstr Surg 2022; 28:57-63. [PMID: 34261109 PMCID: PMC9169548 DOI: 10.1097/spv.0000000000001061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of this study was to determine whether pelvic floor physical therapy (PFPT) attendance differs based on referring provider specialty and identify factors related to PFPT initiation and completion. METHODS This was an institutional review board-approved retrospective cohort study examining referrals from female pelvic medicine and reconstructive surgery (FPMRS) and non-FPMRS providers at a single academic medical center to affiliated PFPT clinics over a 12-month period. Demographics, referring specialty and diagnoses, prior treatment, and details regarding PFPT attendance were collected. Characteristics between FPMRS and non-FPMRS referrals were compared and multivariate logistic regression analyses were performed to identify factors associated with PFPT initiation and completion. RESULTS A total of 497 referrals were placed for PFPT. Compared with non-FPMRS referrals, FPMRS referrals were for patients who were older (54.7 years vs 35.6 years), and had higher parity; more were postmenopausal (56% vs 18%) and had Medicare insurance (22% vs 10%) (all P < 0.001). Most FPMRS referrals were for patients with urinary incontinence (69% vs 31%), whereas non-FPMRS referrals were for patients with pelvic pain (70% vs 27%) (both P < 0.0001). Pelvic floor physical therapy attendance was similar in both groups when comparing rates of initiation (47% vs 45%) and completion (13% vs 16%). In multivariate analysis, factors associated with initiation were age 65 years or older, additional therapy provided at referring visit, private insurance, Asian race, pregnant or postpartum at time of referral, and more than 1 referring diagnosis (all P < 0.05). No factors were associated with completion. CONCLUSIONS Less than half of the patients referred to PFPT initiate therapy, and only 15% complete PFPT. The populations referred by FPMRS and non-FPMRS providers are different, but ultimately PFPT utilization is similar.
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Pereira GMV, Juliato CRT, de Almeida CM, de Andrade KC, Fante JF, Martinho N, Jales RM, Pinto e Silva MP, Brito LGO. Effect of radiofrequency and pelvic floor muscle training in the treatment of women with vaginal laxity: A study protocol. PLoS One 2021; 16:e0259650. [PMID: 34752494 PMCID: PMC8577744 DOI: 10.1371/journal.pone.0259650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Vaginal laxity is an underreported condition that negatively affects women's sexual function and their relationships. Evidence-based studies are needed to better understand this complaint and to discuss its treatment options. Thus, we present a study protocol to compare the effect of radiofrequency and pelvic floor muscle training in the treatment of women with complaints of vaginal laxity. METHODS/DESIGN This is a prospective, parallel-group, two-arm, randomized clinical trial (Registry: RBR-2zdvfp-REBEC). Participants will be randomly assigned to one of the two groups of intervention (Radiofrequency or Pelvic Floor Muscle Training). The study will be performed in the Urogynecology outpatient clinic and in the physiotherapy outpatient clinic at the State University of Campinas-UNICAMP and will include women aged ≥ 18 years and with self-reported complaints of vaginal laxity. Participants will be assessed at baseline (pre-intervention period) and will be followed up in two periods: first follow-up (30 days after intervention) and second follow-up (six months after intervention). EXPECTED RESULTS The results of this randomized clinical trial will have a positive impact on the participants' quality of life, as well as add value to the development of treatment options for women with complaints of vaginal laxity. TRIAL REGISTRATION Registry: RBR-2zdvfp-Registro Brasileiro de Ensaios Clínicos-REBEC (19/02/2020).
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Affiliation(s)
| | | | - Cristiane Martins de Almeida
- Centro de Atenção Integral à Saúde da Mulher (CAISM)—Hospital da Mulher Professor Dr. José Aristodemo Pinotti—UNICAMP, Campinas, Brazil
| | - Kleber Cursino de Andrade
- Centro de Atenção Integral à Saúde da Mulher (CAISM)—Hospital da Mulher Professor Dr. José Aristodemo Pinotti—UNICAMP, Campinas, Brazil
| | - Júlia Ferreira Fante
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Natália Martinho
- Centro Universitário das Faculdades Associadas de Ensino–UNIFAE, São João da Boa Vista, Brazil
- Centro Regional Universitário de Espírito Santo do Pinhal—UNIPINHAL, Santo do Pinhal, Brazil
| | - Rodrigo Menezes Jales
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Marcela Ponzio Pinto e Silva
- Centro de Atenção Integral à Saúde da Mulher (CAISM)—Hospital da Mulher Professor Dr. José Aristodemo Pinotti—UNICAMP, Campinas, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
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Leech KA, Roemmich RT, Gordon J, Reisman DS, Cherry-Allen KM. Updates in Motor Learning: Implications for Physical Therapist Practice and Education. Phys Ther 2021; 102:6409654. [PMID: 34718787 PMCID: PMC8793168 DOI: 10.1093/ptj/pzab250] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022]
Abstract
Over the past 3 decades, the volume of human motor learning research has grown enormously. As such, the understanding of motor learning (ie, sustained change in motor behavior) has evolved. It has been learned that there are multiple mechanisms through which motor learning occurs, each with distinctive features. These mechanisms include use-dependent, instructive, reinforcement, and sensorimotor adaptation-based motor learning. It is now understood that these different motor learning mechanisms contribute in parallel or in isolation to drive desired changes in movement, and each mechanism is thought to be governed by distinct neural substrates. This expanded understanding of motor learning mechanisms has important implications for physical therapy. It has the potential to facilitate the development of new, more precise treatment approaches that physical therapists can leverage to improve human movement. This Perspective describes scientific advancements related to human motor learning mechanisms and discusses the practical implications of this work for physical therapist practice and education.
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Affiliation(s)
- Kristan A Leech
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
- Address all correspondence to Dr Leech at:
| | - Ryan T Roemmich
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - James Gordon
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| | - Darcy S Reisman
- Physical Therapy Department, University of Delaware, Newark, Delaware, USA
| | - Kendra M Cherry-Allen
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA
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Quaghebeur J, Petros P, Wyndaele JJ, De Wachter S. Pelvic-floor function, dysfunction, and treatment. Eur J Obstet Gynecol Reprod Biol 2021; 265:143-149. [PMID: 34492609 DOI: 10.1016/j.ejogrb.2021.08.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/15/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
The pelvic floor functions as a holistic entity. The organs, bladder, bowel, smooth and striated muscles, nerves, ligaments and other connective tissues are directed cortically and reflexly from various levels of the nervous system. Such holistic integration is essential for the system's multiple functions, for example, pelvic girdle stability, continence, voiding/defecation, and sexuality. Pelvic floor dysfunction (PFD) is related to a variety of pelvic pain syndromes and organ problems of continence and evacuation. Prior to treatment, it is necessary to understand which part(s) of the system may be causing the dysfunction (s) of Chronic Pelvic Pain Syndrome (CPPS), pelvic girdle pain, sexual problems, Lower Urinary Tract Symptoms (LUTS), dysfunctional voiding, constipation, prolapse and incontinence. The interpretation of pelvic floor biomechanics is complex and involves multiple theories. Non-surgical treatment of PFD requires correct diagnosis and correctly supervised pelvic floor training. The aims of this review are to analyze pelvic function and dysfunction. Because it is a holistic and entirely anatomically based system, we have accorded significant weight to the Integral Theory's explanations of function and dysfunction.
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Affiliation(s)
- Jörgen Quaghebeur
- Department of Urology, University of Antwerp, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium.
| | - Peter Petros
- Faculty of Medicine, University of New South Wales, Kensington, Sydney, Australia
| | | | - Stefan De Wachter
- Department of Urology, University of Antwerp, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
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Abufaraj M, Xu T, Cao C, Siyam A, Isleem U, Massad A, Soria F, Shariat SF, Sutcliffe S, Yang L. Prevalence and trends in urinary incontinence among women in the United States, 2005-2018. Am J Obstet Gynecol 2021; 225:166.e1-166.e12. [PMID: 33727114 DOI: 10.1016/j.ajog.2021.03.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Women are disproportionately affected by urinary incontinence compared with men. Urinary incontinence results in physical and psychological adverse consequences and impaired quality of life and contributes to significant societal and economic burden. Previous studies reported high urinary incontinence burden in the United States. However, the current prevalence and recent trends in urinary incontinence and its subtypes among US women have not been described. In addition, correlates of urinary incontinence among US women have not been systematically evaluated in the contemporary population. OBJECTIVE The purpose of this study was to determine the prevalence and trends in urinary incontinence among adult women in the United States from 2005 to 2018. In addition, this study aimed to investigate the relationship of urinary incontinence subtypes with several sociodemographic, lifestyle, health-related, and gynecologic factors. STUDY DESIGN We used data from the National Health and Nutrition Examination Survey, a nationally representative series of surveys that was designed to evaluate the health status of the US population. Data on urinary incontinence from 7 consecutive 2-year cycles (2005-2006 to 2017-2018) were used for this study. A total of 19,791 participants aged ≥20 years were included. Weighted prevalence estimates and 95% confidence intervals were calculated in each study cycle for stress, urgency, and mixed urinary incontinence. Multivariate-adjusted weighted logistic regression was used to investigate the temporal trends in urinary incontinence, in addition to determining the association between urinary incontinence subtypes with several participants' factors. RESULTS In the 2017-2018 cycle, stress urinary incontinence was the most prevalent subtype (45.9%; 95% confidence interval, 42.1-49.7), followed by urgency urinary incontinence (31.1%; 95% confidence interval, 28.6-33.6) and mixed urinary incontinence (18.1%; 95% confidence interval, 15.7-20.5). The prevalence rates of urgency and mixed urinary incontinence were higher in women aged 60 years and older (urgency, 49.5% [95% confidence interval, 43.9-55.2]; mixed, 31.4% [95% confidence interval, 26.2-36.6]) than in those aged 40 to 59 years (urgency, 27.9% [95% confidence interval, 23.6-32.1]; mixed, 15.9% [95% confidence interval, 12.9-19.0]) and those aged 20 to 39 years (urgency, 17.6% [95% confidence interval, 13.8-21.5]; mixed, 8.3% [95% confidence interval, 5.4-11.3]). The overall prevalence of stress and mixed urinary incontinence was stable throughout 2005 to 2018 (both Ptrend=.3), with increases in mixed urinary incontinence among women aged 60 years and older (P=.001). The prevalence of urgency urinary incontinence significantly increased, particularly among women aged 60 years and older (both P=.002). Age, obesity, smoking, comorbidities, and postmenopausal hormone therapy were associated with higher prevalence of all types of urinary incontinence. Black women were less likely to report stress urinary incontinence but more likely to report urgency urinary incontinence. CONCLUSION Although the estimated overall prevalence of stress and mixed urinary incontinence remained stable from 2005 to 2018, the prevalence of urgency and mixed urinary incontinence significantly increased among women aged 60 years and older. All subtypes of urinary incontinence were higher among women with obesity and comorbidities, those who used postmenopausal hormone therapy, and those who smoke.
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Oliveira SG, Caroci-Becker A, Mendes EDPB, Riesco MLG, Oliveira RDC, Oliveira SMJVD. Pelvic floor dysfunction in primiparous women up to 6 months after delivery: cohort study. Rev Bras Enferm 2021; 74:e20200607. [PMID: 34346955 DOI: 10.1590/0034-7167-2020-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/20/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze pelvic floor muscular strength (PFMS), urinary (UI) and anal (AI) incontinence and dyspareunia in primiparous women up to 6 months after normal or cesarean delivery. METHODS this is a prospective cohort with 169 women (128 normal births, 41 cesarean sections), followed between 50-70 and 170-190 days postpartum, when PFMS was measured using perineometry, and UI and AI and dyspareunia, through interview. RESULTS PFMS, UI and dyspareunia were similar between types of delivery. The difference was significant only for the time elapsed, with improvement in the studied period (2 and 6 months postpartum). Regarding AI, there was a significant difference between 2 and 6 months postpartum, with an interaction between type of delivery and time (p=0.022). CONCLUSION the type of delivery did not show any influence on pelvic floor dysfunctions, except for AI. For all outcomes, there was an improvement in the period studied.
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What do female university students know about pelvic floor disorders? A cross-sectional survey. Int Urogynecol J 2021; 33:659-664. [PMID: 33991220 DOI: 10.1007/s00192-021-04828-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic floor dysfunction (PFD) is common in women but few seek medical attention. Poor recognition of the condition as pathological and unawareness of treatments may account for low consultation rates. METHODS This cross-sectional study was based on an online survey that was responded to in February and March 2020 by 768 female university students. Knowledge of PFD was assessed using the Prolapse and Incontinence Knowledge Questionnaire (PIKQ). Descriptive and inferential analyses were performed using IBM-SPSS (V26.0). RESULTS Respondents had poor knowledge of PFD and especially of pelvic organ prolapse. Health science students (n = 531; 69.1%) obtained significantly higher scores (p < 0.001) than other students (n = 237; 30.9%). Those who had received information on how to perform pelvic floor muscle training were more likely to score higher than those who had not received previous information. CONCLUSIONS While health science students have better knowledge of PFD than other students, university students in general are little aware of PFD. Most students considered the issue of PFD to be important and wanted more information. Our findings may be useful in planning strategies to raise women's awareness of PFD and its prevention and treatment.
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What Does Your Pelvic Floor Do for You? Knowledge of the Pelvic Floor in Female University Students: A Cross-sectional Study. Female Pelvic Med Reconstr Surg 2021; 27:e457-e464. [PMID: 33109928 DOI: 10.1097/spv.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the knowledge of the pelvic floor in female university students, including knowledge of pelvic floor structure, function, pelvic floor dysfunction, and pelvic floor muscle exercises (PFMEs). METHODS The study design is a cross-sectional study via online questionnaire with convenience sampling of female students registered at University College Cork, Ireland for the academic year 2018 to 2019. An online questionnaire was distributed to students at their registered email addresses. Overall knowledge was assessed through 15 questions, looking at pelvic floor structure, function, pelvic floor dysfunction and PFMEs. A score of 1 was allocated to each correct question, with a maximum possible score of 15. Only respondents who answered all 15 questions were included in the analysis. Ethical approval was granted by the Clinical Research and Ethics Committee, Cork, Ireland, on January 4, 2019. RESULTS Nine hundred thirty-eight responses were received. There were 72.6% (n = 640) students who had never received information on the pelvic floor. There were 83.9% (n = 691) students who reported that they thought it was important to exercise the pelvic floor. The mean overall knowledge score of 792 respondents was 9.57 (SD, ± 2.72). There was a statistically significant difference (P < 0.001) in the overall knowledge between the students in the school of medicine and health (n = 307, mean = 11.8, SD = 2.35) and the students of other schools (n = 529, mean = 9.39, SD = 2.88). CONCLUSIONS Knowledge of the pelvic floor in female university students is poor. Further interventions should aim to improve knowledge of the pelvic floor and encourage correct performance of PFMEs in college students.
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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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Igwe S, Ojukwu C, Orji P, Ede S, Ezeigwe A, Uchenwoke C, Anekwu E. Contraction techniques adopted for pelvic floor muscle exercise education by Nigeria-based physiotherapists: A preliminary study. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_93_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Aka EK, Fanny M, Koffi A, Olou N, Horo A, Kone M. [Opinion survey on postpartum pelvic floor rehabilitation among Ivorian practitioners]. Pan Afr Med J 2020; 37:367. [PMID: 33796180 PMCID: PMC7992408 DOI: 10.11604/pamj.2020.37.367.23426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 12/13/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION the purpose of this study was to report health care providers' experience of perineal rehabilitation in the Maternity Hospital of Abidjan by assessing their level of knowledge and their practical attitudes. METHODS we performed a survey among obstetricians and midwives working in a Maternity Hospital in Abidjan over a period of at least two years. The information were collected using a questionnaire including direct, open and semi-open questions. RESULTS the study included 120 practitioners, 66 midwives and 54 obstetricians. Seventy-nine point six percent of obstetricians and 37.9% of midwives worked in a university hospital. Midwifery knowledge was good or average in 25% of cases (interquartile range [IIQ] 16.8-48.3); 65% of obstetricians had a good or medium level of knowledge (IIQ 41.1 -48.3). The majority of providers summoned women in the postpartum period, but only 7 out of 10 caregivers performed perineal assessment and 2 out of 10 obstetricians suggested the need for rehabilitation. CONCLUSION the low level of knowledge of Ivorian midwives and obstetricians regarding postpartum pelvic floor rehabilitation and the lack of practice suggest the need for ongoing training.
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Affiliation(s)
- Edele Kacou Aka
- Université Félix Houphouët Boigny (FHB), Abidjan, Côte d´Ivoire
- Service de gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Yopougon, Côte d´Ivoire
| | - Mohamed Fanny
- Université Félix Houphouët Boigny (FHB), Abidjan, Côte d´Ivoire
- Service de gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Yopougon, Côte d´Ivoire
| | - Abdoul Koffi
- Université Félix Houphouët Boigny (FHB), Abidjan, Côte d´Ivoire
- Service de gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Yopougon, Côte d´Ivoire
| | - N´guessan Olou
- Université Félix Houphouët Boigny (FHB), Abidjan, Côte d´Ivoire
- Service de gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Yopougon, Côte d´Ivoire
| | - Apollinaire Horo
- Université Félix Houphouët Boigny (FHB), Abidjan, Côte d´Ivoire
- Service de gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Yopougon, Côte d´Ivoire
| | - Mamourou Kone
- Université Félix Houphouët Boigny (FHB), Abidjan, Côte d´Ivoire
- Service de gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Yopougon, Côte d´Ivoire
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Williams AM, Eginyan G, Deegan E, Chow M, Carpenter MG, Lam T. Residual Innervation of the Pelvic Floor Muscles in People with Motor-Complete Spinal Cord Injury. J Neurotrauma 2020; 37:2320-2331. [DOI: 10.1089/neu.2019.6908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Alison M.M. Williams
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Costal Health Research Institute, Vancouver, British Columbia, Canada
| | - Gevorg Eginyan
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Costal Health Research Institute, Vancouver, British Columbia, Canada
| | - Emily Deegan
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Costal Health Research Institute, Vancouver, British Columbia, Canada
| | - Mason Chow
- International Collaboration On Repair Discoveries (ICORD), Vancouver Costal Health Research Institute, Vancouver, British Columbia, Canada
| | - Mark G. Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Costal Health Research Institute, Vancouver, British Columbia, Canada
| | - Tania Lam
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration On Repair Discoveries (ICORD), Vancouver Costal Health Research Institute, Vancouver, British Columbia, Canada
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Fani M, Salehi R, Chitsaz N, Goharpey S, Zahednejad S. Transabdominal Ultrasound Imaging of Pelvic Floor Muscle Activity in Women With and Without Stress Urinary Incontinence: A Case-Control Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:1358-1363. [PMID: 32739357 DOI: 10.1016/j.jogc.2020.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Transabdominal ultrasound (TAU) is an easy and noninvasive way to evaluate and retrain pelvic floor muscle (PFM) function. The purpose of this study was to compare PFM activity in women with and without urinary incontinence (UI) by measuring bladder base displacement (as a marker for PFM activity) using TAU during PFM contraction, Valsalva's maneuver, and abdominal curl. METHODS Sixty-three women, aged 20-55 years, volunteered to participate in this cross-sectional study: 21 were continent and 42 had UI (21 stress urinary incontinence [SUI] and 21 mixed urinary incontinence [MUI]). Mean bladder base displacement in millimeters was measured to evaluate differences between the three groups (continent, SUI, and MUI) and also between the continent and UI groups during the performance of each maneuver. RESULTS No significant differences were seen between the three groups in bladder base elevation during PFM contraction (P > 0.05). Descent of the bladder base during Valsalva's maneuver and abdominal curl was significantly greater in women with SUI and MUI than in women in the continent group (P < 0.05). Comparison of the continent and UI groups showed no significant differences in elevation of the bladder base during PFM contraction, while descent of the bladder base was significantly greater in women with UI than in women in the continent group during Valsalva's maneuver and abdominal curl (P < 0.05). CONCLUSION TAU indicated that bladder base descent was greater in women with SUI and MUI than those in the continent group during the performance of maneuvers that increased intra-abdominal pressure. This effect may be due to decreased PFM performance in women with urinary incontinence.
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Affiliation(s)
- Maedeh Fani
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Salehi
- Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Navid Chitsaz
- Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Shahin Goharpey
- Musculoskeletal Rehabilitation Research Center, Department of Physical Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Shahla Zahednejad
- Musculoskeletal Rehabilitation Research Center, Department of Physical Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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22
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Rial Rebullido T, Chulvi-Medrano I, Faigenbaum AD, Stracciolini A. Pelvic Floor Dysfunction in Female Athletes. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jaffar A, Mohd-Sidik S, Nien FC, Fu GQ, Talib NH. Urinary incontinence and its association with pelvic floor muscle exercise among pregnant women attending a primary care clinic in Selangor, Malaysia. PLoS One 2020; 15:e0236140. [PMID: 32667936 PMCID: PMC7363082 DOI: 10.1371/journal.pone.0236140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/29/2020] [Indexed: 12/02/2022] Open
Abstract
Background Urinary Incontinence (UI) is when a person is unable to hold his/her urine effectively. This is a common problem which can develop and worsen during pregnancy. An effective way to manage UI is to educate patients on the Pelvic Floor Muscle Exercise (PFME) regularly. The present study aimed to ascertain the pregnant women’s knowledge, attitudes, and practices (KAP) related to PFME. Methods This was a cross-sectional study done in a one primary care clinic located in a semi-urban area in Selangor, Malaysia. Simple random sampling was conducted among pregnant women aged 18 years old and above at any gestation. The validated study instruments used consisted of questions on socio-demography, KAP on UI, and also the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form to determine UI among the respondents. Results The response rate for this study was 72.1%, where 440 pregnant women consented to take part in the study. The median age of study respondents was 30 years old and majority of the study respondents was from the Malay ethnicity (80.9%). The prevalence of UI was 40.9%. The proportion of pregnant women with good knowledge, attitude and practice scores were 58.0%, 46.6% and 45.2% respectively. There was a significant association between UI and age (p = .03), body mass index (p = .03), ethnicity (p = .04), gravida. (p = .001), knowledge on PFME (p = .007) and attitude towards PFME (p = .006). Conclusions Findings from this study fill a gap in the prevalence and KAP concerning PFME at the primary care level. The foundation areas for future education and health promotion on UI should address the importance of correct PFME. This education can be delivered through a pragmatic way to ensure its effectiveness and sustainability of the health promotion program.
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Affiliation(s)
- Aida Jaffar
- Primary Care Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Sg Besi, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- * E-mail:
| | - Foo Chai Nien
- Department of Population Medicine, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Gan Quan Fu
- Pre-clinical Department, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
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Alaniz G, Dods M, Dackovic H, Mascola M, Moreira K, Dufour S. Pre-Licensure Inter-Professional Perspectives: Pelvic Health Physiotherapy. Physiother Can 2020; 72:298-304. [PMID: 35110798 DOI: 10.3138/ptc-2018-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: In this study, we examined knowledge and perspectives pertaining to pelvic health physiotherapy among medical, midwifery, nursing, and physician assistant students at McMaster University. Moreover, we identified opportunities to improve knowledge translation to facilitate inter-professional education in urogynecological care. Method: A cross-sectional design was created to distribute an online survey to participants using a modified Dillman approach. The survey assessed areas of clinical interest in, knowledge of the scope of practice of, and regulations governing pelvic health physiotherapy in specific, in addition to clinical applications. Fisher's exact and Kruskal-Wallis tests were used to assess statistical significance. Results: A total of 90% of the participants incorrectly indicated that internal digital exams could be delegated to physiotherapy assistants, and 50% believed that Kegel exercises were appropriate for all presentations of pelvic floor dysfunction. Moreover, when prompted to select conditions that could be treated by pelvic health physiotherapists, only 2% of the participants selected the correct conditions. Conclusions: Knowledge in all four programmes about the scope of practice, authorized activities, and application of pelvic health physiotherapy is inadequate. To foster the optimal integration of urogynecology into the relevant health science curriculums, enhanced inter-professional education, inclusive of pelvic health physiotherapy knowledge, appears to be needed.
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Affiliation(s)
- Grecia Alaniz
- Faculty of Health Science, McMaster University, Hamilton.,Radius Health Clinic, Chatham
| | - Margot Dods
- Faculty of Health Science, McMaster University, Hamilton
| | | | | | - Karen Moreira
- Faculty of Health Science, McMaster University, Hamilton
| | - Sinéad Dufour
- Faculty of Health Science, McMaster University, Hamilton.,The World of My Baby, Burlington, Ont
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Mazur-Bialy AI, Kołomańska-Bogucka D, Nowakowski C, Tim S. Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy. J Clin Med 2020; 9:E1211. [PMID: 32340194 PMCID: PMC7230757 DOI: 10.3390/jcm9041211] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022] Open
Abstract
Urinary incontinence (UI) is a common health problem affecting quality of life of nearly 420 million people, both women and men. Pelvic floor muscle (PFM) training and other physiotherapy techniques play an important role in non-surgical UI treatment, but their therapeutic effectiveness is limited to slight or moderate severity of UI. Higher UI severity requires surgical procedures with pre- and post-operative physiotherapy. Given that nearly 30%-40% of women without dysfunction and about 70% with pelvic floor dysfunction are unable to perform a correct PFM contraction, therefore, it is particularly important to implement physiotherapeutic techniques aimed at early activation of PFM. Presently, UI physiotherapy focuses primarily on PFM therapy and its proper cooperation with synergistic muscles, the respiratory diaphragm, and correction of improper everyday habits for better pelvic organ support and continence. The purpose of this work is a systematic review showing the possibilities of using physiotherapeutic techniques in the treatment of UI in women with attention to the techniques of PFM activation. Evidence of the effectiveness of well-known (e.g., PFM training, biofeedback, and electrostimulation) and less-known (e.g., magnetostimulation, vibration training) techniques will be presented here regarding the treatment of symptoms of urinary incontinence in women.
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Affiliation(s)
- Agnieszka Irena Mazur-Bialy
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland
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Fu Y, Nelson EA, McGowan L. An evidence-based self-management package for urinary incontinence in older women: a mixed methods feasibility study. BMC Urol 2020; 20:43. [PMID: 32312255 PMCID: PMC7171836 DOI: 10.1186/s12894-020-00603-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/13/2020] [Indexed: 11/12/2022] Open
Abstract
Background Urinary incontinence (UI) is a distressing condition that limits women’s quality of life and places a heavy burden on health care services. Behavioural treatments are recommended as a first-line treatment. An evidence-based self-management package was developed following the Medical Research Council (MRC) framework for complex interventions. This study aimed to evaluate the feasibility and acceptability of the intervention. Methods A mixed-methods approach was undertaken, namely a randomised controlled feasibility study with nested qualitative study. Fifty women aged 55 or over living with UI, recruited from community centres were randomly assigned to either a 3-month course with the package with a support session or a control group to receive the same package only 3 months later. Principal outcome measures were: self-reported quality of life, UI severity, self-efficacy and psychological status. Analysis of covariance was undertaken to estimate within- and between- group changes for all outcomes. Acceptability was explored using individual interviews at follow-up. Results Fifty women were randomised (24 to intervention, 26 to control); mean age of 69.7 (±9.1) years and mean UI frequency 2.2 (±2.2) episodes/day at baseline. Overall, 49 women (98%) completed 3-month follow-up (24 in the intervention, 25 in the control). A positive trend was detected in the impact of UI on their personal relationships (− 3.89, p = 0.088), symptom severity (− 1.77, p = 0.025), UI symptoms scale (− 1.87, p = 0.031) and anxiety status (− 2.31, p = 0.001), respectively. Changes in quality of life and self-efficacy did not differ significantly between groups. Majority of women (71%) in the intervention group reported subjective improvement after 3 months. Spearman correlation coefficient was 0.43 (p < 0.05) between their subjective perception of change and self-efficacy. Women perceived the package being acceptable and described that the package had the potential to increase their knowledge and confidence to manage symptoms and improve quality of life. Conclusions The study demonstrated that the self-management package is feasible and acceptable for older women with UI. Further studies are needed with a large sample size in clinical settings to evaluate the effectiveness of this package. Trial registration ISRCTN17194896. Registered on 11th September 2019 (retrospectively registered).
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Affiliation(s)
- Yu Fu
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK.
| | - E Andrea Nelson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Linda McGowan
- School of Healthcare, University of Leeds, Leeds, UK
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Shin G, Kim HJ, Kim M. Predictors of pelvic muscle exercise on the self‐efficacy of women giving birth. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Gisoo Shin
- Red Cross College of NursingChung‐Ang University Seoul South Korea
| | - Hye Jin Kim
- Department of NursingKyungsung University Busan South Korea
| | - Miok Kim
- College of NursingDankook University, Cheonan South Korea
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Reed P, Whittall CM, Osborne LA, Emery S. Impact of Strength and Nature of Patient Health Values on Compliance and Outcomes for Physiotherapy Treatment for Pelvic Floor Dysfunction. Urology 2020; 136:95-99. [DOI: 10.1016/j.urology.2019.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 11/27/2022]
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Fallon R, Farrell K, Leon G, Rajan A, Duane S, FitzGerald C, Tierney M, Vellinga A. GPs' attitudes towards the diagnosis and treatment of male urinary tract infections: a qualitative interview study in Ireland. BJGP Open 2019; 3:bjgpopen19X101667. [PMID: 31615788 PMCID: PMC6995865 DOI: 10.3399/bjgpopen19x101667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/16/2019] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND In general practice, males represent around 20% of the total number of urinary tract infection (UTI) consultations. The majority of UTI research focuses on the diagnosis and treatment of women with UTIs but there is little evidence on how male UTIs are treated. AIM To better understand GPs' attitudes towards the diagnosis and treatment of male UTIs. This research aimed to support future investigations to determine best practice in diagnosis and treatment of male UTI. DESIGN AND SETTING A qualitative interview study was carried out with 15 GPs across Ireland. METHOD A topic guide was created to ensure consistency in interviews. The interviews were audiorecorded and transcribed verbatim. Transcripts were analysed using thematic analysis. RESULTS Fifteen interviews with GPs were completed. Analysis indicated that GPs' knowledge of guidelines and implementation of them varied widely when deciding a treatment plan for a male presenting with UTI symptoms. There was clear consensus that male UTIs were uncommon and complicated to diagnose. Three GPs reported never treating a male UTI, while others reported treating <5 patients in their careers. There was an assumption that sexually transmitted infections (STI) take precedence in young males when presenting with similar symptoms. The use of antimicrobial treatment guidelines varied widely, in line with the interpretation of the origin and severity of symptoms. CONCLUSION Male UTIs are perceived by GPs as rare and complicated. GPs expressed that patient age, resources, and guidelines available limited their confidence in diagnosing and treating male UTIs.
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Affiliation(s)
- Róisín Fallon
- Research Assistant, Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
- Health Research Board Primary Care, Clinical Trials Network, Ireland
| | - Karen Farrell
- Research Assistant, Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
- Health Research Board Primary Care, Clinical Trials Network, Ireland
| | - Genevieve Leon
- House officer, Grade UD41Department of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Aparna Rajan
- House officer, Grade UD41Department of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Sinead Duane
- Post Doctoral Researcher, Health Research Board Trials Methodology Research Network, College of Medicine, Nursing & Health Sciences, National University of Ireland, Galway, Ireland
| | - Christine FitzGerald
- Research Assistant, School of Business and Economics, National University of Ireland, Galway, Ireland
| | - Marie Tierney
- Postdoctoral Researcher, Health Research Board Primary Care Clinical Trials Network, National University of Ireland, Galway, Ireland
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Akke Vellinga
- Epidemiologist and Senior Lecturer, Health Research Board Primary Care Clinical Trials Network, National University of Ireland, Galway, Ireland
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
- Discipline of Bacteriology, School of Medicine, National University of Ireland, Galway, Ireland
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Conrad DH, Pacquee S, Saar TD, Walsh C, Chou D, Rosen D, Cario GM. Long-term patient-reported outcomes after laparoscopic Burch colposuspension. Aust N Z J Obstet Gynaecol 2019; 59:850-855. [PMID: 31514249 DOI: 10.1111/ajo.13048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/23/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND The negative media attention surrounding vaginal mesh procedures has seen a rise in demand for minimally invasive non-mesh options for the treatment of stress urinary incontinence (SUI). The laparoscopic Burch colposuspension (LBC) is a non-mesh alternative to synthetic midurethral slings (MUS) with similar short-term outcomes. However, long-term outcomes are not well established. AIMS To evaluate the long-term outcomes of LBC for treatment of SUI in women. MATERIAL AND METHODS One hundred and fifty-one cases of LBC were performed by a single surgeon over two private hospital settings between January 2010 and January 2016. Follow-up subjective outcomes were obtained in 137 cases (90.7%) utilising standardised questionnaires. Primary outcome was successful treatment of SUI, defined as subjective cure or significant improvement of stress incontinence symptoms. Secondary outcomes included new-onset or worsened symptoms of overactive bladder (OAB), voiding dysfunction, prolapse, and perioperative complications. RESULTS One hundred and thirty-seven patients were analysed with a mean follow-up of 50.6 months (range: 13-89 months). Primary outcome of successful treatment was achieved in 90.5% of women. New-onset or worsened symptoms of OAB was reported in 10.2%, with a further 8.8% of women experiencing symptomatic voiding dysfunction. Sixteen patients (11.7%) reported new-onset or worsening symptoms of prolapse. There were no major surgical complications. CONCLUSIONS LBC is a safe and effective long-term treatment for SUI, with low failure rates and minimal adverse outcomes. It is a suitable alternative for women with contraindications to mesh or those having concomitant laparoscopic procedures.
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Affiliation(s)
- Dean H Conrad
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
| | - Stefaan Pacquee
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
| | - Tal D Saar
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
| | - Caroline Walsh
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
| | - Danny Chou
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
| | - David Rosen
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
| | - Gregory M Cario
- Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Sydney, New South Wales, Australia
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Saboia DM, Vasconcelos CT, Oriá MO, de C Bezerra K, Vasconcelos Neto JA, de M Lopes MH. Continence App: Construction and validation of a mobile application for postnatal urinary incontinence prevention. Eur J Obstet Gynecol Reprod Biol 2019; 240:330-335. [DOI: 10.1016/j.ejogrb.2019.07.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/01/2019] [Accepted: 07/18/2019] [Indexed: 11/26/2022]
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Is pelvic floor muscle training effective for symptoms of overactive bladder in women? A systematic review. Physiotherapy 2019; 106:65-76. [PMID: 32026847 DOI: 10.1016/j.physio.2019.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 07/31/2019] [Accepted: 08/19/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Overactive bladder (OAB) syndrome can be very bothersome and is associated with impaired quality of life and work productivity. OBJECTIVE To evaluate the effect of pelvic floor muscle training (PFMT) on OAB symptoms in women. Furthermore, to assess the influence of PFMT on pelvic floor muscle (PFM) function, satisfaction with treatment, side effects, adherence and the quality of exercise reporting. DATA SOURCES Systematic review of randomized controlled trials (RCTs). Electronic search was conducted on MEDLINE/PubMed, Embase, CINAHL, SciELO, SCOPUS, Web of Science and Physiotherapy Evidence Database (PEDro). The risk of bias was assessed using the PEDro scale. The Consensus on Exercise Reporting Template (CERT) was used to assess the quality of exercise reporting. STUDY SELECTION Full text RCTs including non-pregnant female participants, investigating PFMT vs inactive control or usual care, other life style modifications or other interventions. SYNTHESIS METHODS Descriptive analysis. RESULTS Eleven RCTs were included. There was considerable heterogeneity of PFMT protocols, outcome measures and follow-up periods. Hence, a qualitative analysis was undertaken. PFMT provided a significant reduction of OAB symptoms in five studies with a reduction in urinary frequency (n=1), and urgency urinary incontinence (n=4). PFM function was assessed in three studies, and two studies found improvement in favor of PFMT. LIMITATIONS A meta-analysis was not possible due to huge heterogeneity of included studies. CONCLUSION PFMT might reduce OAB symptoms, however, due to many limitations of the published studies it is not possible to clearly determine the effect of PFMT on OAB symptoms and PFM function. Systematic Review Registration Number PROSPERO CRD42018085640.
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Mathew S, Guzmán Rojas RA, Salvesen KA, Volløyhaug I. Levator ani muscle injury and risk for urinary and fecal incontinence in parous women from a normal population, a cross‐sectional study. Neurourol Urodyn 2019; 38:2296-2302. [DOI: 10.1002/nau.24138] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/27/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Seema Mathew
- Department of Gynecology and ObstetricsSt. Olavs University Hospital Trondheim Norway
- Department of Clinical and Molecular MedicineNorwegian University of Science and Technology Trondheim Norway
| | - Rodrigo A. Guzmán Rojas
- Departamento de Ginecología y Obstetricia, Facultad de MedicinaClínica Alemana‐Universidad del Desarrollo Santiago Chile
- Departamento de Ginecología y ObstetriciaHospital Clínico de la Universidad de Chile Santiago Chile
| | - Kjell A. Salvesen
- Department of Gynecology and ObstetricsSt. Olavs University Hospital Trondheim Norway
- Department of Clinical and Molecular MedicineNorwegian University of Science and Technology Trondheim Norway
| | - Ingrid Volløyhaug
- Department of Gynecology and ObstetricsSt. Olavs University Hospital Trondheim Norway
- Department of Clinical and Molecular MedicineNorwegian University of Science and Technology Trondheim Norway
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Dufour S, Fedorkow D, Kun J, Deng SX, Fang Q. Exploring the Impact of a Mobile Health Solution for Postpartum Pelvic Floor Muscle Training: Pilot Randomized Controlled Feasibility Study. JMIR Mhealth Uhealth 2019; 7:e12587. [PMID: 31298221 PMCID: PMC6657451 DOI: 10.2196/12587] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 04/27/2019] [Accepted: 05/31/2019] [Indexed: 12/16/2022] Open
Abstract
Background The postpartum period is a vulnerable time for the pelvic floor. Early implementation of pelvic floor muscle exercises, appropriately termed as pelvic floor muscle training (PFMT), in the postpartum period has been advocated because of its established effectiveness. The popularity of mobile health (mHealth) devices highlights their perceived utility. The effectiveness of various mHealth technologies with claims to support pelvic floor health and fitness is yet to be substantiated through systematic inquiry. Objective The aim of this study was to determine the acceptability, feasibility, and potential effect on outcomes of an mHealth device purposed to facilitate pelvic floor muscle training among postpartum women. Methods A 16-week mixed methods pilot study was conducted to evaluate outcomes and determine aspects of acceptability and feasibility of an mHealth device. All participants received standardized examination of their pelvic floor muscles and associated instruction on the correct performance of PFMT. Those randomized to the iBall intervention received instructions on its use. Schedules for utilization of the iBall and PFMT were not prescribed, but all participants were informed of the standard established recommendation of PFMT, which includes 3 sets of 10 exercises, 3 to 4 times a week, for the duration of the intervention period. Quantitative data included the measurement of pelvic floor muscle parameters (strength, endurance, and coordination) following the PERFECT assessment scheme: Incontinence Impact Questionnaire scores and the Urogenital Distress Inventory (UDI-6) scores. Aspects of acceptability and feasibility were collected through one-to-one interviews. Interview transcripts were analyzed using Thorne’s interpretive description approach. Results A total of 23 women with a mean age of 32.2 years were randomized to an intervention group (n=13) or a control group (n=10). Both groups improved on all measures. The only statistically significant change was the UDI-6 score within both groups at 16 weeks compared with baseline. There was no statistically significant difference between the intervention group and control group on any outcomes. Most participants using the iBall (n=10, 77%) indicated value in the concept of the mHealth solution. Technical difficulties (n=10, 77%), a cumbersome initiation process (n=8, 61%), and discomfort from the device (n=8, 61%) were reasons impeding intervention acceptability. Most participants (n=17, 74%) indicated that the initial assessment and training was more useful than the mHealth solution, a tenet that was echoed by all control group participants. Conclusions Our pilot study demonstrated the potential for mHealth solution–enhanced PFMT in the early postpartum period. Usability issues in hardware and software hindered feasibility and acceptance by the participants. Our findings can inform the redesign of mHealth solutions that may be of value if acceptability and feasibility issues can be overcome. Trial Registration ClinicalTrials.gov NCT02865954; https://clinicaltrials.gov/ct2/show/NCT02865954
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Affiliation(s)
- Sinéad Dufour
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Donna Fedorkow
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON, Canada
| | - Jessica Kun
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | | | - Qiyin Fang
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada.,Department of Engineering Physics, McMaster University, Hamilton, ON, Canada
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Flandin-Crétinon S, Roelens I, Sellier Y, Bader G, Carbonnel M, Ayoubi JM. [Assessment of pelvic floor muscle training programs and urinary incontinence in women: A literature Review]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2019; 47:591-598. [PMID: 31255837 DOI: 10.1016/j.gofs.2019.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Pelvic floor rehabilitation is efficient for the first line treatment of urinary incontinence in women. However, several questions remain as regards the best pelvic floor muscle training program to recommend. The objective was perform a literature review regarding the muscular strengthening program to recommend to treat stress or mixed urinary incontinence in women. METHODS We performed a systematic review of studies on the topic using Medline's database covering the 10 last years. Among the 1130 articles that were identified, we retained 6 for our analysis. RESULTS Given the heterogeneity of the exercise programs, it was impossible to exhaustively and comparatively analyze their efficacies. However, a significant improvement is noted when the exercises are based on the muscular training principles of the American College of Sports Medicine. They combine long and short contractions with the practice of the knack in situations of pressure exertion and are part of a self-rehabilitation program based on the needs of the patient and the individual's progression. CONCLUSION Current knowledge does not allow us to recommend an optimal muscle training program to treat female urinary incontinence. Research must be conducted to evaluate different muscular training regimens but also their integration into a program based on personal needs as well as factors of adherence to the treatment of patients.
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Affiliation(s)
- S Flandin-Crétinon
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; Service de gynécologie obstétrique, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - I Roelens
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - Y Sellier
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - G Bader
- Chirurgie uro-gynécologique, clinique Hartmann, 92200 Neuilly-sur-Seine, France
| | - M Carbonnel
- Service de gynécologie obstétrique, hôpital Foch, 92150 Suresnes, France.
| | - J-M Ayoubi
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; Service de gynécologie obstétrique, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
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Aguirre F, Heft J, Yunker A. Factors Associated With Nonadherence to Pelvic Floor Physical Therapy Referral for the Treatment of Pelvic Pain in Women. Phys Ther 2019; 99:946-952. [PMID: 30916754 PMCID: PMC6602154 DOI: 10.1093/ptj/pzz050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 09/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with pelvic pain due to pelvic floor myofascial pain syndrome are often referred for pelvic floor physical therapy, the primary treatment option. However, many patients do not adhere to the treatment. OBJECTIVE The purpose of this study was to examine the adherence rate and outcomes of patients referred for physical therapy for pelvic floor myofascial pain syndrome and identify risk factors associated with nonadherence. DESIGN This was a retrospective cohort study. METHODS ICD-9 codes were used to identify a cohort of patients with pelvic floor myofascial pain syndrome during a 2-year time period within a single provider's clinical practice. Medical records were abstracted to obtain information on referral to physical therapy, associated comorbidities and demographics, and clinical outcomes. "Primary outcomes" was defined as attendance of at least 1 visit. Secondary outcomes included attendance of at least 6 physical therapist visits and overall improvement in pain. Statistical analysis was performed using chi-square, Fisher exact, and independent t tests. Nonparametric comparisons were performed using Wilcoxon signed rank test. Multivariate analysis was completed to adjust for confounders. RESULTS Of the 205 patients, 140 (68%) attended at least 1 session with physical therapy. At least 6 visits were attended by 68 (33%) patients. Factors associated with poor adherence included parity and a preexisting psychiatric diagnosis. The odds of attending at least 1 visit were 0.75 (95% confidence interval = 0.62-0.90) and 0.44 (95% confidence interval = 0.21-0.90), respectively. Patients who attended ≥ 6 visits were more likely to have private insurance (78%) and travel shorter distances to a therapist (mean = 16 miles vs 22). Patients with an improvement in pain (compared with those who were unchanged) attended an average of 3 extra physical therapist visits (mean = 6.9 vs 3.1). LIMITATIONS Limitations include reliance on medical records for data integrity; a patient population derived from a single clinic, reducing the generalizability of the results; the age of the data (2010-2012); and the likely interrelatedness of many of the variables. It is possible that maternal parity and psychiatric diagnoses are partial surrogates for social, logistic, or economic constraints and patient confidence. CONCLUSIONS Initial adherence to pelvic floor physical therapy was less likely for multiparous women and women with a history of psychiatric diagnosis. Persistent adherence was more likely with private insurance or if the physical therapist location was closer. Pain improvement correlated with increased number of physical therapist sessions.
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Affiliation(s)
- Frank Aguirre
- Department of Obstetrics and Gynecology, University of South Carolina Medical School, Columbia, South Carolina
| | - Jessica Heft
- Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Amanda Yunker
- Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, 1161 21st Ave, MCN B-1100, Nashville, TN 37232 (USA),Address all correspondence to Dr Yunker at:
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Mercier J, Morin M, Zaki D, Reichetzer B, Lemieux MC, Khalifé S, Dumoulin C. Pelvic floor muscle training as a treatment for genitourinary syndrome of menopause: A single-arm feasibility study. Maturitas 2019; 125:57-62. [DOI: 10.1016/j.maturitas.2019.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/13/2019] [Accepted: 03/04/2019] [Indexed: 02/06/2023]
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Prentice A, Bazzi AA, Aslam MF. Treatment patterns of primary care physicians vs specialists prior to subspecialty urogynaecology referral for women suffering from pelvic floor disorders. World J Methodol 2019; 9:26-31. [PMID: 31367545 PMCID: PMC6658364 DOI: 10.5662/wjm.v9.i2.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/29/2019] [Accepted: 04/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are approximately 25% of women in the United States suffering from pelvic floor disorders (PFDs) and this number is predicted to rise. The potential complications and increasing healthcare costs that exist with an operation indicate the importance of conservative treatment options prior to attempting surgery. Considering the prevalence of PFDs, it is important for primary care physician and specialists (obstetricians and gynecologists) to be familiar with the initial work-up and the available conservative treatment options prior to subspecialist (urogynecologist) referral.
AIM To assess the types of treatments that specialists attempted prior to subspecialty referral and determine the differences in referral patterns.
METHODS This is a retrospective cohort study of 234 patients from a community teaching hospital referred to a single female pelvic medicine and reconstructive surgery (FPMRS) provider for PFD. Specialist vs primary care provider (PCP) referrals were compared. Number, length and treatment types were studied using descriptive statistics.
RESULTS There were 184 referrals (78.6%) by specialists and 50 (21.4%) by PCP. Treatment (with Kegel exercises, pessary placements, and anticholinergic medications) was attempted on 51% (n = 26) of the PCP compared to 48% (n = 88) of the specialist referrals prior to FPMRS referral (P = 0.6). There was no significant difference in length of treatment prior to referral for PCPs vs specialists (14 mo vs 16 mo, respectively, P = 0.88). However, there was a significant difference in the patient’s average time with the condition prior to referral (35 mo vs 58 mo for PCP compared to specialist referrals) (P = 0.02).
CONCLUSION One half of the patients referred to FPMRS clinic received treatment prior to referral. Thus, specialists and generalists can benefit from education regarding therapies for PFD before subspecialty referral.
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Affiliation(s)
- Abigail Prentice
- Department of Family Medicine, Marquette Health System, Marquette, MI 49855, United States
| | - Ali Ahmad Bazzi
- Department of Obstetrics and Gynaecology, St. John Hospital and Medical Center, MI 48236, United States
| | - Muhammad Faisal Aslam
- Department of Family Medicine, Marquette Health System, Marquette, MI 49855, United States
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Lanzafame RJ, de la Torre S, Leibaschoff GH. The Rationale for Photobiomodulation Therapy of Vaginal Tissue for Treatment of Genitourinary Syndrome of Menopause: An Analysis of Its Mechanism of Action, and Current Clinical Outcomes. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:395-407. [PMID: 31210575 PMCID: PMC6648197 DOI: 10.1089/photob.2019.4618] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Light, particularly in the visible to far-infrared spectrum, has been applied to the female genital tract with lasers and other devices for nearly 50 years. These have included procedures on both normal and neoplastic tissues, management of condylomata, endometriosis, and menometrorrhagia, and, more recently, a number of fractional laser devices have been applied for the management of genitourinary syndrome of menopause (GSM) and stress urinary incontinence (SUI), and to achieve so-called vaginal rejuvenation. Photobiomodulation therapy (PBMT) has been proposed as an alternative for use in managing GSM and SUI. Methods: This article reviews the biological basis, symptoms, and management of GSM, and investigates the current status and rationale for the use of PBMT. Results and conclusions: Based on the preliminary evidence available, PBMT is safe and appears to be efficacious in treating GSM.
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Balthazar A, Cullingsworth ZE, Nandanan N, Anele U, Swavely NR, Speich JE, Klausner AP. An external compress-release protocol induces dynamic elasticity in the porcine bladder: A novel technique for the treatment of overactive bladder? Neurourol Urodyn 2019; 38:1222-1228. [PMID: 30947371 PMCID: PMC6581567 DOI: 10.1002/nau.23992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 03/14/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Dynamic elasticity is an acutely regulated bladder material property through which filling and passive emptying produce strain softening, and active voiding restores baseline pressure. The aim of this study was to test the hypothesis that strain softening produced by filling-passive emptying is equivalent to that produced by compression-release in a porcine bladder model. METHODS/MATERIALS Latex balloons and ex vivo perfused pig bladders were used for a series of alternating fill-passive emptying ("Fill") and external compress-release ("Press") protocols. For the Fill protocol balloons/bladders were (1) filled to defined volumes (prestrain softening), (2) filled to capacity to strain soften (reference), and (3) passively emptied to the original volume (poststrain softening). For the Press protocol, balloons/bladders were (1) filled to defined volumes (prestrain softening), (2) externally compressed to reference pressure and then released for five cycles (poststrain softening). After each protocol, bladders were voided with high-KCl buffer to induce "active" voiding. RESULTS In both balloons and porcine bladder, both the Fill and Press protocols produced significant strain softening (P < 0.05) and poststrain softening pressures were not different for Fill and Press protocols (P > 0.05), indicating a similar degree of strain softening with both methods. CONCLUSIONS Repeated external compression can induce bladder strain softening similar to filling and passive emptying. This technique may represent a means to acutely regulate bladder compliance and potentially be used as a mechanical treatment for urinary urgency.
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Affiliation(s)
- Andrea Balthazar
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Zachary E. Cullingsworth
- Department of Mechanical & Nuclear Engineering, Virginia Commonwealth University College of Engineering, Richmond, VA
| | - Naveen Nandanan
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Uzoma Anele
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Natalie R. Swavely
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - John E. Speich
- Department of Mechanical & Nuclear Engineering, Virginia Commonwealth University College of Engineering, Richmond, VA
| | - Adam P. Klausner
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, VA
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Ladi-Seyedian SS, Sharifi-Rad L, Nabavizadeh B, Kajbafzadeh AM. Traditional Biofeedback vs. Pelvic Floor Physical Therapy-Is One Clearly Superior? Curr Urol Rep 2019; 20:38. [PMID: 31147796 DOI: 10.1007/s11934-019-0901-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Pelvic floor physical therapy is a worldwide accepted therapy that has been exclusively used to manage many pelvic floor disorders in adults and children. The aim of this review is to suggest to clinicians an updated understanding of this therapeutic approach in management of children with non-neuropathic voiding dysfunction. RECENT FINDINGS Today, pelvic floor muscle training through biofeedback is widely used as a part of a voiding retraining program aiming to help children with voiding dysfunction which is caused by pelvic floor overactivity. Biofeedback on its own, without a pelvic floor training component, is not an effective treatment. Biofeedback is an adjunct to the pelvic floor training. In the current review, we develop the role of pelvic floor physical therapy in management of children with non-neuropathic voiding dysfunction and compare it with biofeedback therapy alone.
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Affiliation(s)
- Seyedeh-Sanam Ladi-Seyedian
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, No. 62, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194 33151, Iran
| | - Lida Sharifi-Rad
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, No. 62, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194 33151, Iran.,Department of Physical Therapy, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Nabavizadeh
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, No. 62, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194 33151, Iran
| | - Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, No. 62, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194 33151, Iran.
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Effect of intravaginal vibratory versus electric stimulation on the pelvic floor muscles: A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol X 2019; 3:100022. [PMID: 31403114 PMCID: PMC6687376 DOI: 10.1016/j.eurox.2019.100022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/19/2019] [Accepted: 04/16/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction According to the International Urogynecological Association and International Continence Society people with normal pelvic floor muscle function should have the ability to voluntarily and involuntarily contract and relax these muscles. However, many women are unaware of their pelvic floor, and it is estimated that about 30–50% do not know how to actively contract these muscles. Within this context, therapeutic strategies to improve pelvic floor muscle strength and function are particularly relevant. Aims To compare the use of an intravaginal vibratory stimulus (IVVS) versus intravaginal electrical stimulation (IVES) on pelvic floor muscle functionality in women with pelvic floor dysfunctions who cannot voluntarily contract these muscles. Materials and methods Randomized clinical trial performed at a tertiary care hospital from June 2016 to September 2017. The sample comprised adult women with pelvic floor dysfunction who were unable to contract their pelvic floor muscles voluntarily. Women with latex allergy or other allergies in the pelvic region, vaginal or urinary tract infection, gynecological cancer, significant pain on palpation, or pelvic floor training over the preceding 6 months were excluded. After baseline assessment, women that met the inclusion criteria were randomized to receive once-weekly 20-minute sessions of IVVS or IVES for 6 weeks. Results Twenty-one women were randomly assigned to each group; 18 completed the IVVS and 17 completed the IVES protocols. The IVVS group presented a significant increase in PFM strength in relation to the IVES group (p = 0.026). There was a significant interaction between time and type of intervention for the same variable (p = 0.008) in the IVVS group. Conclusion Both techniques were beneficial, but IVVS was significantly superior to IVES in improving pevic floor muscle strength. Additional studies are warranted to consolidate the utility of IVVS as a treatment modality for pelvic floor dysfunction.
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Lemos AQ, Brasil CA, Valverde D, Ferreira JDS, Lordêlo P, Sá KN. The pilates method in the function of pelvic floor muscles: Systematic review and meta-analysis. J Bodyw Mov Ther 2019; 23:270-277. [PMID: 31103107 DOI: 10.1016/j.jbmt.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/14/2017] [Accepted: 02/10/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Many Pilates instructors believe that the method can produce significant improvement in the resistance of pelvic floor muscles, but it is known that about 49% of women who can contract this muscle do not perform an adequate contraction and cannot increase urethral closure pressure. OBJECTIVES To evaluate the response of the Pilates method in the function of the pelvic floor muscles, compared to the control group, in healthy women. SEARCH METHODS The following databases were searched from October to December 2016: PUBMED, SCIELO, LILACS, MEDLINE, WEB OF SCIENCE and CINAHL via PERIÓDICOS CAPES, without restriction of language and year of publication. SELECTION CRITERIA Randomized (RCTs), quasi-randomized, and non-randomized clinical trials assessing the effectiveness of the Pilates method for the fuction of pelvic floor muscles in healthy women were included. DATA COLLECTION AND ANALYSIS Two reviewers independently selected the studies, assessed the risk of bias and performed the data extraction. Primary outcomes were the method of evaluation of strength, function, coordination, and symmetry of contraction of the pelvic floor muscles. RESULTS 4434 articles were identified and 2 articles were selected to compose this review and the meta-analysis. No between-group difference was demonstrated for the pelvic floor muscle function as measured by perineometry (p = 0.32). CONCLUSIONS No evidence showed a modification of the function of pelvic floor muscles in healthy women practicing the Pilates method.
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Affiliation(s)
- Amanda Queiroz Lemos
- Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil; Metropolitan Union for the Development of Education and Culture (UNIME), Lauro de Freitas, Bahia, Brazil.
| | - Cristina Aires Brasil
- Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil; Metropolitan Union for the Development of Education and Culture (UNIME), Lauro de Freitas, Bahia, Brazil
| | - Danielle Valverde
- Bahiana School of Medicine and Public Health, Center for Attention to the Pelvic Floor, Salvador, Bahia, Brazil
| | - Janine Dos Santos Ferreira
- Bahiana School of Medicine and Public Health, Center for Attention to the Pelvic Floor, Salvador, Bahia, Brazil
| | - Patrícia Lordêlo
- Postgraduate Program at the Bahiana School of Medicine and Public Health, Center for Attention to the Pelvic Floor, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Postgraduate Program at the Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
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Schvartzman R, Schvartzman L, Ferreira CF, Vettorazzi J, Bertotto A, Wender MCO. Physical Therapy Intervention for Women With Dyspareunia: A Randomized Clinical Trial. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:378-394. [PMID: 30640585 DOI: 10.1080/0092623x.2018.1549631] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dyspareunia negatively affects women´s quality of life, and is a frequent complaint during the peri- and postmenopausal period. A randomized trial evaluated sexual function, quality of life, pain, and pelvic floor muscle function of climacteric women aged between 40 and 60 years old who were sexually active and had complaints of dyspareunia for at least six months. They were assessed before and after their randomization in one of the following interventions: the first group (n = 21) received five one-hour sessions of thermotherapy for relaxation of pelvic floor muscles, myofascial release, and pelvic training (pelvic floor muscle training-PFMT group). The second group (n = 21) received five one-hour sessions during which heat was applied to the lower back with myofascial release of abdominal diaphragm, piriformis, and iliopsoas muscles, with no involvement of pelvic training (lower back-LB group). Forty-two climacteric women with dyspareunia (mean ± SD, PFMT group: 51.9 ± 5.3 years, LB group: 50.6 ± 4.7 years, Student's t-test, p = 0.397) were studied. Pain scores (mean ± SEM) in the PFMT group decreased from 7.77 ± 0.38 to 2.25 ± 0.30; and in the LB group from 7.62 ± 0.29 to 5.58 ± 0.49 (generalized estimating equation-GEE model, p ≤ 0.001 for group, time, and interaction pairwise comparisons). Conclusion: The proposed pelvic floor muscle training protocol was effective to improve pain, quality of life, sexual function, and pelvic floor muscle function in climacteric women with dyspareunia.
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Affiliation(s)
- Renata Schvartzman
- a Pos-Graduation Program in Medical Sciences (PPGCM) , Hospital de Clínicas de Porto Alegre (HCPA). Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil
| | - Luiza Schvartzman
- a Pos-Graduation Program in Medical Sciences (PPGCM) , Hospital de Clínicas de Porto Alegre (HCPA). Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil
| | - Charles Francisco Ferreira
- b Pos-Graduation Program in Health Sciences: Gynecology and Obstetrics (PPGGO) , Hospital de Clínicas de (HCPA), Universidade Federal do (UFRGS) , Porto Alegre , RS , Brazil
| | - Janete Vettorazzi
- b Pos-Graduation Program in Health Sciences: Gynecology and Obstetrics (PPGGO) , Hospital de Clínicas de (HCPA), Universidade Federal do (UFRGS) , Porto Alegre , RS , Brazil
| | - Adriane Bertotto
- a Pos-Graduation Program in Medical Sciences (PPGCM) , Hospital de Clínicas de Porto Alegre (HCPA). Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil
| | - Maria Celeste Osório Wender
- a Pos-Graduation Program in Medical Sciences (PPGCM) , Hospital de Clínicas de Porto Alegre (HCPA). Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil
- b Pos-Graduation Program in Health Sciences: Gynecology and Obstetrics (PPGGO) , Hospital de Clínicas de (HCPA), Universidade Federal do (UFRGS) , Porto Alegre , RS , Brazil
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Abstract
BACKGROUND Investigations on the quality of nursing care relating to various care problems are rare. PURPOSE This study assessed the (1) fulfillment of structural indicators, (2) application of nursing interventions as process indicators, and (3) prevalence rate as outcome indicators with regard to various care problems. METHODS A cross-sectional multicenter study was conducted in 30 Austrian hospitals with 2878 patients. RESULTS The highest number of structural quality indicators was fulfilled for pressure ulcers, falls, restraints, and pain. In malnutrition and urinary incontinence, a lack of structural indicators was observed. Most interventions were offered to patients with pressure ulcers or those who had experienced a fall. The lowest frequency of nursing interventions was seen in malnourished and incontinent persons. CONCLUSION There is a need for the national adaptation of guidelines for malnutrition and urinary incontinence. This may increase the frequency of evidence-based nursing interventions.
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Sihra N, Kujawa M, Solomon E, Harding C, Sahai A, Malde S. Female stress urinary incontinence MDT. JOURNAL OF CLINICAL UROLOGY 2019. [DOI: 10.1177/2051415818821548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The management of female stress urinary incontinence (SUI) has come under scrutiny in recent years following growing reports of mesh-related complications. Patients require thorough evaluation and management as part of a multidisciplinary team, and extensive counselling about the surgical treatment options is imperative. There is no clear consensus on the optimal management of the complex group of patients with mesh-related complications or recurrent SUI. We present two cases of female SUI to highlight the key factors to be considered when managing these patients. Level of evidence: Level 5.
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Affiliation(s)
- Néha Sihra
- Department of Urology, St George’s Hospital, London, UK
| | - Magda Kujawa
- Department of Urology, Stockport NHS Foundation Trust, Stepping Hill Hospital, UK
| | - Eskinder Solomon
- Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, Guy’s Hospital, UK
| | | | - Arun Sahai
- Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, Guy’s Hospital, UK
| | - Sachin Malde
- Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, Guy’s Hospital, UK
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Vaz CT, Sampaio RF, Saltiel F, Figueiredo EM. Effectiveness of pelvic floor muscle training and bladder training for women with urinary incontinence in primary care: a pragmatic controlled trial. Braz J Phys Ther 2019; 23:116-124. [PMID: 30704906 DOI: 10.1016/j.bjpt.2019.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 01/08/2019] [Accepted: 01/14/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Although the efficacy of pelvic floor muscle training (PFMT) and bladder training are well established, there is a paucity of patient centered models using these interventions to treat women with UI at primary level of health assistance in Brazil. OBJECTIVE To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers. METHODS Pragmatic non-randomized controlled trial in which women with UI from the community participated in a supervised physical therapy program consisting of bladder training plus 12 weeks of PFMT, performed either at home or in the health center. Outcome measures were amount and frequency of urine loss measured by the 24-h pad-test and the 24-h voiding diary; secondary outcome was the impact of UI on quality of life measured by the ICIQ-SF. Outcomes were measured at baseline, at the 6th and 12th weeks of the intervention and 1 month after discharge. RESULTS Interventions reduced the amount (pad-test, p=0.004; d=0.13, 95% CI=-0.23 to 0.49) and frequency of urine loss (voiding diary, p=0.003; d=0.51, 95%CI=0.14 to 0.87), and the impact of UI on quality of life (ICIQ-SF, p<0.001; d=1.26, 95%CI=0.87 to 1.66) over time, with positive effects from the 6th week up to 1 month for both intervention setting (home and health center), and no differences between them. CONCLUSION Interventions were effective, can be implemented in primary health centers favoring the treatment of a greater number of women who do not have access to specialized physical therapy. TRIAL REGISTRATION RBR-8tww4y.
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Affiliation(s)
- Camila Teixeira Vaz
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Physical Therapy Department, Universidade Federal de Juiz de Fora (UFJF), Governador Valadares, MG, Brazil
| | - Rosana Ferreira Sampaio
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Fernanda Saltiel
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; Faculdade de Ciências Médicas de Minas Gerais (FCMMG) Belo Horizonte, MG, Brazil
| | - Elyonara Mello Figueiredo
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Effects of wearing supportive underwear versus pelvic floor muscle training or no treatment in women with symptoms of stress urinary incontinence: an assessor-blinded randomized control trial. Int Urogynecol J 2019; 30:1093-1099. [PMID: 30627829 DOI: 10.1007/s00192-018-03855-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS In our previous single-arm pilot study, we reported that ready-made supportive underwear (shaper) was effective in elevating the bladder neck and reducing urinary incontinence (UI) symptoms. The aim of this study was to determine the effects of wearing a shaper compared with pelvic floor muscle training (PFMT) at home using a training compact disc with music, or no treatment, in an assessor-blinded randomized control trial, on reducing UI symptoms. METHODS Participants aged 30-59 years with symptoms of stress urinary incontinence were randomly assigned to three groups: the shaper group, PFMT group, and no treatment group. The UI episodes/week and the Japanese version of the International Consultation on Incontinence Questionnaire Short-Form were compared between the baseline and the 6th or 12th week of the intervention period. RESULTS Eighty-nine women who completed the 12-week intervention period were analyzed. After the 12-week intervention period, the improvement rate in UI symptoms (ratio of the case number in which the UI episodes/week decreased at least 50% from the baseline) was 73.3% (22/30 women) in the shaper group, 74.2% (23/31 women) in the PFMT group, and 25.0% (7/28 women) in the no treatment group. The improvement rate in UI symptoms in the shaper and PFMT groups was significantly higher than that in the no treatment group (both P < 0.001). CONCLUSIONS Wearing supportive underwear (shaper) was almost as effective as PFMT at home in reducing UI symptoms.
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Pelvic floor muscle knowledge and relationship with muscle strength in Brazilian women: a cross-sectional study. Int Urogynecol J 2018; 30:1903-1909. [DOI: 10.1007/s00192-018-3824-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/09/2018] [Indexed: 11/25/2022]
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