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Garcia C, Homewood D, Gani J, O'Connell HE. Perspectives on technology: urethral slings in a post-mesh world. BJU Int 2024; 134:337-350. [PMID: 38822540 DOI: 10.1111/bju.16388] [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] [Indexed: 06/03/2024]
Abstract
OBJECTIVES To detail the history of synthetic mid-urethral slings (SMUSs) and fascial slings, their efficacy, associated complications, and changes to practice that have occurred after the issuing of the 2011 US Food and Drug Administration (FDA) Safety Communication statement on transvaginal mesh (TVM), and to highlight the need for surgical registries and high-quality randomised controlled data to guide recommendations for continence procedures, in view of current concerns regarding mesh. METHODS A literature search was conducted in EMBASE, PubMed, and the Cochrane Database of systematic reviews to identify articles published from 2011 onward, following the FDA Safety Communication regarding TVM. RESULTS Prior to the formal FDA Safety Communication in 2011, TVM was considered a safe option for the treatment of both pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The 2011 FDA safety communications and ensuing widely publicised litigation against TVM manufacturers have shifted both surgeon and patient acceptance of mesh products. Several efforts by medical and government bodies have been made to establish ways to monitor the surgical outcomes and safety of mesh products. The Australasian Pelvic Floor Procedure Registry is one such example. Although SMUSs have a long and established safety profile, perceptions of mesh products for SUI have also been negatively affected. The extent of this, however, has yet to be adequately measured through qualitative and quantitative data. The available data suggest it has been difficult for patients and consumers to distinguish between TVM morbidity for POP vs SUI. Furthermore, there remains a lack of high-quality randomised or real-world registry data to definitively exclude the SMUS from the SUI treatment algorithm. Since SMUSs are a viable option for SUI treatment, the concept of a 'post-mesh world' remains contentious. CONCLUSION Controversies surrounding SMUSs have changed the treatment landscape of SUI. Against the background of significant litigious action following the FDA warnings against mesh use, there has been significant reduction in the uptake of synthetic mesh products. Although there are ample data related to surgical outcomes and safety for both autologous fascial and retropubic SMUSs in carefully selected patients, informed consent and surgical training will be of paramount importance as newer synthetic materials reach clinical maturity.
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Affiliation(s)
- Cindy Garcia
- North Shore Private Hospital, Sydney, NSW, Australia
| | - David Homewood
- Department of Urology, Western Health, Melbourne, VIC, Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- International Medical Robotics Academy, Melbourne, VIC, Australia
| | - Johan Gani
- Department of Urology, Western Health, Melbourne, VIC, Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Epworth Healthcare, Melbourne, VIC, Australia
| | - Helen E O'Connell
- Urological Society of Australia and New Zealand, Edgecliff, NSW, Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Epworth Healthcare, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, VIC, Australia
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Farley D, Kłosowska J, Brączyk J, Buglewicz E, Bąbel P. Treatment of last resort? Psychological therapy seeking in chronic pain patients. Chronic Illn 2024; 20:184-196. [PMID: 37143291 DOI: 10.1177/17423953231172796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Our goal was to assess how many chronic pain patients seek psychological treatment for their condition and what psychological and demographic characteristics are associated with that decision. METHODS The association between pain intensity, quality of life and psychological treatment seeking was tested in two hypothetical models which differed according to beliefs about either external or internal control over pain. RESULTS A minority of patients had experience with psychological treatment of chronic pain. Patients who had that experience were younger, suffered from more intense pain, and applied many more coping strategies than patients who never tried this kind of treatment. Intense pain and low quality of life motivated chronic pain patients to seek psychological treatment only if they believed that doctors could control their pain. DISCUSSION The study results stress the importance of diversifying the methods used to treat chronic pain and educating patients about the benefits of psychological treatment. Low numbers of chronic pain patients who take advantage of psychological treatment indicate that encouragement from medical professionals might be necessary.
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Affiliation(s)
- Dominika Farley
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Joanna Kłosowska
- Clinical Psychology Unit, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Justyna Brączyk
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Ewa Buglewicz
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Przemysław Bąbel
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
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Ackerman AL, Jackson NJ, Caron AT, Kaufman MR, Routh JC, Lowder JL. Myofascial urinary frequency syndrome is a novel syndrome of bothersome lower urinary tract symptoms associated with myofascial pelvic floor dysfunction. Sci Rep 2023; 13:18412. [PMID: 37891217 PMCID: PMC10611808 DOI: 10.1038/s41598-023-44862-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
This study describes a novel, distinct phenotype of urinary symptoms named "myofascial urinary frequency syndrome" (MUFS) present in one-third of individuals presenting with urinary frequency. In addition to a characteristic symptom constellation suggestive of myofascial dysfunction, MUFS subjects exhibit "persistency": a persistent feeling of needing to urinate regardless of urine volume. On examination, 97% of MUFS patients demonstrated pelvic floor hypertonicity with either global tenderness or myofascial trigger points, and 92% displayed evidence of impaired muscular relaxation, hallmarks of myofascial dysfunction. To confirm this symptom pattern was attributable to the pelvic floor musculature, we confirmed the presence of "persistency" in 68 patients with pelvic floor myofascial dysfunction established through comprehensive examination and electromyography and corroborated by improvement with pelvic floor myofascial release. These symptoms distinguish subjects with myofascial dysfunction from subjects with OAB, IC/BPS, and asymptomatic controls, confirming MUFS is a distinct LUTS symptom complex.
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Affiliation(s)
- A Lenore Ackerman
- Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Box 951738, Los Angeles, CA, 90095-1738, USA.
| | - Nicholas J Jackson
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Ashley T Caron
- Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Melissa R Kaufman
- Division of Reconstructive Urology and Pelvic Health, Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonathan C Routh
- Division of Urologic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis, USA
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Zhang D, Sun X, Zhu H, Wang H, Sun X, Wang J. Help-seeking behavior for nonsevere stress urinary incontinence among elderly women in communities, Beijing, China. Int Urogynecol J 2023; 34:2565-2572. [PMID: 37300566 DOI: 10.1007/s00192-023-05544-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) is a common health problem and influences women's quality of life significantly. In order to enhance health education according to a specific situation, it is essential to identify barriers to seeking help among elderly women with nonsevere SUI. The objectives were to investigate reasons for (not) seeking help for nonsevere SUI among women aged ≥60 years, and to analyze factors affecting help-seeking behavior. METHODS We enrolled 368 women aged ≥60 years with nonsevere SUI from communities. They were asked to filled out sociodemographic information, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Incontinence Quality of Life (I-QOL), and self-constructed questiones on help-seeking behavior. Mann-Whitney U tests were used to analyze the different factors between seeking group and nonseeking group. RESULTS Only 28 women (7.61%) had ever sought help from health professionals for SUI. The most frequent reason for seeking help was urine-soaked clothes (67.86%, 19 out of 28). The most frequent reason for not seeking help was that women thought it was normal (67.35%, 229 out of 340). Compared with the nonseeking group, the seeking group had higher total ICIQ-SF scores and lower total I-QOL scores. CONCLUSION Among elderly women with nonsevere SUI, the rate of seeking help was low. Lack of correct perception about the SUI kept women from doctor visits. Women who were bothered by more severe SUI and lower quality of life were more likely to seek help.
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Affiliation(s)
- Di Zhang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing, 100044, China
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- Research Center of Female Pelvic Floor Disorders of Peking University, Beijing, China
| | - Xiaohui Sun
- Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing, 100044, China
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- Research Center of Female Pelvic Floor Disorders of Peking University, Beijing, China
| | - Hongmei Zhu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing, 100044, China
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- Research Center of Female Pelvic Floor Disorders of Peking University, Beijing, China
- Department of Sports medicine and rehabilitation, Beijing Sports University, No.48, Xin Xi Road, Hai Dian District, Beijing, 100084, China
| | - Haibo Wang
- Clinical Research Institute, Peking University, Beijing, China
| | - Xiuli Sun
- Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing, 100044, China.
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing, China.
- Research Center of Female Pelvic Floor Disorders of Peking University, Beijing, China.
| | - Jianliu Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing, 100044, China
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing, China
- Research Center of Female Pelvic Floor Disorders of Peking University, Beijing, China
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Rashidi Fakari F, Hajian S, Darvish S, Alavi Majd H. Predictors of help-seeking behaviors in women with urinary incontinence: Based on Iranian women's lens. PLoS One 2023; 18:e0289785. [PMID: 37540696 PMCID: PMC10403081 DOI: 10.1371/journal.pone.0289785] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023] Open
Abstract
Urinary incontinence has an undeniable impact on the quality of life of affected women; however, talking about incontinence is not comfortable for many women, and they often hide it and do not seek treatment. Predictors affecting women's decisions to seek treatment in communities can be different. This study was designed to identify predictors of help-seeking behaviors among Iranian women with urinary incontinence. METHODS This cross-sectional, analytical study was conducted on 199 women with urinary incontinence who met the inclusion criteria by convenience sampling from the beginning of 2020 to the middle of 2021. The Incontinence Severity Index, Bradley's Questionnaire for Urinary Incontinence Diagnosis, Medical Embarrassment Questionnaires, Brief-Illness Perception Questionnaire, Incontinence Quality of Life Questionnaire, Barrier to Incontinence Care Seeking Questionnaire, Medical Help Seeking Scale, and Medical Outcomes Study Social Support Survey were all self-administered data collection tools used in this study. Multiple linear regression was used to investigate the relationship and prediction of help-seeking behaviors by other variables. To analyze the data, SPSS software version 20 was used. RESULTS The variables of shame, barriers to care, social support, quality of life, and age were found to be predictors of help-seeking behavior in the research population of women with urinary incontinence. Help-seeking had a direct relationship with quality of life and an inverse relationship with other factors. Among these factors, shame has the greatest impact (P = 0/001, β = - 0/37). CONCLUSIONS The extracted predictors, especially the variable of "shame" as the most important negative factor related to the treatment decisions of women with urinary incontinence, will help to health service providers to take into account these factors in the regular service provision programs that promote women's health, which are effective in facilitating the help-seeking of sufferers and correct guidance towards treatment or rehabilitation.
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Affiliation(s)
- Fahimeh Rashidi Fakari
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodabeh Darvish
- Department of Obstetrics & Gynaecology, Fellowship of Female Pelvic Floor Medicine and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ackerman AL, Jackson NJ, Caron AT, Kaufman MR, Routh JC, Lowder JL. Myofascial Frequency Syndrome: A novel syndrome of bothersome lower urinary tract symptoms associated with myofascial pelvic floor dysfunction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.14.23288590. [PMID: 37131628 PMCID: PMC10153318 DOI: 10.1101/2023.04.14.23288590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Patients presenting with lower urinary tract symptoms (LUTS) are historically classified to several symptom clusters, primarily overactive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS). Accurate diagnosis, however, is challenging due to overlapping symptomatic features, and many patients do not readily fit into these categories. To enhance diagnostic accuracy, we previously described an algorithm differentiating OAB from IC/BPS. Herein, we sought to validate the utility of this algorithm for identifying and classifying a real-world population of individuals presenting with OAB and IC/BPS and characterize patient subgroups outside the traditional LUTS diagnostic paradigm. Methods An Exploratory cohort of 551 consecutive female subjects with LUTS evaluated in 2017 were administered 5 validated genitourinary symptom questionnaires. Application of the LUTS diagnostic algorithm classified subjects into controls, IC/BPS, and OAB, with identification of a novel group of highly bothered subjects lacking pain or incontinence. Symptomatic features of this group were characterized by statistically significant differences from the OAB, IC/BPS and control groups on questionnaires, comprehensive review of discriminate pelvic exam, and thematic analysis of patient histories. In a Reassessment cohort of 215 subjects with known etiologies of their symptoms (OAB, IC/BPS, asymptomatic microscopic hematuria, or myofascial dysfunction confirmed with electromyography), significant associations with myofascial dysfunction were identified in a multivariable regression model. Pre-referral and specialist diagnoses for subjects with myofascial dysfunction were catalogued. Findings Application of a diagnostic algorithm to an unselected group of 551subjects presenting for urologic care identified OAB and IC/BPS in 137 and 96 subjects, respectively. An additional 110 patients (20%) with bothersome urinary symptoms lacked either bladder pain or urgency characteristic of IC/BPS and OAB, respectively. In addition to urinary frequency, this population exhibited a distinctive symptom constellation suggestive of myofascial dysfunction characterized as "persistency": bothersome urinary frequency resulting from bladder discomfort/pelvic pressure conveying a sensation of bladder fullness and a desire to urinate. On examination, 97% of persistency patients demonstrated pelvic floor hypertonicity with either global tenderness or myofascial trigger points, and 92% displayed evidence of impaired muscular relaxation, hallmarks of myofascial dysfunction. We therefore classified this symptom complex "myofascial frequency syndrome". To confirm this symptom pattern was attributable to the pelvic floor, we confirmed the presence of "persistency" in 68 patients established to have pelvic floor myofascial dysfunction through comprehensive evaluation corroborated by symptom improvement with pelvic floor myofascial release. These symptoms distinguish subjects with myofascial dysfunction from subjects with OAB, IC/BPS, and asymptomatic controls, confirming that myofascial frequency syndrome is a distinct LUTS symptom complex. Interpretation This study describes a novel, distinct phenotype of LUTS we classified as myofascial frequency syndrome in approximately one-third of individuals with urinary frequency. Common symptomatic features encompass elements in other urinary syndromes, such as bladder discomfort, urinary frequency and urge, pelvic pressure, and a sensation of incomplete emptying, causing significant diagnostic confusion for providers. Inadequate recognition of myofascial frequency syndrome may partially explain suboptimal overall treatment outcomes for women with LUTS. Recognition of the distinct symptom features of MFS (persistency) should prompt referral to pelvic floor physical therapy. To improve our understanding and management of this as-yet understudied condition, future studies will need to develop consensus diagnostic criteria and objective tools to assess pelvic floor muscle fitness, ultimately leading to corresponding diagnostic codes. Funding This work was supported by the AUGS/Duke UrogynCREST Program (R25HD094667 (NICHD)) and by NIDDK K08 DK118176 and Department of Defense PRMRP PR200027, and NIA R03 AG067993.
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Affiliation(s)
- A. Lenore Ackerman
- Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Nicholas J. Jackson
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Ashley T. Caron
- Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Melissa R. Kaufman
- Division of Reconstructive Urology and Pelvic Health, Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Jonathan C. Routh
- Division of Urologic Surgery, Duke University School of Medicine, Durham, NC
| | - Jerry L. Lowder
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis
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Öz Yıldırım Ö, Aydın Avci İ, Yıldırım E, Bostancı Y. The effect of the Incontinence Health Belief Development Program on women's urinary incontinence awareness and health beliefs: a randomized controlled trial. Int Urogynecol J 2022:10.1007/s00192-022-05343-x. [PMID: 36129479 DOI: 10.1007/s00192-022-05343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION AND HYPOTHESIS This study is aimed at determining the effects of the Incontinence Health Belief Development Program (IHBDP) on the urinary incontinence awareness and health beliefs of women in the pre-menopausal period. METHODS This randomized controlled study was conducted in 160 eligible women. The pre-test and post-test data of the study were collected from experimental and control groups using the Socio-Demographic Characteristics Information Form, the Incontinence Awareness Scale, the Health Belief Scale on Urinary Incontinence and Kegel Exercise, and the Broome Pelvic Muscle Self-Efficacy Scale. The IHBDP was implemented with members of the experimental group for 5 weeks. RESULTS The women in the experimental group showed a significant difference in mean scores at the end of the program on the UI Awareness Scales, the Health Belief Scale on UI, and the Kegel Exercise compared with pre-training scores (p<0.05). In the experimental group, the factor scores and the total score of the Broome Pelvic Muscle Self-Efficacy Scale also increased. Furthermore, a statistically significant total score increase (p<0.05) was observed at the end of the program (79.8±8.8) compared with before the program (35.2±19.6). CONCLUSIONS The training given to the women in the pre-menopausal period based on the Health Belief Model appears highly effective in raising awareness about UI, fostering beliefs about Kegel exercises and increasing pelvic floor muscle self-efficacy.
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Affiliation(s)
- Özge Öz Yıldırım
- Department of Public Health Nursing, Health Sciences Faculty of Ondokuz Mayıs University, Samsun, Turkey.
| | - İlknur Aydın Avci
- Department of Public Health Nursing, Health Sciences Faculty of Ondokuz Mayıs University, Samsun, Turkey
| | | | - Yakup Bostancı
- Medical Faculty, Ondokuz Mayıs University, Samsun, Turkey
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Demirtaş FA, Başar F, Aba YA. Urinary symptoms and incontinence in postmenopausal women and the effects on quality of life. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Fatma Aslan Demirtaş
- Department of Women's Health and Diseases Nursing, Florence Nightingale Faculty of Nursing Istanbul University – Cerrahpasa İstanbul Turkey
| | - Fatma Başar
- Department of Nursing, Faculty of Health Sciences Kutahya Health Sciences University Kütahya Turkey
| | - Yılda Arzu Aba
- Department of Nursing, Faculty of Health Science Bandirma Onyedi Eylul University Bandirma Turkey
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Prevalence, social impact and help-seeking behaviour among women with urinary incontinence in the Gulf countries: A systematic review. Eur J Obstet Gynecol Reprod Biol 2021; 266:150-156. [PMID: 34653920 DOI: 10.1016/j.ejogrb.2021.10.005] [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: 05/27/2021] [Revised: 07/06/2021] [Accepted: 10/02/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Urinary incontinence (UI) in women is a common problem worldwide. It has a major impact on the physical and social activities and interpersonal relationships. The societies in the Gulf countries are conservative and favours large families, high parity and short inter-pregnancy intervals. Moreover, there is a high prevalence of gestational diabetes with many macrosomic babies. This study aimed to review the published literature on UI among women in this region. METHODS All published literature which investigated the prevalence, social impact and help-seeking behavior in women with UI in the Gulf countries was reviewed. RESULTS Nine studies met the criteria and were very heterogeneous. None of them was a true population-based study and all except one, investigated subjects from healthcare facilities. The prevalence of UI ranged from 20.3% to 54.5%. Stress UI was the main type reported. The main predisposing factors were chronic respiratory diseases and constipation. There was a large impact on the quality of life with major interference with prayers (34-90%) and sexual relationships (18-57%). The main reasons for not seeking medical advice were embarrassment to see doctors especially male doctors and the belief that UI is common, normal or incurable disease. CONCLUSIONS There is a need for true whole population-based studies of UI in this region with the use of validated international questionnaires. UI was shown to have a major impact on the act of prayers and sexual relationships. A large proportion of women are still embarrassed to discuss the issue with doctors especially male doctors.
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Imoto A, Sarker M, Akter R, Matsuyama A, Honda S. Health-related quality of life in parous women with pelvic organ prolapse and/or urinary incontinence in Bangladesh. Int Urogynecol J 2020; 32:887-895. [PMID: 32607714 DOI: 10.1007/s00192-020-04410-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We assessed the association of pelvic organ prolapse (POP) and urinary incontinence (UI), alone and in combination (POP-UI), and related factors with health-related quality of life (HRQOL) in parous women in Bangladesh. METHODS The study included 357 parous women: 107 with POP alone, 124 with POP-UI, and 126 with UI alone. Data were collected on sociodemographic characteristics, comorbidities, symptom duration, UI severity and type, POP stage, and the 12-item Short-Form Health Survey (SF-12). RESULTS The median scores of the SF-12 Physical and Mental Component Summary (PCS and MCS) were 29.1 and 35.7 for POP alone, 28.0 and 35.1 for POP-UI, and 33.9 and 42.0 for UI alone, and there were significant differences among the three groups (p < 0.001). Participants with mixed UI had lower scores on both components than those with stress or urgency UI. UI severity was associated with lower MCS scores, but not with POP stage. Multiple regression analysis showed that the coexistence of POP and UI was associated with significantly worse PCS scores than UI or POP alone and worse MCS scores than UI alone. Age ≥ 46 years was associated with lower PCS scores, and not completing primary school was associated with lower MCS scores. CONCLUSION POP and UI were associated with HRQOL, especially in those who had POP-UI, were older, and had a low educational level, mixed UI, and severe UI. Healthcare providers should understand the significance of these illnesses and address them to improve women's HRQOL.
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Affiliation(s)
- Atsuko Imoto
- Department of Community-based Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki, 852-8523, Japan.
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki, 852-8523, Japan.
| | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, 5th Floor (Level-6), icddr,b Building, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130/3, 69120, Heidelberg, Germany
| | - Rahima Akter
- BRAC James P Grant School of Public Health, BRAC University, 5th Floor (Level-6), icddr,b Building, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Akiko Matsuyama
- Department of International Cooperation and Multicultural Studies, Tsuda University, 2-1-1 Tsuda-machi, Kodaira-shi, Tokyo, 187-0025, Japan
| | - Sumihisa Honda
- Department of Community-based Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki, 852-8523, Japan
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Dheresa M, Worku A, Oljira L, Mengistie B, Assefa N, Berhane Y. Women's health seeking behavior for pelvic floor disorders and its associated factors in eastern Ethiopia. Int Urogynecol J 2020; 31:1263-1271. [PMID: 32333061 DOI: 10.1007/s00192-020-04309-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pelvic floor disorders (PFDs), include urinary incontinence, overactive bladder, anal incontinence, and pelvic organ prolapse negatively affect physical, psychosocial, and economic wellbeing of women. In developing countries, less than a quarter of women with PFDs seek health care for their problem. Health care seeking for PFDs, and its associated factors, is little known in Ethiopia. This study aimed to assess health care seeking for PFDs, associated factors, and deterrents for seeking care. METHODS From a community based cross sectional study conducted form August 10 to September 4, 2016 to assess pelvic floor disorders, seven hundred four participants with PFDs drawn for health care seeking behavior analysis. Data were collected through interviewed administered questionnaire. Poisson regression model with robust variance was used to investigate the association of the independent variable with health care seeking behaviors. The results are reported in crude and adjusted prevalence ratio with 95% confidence intervals. RESULT Two hundred twenty five (32%; CI: 26.8-35.5) women sought care for their PFDs. Majority 160 (71%) of them seek care from government health facilities. Middle wealth index Adjusted Prevalence Ratio (APR) = 1.4, CI: 1.1, 1.8), autonomous decision making on own health (APR = 1.3, CI: 1.1, 1.7), and sever impact of PFDs on quality of life (APR = 1.4, CI:1.1, 1.9) were identified as associated factors for health care seeking. CONCLUSION A large number of women with pelvic floor disorder did not seek health care: this calls for urgent and tailored intervention to enhance health care seeking behaviors of women with PFD.
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Affiliation(s)
- Merga Dheresa
- Health and Medical Sciences College, Haramaya University, P. O. Box 235, Harar, Ethiopia.
| | - Alemayehu Worku
- School of Public Health, Addis Ababa, Ethiopia & Addis Continental Institutes of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Lemessa Oljira
- Health and Medical Sciences College, Haramaya University, Harar, Ethiopia
| | - Bezatu Mengistie
- Health and Medical Sciences College, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- Health and Medical Sciences College, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Addis Continental Institutes of Public Health, Addis Ababa, Ethiopia
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12
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Demands for perimenopausal health care in women aged 40 to 60 years—a hospital-based cross-sectional study in Shanghai, China. Menopause 2019; 26:189-196. [DOI: 10.1097/gme.0000000000001172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Cheng KY, Yusoff DM, Ismail H, Naing NN. The Incontinence Praying Ability and the Incontinence Quality of Life Questionnaires for Muslim Women: A Confirmatory Study of the Malay Language Versions. Malays J Med Sci 2018; 25:115-127. [PMID: 30914868 PMCID: PMC6419887 DOI: 10.21315/mjms2018.25.5.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of the present study was to determine the validity and reliability of the Malay versions of the Incontinence Praying Ability (I-PA) and the Incontinence Quality of Life (I-QoL) questionnaires among childbearing-aged Muslim women. METHODS This cross-sectional study included 338 childbearing-aged Muslim women (mean age: 31.1 years; SD = 5.57) who attended clinics at Hospital Universiti Sains Malaysia. Confirmatory factor analysis was conducted to determine the construct validity of the Malay versions of the I-PA and the I-QoL, while composite reliability was used to examine their internal consistency reliability. RESULTS The hypothesised models of the I-PA and the I-QoL consisted of 10 items with one latent variable and 22 items with three latent variables, respectively. The hypothesised models of the I-PA and the I-QoL did not have good fit. Modifications included co-varying the residual terms for items within the subscales, which resulted in improved fit indices for the I-PA (CFI = 0.976 TLI = 0.961, RMSEA = 0.068) and the I-QoL (CFI = 0.948, TLI = 0.938, RMSEA = 0.063). The composite reliability of the I-PA was 0.93, and the I-QoL ranged from 0.91 to 0.94. CONCLUSION The Malay versions of the I-PA and I-QoL were considered to be valid, reliable questionnaires measuring incontinence QoL among Muslim women of childbearing age.
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Affiliation(s)
- Kueh Yee Cheng
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Dariah Mohd Yusoff
- School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Hanis Ismail
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nyi Nyi Naing
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
- Institute for Community (Health) Development (i-CODE), Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
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Nonbiologic factors that impact management in women with urinary incontinence: review of the literature and findings from a National Institute of Diabetes and Digestive and Kidney Diseases workshop. Int Urogynecol J 2017; 28:1295-1307. [PMID: 28674734 DOI: 10.1007/s00192-017-3400-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/12/2017] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI)-defined as a complaint of involuntary loss of urine-is common in women, with major public health, financial, and quality of life (QoL) implications. Despite the high toll of UI and the availability of effective conservative treatments, many women with UI do not seek care. Those who do often continue to experience symptoms. Improving UI treatment may require a comprehensive approach to urology research, including a broad set of potentially influential factors beyond biologic. METHODS To explore the effects of nonbiologic factors (NBF) on UI management and treatment response, the National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop for clinical and psychosocial researchers. Participants proposed a UI treatment pathway: recognizing the problem, willingness to seek treatment, access to care, receiving quality treatment, engaging in self-management, and adhering to chosen treatments; discussed potential NBFs that may affect the pathway; and identified areas for future research. After the meeting, a rapid literature review was conducted to assess the current state of research on NBFs in women with UI. RESULTS Participants identified several patient-level NBFs that may influence the UI management pathway, including QoL and perceived bother; stigma, shame, and embarrassment; knowledge and perceptions; social determinants of health; cultural and language characteristics; personal characteristics and skills; and physical abilities. Additionally, participants acknowledged that provider- and system-level factors also play a role and likely interact with patient-level factors. CONCLUSIONS NBFs that potentially affect the UI management pathway are not well understood, and a comprehensive, interdisciplinary approach to research is needed to understand and appropriately support effective UI treatment.
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15
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Bonilla-Becerra SM, de Oliveira MG, Calmasini FB, Rojas-Moscoso JA, Zanesco A, Antunes E. Micturition dysfunction in four-month old ovariectomized rats: Effects of testosterone replacement. Life Sci 2017; 179:120-129. [PMID: 28487215 DOI: 10.1016/j.lfs.2017.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/13/2017] [Accepted: 05/05/2017] [Indexed: 01/01/2023]
Abstract
AIMS Androgen deficiency has been implicated in urological complications of postmenopausal women. This study examined the effects of testosterone replacements on the lower urinary tract dysfunction in 4-month old ovariectomized (OVX) rats. MAIN METHODS Sprague-Dawley female rats were OVX bilaterally. Three months later, rats received single intramuscular injections of testosterone undecanoate. Cystometric study, and bladder and urethra smooth muscle reactivities were evaluated. KEY FINDINGS Ovariectomy reduced by 65% (p<0.05) the serum testosterone levels. Testosterone replacement at 5mg/kg restored serum hormone levels to baseline, whereas 10mg/kg produced 14-fold higher testosterone levels. OVX rats exhibited significant increases of body weight, perigonadal fat and blood pressure, and reduced uterus weight, but none of these parameters were changed by testosterone replacements. OVX rats exhibited micturition dysfunction characterized by increases of basal pressure, threshold pressure, voiding frequency and post-voiding pressure. In addition, the bladder contractions induced by electrical-field stimulation (EFS) and carbachol were significantly reduced, whereas angiotensin II-induced urethral contractions were significantly increased in OVX rats. Testosterone replacement at 10mg/kg (but not at 5mg/kg) dose fully normalized the in vivo micturition dysfunction, as well as the in vitro bladder and urethral alterations. Testosterone (10mg/kg) also significantly potentiated the bladder relaxations induced by the β3-adrenoceptor agonist mirabegron. The protective effects of testosterone were not modified by concomitant treatment with the aromatase inhibitor letrozole (2.5mg/kg, 4weeks). SIGNIFICANCE The improvement of micturition dysfunction by testosterone replacement suggests that androgen therapy might be of therapeutic benefit for urological complications associated with post-menopause.
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Affiliation(s)
- Sandra M Bonilla-Becerra
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Mariana G de Oliveira
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Fabiano B Calmasini
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Julio A Rojas-Moscoso
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | | | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
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Tomasi AVR, Santos SMAD, Honório GJDS, Locks MOH. URINARY INCONTINENCE IN ELDERLY PEOPLE: CARE PRACTICES AND CARE PROPOSAL IN PRIMARY HEALTH CARE. TEXTO & CONTEXTO ENFERMAGEM 2017. [DOI: 10.1590/0104-07072017006800015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: identify the knowledge and care practices concerning urinary incontinence in elderly women and develop a care proposal for these women for the purpose of health promotion in Primary Health Care. Method: a qualitative, convergent care research was undertaken. The data were collected between August and October 2014 through semistructured interviews and thematic workshops with 14 physiotherapists and ten nurses. The analysis involved apprehension, synthesis, theorization and transference processes, revealing two thematic axes: the professionals' perception of urinary incontinence in elderly women; and the conception of a care proposal for elderly women with urinary incontinence. Results: the professionals' limited knowledge of urinary incontinence was verified, as well as the lack of information on the possible orientations for self-care concerning the urinary symptoms. Conclusion: training actions should be implemented for these professionals with a view to health promotion for self-care.
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17
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Güvenç G, Kocaöz S, Kök G. Quality of life in climacteric Turkish women with urinary incontinence. Int J Nurs Pract 2016; 22:649-659. [DOI: 10.1111/ijn.12495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/25/2016] [Accepted: 09/10/2016] [Indexed: 01/17/2023]
Affiliation(s)
- Gülten Güvenç
- Department of Obstetrics and Gynecology Nursing, Gulhane School of Nursing; Health Sciences University; Ankara Turkey
| | - Semra Kocaöz
- Department of Obstetrics and Gynecology Nursing, Nursing Department; Nigde Zübeyde Hanim School of Health, Omer Halisdemir University; Nigde Turkey
| | - Gülşah Kök
- Department of Obstetrics and Gynecology Nursing, Gulhane School of Nursing; Health Sciences University; Ankara Turkey
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Juliato CRT, Baccaro LF, Pedro AO, Gabiatti JRE, Lui-Filho JF, Costa-Paiva L. Factors associated with urinary incontinence in middle-aged women: a population-based household survey. Int Urogynecol J 2016; 28:423-429. [PMID: 27640065 DOI: 10.1007/s00192-016-3139-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/27/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to determine the prevalence of urinary incontinence (UI) and factors associated in a sample of Brazilian middle-aged women. METHODS A cross-sectional study was conducted between September 2012 and June 2013 with 749 women. UI was defined as any complaint of involuntary loss of urine. The independent variables were sociodemographic data and health-related habits and problems. Statistical analysis was carried out using Chi-squared test and Poisson regression. RESULTS The mean age was 52.5 (±4.4) years. The prevalence of UI was 23.6 %. Of these, 48 (6.4 %) had stress urinary incontinence, 59 (7.8 %) urinary urgency, and 70 (9.5 %) had mixed urinary incontinence. In the final statistical model, self-perception of health as fair/poor/very poor (PR: 1.90; 95 % CI, 1.45-2.49; P < 0.001), ≥1 vaginal deliveries (PR: 1.84; 95 % CI, 1.35-2.50; P < 0.001), higher body mass index (PR: 1.04; 95 % CI, 1.02-1.06; P = 0.001), vaginal dryness (PR: 1.60; 95 % CI, 1.23-2.08; P = 0.001), current or previous hormone therapy (PR: 1.38; 95 % CI, 1.06-1.81; P = 0.019), pre-/perimenopause (PR: 1.42; 95 % CI, 1.06-1.91; P = 0.021), and previous hysterectomy (PR: 1.41; 95 % CI, 1.03-1.92; P = 0.031) were associated with a greater prevalence of UI. Current or previous use of soy products to treat menopausal symptoms was associated with a lower prevalence of UI (PR: 0.43; 95 % CI, 0.24-0.78; P = 0.006). CONCLUSIONS Several factors are associated with UI in middle-aged Brazilian women. The results highlight the importance of carrying out interventions aimed at reducing modifiable factors.
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Affiliation(s)
- Cássia Raquel Teatin Juliato
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil, 13083-881.
| | - Luiz F Baccaro
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil, 13083-881
| | - Adriana O Pedro
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil, 13083-881
| | - José R E Gabiatti
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil, 13083-881
| | - Jeffrey F Lui-Filho
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil, 13083-881
| | - Lucia Costa-Paiva
- Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil, 13083-881
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Care-Seeking for Stress Incontinence and Overactive Bladder Among Parous Women in the First Two Decades After Delivery. Female Pelvic Med Reconstr Surg 2016; 22:199-204. [PMID: 26945268 DOI: 10.1097/spv.0000000000000262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to establish the extent to which care-seeking for urinary incontinence is a function of symptom bother; and to identify bother-score thresholds that predict care-seeking in the first 2 decades after delivery. METHODS In this longitudinal cohort, women were assessed annually for symptom bother related to stress urinary incontinence (SUI) and overactive bladder (OAB), as well as for recent episodes of care-seeking for urinary symptoms. Because the goal was to model care-seeking as a function of the woman's characteristics at her prior visit, women who completed 2 or more consecutive visits were included. The population was randomly divided into "training" (model development) and "testing" (model validation) sets. The predictive model was developed in the training set. For SUI and OAB bother scores, we identified thresholds to define statistically distinct probabilities of care-seeking. A multivariable model was created, including SUI and OAB bother categories as well as characteristics associated with care seeking at the P < 0.05 level. The resultant prediction model was then applied to the "testing set"; predicted and observed care-seeking frequencies were compared. RESULTS Care-seeking was strongly associated with SUI and OAB bother. We defined 3 categories for OAB score and 4 categories for SUI score. The resulting 12 risk categories were then collapsed into 5 distinct risk-groups. These groups accurately predicted care-seeking in the testing set (area under the receiver operating curve, 0.760; 95% confidence interval, 0.713-0.807). Inclusion of other risk factors did not improve the model. CONCLUSIONS Symptom bother is a strong determinant of care-seeking in the first 2 decades after delivery. These results define 5 ordinal categories that predict seeking care for urinary symptoms in a community population.
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Bakarman MA, Al-Ghamdi SS. The Effect of Urinary Incontinence on Quality of Life of Women at Childbearing Age in Jeddah, Saudi Arabia. Glob J Health Sci 2015; 8:281-7. [PMID: 26383213 PMCID: PMC4803930 DOI: 10.5539/gjhs.v8n2p281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 07/11/2015] [Accepted: 04/14/2015] [Indexed: 11/23/2022] Open
Abstract
To estimate the prevalence of urinary incontinence among women of childbearing age at Maternity and Children’s Hospital (MCH), Jeddah, 2012, and to assess its impact on the quality of their life. A cross– sectional analytic approach was carried out among women of childbearing age seen at MCH, Jeddah. Systematic random sampling technique was followed. Each woman fulfilling the inclusion criteria was invited to enroled in the study, the inclusion criteria were women aged 15-50 years, agreed to participate in the study, the exclusion criteria were pregnant women and patients who are seriously ill. Self-administered questionnaire using the King’s Health Questionnaire was utilized to measure Health Related Quality of Life (HRQOL) of patients with UI. Out of 1200 patients attending the gynecology clinic in the MCH, 412 (34.3%) were diagnosed as having UI. Their age ranged between 15 and 50 years with a mean of 34.3 + 7.2 years. Almost 50% indicated that UI affected them badly as wife, mother, their emotions, and their physical and social activities. The most commonly occurring problems were frequent micturition (88.3%), nocturnal enuresis (87.9%). The least occurring, were kidney problems (38.6%) and dripping during sexual activities (40.8%). Increasing age and higher parity were significantly associated with limitations in different life domains. Urinary incontinence is common and often disturbing for Saudi women. It adversely impaired their quality of life.
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