Female Voiding Dysfunction and Urinary Incontinence

State of the Art of Non-Invasive Technologies for Bladder Monitoring: A Scoping Review

Bladder monitoring, including urinary incontinence management and bladder urinary volume monitoring, is a vital part of urological care. Urinary incontinence is a common medical condition affecting the quality of life of more than 420 million people worldwide, and bladder urinary volume is an important indicator to evaluate the function and health of the bladder. Previous studies on non-invasive techniques for urinary incontinence management technology, bladder activity and bladder urine volume monitoring have been conducted. This scoping review outlines the prevalence of bladder monitoring with a focus on recent developments in smart incontinence care wearable devices and the latest technologies for non-invasive bladder urine volume monitoring using ultrasound, optical and electrical bioimpedance techniques. The results found are promising and their application will improve the well-being of the population suffering from neurogenic dysfunction of the bladder and the management of urinary incontinence. The latest research advances in bladder urinary volume monitoring and urinary incontinence management have significantly improved existing market products and solutions and will enable the development of more effective future solutions.

Living with Urinary Incontinence: Potential Risks of Women's Health? A Qualitative Study on the Perspectives of Female Patients Seeking Care for the First Time in a Specialized Center

Background: Urinary incontinence (UI) represents a complex problem which commonly affects women and influences their physical, mental, and social wellbeing. The objective of this study was to explore the experiences of a group of women with urinary incontinence. Methods: A qualitative exploratory study. Purposeful sampling was used. Recruited patients were females aged >18 years old with positive symptoms, signs of urinary incontinence, and attending a specialized urinary incontinence center for the first time. We collected data using interviews and participants’ personal letters. A thematic analysis was performed. Results: 18 women participated with a mean age of 47.32 years. Four themes emerged: (a) Experiencing uncontrolled urinary leakage, (b) Information based on beliefs and myths regarding UI, (c) Adapting to change and developing strategies, (d) The role of education. Women’s experiences were accompanied by feelings of stress and shame. A lack of information regarding UI was found, together with numerous misconceptions. Urinary incontinence triggers many changes in women. Some women may develop feelings of rejection towards their own body. Family involvement during these times is essential for education and promoting healthy sexual practices. Conclusions: This study highlights the importance of developing educational programs that focus on women’s information and education regarding triggering factors and coping strategies.

Severity of urinary incontinence is associated with prevalence of sexual dysfunction

INTRODUCTION AND HYPOTHESIS

Urinary incontinence (UI) affects overall health-related and sexual quality of life (QoL) in women. There is no consensus on the impact of severity and type of UI on the prevalence of sexual dysfunction (DS). The aim of this study was to evaluate the association between types and severity of UI and DS.

METHODS

A cross-sectional study of women with UI.

INCLUSION CRITERIA

women complaining of UI and > 18 years old. Women with a history of previous treatment for UI, recurrent urinary tract infections, renal lithiasis, previous radiation therapy or pelvic organ prolapse above stage 2 in the Pelvic Organ Prolapse Quantification (POP-Q) system were excluded. Clinical and epidemiological data were collected, and the following questionnaires were applied: ICIQ-SF, ICIQ-OAB, King's Health Questionnaire (KHQ) and Female Sexual Function Index (FSFI).

RESULTS

Concerning the type of UI, the majority of women had MUI (69.1%) and 56.8% reported having coital UI. The mean score was 20.81 ± 8.45 in the FSFI questionnaire. There was a prevalence of SD in 71.6% of women, with no difference in types of UI (p = 0.753) and loss during sexual intercourse (p = 0.217). There was a correlation between severity of UI (ICIQ-SF) and arousal (r = -0.26; p = 0.008), lubrication (r = -0.25; p = 0.009), orgasm (r = -0.25; p = 0.009), pain (r = -0.26; p = 0.007) and total (r = -0.28; p = 0.004) domain scores.

CONCLUSIONS

There is a high prevalence of SD in women with urinary incontinence, irrespective of the type of UI and urine leakage during sexual intercourse. However, the greater the severity of UI is, the worse the sexuality questionnaire scores.

Efficacy and tolerability of mirabegron in female patients with overactive bladder symptoms after surgical treatment for stress urinary incontinence

PURPOSE

To evaluate the efficacy and tolerability of mirabegron in females with overactive bladder (OAB) symptoms after surgical treatment for stress urinary incontinence (SUI).

MATERIALS AND METHODS

The study was conducted with a prospective, randomized and double-blinded design. 62 patients over the age of 40 who met the inclusion-exclusion criterias of the study were enrolled and randomly divided into two groups as Group A (mirabegron 50mg) and B (solifenacin 5mg). Patients were compared based on efficacy of treatment [Patient Perception of Bladder Condition (PPBC) scale and micturition diaries], safety of treatment (heart rate, systolic and diastolic blood pressure, adverse events), number of micturitions per day, patient's satisfaction status after treatment [Visual Analog Scale(VAS)] and quality of life.

RESULTS

The mean age of the population was 48.2±3.8 years and the duration of OAB symptoms was 5.9±2.9 months. Baseline values for the mean number of micturitions, volume voided in each micturition, nocturia episodes, urgency and urgency incontinence episodes were 15.3±0.34, 128±3.88mL, 3.96±1.67, 5.72±1.35 and 4.22±0.69, respectively. After treatment, values for these parameters were 11.7±0.29, 164.7±2.9mL, 2.25±0.6, 3.38±0.71, 2.31±0.49 respectively. Quality of life score, symptom bother score, VAS for treatment satisfaction score, PPBC score after treatment were 66.1±0.85, 43.7±0.77, 4.78±0.14, 4.78±0.14, respectively. There were no significant differences between two groups on any parameter. However, mirabegron showed better tolerability than solifenacin, particularly after 6 months.

CONCLUSION

Mirabegron is safe, effective and tolerable in the long-term treatment of females with OAB symptoms after surgery for stress urinary incontinence.