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Özgül S, Gürşen C, Toprak Çelenay Ş, Baran E, Üzelpasacı E, Nakip G, Çinar GN, Beksaç MS, Akbayrak T. Contributory effects of individual characteristics on pelvic floor distress in women with pelvic floor dysfunctions. Physiother Theory Pract 2024; 40:625-636. [PMID: 36168816 DOI: 10.1080/09593985.2022.2127137] [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: 03/08/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To determine individual characteristics (i.e. sociodemographic and medical, obstetric and gynecological, and musculoskeletal and anthropometric parameters) for greater pelvic floor distress (PFD). METHODS A cross-sectional study was performed in 253 women with pelvic floor dysfunction. PFD was assessed using the Pelvic Floor Distress Inventory-20 (PFDI-20). The score of Urogenital Distress Inventory-6 (UDI-6) was used to perform secondary analyses. Sociodemographic, medical, and obstetric & gynecological parameters were recorded. Waist and hip circumferences and pelvic diameters were measured as anthropometric parameters. Pearson test, t-test, and linear regression analyses were conducted with a significance level of 0.05. RESULTS Education level (r = -0.23, p < .001; r = -0.24, p < .001), number of vaginal births (r = 0.15, p = .012; r = 0.12, p = .048), total vaginal birth weight (r = 0.15, p = .021; r = 0.16, p = .019), and Body Mass Index (r = 0.12, p = .043; r = 0.16, p = .007) were significantly correlated with the higher PFDI-20 and UDI-6 scores. The maternal age at the first vaginal birth (r = -0.13, p = .049) and pelvic antero-posterior diameter (r = 0.17, p = .013) were also significantly correlated with higher UDI-6 score. Linear regression analyses revealed that younger age (Beta coefficient (β) = -1.10, p = .005), greater symptom duration (β = 2.28, p = .001), the presence of chronic cough/constipation (β = 25.72, p = .001), and increased total vaginal birth weight (β = 2.38, p = .030) were associated with the greater PFDI-20 score. Increased pelvic antero-posterior diameter (β = 0.88, p = .049) was a contributory factor for the greater UDI-6 score. CONCLUSION This study showed that younger age, chronic cough/constipation, higher total vaginal birth weight, greater symptom duration, and pelvic antero-posterior diameter can be contributors of greater PFD. We suggest further longitudinal studies that better reveal the causal relationship between individual characteristics and PFD.
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Affiliation(s)
- Serap Özgül
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ceren Gürşen
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Şeyda Toprak Çelenay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Emine Baran
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hitit University, Corum, Turkey
| | - Esra Üzelpasacı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gülbala Nakip
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gamze Nalan Çinar
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Mehmet Sinan Beksaç
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Türkan Akbayrak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Volløyhaug I, Semmingsen T, Laukkanen AM, Karoliussen C, Bjørkøy K. Pelvic floor status in opera singers. a pilot study using transperineal ultrasound. BMC Womens Health 2024; 24:67. [PMID: 38267929 PMCID: PMC10809662 DOI: 10.1186/s12905-024-02895-6] [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: 09/30/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Control of pelvic floor muscles (PFM) is emphasized as important to obtain functional breath support in opera singing, but there is not much research that proves PFM function as part of breath support in classical singing. Transperineal ultrasound is a reliable method for quantification of PFM contraction in urogynecology. Our aim was to establish if transperineal ultrasound can be used for observation of movement of the PFM during singing and to quantify pelvic floor contraction. METHODS Cross sectional study of 10 professional opera singers examined with transperineal ultrasound in the supine position at rest and contraction, and standing at rest and during singing. Levator hiatal area was measured in a 3D rendered volume. Levator hiatal anteroposterior (AP) diameter and bladder neck distance from symphysis were measured in 2D images. RESULTS The AP diameter was shortened from supine rest to contraction (15 mm), standing (6 mm) and singing (9 mm), all p < 0.01. The bladder neck had a non-significant descent of 3 mm during singing. The mean proportional change in AP diameter from rest to contraction was 24.2% (moderate to strong contraction) and from rest to singing was 15% (weak to moderate contraction). CONCLUSIONS Transperineal ultrasound can be used to examine the PFM during singing. The classically trained singers had good voluntary PFM contraction and moderate contraction during singing. AP diameter was significantly shortened from supine to upright position, with further shortening during singing, confirming that female opera singers contracted their pelvic floor during singing.
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Affiliation(s)
- Ingrid Volløyhaug
- Department of Obstetrics and Gynaecology, St Olavs Hospital, Trondheim University Hospital, 3250, Torgarden, Trondheim, NO, 7006, Norway.
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Tuva Semmingsen
- Griegakademiet, UiB, Bergen, Norway
- RDAM, Copenhagen, Denmark
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Li Q, Cheng Y, Shi H, Xue K, Zhou F. Advances in the natural history of urinary incontinence in adult females. J OBSTET GYNAECOL 2023; 43:2171774. [PMID: 36772931 DOI: 10.1080/01443615.2023.2171774] [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: 02/12/2023]
Abstract
The aim of this review is to summarise the related characteristics of the natural history of female urinary incontinence (UI) using a narrative descriptive approach. PubMed, EMBASE and Web of Science were searched for articles published from 1 January 2010 to 1 January 2020 on the natural history of female UI, which including incidence, persistence, progression, remission, and regression of a single subtype of UI and the mutual influence of different UI subtypes. This literature review includes 15 articles published, indicates that UI is highly dynamic, with symptoms varying according to disease severity and subtype and influenced by multiple factors at different disease stages. Recent studies have increased our understanding of the natural history of UI. Future research should systematically analyse the progression of each subtype of UI and interactions between subtypes to prevent the progression of UI across females life course.
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Affiliation(s)
- Qianqian Li
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yun Cheng
- Xuzhou Maternity and Child Health Care Hospital, Xuzhou, China
| | - Hongli Shi
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Kaikai Xue
- Jiangsu College of Nursing, Huai'an, China
| | - Fang Zhou
- Dean of School of Nursing, Xuzhou Medical University, Xuzhou, China
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Shang X, Fu Y, Jin X, Wang C, Wang P, Guo P, Wang Y, Yan S. Association of overweight, obesity and risk of urinary incontinence in middle-aged and older women: a meta epidemiology study. Front Endocrinol (Lausanne) 2023; 14:1220551. [PMID: 37886637 PMCID: PMC10598345 DOI: 10.3389/fendo.2023.1220551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Aims The aim of this meta-analysis is to evaluate the potential correlation between obesity and overweight, and the vulnerability to urinary incontinence (UI) in women aged middle-aged and above. Methods We searched PubMed, Cochrane Library, and Embase for observational studies published between the inception of the databases and April 25, 2023. A fixed-effects model was used when the P>0.1 and the I2 ≤ 50%. In cases where I2 ≥ 50% (indicating significant heterogeneity), a random-effects model was applied. For the purpose of evaluating publication bias, a funnel plot and Egger's test were used. Stata 14.0 was used for all statistical analyses. Findings This meta-analysis includes 16 observational studies, covering29,618 individuals. The pooled analysis shows that being overweight(25 kg/m2≤BMI<30kg/m2) in middle-aged and elderly women is more likely to develop UI (OR=1.27; 95% CI: 1.17-1.37; I2 = 51.8%, P=0.013). Middle-aged and elderly women with obesity(30 kg/m2≤BMI<35 kg/m2) are significantly more likely to develop UI (OR=1.60; 95% CI: 1.42-1.81; I2 = 71.8%, P=0.000). In addition, the results indicated a higher probability of UI in middle-aged and older women with obesity class II (BMI≥35 kg/m2) (OR=1.85; 95% CI: 1.59-2.16; I2 = 48.1%, P=0.103). In subgroup analysis, there is no direct relationship between the obesity in middle-aged and elderly women and an increased risk of stress urinary incontinence (SUI) (OR=1.31; 95% CI: 0.99-1.74; I2 = 63.7%, P=0.011). In middle-aged and elderly women with obesity are more likely to develop urgent urinary incontinence (UUI) (OR=2.11; 95% CI: 1.54-2.89; I2 = 80.2%, P=0.000). Conclusion In this meta-analysis, overweight and obesity are associated with an increased risk of UI in middle-aged and elderly women. Obesity and overweight are independent risk factors for UI, as demonstrated by this study. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023421986.
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Affiliation(s)
- Xin Shang
- First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yu Fu
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaoqin Jin
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Chenxiao Wang
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ping Wang
- First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Panpan Guo
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ying Wang
- Department of Geriatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuxun Yan
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Yamashita K, Kijima Y, Sekido E, Nagasaka N, Inui M. Predictors of Long-Term Urinary Incontinence After Robot-Assisted Laparoscopic Prostatectomy. Res Rep Urol 2023; 15:387-393. [PMID: 37638328 PMCID: PMC10455970 DOI: 10.2147/rru.s419903] [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: 05/04/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Urinary incontinence is a major complication after radical prostatectomy. We analyzed the predictors of urinary incontinence after robot-assisted radical prostatectomy. Material and Methods One hundred twenty-one patients, whose urinary continence status was evaluable at 3 months, 6 months, and 12 months after robot-assisted radical prostatectomy, were included from October 2016 to September 2021. Data were retrospectively collected from electronic medical records. The continence status was evaluated by interviewing the patients about the number of urinary pads used per day. We compared the patients' age, body mass index, prostate volume, membranous urethral length on preoperative magnetic resonance imaging, surgeon experience, and pathological findings between patients with and without regained continence at 12 months after robot-assisted radical prostatectomy. Results The urinary continence rates were 30%, 57.8% and 79.3% at 3 months, 6 months, and 12 months, respectively, after robot-assisted radical prostatectomy. Twelve months after robot-assisted radical prostatectomy, 96 patients had regained continence and did not require urinary pads, whereas 25 patients had persistent urinary incontinence and required urinary pads. Membranous urethral length and surgeon experience were significantly different between patients with and without regained continence at 12 months after robot-assisted radical prostatectomy (P=0.05). However, no significant differences existed in age, body mass index, prostate volume, and pathological findings between patients with and without regained continence at 12 months after robot-assisted radical prostatectomy. Conclusion Membranous urethral length and surgeon experience are predictors of urinary incontinence after robot-assisted radical prostatectomy. Measuring the membranous urethral length is recommended before performing the operation.
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Affiliation(s)
- Kaori Yamashita
- Department of Urology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo-city, Japan
| | - Yu Kijima
- Department of Urology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo-city, Japan
| | - Eri Sekido
- Department of Urology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo-city, Japan
| | - Naoki Nagasaka
- Department of Urology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo-city, Japan
| | - Masashi Inui
- Department of Urology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo-city, Japan
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Mülkoğlu C, Ersever EM, Çakıt BD. Evaluation of incontinence and lymphedema in gynecological cancer patients along with their impact on the quality of life. Support Care Cancer 2023; 31:437. [PMID: 37395832 DOI: 10.1007/s00520-023-07896-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE The aim of this study is to evaluate the patients who developed both urinary incontinence and lymphedema in gynecological cancer survivors and to investigate the impact of these conditions on the quality of life among these patients. METHODS Our study included 56 patients who have lymphedema and urinary incontinence which started within first 2 years after surgery for gynecological cancer. We evaluated the presence of urinary incontinence by Overactive Bladder Assessment Tool (OABT) and Urogenital Distress Inventory (UDI). Incontinence Impact Questionnaire (IIQ-7) was used to assess the quality of life. RESULTS OABT and UDI scores were found to be statistically significantly increased in patients with grade 3 lymphedema (respectively p: 0.006, p: 0.008). A statistically significant difference was found between lymphedema grade 1-2-3 patients in terms of IIQ-7 (p:0.002). The difference was statistically significant between the grade 1-3 (p:0.001) and grade 2-3 (p:0.013) groups. We did not find any correlation between age, type of cancer, radiotherapy, and urinary incontinence. There was a statistically significant positive correlation between BMI and OABT, UDI scores (respectively, r = 0.43, p = 0.001; r = 0.38, p = 0.003). CONCLUSION It was concluded that there was a relationship between urinary incontinence and grade 3 lymphedema in gynecological cancer survivors. Grade 3 lymphedema increases urinary incontinence and worsens daily living functions in these patients.
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Affiliation(s)
- Cevriye Mülkoğlu
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Emine Merve Ersever
- Department of Physical Therapy, Ankara Training and Research Hospital, Ankara, Turkey
| | - Burcu Duyur Çakıt
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
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Hjorth S, Axelsen SM, Gommesen D, Kjeldsen ACM, Taastrøm KA, Nohr EA. Body mass index, waist circumference, and urinary incontinence in midlife: A follow-up of mothers in the Danish National Birth Cohort. Neurourol Urodyn 2023. [PMID: 36942471 DOI: 10.1002/nau.25175] [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: 08/31/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Obesity is a modifiable risk factor for urinary incontinence, yet few studies have investigated how waist circumference as compared to body mass index (BMI) influences the risk of urinary incontinence. OBJECTIVE To estimate how BMI and waist circumference associates with risk of urinary incontinence in midlife and determine which of the two is the strongest predictor of urinary incontinence. METHODS Cohort study among mothers in the Danish National Birth Cohort. Weight and waist circumference were self-reported 7 years after cohort entry. Symptoms of urinary incontinence in midlife were self-reported using the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and analyzed continuously and as presence or absence of any, stress (SUI), urgency (UUI), and mixed (MUI) urinary incontinence. Linear and log binomial regressions were used to calculate mean differences and risk ratios (RR) with 95% confidence intervals (CI). Restricted cubic splines were generated to explore nonlinear relationships. RESULTS Among 27 254 women at a mean age of 44.2 years, any urinary incontinence was reported by 32.1%, SUI by 20.9%, UUI by 2.4%, and MUI by 8.6%. For all outcomes, increases in risk were similar with higher BMI and waist circumference. The estimates of association were strongest for MUI (RR 1.10, 95% CI 1.08;1.12 and RR 1.12, 95% CI 1.10;1.14 for half a standard deviation increase in BMI and waist circumference, respectively). While increases in risk of the other outcomes were seen across the entire range of BMI and waist circumference, the risk of SUI rose until BMI 28 kg/m2 (waist circumference 95 cm), and then fell slightly. CONCLUSIONS Symptoms of urinary incontinence and prevalence of any urinary incontinence, SUI, UUI, and MUI increased with higher BMI and waist circumference. Self-reported BMI and waist circumference were equally predictive of urinary incontinence.
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Affiliation(s)
- Sarah Hjorth
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Susanne M Axelsen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Gommesen
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Anne C M Kjeldsen
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Katja A Taastrøm
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Ellen A Nohr
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
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Impact of Weight Gain on Surgical Outcomes and Quality of Life among Women after Sling Surgeries. J Minim Invasive Gynecol 2023; 30:199-204. [PMID: 36442756 DOI: 10.1016/j.jmig.2022.11.014] [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: 05/11/2022] [Revised: 10/16/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE To investigate the impact of body weight gain after sling surgeries on outcomes in women with stress urinary incontinence. DESIGN A single-center, retrospective study. SETTING Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taiwan. PATIENTS A total of 248 women who underwent sling surgeries from 2010 to 2015 were reviewed. Patients who gained more than 10% body weight were compared with those with stable body weight. INTERVENTIONS Midurethral sling surgery with single-incision, transobturator, or retropubic slings. MEASUREMENTS AND MAIN RESULTS Objective success was defined as no urine leakage during the stress test in the filling phase of urodynamic studies. De novo overactive bladder (OAB) was defined as the appearance of urgency, frequency, and/or nocturia, with or without urinary incontinence after midurethral sling surgery persisting after 6 months. Quality of life evaluations included the short forms of the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7. A total of 248 women who underwent sling surgeries and had complete weight measurement and evaluation data before and after the surgeries were included, of whom 47 gained body weight, and 201 had a stable body weight. The median follow-up duration was 18 months (range, 6-47 months). There were no significant differences in surgical outcomes between the 2 groups regarding objective cure rate (86% vs 87%, p = .834), 1-hour pad test (4.5 ± 17.8 vs 3.6 ± 18.6 g, p = .770), or postoperative quality of life (Urogenital Distress Inventory-6: 1.9 ± 2.8 vs 2.8 ± 3.2, p = .122; Incontinence Impact Questionnaire-7: 1.8 ± 3.9 vs 2.6 ± 4.3, p = .307). A trend toward increased de novo OAB rate was observed, although this finding was not adequately powered. CONCLUSION Weight gain after sling surgeries did not influence surgical outcomes, but there was a nonsignificant trend toward increased OAB in the weight gain group. It may be beneficial to counsel patients with regard to body weight maintenance after sling surgeries.
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Dominguez-Antuña E, Diz JC, Suárez-Iglesias D, Ayán C. Prevalence of urinary incontinence in female CrossFit athletes: a systematic review with meta-analysis. Int Urogynecol J 2023; 34:621-634. [PMID: 35635565 PMCID: PMC9150382 DOI: 10.1007/s00192-022-05244-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Studies on the prevalence of urinary incontinence (UI) among CrossFit practitioners are on the rise. This systematic review with meta-analysis was aimed at determining the prevalence of UI among CrossFit practitioners. METHODS A systematic review of the literature was performed by searching MEDLINE/PubMed, Scopus, and SPORTDiscus through January 2021. The search strategy included the keywords CrossFit, urine incontinence, exercise, high impact and pelvic floor dysfunction. The inclusion criterion was any study with a sample of CrossFit practitioners and results separated from the other fitness modalities analysed. The subjects were women with no restriction of age, parity, experience or frequency of training. Quality assessment of the studies included was conducted using the Oxford Centre of Evidence-Based Medicine scale and the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. RESULTS Thirteen studies (6 comparative and 7 non-comparative) were included for the systematic review, all using a cross-sectional design. The level of evidence was 4, with their quality ranging from poor (n = 10) to fair (n = 3). A total of 4,823 women aged 18 to 71 were included, 91.0% participated in CrossFit, and 1,637 presented UI, which indicates a prevalence of 44.5%. Also, 55.3% and 40.7% presented mild or moderate UI respectively. Stress UI was the most common type reported (81.2%). CONCLUSIONS The factors that increased the likelihood of UI were age, body mass index and parity. Exercises based on jumps were commonly associated with urine leakage. CrossFit practitioners presented higher UI than control groups.
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Affiliation(s)
| | - José Carlos Diz
- Unidad de Cuidados Intensivos, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.,Departamento de Didácticas Especiais, Universidade de Vigo, Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Pontevedra, Spain
| | - David Suárez-Iglesias
- VALFIS Research Group, Institute of Biomedicine (IBIOMED), Faculty of Physical Activity and Sports Sciences, University of León, León, Spain.
| | - Carlos Ayán
- Departamento de Didácticas Especiais, Universidade de Vigo, Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Pontevedra, Spain
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Shi Q, Wen L, Zhao B, Huang S, Liu D. The Association of Hiatal Dimensions and Urethral Mobility With Stress Urinary Incontinence. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:671-677. [PMID: 33987879 DOI: 10.1002/jum.15748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/16/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To investigate the association of hiatal area (HA), bladder neck mobility, and urethral mobility during the cough stress test (CST) with stress urinary incontinence (SUI). METHODS This was a prospective study of 110 continent and 190 incontinent women using transperineal ultrasound. HA, bladder neck mobility, and the mobility of six points along the urethra (Vectors 1-6) were measured. The cohort was randomly divided at a ratio of 2:1 into a training cohort and a validation cohort. The correlations of HA with bladder neck mobility, urethral mobility, and SUI were tested. The predictive model was yielded by fisher linear discriminant analysis and receiver operating characteristics to assess the parameters' ability to predict SUI. RESULTS Valid data were collected from 177 incontinent women and 105 continent women. Significant differences were identified in HA, body mass index (BMI), funneling, bladder neck mobility, and Vectors 1-6 between them. HA was positively correlated to bladder neck mobility. In the training cohort, bladder neck position on Valsalva, Vectors 3, and BMI had the area under curves of 0.74, 0.69, and 0.66 (all P < 0.001); Funneling and Vector 3 had odds ratios of 18.96 and 3.65 (all P < 0.001), for predicting SUI. The predictive model incorporating funneling, Vectors 3, and BMI provided the best performance in predicting SUI in both cohorts. CONCLUSION The larger the HA was, the higher the bladder neck mobility. However, it was mid-urethral mobility rather than bladder neck mobility that performed best at predicting SUI.
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Affiliation(s)
- Qingling Shi
- Second Xiangya Hospital, Central South University, China
| | - Lieming Wen
- Second Xiangya Hospital, Central South University, China
| | - Baihua Zhao
- Second Xiangya Hospital, Central South University, China
| | - Shanya Huang
- Second Xiangya Hospital, Central South University, China
| | - Dan Liu
- Second Xiangya Hospital, Central South University, China
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Rajavuori A, Repo JP, Häkkinen A, Palonen P, Multanen J, Aukee P. Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol X 2021; 13:100138. [PMID: 34825175 PMCID: PMC8605044 DOI: 10.1016/j.eurox.2021.100138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 11/18/2022] Open
Abstract
Urinary incontinence after delivery affects every fifth woman. Urinary incontinence before pregnancy is a risk factor of postpartum incontinence. Primiparous women are at a greater risk of urinary incontinence after birth.
Introduction Urinary incontinence (UI) during pregnancy is a common health problem. Vaginal delivery in particular affects the pelvic floor and increases the risk of pelvic floor dysfunctions. This prospective cohort study was conducted to investigate the incidence of UI during pregnancy and three months postpartum and determine the risk factors underlying UI. Methods In total, 547 volunteer women were recruited from the maternity clinic of a tertiary hospital. The participants filled out a questionnaire twice, one in the second trimester and the other three months after delivery. A multivariate logistic regression model with forward stepwise selection was used to analyze known risk factors for UI. Results The prevalence of UI during pregnancy was 39.5% and three months after childbirth 16.1%. Twenty-two percent of participants had pre-existing UI compared to 41.0% of the 88 women with UI three months postpartum. UI before pregnancy (OR 2.2), during pregnancy (OR 3.8) and primiparity (OR 2.3) were significantly associated with postpartum UI. Conclusions Women with UI before or during pregnancy and who are primiparous are at increased risk for postpartum UI. To prevent and reduce the risk factors contributing to UI, pregnant women should be routinely counseled.
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Affiliation(s)
- Anna Rajavuori
- Department of Obstetrics and Gynecology, Turku University Hospital, PL 52, 20521 Turku, Finland
- Correspondence to: TYKS Obstetrics and Gynecology, PL 52, 20521 Turku, Finland.
| | - Jussi P. Repo
- Department of Orthopedics and Traumatology, Tampere University Hospital, PL 2000, 33521 Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, PL 35, FI-40014 Jyväskylän yliopisto, Finland
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Pirkko Palonen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, PL 35, FI-40014 Jyväskylän yliopisto, Finland
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology and Pelvic Floor Research and Therapy Unit, Central Finland Health Care Center, Hoitajantie 3, 40620 Jyväskylä, Finland
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12
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Yin S, Wu L, Huang Z, Fan Y, Lin T, Song T. Nonlinear relationship between body mass index and clinical outcomes after kidney transplantation: A dose-response meta-analysis of 50 observational studies. Surgery 2021; 171:1396-1405. [PMID: 34838329 DOI: 10.1016/j.surg.2021.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Exact dose-response relationship between body mass index at transplantation and clinical outcomes after kidney transplantation remained unclear, and no specific body mass index threshold and pretransplant weight loss aim were recommended for kidney transplantation candidates among transplant centers. METHODS PubMed, Embase, Web of Science, and Cochrane Library were searched for literature published up to December 31, 2019. The two-stage, random effect meta-analysis was performed to estimate the dose-response relationship between body mass index and clinical outcomes after kidney transplantation. RESULTS Ninety-four studies were included for qualitative assessment and 50 for dose-response meta-analyses. There was a U-shaped relationship between graft loss, patient death, and body mass index. Body mass index with the lowest risk of graft loss was 25.2 kg/m2, and preferred body mass index range was 22-28 kg/m2. Referring to a body mass index of 22 kg/m2, the risk of graft loss was 1.088, 0.981, 1.003, and 1.685 for a body mass index of 18, 24, 28, and 40 kg/m2, respectively. Body mass index with the lowest risk of patient death was 24.7 kg/m2, and preferred body mass index range was 22-27 kg/m2. Referring to a body mass index of 22 kg/m2, the patient death risk was 1.115, 0.981, 1.032, and 2.634 for a body mass index of 18, 24, 28, and 40 kg/m2, respectively. J-shaped relationships were observed between body mass index and acute rejection, delayed graft function, primary graft nonfunction, and de novo diabetes. Pair-wise comparisons showed that higher body mass index was also a risk factor for cardiovascular diseases, hypertension, infection, longer length of hospital stay, and lower estimated glomerular filtration rate level. CONCLUSION Underweight and severe obesity at transplantation are associated with a significantly increased risk of graft loss and patient death. A target body mass index at kidney transplantation is 22-27 kg/m2.
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Affiliation(s)
- Saifu Yin
- Urology Department, Urology Research Institute, Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Linyan Wu
- Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Zhongli Huang
- Urology Department, Urology Research Institute, Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Yu Fan
- Urology Department, Urology Research Institute, Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Tao Lin
- Urology Department, Urology Research Institute, Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Turun Song
- Urology Department, Urology Research Institute, Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
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Takahashi S, Mishima Y, Kuroishi K, Ukai M. Efficacy of mirabegron, a β 3 -adrenoreceptor agonist, in Japanese women with overactive bladder and either urgency urinary incontinence or mixed urinary incontinence: Post-hoc analysis of pooled data from two randomized, placebo-controlled, double-blind studies. Int J Urol 2021; 29:7-15. [PMID: 34605079 PMCID: PMC9293404 DOI: 10.1111/iju.14700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Objective To confirm if mirabegron 50 mg shows efficacy in women with overactive bladder and either urgency urinary incontinence or mixed urinary incontinence versus placebo. Methods Post‐hoc analyses were carried out using pooled data from a Japanese phase IIb and a phase III study. The primary efficacy end‐point was baseline to end‐of‐treatment change in the mean number of micturitions/24 h. The secondary end‐points were changes in the mean voided volume/micturition, mean number of urgency and incontinence episodes/24 h, and mean number of nocturia episodes/night. Other end‐points were quality of life and incontinence normalization rates. Results Women with urgency urinary incontinence (placebo n = 204, mirabegron n = 214) and mixed urinary incontinence (placebo n = 122, mirabegron n = 139) were included. Change in mean micturitions/24 h at end‐of‐treatment for mirabegron was statistically significant versus placebo in both populations; the effect size increased over time. For all secondary end‐points, median changes for mirabegron were statistically significant versus placebo at end‐of‐treatment, except for nocturia for the urgency urinary incontinence population and urgency for the mixed urinary incontinence population. Mirabegron showed larger improvements versus placebo in all quality‐of‐life domains, except for general health perception in the urgency urinary incontinence population. Incontinence normalization rates for mirabegron were 47.2% and 49.6% in the urgency urinary incontinence and mixed urinary incontinence populations, respectively, versus 42.6% and 39.3% for placebo. Conclusions Mirabegron 50 mg significantly improved key overactive bladder symptoms versus placebo in women with urgency urinary incontinence, and it also improved most overactive bladder symptoms, including micturition frequency, in patients with mixed urinary incontinence. These findings support the benefits of using mirabegron in the female overactive bladder wet population.
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Baer R, Tene L, Weintraub AY, Kalichman L. The effect of vitamin D deficiency and supplementation on urinary incontinence: scoping review. Int Urogynecol J 2021; 33:1083-1090. [PMID: 34491371 DOI: 10.1007/s00192-021-04963-z] [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: 04/14/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Vitamin D receptors are found in skeletal and smooth muscle cells throughout the body, specifically in the bladder detrusor muscle. We reviewed the current literature on the association between vitamin D deficiency and urinary incontinence (UI), and whether vitamin D supplementation plays a role in the treatment of UI symptoms. METHODS We performed a scoping review of all available studies. PubMed, Google Scholar, and PEDro databases were searched from inception until August 2020 with the keywords "urinary incontinence," "pelvic floor disorders," "lower urinary tract symptoms," "overactive bladder," and various terms for vitamin D. No language restrictions were imposed. The reference lists of all retrieved articles were also searched. RESULTS The search revealed 12 studies of different research methodologies after elimination. In 6 out of the 7 cross-sectional studies reviewed, a significant association between vitamin D deficiency or insufficiency and the onset and severity of UI was found. In 2 out of the 3 prospective studies included, no association between vitamin D intake and UI was found; however, both randomized controlled trials that were reviewed found that vitamin D supplementation is effective for the treatment of UI. CONCLUSIONS The existing literature supports an association between low levels of serum vitamin D and UI. Initial evidence regarding the effect of vitamin D supplementation on UI is accumulating, yet additional, comprehensive research is warranted to establish these findings.
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Affiliation(s)
- Ronnie Baer
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer Sheva, Israel
| | - Lea Tene
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer Sheva, Israel.
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Leonid Kalichman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer Sheva, Israel
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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: 82] [Impact Index Per Article: 27.3] [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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16
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Habitus and Pelvic Floor Symptoms and Support 1 Year Postpartum. Obstet Gynecol 2021; 137:821-830. [PMID: 33831903 DOI: 10.1097/aog.0000000000004349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/28/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the association between habitus measures and pelvic floor support and symptoms in primiparous women 1 year after term vaginal delivery. METHODS In this cross-sectional study including women enrolled at seven academic and community sites, we assessed pelvic floor support, weight, height, waist circumference, and percent fat using air displacement plethysmography and participants completed questionnaires, all at one year postpartum. We tested the association of quintiles of habitus measure, including body mass index (BMI), waist circumference, percent body fat, and waist/height ratio, with the primary outcomes: anatomic support, dichotomized as maximal vaginal descent less than 0 cm (better support) compared with 0 cm or more (worse support) per the pelvic organ prolapse quantification examination and symptom burden (positive with bothersome symptoms in two or more of six symptom domains), and on five secondary outcomes. The sample size provides 90% power to detect odds ratios (ORs) of 1.78 or greater between women at mean compared with mean+1 SD of habitus measure. RESULTS Of 592 participants, 55 (9.3%) demonstrated worse support and 321 (54.2%) symptom burden. In multivariable analyses, habitus measures were not significantly associated with anatomic support or, except for the highest waist/height ratio quintile, with symptom burden. Compared with women in the first quintile of each habitus measure, those in most higher quintiles demonstrated elevated odds of moderate to severe urinary incontinence (UI); increased odds for stress urinary incontinence (SUI) were mainly limited to the highest quintile. After adjusting for percent body fat, the increased odds for BMI on SUI (OR 2.47, 95% CI 1.43-4.28) were no longer significant (OR 1.38, 95% CI 0.54, 3.51). CONCLUSION Habitus in primiparous patients at 1 year postpartum was not associated with anatomic support or symptom burden. Habitus was more associated with moderate to severe UI than mild UI. The association of higher BMI with SUI was attenuated by fitness, reflected by fat percentage.
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17
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Zhao B, Wen L, Liu D, Huang S. Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography. Ultrasonography 2021; 41:171-176. [PMID: 34399041 PMCID: PMC8696134 DOI: 10.14366/usg.21058] [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: 03/10/2021] [Accepted: 06/15/2021] [Indexed: 11/05/2022] Open
Abstract
Purpose The aim of this study was to explore differences in the bladder neck configuration and segmental urethral mobility during the cough stress test (CST) in the supine and standing positions between women with and without stress urinary incontinence (SUI). Methods This prospective study included 100 control women and 100 incontinent women who had a CST with transperineal ultrasonography. The bladder neck configuration and urethral mobility were described in terms of urethral funneling, bladder neck descent (BND), retrovesical angle (RVA), urethral rotation angle, and urethral mobility at six points along the urethra (vectors 1 to 6). The two groups’ ultrasound findings in the two positions were compared. Results Valid data were collected from 78 control women and 90 women with SUI. Significant differences were found in age and body mass index between the two groups (P<0.01). Urethral funneling was found in 33 women (36.7%) with SUI and five continent women (6.4%) and altered little in the standing position. In the standing position, the mean RVA significantly increased (160° to 179°, P<0.001) in the SUI group; The mean vector of points 1 to 6 significantly increased in the control group (all P<0.001). The RVA, BND, and vectors 1 to 4 were significantly greater (all P≤0.01) in women with SUI than without, in both positions. Conclusion Urethral funneling was an intrinsic anatomical characteristic relative to SUI. Weak upper- and mid-urethral support and an unstable connection between the trigone and proximal urethra were the anatomical signs of SUI.
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Affiliation(s)
- Baihua Zhao
- Department of Ultrasound Diagnosis, Second Xiangya Hospital, Central South University, China
| | - Lieming Wen
- Department of Ultrasound Diagnosis, Second Xiangya Hospital, Central South University, China
| | - Dan Liu
- Department of Ultrasound Diagnosis, Second Xiangya Hospital, Central South University, China
| | - Shanya Huang
- Department of Ultrasound Diagnosis, Second Xiangya Hospital, Central South University, China
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Hill JE, Christian D, Shaw K, Clegg A. Weight loss interventions as an option for a lifestyle treatment in urinary incontinence. Br J Community Nurs 2020; 25:616-619. [PMID: 33275503 DOI: 10.12968/bjcn.2020.25.12.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Danielle Christian
- Senior Research Assistant, Stroke Research Team, University of Central Lancashire, Preston
| | - Kelly Shaw
- Specialist Physiotherapist in Women's Health, Lancashire Teaching Hospitals
| | - Andrew Clegg
- Professor of Health Services Research, Health Technology Assessment Group University of Central Lancashire, Preston
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Abstract
PURPOSE OF REVIEW Despite available treatments for urinary incontinence, the data regarding prevention is less established. This review sought to identify prevention measures and discuss their underlying evidence base with an attempt to include the most recent updates in the field. RECENT FINDINGS Urinary incontinence is a prevalent issue among women, particularly surrounding pregnancy and menopause. Interventions regarding pregnancy include not only general health promotion but also potentially interventions such as pelvic floor muscle training and decisions regarding method of delivery. With regard to menopause, the literature suggests avoiding treatments that have adverse effects on continence. Lastly, promoting healthy life style and reducing effects of co-morbid conditions can impact a woman's continence. The literature indicates that preventative strategies exist for urinary incontinence, though the data is limited in this area. Further work is needed to determine the impact of prevention measures and how best to implement them.
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Affiliation(s)
- Amanda R Swanton
- Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - E Ann Gormley
- Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH, 03756, USA.
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Lee KY, Lee JI, Park YY, Kim YS, Lee DH, Chae HS, Lee TK, Sohn TS, Jeong SC, Lee YB, Han K. Hemorrhoids Are Associated with Urinary Incontinence. J Womens Health (Larchmt) 2020; 29:1464-1468. [PMID: 32762610 DOI: 10.1089/jwh.2019.8168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Hemorrhoids are a common anal disorder and are more frequent in women than in men. Urinary incontinence (UI) also occurs more frequently in women than in men. Although both diseases share similar risk factors, research on the association between the two diseases is lacking. This study aimed to investigate the relationship between hemorrhoids and UI in adult Korean women. Methods: This study was based on the data of the 2008-2009 Korean National Health and Nutrition Examination Survey. Logistic regression test was performed to determine the relationship between hemorrhoids and UI after adjusting for age, body mass index (BMI), smoking, heavy drinking, physical activity, education level, income, diabetes mellitus, and hypertension. Results: Analysis of the data of 8,139 adult women revealed that the prevalence of hemorrhoids, which were self-reported and diagnosed by a physician, was 17.5% and 7.9%, respectively. Both types of hemorrhoids were more prevalent in older women with spouses, those with a large waist circumference, and those with a high BMI. The prevalence of UI was significantly high in the hemorrhoid group, regardless of whether it was self-reported or diagnosed by a physician. Multiple logistic regression analyses revealed a significant association between the prevalence of UI and hemorrhoids, both of which were found to peak at 19-39 years of age. Conclusions: Our findings demonstrate that hemorrhoids are significantly correlated with UI in adult Korean women. When treating adult women with hemorrhoids, it is, therefore, necessary to consider other pelvic floor diseases such as UI.
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Affiliation(s)
- Kil-Yong Lee
- Department of Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Jae Im Lee
- Department of Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu-si, Korea.,Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Youn Young Park
- Department of Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Young Soo Kim
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Dong-Hee Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Hyun Suk Chae
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Tae-Kyu Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Tae Seo Sohn
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Seong Cheol Jeong
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Young Bok Lee
- Epidemiology Study Cluster of Uijeongbu St. Mary's Hospital, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Korea
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Abstract
Urinary incontinence is a common problem affecting 25-45% women. Effective management can have a huge impact on a patient's quality of life and many treatments are available. Management should be dictated by the degree of bother the symptoms are having, and vary depending on the type on incontinence. Conservative measures should always be initiated, including optimisation of body mass index and smoking cessation. Overactive bladder and urge urinary incontinence can be improved with bladder retraining and avoidance of bladder stimulants. Medical treatment then includes anticholinergic medications or Mirabegron. More invasive options include Botulinum Toxin A (Botox®) injections, sacral nerve stimulation or urological surgery. Stress urinary incontinence should be managed initially with pelvic floor exercises, and input from a specialist nurse or physiotherapist is beneficial. The surgical options for managing stress incontinence have changed considerably over the years, but include bladder neck injections, mid-urethral slings, colposuspension or autologous fascial slings. Mixed urinary incontinence is more challenging to manage, but all conservative measures should be started. Further treatment is directed towards the predominant symptom, but overactivity should be controlled before surgical measures for stress urinary incontinence are performed.
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Bovbjerg ML, Irvin V. Current Resources for Evidence-Based Practice, March 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:212-222. [PMID: 32061594 DOI: 10.1016/j.jogn.2020.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of the concept of overdiagnosis and implications for research and commentaries on reviews focused on exogenous progestogen to maintain pregnancies and cancer risk among children conceived using fertility treatments.
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