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Dimli BO, Mutlu EK, Altac DS, Taskiran H. Comparison of the effects of pelvic floor muscle training and modified pilates exercises in elderly women with stress urinary incontinence: A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2024; 300:327-336. [PMID: 39084033 DOI: 10.1016/j.ejogrb.2024.07.033] [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: 03/06/2024] [Revised: 05/13/2024] [Accepted: 07/14/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE The aim of this study was to compare the effects of pelvic floor muscle training (PFMT) and modified pilates exercises (MPE) in elderly women with stress urinary incontinence (SUI). STUDY DESIGN Both randomized groups [Group 1: PFMT (n = 17), Group 2: MPE (n = 17)] performed their exercises twice a week for 12 weeks. Incontinence Severity Index (ISI), Urogenital Distress Inventory-Short Form (UDI-6) and Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to assess SUI frequency and level of exposure from symptoms, electromyography (EMG) device was used to assess PFM activation response and a stabilizer was used to assess transversus abdominis (TrA) muscle strength. The assessments were performed at baseline and at week 12. RESULTS While in-group assessment there were statistically significant differences in ISI, UDI-6, IIQ-7 in both groups at week 12 (p < 0.05); in the assessment between groups, there were statistically significant difference for EMG-work avarage (U = 60.00, P = 0.02), EMG-work peak (U = 62,50, P = 0.03) and EMG-rest peak (U = 61,50, P = 0.03) in favor of Group 1 and TrA muscle strength (U = 61.00, P = 0.02) in favor of Group 2 from baseline to week 12 (p < 0.05). CONCLUSION In summary, MPE can be considered alternative and safe exercise in clinic for elderly women with SUI who do not want to receive PFMT for various reasons.
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Affiliation(s)
- Berna Okdemir Dimli
- Istanbul Aydin University, Institute of Graduate Education, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Bandirma Onyedi Eylul University, Faculty of Health Science, Division of Physiotherapy and Rehabilitation, Bandirma, Turkey
| | - Duygu Sahin Altac
- Halic University, Faculty of Health Science, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Hanifegul Taskiran
- Istanbul Aydin University, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey
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VanWiel L, Unke M, Samuelson RJ, Whitaker KM. Associations of pelvic floor dysfunction and postnatal mental health: a systematic review. J Reprod Infant Psychol 2024:1-22. [PMID: 38357811 DOI: 10.1080/02646838.2024.2314720] [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: 09/14/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Postpartum mental health conditions are common and can have devastating effects for both mother and infant. Adverse birth outcomes increase the risk of postnatal mental health conditions. Pelvic floor dysfunction (PFD) is a common adverse pregnancy outcome that may be a risk factor for postnatal mental health conditions. There are many studies reporting associations between PFD and postnatal mental health conditions, but no reports have synthesised the current literature as it relates to pregnancy and the postpartum period. METHODS A research librarian conducted systematic literature searches using terms concerning PFD, postnatal mental health conditions, and pregnancy. Searches were conducted within PubMed, Embase, CINAHL, Cochrane, and Scopus. Two reviewers independently rated each study for inclusion and study quality. No studies were excluded based on quality. RESULTS A total of 47 studies were included for review. Articles addressed sexual dysfunction (n = 11), incontinence (n = 21), perineal laceration (n = 13), pelvic organ prolapse (n = 2), and general pelvic floor symptoms (n = 2) and associations with postnatal mental health conditions. Two articles addressed more than one type of PFD. The majority (44 studies) reported associations between PFD and adverse postnatal mental health conditions. DISCUSSION Most studies included for review found consistent associations between PFD and adverse mental health conditions. Healthcare providers should screen for PFD and postnatal mental health conditions early in the postpartum period. Future research should investigate whether the treatment of PFD can modify the associations between PFD and postnatal mental health conditions.
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Affiliation(s)
- Lisa VanWiel
- Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Mackenzie Unke
- Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | | | - Kara M Whitaker
- Health and Human Physiology, University of Iowa, Iowa City, IA, USA
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Liu X, Wang Q, Chen Y, Luo J, Wan Y. Factors Associated With Stress Urinary Incontinence and Diastasis of Rectus Abdominis in Women at 6-8 Weeks Postpartum. UROGYNECOLOGY (PHILADELPHIA, PA.) 2023; 29:844-850. [PMID: 37093577 PMCID: PMC10521785 DOI: 10.1097/spv.0000000000001353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
IMPORTANCE In recent years, pelvic-abdominal dynamics has become a research topic in the field of pelvic floor dysfunction (PFD), and the relationship between diastasis of the rectus abdominis (DRA) and stress urinary incontinence (SUI) has been controversial. The study is helpful to further strengthen perinatal education, accurately identify the risk factors of SUI and DRA, and improve the quality of life of puerperae. OBJECTIVE This study aimed to investigate the association of SUI and DRA in women with PFD as measured by vaginal palpation or pelvic floor biofeedback machine testing. STUDY DESIGN A total of 301 patients diagnosed with female PFD who were 6-8 weeks postpartum at The Fifth People's Hospital of Zhuhai between May 2018 and April 2021 were enrolled. The prevalence rates and potential influencing factors of SUI and DRA were analyzed. RESULTS A total of 29.5% (89 of 301) of the patients were diagnosed with SUI, and 31.9% (96 of 301) were diagnosed with DRA. Binary logistic regression showed that a history of delivery ( P = 0.012; odds ratio [OR], 1.982) and vaginal delivery with perineal lacerations or episiotomy ( P = 0.016; OR, 2.187) were risk factors for SUI. High birth weight (weight>4.0 kg, P < 0.001; OR, 14.507) was a risk factor for DRA. CONCLUSIONS A history of delivery and vaginal delivery with perineal lacerations or episiotomy increased the risk of SUI, and high birth weight was an independent risk factor for DRA. Early intervention, including exercise therapy, manual therapy, and neuromuscular electrical stimulation, may be important for patients with PFD having these risk factors.
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Affiliation(s)
- Xiaohong Liu
- From the Department of Gynecology, Obstetrics and Gynecology Center, Zhujiang Hospital, Southern Medical University, Guangzhou
- Department of Obstetrics and Gynecology, The Fifth People's Hospital of Zhuhai, Zhuhai, Guangdong Province, China
| | - Qin Wang
- Department of Obstetrics and Gynecology, The Fifth People's Hospital of Zhuhai, Zhuhai, Guangdong Province, China
| | - Yanling Chen
- Department of Obstetrics and Gynecology, The Fifth People's Hospital of Zhuhai, Zhuhai, Guangdong Province, China
| | - Jiamao Luo
- From the Department of Gynecology, Obstetrics and Gynecology Center, Zhujiang Hospital, Southern Medical University, Guangzhou
| | - Yifeng Wan
- From the Department of Gynecology, Obstetrics and Gynecology Center, Zhujiang Hospital, Southern Medical University, Guangzhou
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Kegel Exercise Training Program among Women with Urinary Incontinence. Healthcare (Basel) 2022; 10:healthcare10122359. [PMID: 36553882 PMCID: PMC9777910 DOI: 10.3390/healthcare10122359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
A common condition with a large global prevalence and a persistent medical taboo for many people is urinary incontinence. Around one in three women globally are impacted by it. The most frequently suggested physical therapy treatment for women with stress incontinence or urge incontinence is Kegel exercise (also called pelvic floor muscle training). This study aims to assess the effects of a Kegel exercise training program among women with urinary incontinence. The study was conducted at three government hospitals in Egypt's Port Said city's outpatient gynecological clinic. The intervention design was quasi-experimental. In total, 292 women with urine incontinence who visited the research sites made up the subjects. The necessary data were gathered using an interview questionnaire. Improvements in urinary incontinence and quality of life were positively correlated with daily Kegel exercise practice. Urinary incontinence has statistically significant positive correlations with age (p = 0.026), respiratory rate (p = 0.007), and body mass index (p = 0.026) as women grow older. Urinary incontinence, being single, and increasing pulse, however, had adversely significant negative correlations (p = 0.031 and 0.020, respectively). Urinary incontinence affects women's overall wellbeing, particularly in the emotional and social spheres, as well as their quality of life and their ability to participate in normal everyday activities. Following the adoption of the Kegel exercise training program, there was a substantial improvement in both urine incontinence and quality of life.
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Hutchison D, Ali M, Zillioux J, Ortiz NM, Smith R, Rapp DE. Pelvic Floor Muscle Training in the Management of Female Pelvic Floor Disorders. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martinez S, Martel P, Roth B, Grilo N. [Urinary incontinence: a good diagnosis as a basis for treatment]. PRAXIS 2022; 110:32-37. [PMID: 34983203 DOI: 10.1024/1661-8157/a003800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Urinary incontinence: a good diagnosis as a basis for treatment Abstract. Abtract: Everyone has experienced incontinence at an early age. However, it also affects approximately 200 million people worldwide at the adult age. This common condition is frequently underreported by patients but can dramatically limit their social life. Subject to appropriate differential diagnosis, urinary incontinence is a condition that can be treated with good results in the majority of patients. This article provides a review of the essential symptomatology and current treatments, so that clinicians confronted with the problem may adopt the appropriate management.
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Affiliation(s)
- Silvia Martinez
- Service d'urologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne
| | - Paul Martel
- Service d'urologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne
| | - Beat Roth
- Service d'urologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne
| | - Nuno Grilo
- Service d'urologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne
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Effect of a Comprehensive Rehabilitation Program for Community Women with Urinary Incontinence: A Retrospect Cohort Study. Healthcare (Basel) 2021; 9:healthcare9121686. [PMID: 34946412 PMCID: PMC8701398 DOI: 10.3390/healthcare9121686] [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: 11/02/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022] Open
Abstract
Urinary incontinence (UI) is a common problem affecting older adult women globally, but studies regarding combined treatments for all types of UI are still lacking. Here we evaluate the efficacy of a comprehensive rehabilitation program for women with UI. A comprehensive rehabilitation program was introduced that combines pelvic floor muscle (PFM) exercises, functional electrical stimulation, and timely biofeedback during the training process. Data of patients with stress (SUI), urgency (UUI), or mixed (MUI) urinary incontinence who participated in this program between 2016 and 2019 were reviewed retrospectively. Seventy-three subjects (mean age 59.2 ± 12.7 years) were enrolled. After 12 weeks of rehabilitation, vaginal pressure and control accuracy increased in all groups. PFM maximum recruitment increased significantly at week 12 in SUI and UUI, but not in MUI. At week 6, only the SUI group had achieved significant improvements in vaginal pressure, PFM maximum recruitment and control accuracy. The Short-form Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) scores declined dramatically after the program started, and significant improvements were maintained to week 48. The comprehensive rehabilitation program is effective and decreases urinary leakage episodes and improves quality of life in women with UI, especially SUI.
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Quality of Life of Physically Active and Inactive Women Who Are Older after Surgery for Stress Urinary Incontinence Using a Transobturator Tape (TOT). J Clin Med 2021; 10:jcm10204761. [PMID: 34682882 PMCID: PMC8537612 DOI: 10.3390/jcm10204761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/15/2021] [Indexed: 12/13/2022] Open
Abstract
Urinary incontinence is a major health problem. According to various authors, it concerns 30–40% of the population and grows with age, affecting approximately 50% of women aged over 70. According to the recommendations of the International Continence Society, the treatment of urinary incontinence should commence with conservative treatment and, above all, with physiotherapy. If the conservative treatment fails or the level of urinary incontinence is too high, surgery is recommended. With regard to female patients examined at work, the TOT method was applied. The aim of this study was to assess the relationship between regular physical activity and the quality of life of women aged 65–87 who underwent surgical treatment for stress urinary incontinence (SUI) using the TOT method. The study group involved 60 postmenopausal women, patients of the Department of Gynaecology of the Hospital of Ministry of the Interior and Administration in Wroclaw, with SUI diagnosed during ultrasonography. The female patients were surveyed before and 12 months after the surgery using standardised IPAQ and WHOQOL-BREF.FL questionnaires. Significant positive relationships between quality of life and physical activity before and 12 months after the surgery were demonstrated in the somatic and social domains. Physically active postmenopausal women presented higher values in all domains and total quality of life according to the WHOQOL-BREF compared with physically inactive women, both before and 12 months after the procedure using the TOT method.
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Non-oestrogenic modalities to reverse urogenital aging. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2021; 20:140-147. [PMID: 34703415 PMCID: PMC8525256 DOI: 10.5114/pm.2021.109772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023]
Abstract
Urogenital aging is a common process affecting all women in the post-menopausal period of their life, and it is substantially due to oestrogen deprivation after ovarian function cessation. These changes can lead to a progressive, chronic, and complex association of symptoms identified as the genitourinary syndrome of menopause, which has a significant impact on quality of life. Genitourinary syndrome and urogenital aging do not resolve spontaneously and usually recur when treatment is stopped. Therefore, appropriate long-term management is of paramount importance, and local oestrogen is the most effective treatment to reverse urogenital aging and to improve symptoms of genitourinary syndrome as replacement therapy. In some women, topical oestrogen may be inconvenient, it may not achieve complete response, or it may be contra-indicated. Several non-hormonal therapies have been investigated, but few treatments have been reported as potentially able to reverse the urogenital aging process similarly to exogenous oestrogens. Laser seems the most promising, although further studies to define its safety and efficacy are mandatory. Vitamin D and E, and phytotherapy have returned conflicting results and require further confirmation. Lifestyle modifications, physiotherapy, and electrical stimulation represent inexpensive and applicable treatments that might slow urogenital aging. Among the hormonal non-oestrogenic therapies, the use of vaginal oxytocin and dehydroepiandrosterone have been found to be effective compared to placebo, as well as the use of oral ospemifene, which partially relieves vulvovaginal atrophy.
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The Prevalence and Association of Stress Urinary Incontinence, Core Muscle Endurance, and Low Back Pain among Married Women in Saudi Arabia: A Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5533241. [PMID: 34337021 PMCID: PMC8298156 DOI: 10.1155/2021/5533241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/27/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
Purpose There may be a strong association among stress urinary incontinence (SUI), low back pain (LBP), and core muscle endurance (CME) in married women. This study is aimed at evaluating the prevalence and clinical association between SUI, CME, and LBP among married women in Saudi Arabia. Methods The study was based on a case-control research design, conducted among 143 women with LBP (mean age, 32 ± 7.4 years) and 160 healthy women (mean age, 31.7 ± 6.7 years). SUI, CME, and functional disability were assessed using the international consultation on the Incontinence Questionnaire-Short Form (ICIQ-SF), prone plank test (PP), and Oswestry Disability Index for LBP-United Arab Emirates edition (ODI-UAE). Results The prevalence of SUI was found to be 60% in the LBP group while 20% in the control group. CME revealed a stronger negative correlation with SUI in the LBP group (rs = −0.75) than in the control group (rs = −0.63). Conclusions The prevalence of SUI was observed higher in women with LBP than healthy women. CME exhibited a stronger association with SUI than LBP among women with LBP compared to healthy women in Saudi Arabia. Therefore, the role of CME in SUI development or vice versa among married women with LBP may be subjected to further research.
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Corrado B, Giardulli B, Polito F, Aprea S, Lanzano M, Dodaro C. The Impact of Urinary Incontinence on Quality of Life: A Cross-Sectional Study in the Metropolitan City of Naples. Geriatrics (Basel) 2020; 5:E96. [PMID: 33233663 PMCID: PMC7709681 DOI: 10.3390/geriatrics5040096] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/23/2022] Open
Abstract
Urinary incontinence is a hygienic and psychosocial problem that often brings people to restrict their social life and to experience depression. The main aim of this study was to evaluate the impact of urinary incontinence on quality of life among residents of the Metropolitan City of Naples, Italy, using a newly designed multidimensional questionnaire. The secondary objective was to find which variables affect the quality of life and symptom severity in these patients. To do so, a sample composed of twenty-eight patients was recruited in a multicentre cross-sectional study. Most of the participants had a mild impairment (60%) concerning social life and self-perception, especially those whose education was above the primary level (p = 0.036) and those who followed a pelvic floor rehabilitation program (p = 0.002). Overflow urinary incontinence was associated with a greater deterioration in the aspirational and occupational domain (p = 0.044). Symptom severity was worse in those who had comorbidities (p = 0.038), who had a high body mass index (p = 0.008) or who used diuretics (p = 0.007). In conclusion, our results suggest that there is a significant impairment of quality of life in patients who have only primary education and who follow a pelvic floor rehabilitation program.
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Affiliation(s)
- Bruno Corrado
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (B.C.); (F.P.); (S.A.); (M.L.)
| | - Benedetto Giardulli
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (B.C.); (F.P.); (S.A.); (M.L.)
| | - Francesco Polito
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (B.C.); (F.P.); (S.A.); (M.L.)
| | - Salvatore Aprea
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (B.C.); (F.P.); (S.A.); (M.L.)
| | - Mariangela Lanzano
- Department of Public Health, University Federico II of Naples, 80138 Naples, Italy; (B.C.); (F.P.); (S.A.); (M.L.)
| | - Concetta Dodaro
- Department of Advanced Biomedical Sciences, University Federico II of Naples, 80138 Naples, Italy;
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Stress Incontinence during Different High-Impact Exercises in Women: A Pilot Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228372. [PMID: 33198262 PMCID: PMC7696460 DOI: 10.3390/ijerph17228372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/07/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022]
Abstract
The aim of this survey was to investigate the prevalence of stress urinary incontinence (SUI) among women (primigravida, multigravida, and nulligravida) in high-impact exercise groups—CrossFit, kickboxing, and boot camp. Incontinence Survey was modified to an anonymous online questionnaire. A total of 17 participants, 64.2% reported at least some urinary leakage during exercise. About 85.7% of participants in each of the 3 high-intensity exercise groups exercised >3 h/week. There was no significant difference in the likelihood of urinary leakage between participants who have had at least 1 pregnancy and those who had never been pregnant. CrossFit group were significantly more likely to report urinary leakage than those in the kickboxing and boot camp groups combined (p = 0.023). The participants did not exhibit typical risk factors, as they were premenopausal, active, and had an average body mass index within the normal range. This pilot survey indicates that all women those who do high-impact exercises are susceptible to stress urinary incontinence (SUI), and that CrossFit poses a greater risk for SUI in terms of more jumping resulting in increased intra-abdominal pressure and ground reaction forces compared to others. Our pilot study indicates that a higher risk of SUI during high impact exercises may exist associated with previous pregnancy but also in nulliparous women.
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The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress urinary incontinence and low back pain: a randomized controlled trial. Int Urogynecol J 2020; 31:2301-2307. [PMID: 32274521 DOI: 10.1007/s00192-020-04284-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) and low back pain (LBP) are common postnatal problems. We aimed to compare the effects of stabilization exercises focusing on the pelvic floor on postnatal SUI and LBP. METHODS This two-arm, single-blind, parallel, randomized controlled trial was done on 80 women (mean age: 30.5, range: 20-45 years), with postnatal SUI and LBP. They were randomized into two equal control and intervention groups. The control group received no treatment while the intervention group received home-based stabilization exercises focusing on pelvic floor muscles (PFM) 3 days a week for 12 weeks, three sets a day; each set included three different types of exercise each week. Outcome measures were UI severity, assessed by ICIQ-UI-SF, low back pain functional disability, assessed by the Oswestry Disability Index (ODI), LBP severity, assessed by visual analog scale (VAS), and PFM strength and endurance, assessed by vaginal examination. Transverse abdominis (TrA) muscle strength was assessed by manometric biofeedback. All outcomes were measured directly before and after treatment. RESULTS In the intervention group, PFM strength, TrA muscle strength, functional disability and pain severity were significantly improved (P < 0.05). Within-group results showed that all outcomes except pain severity (P = 0.06) had directly improved in the intervention group after treatment (P < 0.05), while in the control group only PFM strength and endurance and UI severity had improved (P < 0.05). CONCLUSIONS Home-based stabilization exercises focusing on the pelvic floor muscles could be effective for postnatal LBP and SUI. TRIAL REGISTRATION Iranian Registry of Clinical Trials (Code: IRCT2017050618760N4).
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Witkoś J, Hartman-Petrycka M. Will future doctors know enough about stress urinary incontinence to provide proper preventive measures and treatment? MEDICAL EDUCATION ONLINE 2019; 24:1685635. [PMID: 31662061 PMCID: PMC6830270 DOI: 10.1080/10872981.2019.1685635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/14/2019] [Accepted: 10/07/2019] [Indexed: 05/26/2023]
Abstract
Background: Stress urinary incontinence (SUI) is an embarrassing condition, which is one of the last taboos in modern medicine. The study aim was an attempt to assess medical students' knowledge of female stress urinary incontinence.Methods: The study involved 432 students of the Medical Department at the Medical University of Silesia in Katowice. Participants answered open-ended questions about: risk factors, prevention, diagnostic tests, conservative and surgical treatment in stress urinary incontinence.Results: The obtained results indicated that female students know more about SUI than male students. Women - more often than men - could provide the definition of SUI (p < 0.01); additionally, they more frequently indicated prevention methods (p < 0.01), diagnostic testing (p < 0.001) and conservative methods of treatment (p < 0.001). Not all the respondents were able to properly define stress urinary incontinence. Risk factors were known to most of the respondents but only half of them were aware of surgical treatment and prevention methods. Even fewer answered questions about conservative treatment and diagnostic tests correctly.Conclusions: We conclude that the knowledge of medical undergraduates who took part in the survey was not satisfactory. Most of the students were able to define properly the disease and point out risk factors. However, several steps should be taken to make stress urinary incontinence a disease much more known to medical students.Abbreviations: SUI: Stress urinary incontinence; Group F: Females Group; Group M: Males Group; TVT: Tension Free Vaginal Tape; TOT: Transobturator Tape.
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Affiliation(s)
- Joanna Witkoś
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Magdalena Hartman-Petrycka
- Department of Basic Biomedical Science, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, The Medical University of Silesia in Katowice, Katowice, Poland
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Chisholm L, Delpe S, Priest T, Reynolds WS. Physical Activity and Stress Incontinence in Women. CURRENT BLADDER DYSFUNCTION REPORTS 2019; 14:174-179. [PMID: 31456864 DOI: 10.1007/s11884-019-00519-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose of Review This review aims to discuss the current literature addressing associations between physical activity and stress urinary incontinence in women. Recent Findings Multiple cross-sectional studies utilize survey questionnaires to determine prevalence of stress urinary incontinence, impact of various types and intensities of physical activity on stress urinary incontinence, and explain differences in urinary symptoms among active women. Summary Although there is evidence for increased rates of stress incontinence among women who are physically active, pathophysiology is not fully understood and there is a need for additional research exploring changes to the pelvic floor during exercise. Future research focusing on the mechanism in which physical activity contributes to urinary symptoms can guide development of primary preventions for stress urinary incontinence.
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Affiliation(s)
- Leah Chisholm
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sophia Delpe
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tiffany Priest
- Department of Orthopedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee
| | - W Stuart Reynolds
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Samuels JB, Pezzella A, Berenholz J, Alinsod R. Safety and Efficacy of a Non-Invasive High-Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life. Lasers Surg Med 2019; 51:760-766. [PMID: 31172580 PMCID: PMC6851770 DOI: 10.1002/lsm.23106] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 12/26/2022]
Abstract
Background and Objectives Urinary incontinence is a common and distressing condition which interferes with everyday life. Patients frequently experience discomfort related to urine leakage and the subsequent need to use absorbent pads. Since the continence mechanism is primarily maintained by a proper function of pelvic floor muscles (PFM), many treatment methods focused on strengthening of the PFM have been introduced in the past. The aim of this study was to evaluate the safety and efficacy of a high‐intensity focused electromagnetic technology (HIFEM) for treatment of urinary incontinence with emphasis on effects on prospective patients’ quality of life. Study Design/Materials and Methods The study followed an institutional review board approved protocol. A total of 75 women (55.45 ± 12.80 years, 1.85 ± 1.28 deliveries) who showed symptoms of stress, urge, or mixed urinary incontinence were enrolled. They received six HIFEM treatments (2 per week) in duration of 28 minutes. Outcomes were evaluated after the sixth treatment and at the 3‐month follow‐up. The primary outcome was to assess changes in urinary incontinence by the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF) and changes in the number of absorbent pads used per day. The secondary outcome was subjective evaluation of the therapy and self‐reported changes in quality of life. The statistical analysis was conducted by paired T‐test and Pearson correlation coefficient (
α = 0.05). Results After the sixth session, 61 out of 75 patients (81.33%) reported significant reduction of their symptoms. The average improvement of 49.93% in ICIQ‐SF score was observed after the sixth treatment, which further increased to 64.42% at the follow‐up (both P < 0.001). Individually, the highest level of improvement was reached in patients suffering from mixed urinary incontinence (69.90%). The reduction of absorbent pads averaged 43.80% after the sixth treatment and 53.68% at 3 months (both P < 0.001), while almost 70% of patients (30 out of 43) reported decreased number of used pads. At the follow‐up, a highly significant medium correlation (r = 0.53, P < 0.001) was found between the ICIQ‐SF score improvement and the reduction in pad usage. A substantial decrease in the frequency of urine leakage triggers was documented. Patients reported no pain, downtime or adverse events, and also reported additional beneficial effects of the therapy such as increased sexual desire and better urination control. Conclusions This study demonstrated that HIFEM technology is able to safely and effectively treat a wide range of patients suffering from urinary incontinence. After six treatments, an improvement in ICIQ‐SF score and reduction in absorbent pads usage was observed. Based on subjective evaluation, these changes positively influenced quality of life. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Julene B Samuels
- FACS, Louisville, MD9419 Norton Commons Blvd Suite 101, River Bluff, KY, 40059
| | - Andrea Pezzella
- Southern Urogynecology: Center for Female Pelvic Medicine and Reconstructive Surgery, 115 Midlands Ct, West Columbia, SC, 29169
| | - Joseph Berenholz
- The Laser Vaginal Rejuvenation Institute of Michigan, 30445 Northwestern Hwy Suite 100, Farmington Hills, MI, 48334
| | - Red Alinsod
- South Coast Urogynecology, 31852 Coast Hwy #203, Laguna Beach, CA, 92651
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17
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López-Liria R, Varverde-Martínez MDLÁ, Padilla-Góngora D, Rocamora-Pérez P. Effectiveness of Physiotherapy Treatment for Urinary Incontinence in Women: A Systematic Review. J Womens Health (Larchmt) 2018; 28:490-501. [PMID: 30575448 DOI: 10.1089/jwh.2018.7140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Urinary incontinence (UI) may be defined as involuntary urine loss, which can be diagnosed based on patient-reported measures and is a hygiene and social problem in those who have it, affecting their quality of life negatively. OBJECTIVE The study aimed to determine the effectiveness of distinct physiotherapy techniques used in the treatment of UI in women through a systematic review of the existing literature. The scales and instruments used for the assessment and follow-up of UI were described. METHODS On searching the PubMed, Dialnet, PEDro, and SciELo databases, 16 articles, with information on 1220 patients that comply with the inclusion criteria and conform to the proposed objectives were obtained, limiting the publication period to 2007-2016. The PRISMA statement was adopted. RESULTS The "Pad Test" is a commonly used diagnostic test and bladder diaries on paper; the Oxford scale was used in the assessment of pelvic floor muscle strength. Distinct protocols and techniques have been described in the treatment of UI in women, namely, pelvic floor exercises, vaginal cones, biofeedback, and electrostimulation. Upon analysis of the content of the articles, the quality of the included clinical trials was determined using the PEDro scale. CONCLUSIONS Studies included in this work propose that physiotherapy treatment may improve UI, the patients' quality of life, and social relations in women. It is necessary to establish group treatment protocols for women with UI, supervised by a physiotherapist to reduce the financial burden incurred from this health problem.
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Affiliation(s)
- Remedios López-Liria
- 1 Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
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18
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Lasak AM, Jean-Michel M, Le PU, Durgam R, Harroche J. The Role of Pelvic Floor Muscle Training in the Conservative and Surgical Management of Female Stress Urinary Incontinence: Does the Strength of the Pelvic Floor Muscles Matter? PM R 2018; 10:1198-1210. [PMID: 29753829 DOI: 10.1016/j.pmrj.2018.03.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 01/06/2018] [Accepted: 03/02/2018] [Indexed: 01/23/2023]
Abstract
The purpose of this review is to provide an in-depth overview of the role of pelvic floor muscle (PFM) training in the management of stress urinary incontinence (SUI). The definition, epidemiology, and pathogenesis of SUI are described. We review the anatomy of the PFM and the importance of PFM strength in maintaining urinary continence and establishing normal voiding function. A brief description of the surgical options currently available for SUI and the existing data regarding the role of perioperative PFM training for SUI are included. Critical research questions to better evaluate and assess PFM training during the perioperative period are proposed. Promising novel approaches in the treatment of SUI are also presented. This review is useful for physiatrists, urogynecologists, female urologists, and nurse practitioners who specialize in the management and treatment of women with SUI. LEVEL OF EVIDENCE: IV.
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Affiliation(s)
- Anna Maria Lasak
- Department of Rehabilitation Medicine, Montefiore Medical Center, The University Hospital For Albert Einstein College of Medicine, Bronx, NY(∗)
| | | | - Phuong Uyen Le
- Department of Rehabilitation Medicine, Montefiore Medical Center, The University Hospital For Albert Einstein College of Medicine, 150 East 210(th) Street, 2(nd) floor, Bronx, NY 10467(‡).
| | - Roshni Durgam
- Department of Rehabilitation Medicine, Montefiore Medical Center, The University Hospital For Albert Einstein College of Medicine, Bronx, NY(§)
| | - Jessica Harroche
- Montefiore Medical Center, The University Hospital For Albert Einstein College of Medicine, Bronx, NY(¶)
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19
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Pereira CMDA, Castiglione M, Kasawara KT. Effects of physiotherapy treatment for urinary incontinence in patient with multiple sclerosis. J Phys Ther Sci 2017; 29:1259-1263. [PMID: 28744060 PMCID: PMC5509604 DOI: 10.1589/jpts.28.1259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/11/2016] [Indexed: 01/22/2023] Open
Abstract
[Purpose] The aim of the study was to evaluate the benefits of physical therapy for
urinary incontinence in patients with multiple sclerosis and to verify the impact of
urinary incontinence on the patient’s quality of life. [Subject and Methods] A case study
of a 55-year-old female patient diagnosed with multiple sclerosis and mixed urinary
incontinence was conducted. Physical therapy sessions were conducted once a week, in total
15 sessions, making use of targeted functional electrical vaginal stimulation, along with
active exercises for the pelvic floor muscles and electrical stimulation of the posterior
tibial nerve, behavioral rehabilitation and exercise at home. [Results] After 15 physical
therapy sessions, a patient diagnosed with multiple sclerosis and mixed urinary
incontinence showed continued satisfactory results after five months. She showed better
quality of life, higher strength of pelvic floor muscle and reduced urinary frequency
without nocturia and enuresis. [Conclusion] The physical therapy protocol in this patient
with multiple sclerosis and mixed urinary incontinence showed satisfactory results
reducing urinary incontinence symptomatology and improving the patient’s quality of
life.
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Affiliation(s)
- Carla Maria de Abreu Pereira
- Department of Obstetrics and Gynecology, Santa Casa de São Paulo Medical School and Centro Universitário Uniítalo, Brazil
| | - Mariane Castiglione
- Department of Obstetrics and Gynecology, Santa Casa de São Paulo Medical School and Centro Universitário Uniítalo, Brazil
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20
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Bertotto A, Schvartzman R, Uchôa S, Wender MCO. Effect of electromyographic biofeedback as an add-on to pelvic floor muscle exercises on neuromuscular outcomes and quality of life in postmenopausal women with stress urinary incontinence: A randomized controlled trial. Neurourol Urodyn 2017; 36:2142-2147. [PMID: 28508398 DOI: 10.1002/nau.23258] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/27/2017] [Indexed: 12/21/2022]
Abstract
AIMS To compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (BF) in increasing muscle strength, improving myoelectric activity, and improving pre-contraction and quality of life in postmenopausal women with stress urinary incontinence. METHODS Randomized controlled trial of 49 postmenopausal women with stress urinary incontinence. Participants were allocated across three groups: control, PFME alone, and PFME + BF. Forty-five women completed the study (14 control, 15 PFME, 16 PFME + BF; mean age 58.26 years). Outcome assessment was carried out using digital palpation (modified Oxford grading scale), electromyography, and the International Consultation Incontinence Questionnaire-Short Form (ICIQ-SF) quality of life instrument. The treatment protocol consisted of eight twice-weekly, 20-min one-on-one sessions. Controls were assessed only at baseline and after 1 month. RESULTS The PFME and PFME + BF groups exhibited significant increases in muscle strength (Oxford scale) (P < 0.0001), precontraction while coughing (P < 0.0001), maximum voluntary contraction, duration of endurance contraction, and ICIQ-SF scores (P < 0.0001). PFME + BF was associated with significantly superior improvement of muscle strength, precontraction while coughing, maximum voluntary contraction, and duration of endurance contraction as compared to PFME alone (P < 0.05). CONCLUSIONS This preliminary study suggests that pelvic floor muscle training, with and without biofeedback, is associated with increased muscle strength, myoelectric activity, precontraction of pelvic floor muscles, and improved quality of life in postmenopausal women with stress urinary incontinence.
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Affiliation(s)
- Adriane Bertotto
- Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Departament of Physical Therapy, Centro Universitário La Salle, Canoas, RS, Brazil
| | - Renata Schvartzman
- Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Silvana Uchôa
- Department of Physical Therapy, Universidade Católica de Pernambuco (UNICAP), Recife, PE, Brazil
| | - Maria Celeste Osório Wender
- Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Gynecology Service-Menopause Clinic, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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21
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Sousa MS, Peate M, Jarvis S, Hickey M, Friedlander M. A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy. Ther Adv Med Oncol 2017; 9:269-285. [PMID: 28491147 PMCID: PMC5405994 DOI: 10.1177/1758834016687260] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/16/2016] [Indexed: 12/19/2022] Open
Abstract
There is increasing attention and concern about managing the adverse effects of adjuvant endocrine therapy for women with early breast cancer as the side effects of therapy influence compliance and can impair quality of life (QoL). Most side effects associated with tamoxifen (TAM) and aromatase inhibitors (AIs) are directly related to estrogen deprivation, and the symptoms are similar to those experienced during natural menopause but appear to be more severe than that seen in the general population. Prolonged estrogen deprivation may lead to atrophy of the vulva, vagina, lower urinary tract and supporting pelvic structures, resulting in a range of genitourinary symptoms that can in turn lead to pain, discomfort, impairment of sexual function and negatively impact on multiple domains of QoL. The genitourinary side effects may be prevented, reduced and managed in most cases but this requires early recognition and appropriate treatment. We provide an overview of practical clinical approaches to understanding the pathophysiology and the management of genitourinary symptoms in postmenopausal women receiving adjuvant endocrine therapy for breast cancer.
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Affiliation(s)
- Mariana S. Sousa
- School of Nursing and Midwifery, Western Sydney University, Centre for Applied Nursing Research, South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
Prince of Wales Clinical School, University of New South Wales Australia Sydney, New South Wales, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia Department of Obstetrics and Gynaecology, Royal Women’s Hospital, Parkville, Victoria, Australia
| | - Sherin Jarvis
- Pelvic Floor Physiotherapy, Women’s Health & Research Institute of Australia, New South Wales, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia Department of Obstetrics and Gynaecology, Royal Women’s Hospital, Parkville, Victoria, Australia
| | - Michael Friedlander
- Prince of Wales Clinical School, University of New South Wales Australia, Sydney, New South Wales, Australia
Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia
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22
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Wolz-Beck M, Reisenauer C, Kolenic GE, Hahn S, Brucker SY, Huebner M. Physiotherapy and behavior therapy for the treatment of overactive bladder syndrome: a prospective cohort study. Arch Gynecol Obstet 2017; 295:1211-1217. [PMID: 28361203 DOI: 10.1007/s00404-017-4357-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the efficacy of physiotherapy and behavior therapy and to find specific subgroups of women with overactive bladder syndrome that might gain increased benefit from this therapy. METHODS Women with ≥10 micturitions per 24-h period were included. Six to nine therapy sessions were held within a 14-day interval. Efficacy end point was a reduction in micturitions and in episodes of nocturia. Secondary outcomes included ICIQ-OAB, ICIQ-OABqol and visual analog scales. Follow-up was 6 months. Levene test, Student's t test, Pearson´s and Spearman's correlations were utilized as well as the Friedman test and a multivariable-multilevel model. RESULTS 32 women were included. Mean age was 51 ± 15.9 (years ± standard deviation, sd). Mean body mass index (BMI) was 24.4 ± 4.8 (kg/m2 ± sd). There was a 22.9% reduction in the number of micturitions per 24 h (11.7 ± 1.6 vs. 9.0 ± 1.3 p < 0.001), a 21.3% reduction during the day (10.3 ± 1.4 vs. 8.1 ± 1.1 p < 0.001) and a 34.7% reduction in episodes of nocturia (1.5 ± 1.0 vs. 1.0 ± 0.8 p = 0.026). Both ICIQ-OAB (8.7 ± 2.3 vs. 5.8 ± 2.7 vs. 6.3 ± 3.3 p < 0.001) and ICIQ-OABqol (73.4 ± 25.9 vs. 47.5 ± 14.5 vs. 47.7 ± 18.6 p < 0.001) questionnaires as well as VAS (7.5 ± 1.4 vs. 4.1 ± 2.4 vs. 4.2 ± 2.7 p < 0.001) showed significant improvement persisting in the 6-month follow-up. In addition, in a multivariable model controlling for age, women who were overactive bladder syndrome therapy naïve responded significantly better than those who had already been under therapy (p < 0.001). CONCLUSIONS This study shows the efficacy of physiotherapy and behavior therapy in women with overactive bladder syndrome with a post-therapy effect especially for women with no prior treatment.
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Affiliation(s)
- Martina Wolz-Beck
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany
| | - Christl Reisenauer
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany
| | - Giselle E Kolenic
- Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Sabine Hahn
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany
| | - Sara Y Brucker
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.,Research Centre for Women's Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - Markus Huebner
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.
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23
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Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. Int Urogynecol J 2017; 28:1557-1565. [DOI: 10.1007/s00192-017-3309-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/26/2017] [Indexed: 12/22/2022]
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24
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Varella LRD, Bezerra da Silva R, Eugênia de Oliveira MC, Melo PHA, Maranhão TMDO, Micussi MTABC. Assessment of lower urinary tract symptoms in different stages of menopause. J Phys Ther Sci 2016; 28:3116-3121. [PMID: 27942131 PMCID: PMC5140811 DOI: 10.1589/jpts.28.3116] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/21/2016] [Indexed: 01/04/2023] Open
Abstract
[Purpose] To assess lower urinary tract symptoms in different stages of menopause and the quality of life of females with incontinence. [Subjects and Methods] The sample consisted of 302 females, aged between 40 and 56 years, divided into three groups: PRE (n= 81), PERI (n= 108) and POST (n= 113). This was a cross-sectional, analytical, observational study. Data were collected by assessment chart and conducting the International Consultation on Incontinence Questionnaire-Short Form. [Results] Most of the women had less than 10 years of schooling and were married. In PERI and POST menopause, the most frequent lower urinary tract symptoms were urinary urgency and stress incontinence. The PRE group did not exhibit nocturia, urge incontinence or urinary urgency, and had the lowest symptoms frequency. In the three stages, stress incontinence was the most prevalent symptom. Of the three menopause stages, PERI had a greater impact on urinary incontinence according to the International Consultation on Incontinence Questionnaire. [Conclusion] The presence of lower urinary tract symptoms can vary across the different stages of menopause and the urinary incontinence was the most frequent complaint. Moreover, it was observed that quality of life was more affected in the perimenopause stage.
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25
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Frawley J, Sibbritt D, Steel A, Chang S, Adams J. Complementary and Conventional Health-care Utilization Among Young Australian Women With Urinary Incontinence. Urology 2016; 99:92-99. [PMID: 27720777 DOI: 10.1016/j.urology.2016.07.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/21/2016] [Accepted: 07/12/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the relationship between health status and health service utilization (including conventional and complementary and alternative medicine [CAM]) accessed by women experiencing urinary incontinence (UI). Although a high number of younger women report symptoms of UI, such as leaking urine, only a small proportion seek help for these symptoms. MATERIALS AND METHODS The Australian Longitudinal Study on Women's Health is a large nationally representative study that investigates the health and well-being of women. The 2 most recent surveys (2006 and 2009) of the young cohort (women aged 28-33 and 31-36 respectively) were analyzed. RESULTS The presence of UI was 8.5% in 2006 (n = 859) and 23.3% in 2009 (n = 1878), whereas the percentage of women who sought help for their UI was 18.6% (n = 160) and 2.2% (n = 182) respectively. Women with UI had poorer health compared with women without UI (P < .005), and women who sought help for their symptoms had poorer physical functioning than women who did not (P < .005). Women who sought help were greater users of conventional and CAM health services (P < .005), including a general practitioner, specialist, hospital doctor, physiotherapist, and naturopath. CONCLUSION UI is relatively common in younger women. However, many do not seek help. Of the women who do seek care, a large number visit CAM professionals as well as conventional medical professionals, despite a lack of research evaluating the efficacy of CAM treatment. Research is needed to explore CAM practitioner approaches to the treatment of UI and to evaluate the efficacy of these treatments.
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Affiliation(s)
- Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, UTS, Ultimo, NSW, Australia.
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, UTS, Ultimo, NSW, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, UTS, Ultimo, NSW, Australia; Endeavour College of Natural Health, Brisbane, QLD, Australia
| | - Sungwon Chang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, UTS, Ultimo, NSW, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, UTS, Ultimo, NSW, Australia
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26
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Ghaderi F, Mohammadi K, Amir Sasan R, Niko Kheslat S, Oskouei AE. Effects of Stabilization Exercises Focusing on Pelvic Floor Muscles on Low Back Pain and Urinary Incontinence in Women. Urology 2016; 93:50-4. [DOI: 10.1016/j.urology.2016.03.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 10/22/2022]
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Neels H, Wyndaele JJ, Tjalma WAA, De Wachter S, Wyndaele M, Vermandel A. Knowledge of the pelvic floor in nulliparous women. J Phys Ther Sci 2016; 28:1524-33. [PMID: 27313364 PMCID: PMC4905903 DOI: 10.1589/jpts.28.1524] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/02/2016] [Indexed: 01/09/2023] Open
Abstract
[Purpose] Proper pelvic floor function is important to avoid serious dysfunctions including incontinence, prolapse, and sexual problems. The current study evaluated the knowledge of young nulliparous women about their pelvic floor and identified what additional information they wanted. [Subjects and Methods] In this cross-sectional survey, a validated, 36 item questionnaire was distributed to 212 nulliparous women. The questionnaire addressed demography, pelvic floor muscles, pelvic floor dysfunction, and possible information sources. Descriptive statistics were generated for all variables. Stability and validity testing were performed using Kappa statistics and intra class correlation coefficients to define agreement for each question. The study was approved by the ethics Committee (B300201318334). [Results] Using a VAS scale (0 to 10), the women rated their knowledge about the pelvic floor as a mean of 2.4 (SD 2.01). A total of 93% of the women were insufficiently informed and requested more information; 25% had concerns about developing urinary incontinence, and 14% about fecal incontinence. Many of the women were unaware what pelvic floor training meant. [Conclusion] There was a significant lack of knowledge about pelvic floor function among nulliparous women. The majority of nulliparous women expressed a need for education, which might offer a way to reduce dysfunction.
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Affiliation(s)
- Hedwig Neels
- Department of Rehabilitation Sciences and Physiotherapy,
University of Antwerp, Belgium
- Department of Urology, Antwerp University Hospital,
Belgium
| | | | - Wiebren A. A. Tjalma
- Multidisciplinary Breast Clinic, Unit of Gynecologic
Oncology, Antwerp University Hospital, University of Antwerp, Belgium
- Department of Obstetrics and Gynecology, Antwerp University
Hospital, University of Antwerp, Belgium
| | - Stefan De Wachter
- Department of Urology, Antwerp University Hospital,
Belgium
- Department of Urology, University of Antwerp, Belgium
| | - Michel Wyndaele
- Department of Urology, Antwerp University Hospital,
Belgium
- Department of Urology, University of Antwerp, Belgium
| | - Alexandra Vermandel
- Department of Rehabilitation Sciences and Physiotherapy,
University of Antwerp, Belgium
- Department of Urology, Antwerp University Hospital,
Belgium
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Wyndaele JJ. Study on the influence of the type of current and the frequency of impulses used for electrical stimulation on the contraction of pelvic muscles with different fibre content. Scand J Urol 2016; 50:228-33. [DOI: 10.3109/21681805.2016.1142473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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29
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Tosun OC, Solmaz U, Ekin A, Tosun G, Gezer C, Ergenoglu AM, Yeniel AO, Mat E, Malkoc M, Askar N. Assessment of the effect of pelvic floor exercises on pelvic floor muscle strength using ultrasonography in patients with urinary incontinence: a prospective randomized controlled trial. J Phys Ther Sci 2016; 28:360-5. [PMID: 27065519 PMCID: PMC4792974 DOI: 10.1589/jpts.28.360] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/30/2015] [Indexed: 11/26/2022] Open
Abstract
[Purpose] The aim of this study was to evaluate whether the effect of pelvic floor
exercises on pelvic floor muscle strength could be detected via ultrasonography in
patients with urinary incontinence. [Subjects and Methods] Of 282 incontinent patients,
116 participated in the study and were randomly divided into a pelvic floor muscle
training (n=65) group or control group (n=51). The pelvic floor muscle training group was
given pelvic floor exercise training for 12 weeks. Both groups were evaluated at the
beginning of the study and after 12 weeks. Abdominal ultrasonography measurements in
transverse and longitudinal planes, the PERFECT scheme, perineometric evaluation, the stop
test, the stress test, and the pad test were used to assess pelvic floor muscle strength
in all cases. [Results] After training, the PERFECT, perineometry and transabdominal
ultrasonography measurements were found to be significantly improved, and the stop test
and pad test results were significantly decreased in the pelvic floor muscle training
group, whereas no difference was observed in the control group. There was a positive
correlation between the PERFECT force measurement scale and ultrasonography force
measurement scale before and after the intervention in the control and pelvic floor muscle
training groups (r=0.632 and r=0.642, respectively). [Conclusion] Ultrasonography can be
used as a noninvasive method to identify the change in pelvic floor muscle strength with
exercise training.
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Affiliation(s)
- Ozge Celiker Tosun
- School of Physiotherapy and Rehabilitation, Dokuz Eylul University, Turkey
| | - Ulas Solmaz
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Turkey
| | - Atalay Ekin
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Turkey
| | - Gokhan Tosun
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Turkey
| | - Cenk Gezer
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Turkey
| | - Ahmet Mete Ergenoglu
- Department of Obstetrics and Gynecology, Ege Faculty, University of Medicine, Turkey
| | - Ahmet Ozgur Yeniel
- Department of Obstetrics and Gynecology, Ege Faculty, University of Medicine, Turkey
| | - Emre Mat
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Turkey
| | - Mehtap Malkoc
- School of Physiotherapy and Rehabilitation, Dogu Akdeniz University, North Cyprus
| | - Niyazi Askar
- Department of Obstetrics and Gynecology, Ege Faculty, University of Medicine, Turkey
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Micussi MT, Freitas RP, Angelo PH, Soares EM, Lemos TM, Maranhão TM. Is there a difference in the electromyographic activity of the pelvic floor muscles across the phases of the menstrual cycle? J Phys Ther Sci 2015; 27:2233-7. [PMID: 26311960 PMCID: PMC4540855 DOI: 10.1589/jpts.27.2233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To evaluate the electrical activity of the pelvic floor muscle in women during the follicular, ovulatory, and luteal phases of the menstrual cycle and its correlation with estradiol and total testosterone levels. [Subjects and Methods] This cross-sectional study involved 30 women with ovulatory menstrual cycles. Total testosterone and estradiol levels were measured and the muscle tone and maximum voluntary contraction of the pelvic floor muscles were evaluated using surface electromyography. [Results] Muscle tone was significantly lower during the follicular (21.1±3.3 μV) and ovulatory (27.1±5.9 μV) phases than the luteal phase (30.4±4.1 μV). The maximum voluntary contraction was not different across phases. The estradiol level on the 7th day of the menstrual cycle showed a strong positive correlation with muscle tone and maximum voluntary contraction, and the testosterone level was positively correlated with muscle tone on the 21st day. [Conclusion] Women have better muscle tone during the luteal phase. The muscle tone and maximum voluntary contraction were strongly correlated with the estradiol level on the 7th day, and the muscle tone was correlated with the testosterone level on the 21st day of the menstrual cycle. These findings suggest that hormonal fluctuations during the menstrual cycle alter pelvic floor muscle activity.
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Affiliation(s)
| | | | | | - Elvira Maria Soares
- Maternidade-Escola Januário Cicco, Universidade Federal do Rio Grande do Norte, Brazil
| | - Telma Maria Lemos
- Department of Clinical Analysis, Universidade Federal do Rio Grande do Norte, Brazil
| | - Técia Maria Maranhão
- Department of Tocogynecology, Universidade Federal do Rio Grande do Norte, Brazil
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