The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence - a pilot study

Comparison of the effects of pelvic floor muscle training and modified pilates exercises in elderly women with stress urinary incontinence: A randomized clinical trial

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.

A review of the role for pelvic floor physiotherapy in postmenopausal women with urinary incontinence

Urinary incontinence is a prevalent condition affecting women. Pelvic floor physiotherapy is a specialized field of physiotherapy dedicated to assessing and treating pelvic floor muscles. This therapy has demonstrated benefits in addressing stress urinary incontinence in premenopausal women, with numerous studies supporting its efficacy in this population. However, pelvic floor physiotherapy in the treatment of postmenopausal women is less well-established, and furthermore, the types of urinary incontinence in postmenopausal women are much broader. We provide a comprehensive review of recent literature investigating the effectiveness of pelvic floor physiotherapy therapy for various conditions in postmenopausal women, including urinary incontinence, urgency urinary incontinence, pelvic organ prolapse, genitourinary syndrome of menopause, sexual dysfunction, and urinary incontinence in the context of obesity, frailty, mobility, and dementia. After evaluating the current literature, it is evident that there is insufficient data to definitively endorse or dismiss the utilization of Pelvic floor physiotherapy for treating urinary incontinence in postmenopausal women. Nevertheless, considering the low associated risks of pelvic floor physiotherapy, we advocate for the initiation of comprehensive, large-scale randomized studies aimed at evaluating its effectiveness in addressing urinary incontinence in postmenopausal women with special attention to vulnerable subgroups, including individuals who are obese, frail or experiencing cognitive impairment.

Construction of Progress Prediction Model of Urinary Incontinence in Elderly Women: Protocol for a Multi-Center, Prospective Cohort Study

BACKGROUND

Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to establish an effective UI progress prediction model for elderly women with UI for earlier detection and better treatment.

METHODS

This study is conducted as a prospective, multi-center, cohort study, and recruits 800 women aged ≥60 with mild or moderate UI in China. Participants are divided into three groups: stress urinary incontinence group (SUI), urgency urinary incontinence group (UUI), and mixed urinary incontinence group (MUI). This study will investigate the general conditions of patients, after complete relevant pelvic floor function assessment, as well as after follow up at 6 months, 12 months, and 18 months by telephone. The primary endpoint is UI disease progress. Single factor and multi-factor Cox regression model analyses are undertaken to evaluate the associated risk factors affecting the progress of UI to establish a progress prediction model for elderly women.

DISCUSSION

This study will provide more predictive information for elderly women with UI, and new clinical references for the intervention and the treatment of UI for medical staff.

Hypothetical Role of Growth Factors to Reduce Intervertebral Disc Degeneration Significantly through Trained Biological Transformations

BACKGROUND

Given the evidence of little or no therapeutic benefit of injection-based growth factor therapies, it has been proposed that a naturally triggered uninterrupted blood circulation of the growth factors would be superior.

OBJECTIVE

We seek to stimulate discussions and more research about the possibility of using the already available growth factors found in the prostate gland and endometrium by starting novel educable physiology, known as biological transformations controlled by the mind.

METHODS

We summarized the stretch-gated ion channel mechanism of the cell membrane and offer several practical methods that can be applied by anyone, in order to stimulate and enhance the blood circulation of the growth factors from the seminal fluid to sites throughout the body. This study describes, in detail, the practical application of our earlier published studies about biological transformations.

RESULTS

A previously reported single-patient case study has been extended, adding more from his personal experiences to continually improve this novel physiological training and extending the ideas from our earlier findings in detail.

CONCLUSION

The biological transformation findings demonstrate the need for additional research to establish the benefits of these natural therapies to repair and rejuvenate tissues affected by various chronic diseases or aging processes.

Randomized-Controlled Trial Examining the Effect of Pelvic Floor Muscle Training in the Treatment of Stress Urinary Incontinence in Men after a Laparoscopic Radical Prostatectomy Pilot Study

AIM

The aim of this study was to assess the impact of pelvic floor muscle training (PMFT) in the treatment of stress urinary incontinence (SUI) in men after they received radical prostatectomy (RP).

METHODS

From November 2018 to September 2019, patients who underwent radical prostatectomy were assessed for eligibility. A total of 37 men were then randomly assigned to the experimental group (EG) and the control group (CG). The EG group received supervised exercise twice a week for 12 weeks, and the CG did not receive any intervention. To objectify the results obtained in both groups before and after the intervention, the authors assessed myostatin concentration. Moreover, the Expanded Prostate Cancer Index Composite (EPIC-26) was applied to assess the quality of life, and Beck's Depression Inventory (BDI-II) was used to measure depression severity.

RESULTS

Study results demonstrated a statistically significant reduction of myostatin concentration in the EG following the treatment and no statistically significant differences in this parameter in the CG. In addition, a comparison of the EPIC-26 scores in the EG at the initial and final assessments revealed a statistically significant improvement in the quality of life in each domain. A comparison of the EPIC-26 scores in the CG at the initial and final assessments showed there is a statistically significant decline in quality of life in the "overall urinary problem" and "sexual" domain. A comparison of the BDI-II scores at the initial and final assessments showed a statistically significant decline in depressive symptoms in the EG and no statistically significant differences in the CG.

CONCLUSIONS

PFMT is an effective treatment for urinary incontinence (UI) in men who received radical prostatectomy.

Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial

Objective

The purpose of this study is to assess the effectiveness of pelvic floor muscle training and extracorporeal magnetic innervation in treatment of urinary incontinence in women with stress urinary incontinence.

Methods

The randomized controlled trial enrolled 128 women with stress urinary incontinence who were randomly allocated to either one out of two experimental groups (EG1 or EG2) or the control group (CG). Subjects in the experimental group 1 (EG1) received 12 sessions of pelvic floor muscle training, whereas subjects in the experimental group 2 (EG2) received 12 sessions of extracorporeal magnetic innervation. Subjects in the control group (CG) did not receive any therapeutic intervention. The following instruments were used to measure results in all study groups at the initial and final assessments: Revised Urinary Incontinence Scale (RUIS), Beck Depression Inventory (BDI-II), General Self-Efficacy Scale (GSES), and King's Health Questionnaire (KHQ).

Results

In both experimental groups, a statistically significant decline in depressive symptoms (BDI-II) and an improvement in urinary incontinence severity (RUIS) and quality of life (KHQ) were found in the following domains: “social limitations,” “emotions,” “severity measures,” and “symptom severity scale.” Moreover, self-efficacy beliefs (GSES) improved in the experimental group that received ExMI (EG2). No statistically significant differences were found between all measured variables in the control group. Comparative analysis of the three study groups showed statistically significant differences at the final assessment in the quality of life in the following domains: “physical limitations,” “social limitations,” “personal relationships,” and “emotions.” Conclusion. Pelvic floor muscle training and extracorporeal magnetic innervation proved to be effective treatment methods for stress urinary incontinence in women. The authors observed an improvement in both the physical and psychosocial aspects.

A randomised-controlled trial pilot study examining the effect of pelvic floor muscle training on steroid hormone concentrations in elderly women with stress urinary incontinence

INTRODUCTION

In this study, we attempted to examine the effect of pelvic floor muscle training on testosterone and cortisol concentrations in elderly women with stress urinary incontinence.

MATERIAL AND METHODS

The number of participants included in the analysis was 59: 30 women in the experimental group (EG) and 29 women in the control group (CG). The EG underwent pelvic floor muscle training, whereas the CG did not receive any therapeutic intervention. In the present study the authors measured testosterone and cortisol concentrations as well as body mass index (BMI) in all study participants at the initial and final assessments.

RESULTS

The initial and final assessment results were compared and showed a statistically significant decrease in cortisol concentration and an increase in testosterone concentration in the EG. However, no statistically significant differences in the measured variables were observed in the CG at the initial and final assessments. The authors did not report any statistically significant correlations between testosterone and cortisol concentrations and the BMI score in the EG and CG. Also, statistically significant correlations between testosterone and cortisol concentrations in the EG were not apparent.

CONCLUSIONS

Determination of the concentration of testosterone and cortisol is a method that may help to objectify pelvic floor muscle training outcomes in elderly women with stress urinary incontinence.

A Randomized-Controlled Trial Pilot Study Examining the Effect of Pelvic Floor Muscle Training on the Irisin Concentration in Overweight or Obese Elderly Women with Stress Urinary Incontinence

Objective

This study aimed to examine the effect of pelvic floor muscle training on the irisin (Ir) concentration in overweight or obese elderly women with stress urinary incontinence.

Methods

The number of participants included in analysis was 49: 28 women in the experimental group and 21 women in the control group. The experimental group (EG) underwent pelvic floor muscle training, whereas no therapeutic intervention was applied to the control group (CG). Irisin concentration, severity of urinary incontinence (RUIS), and body mass index (BMI) were measured in all women at the initial and final assessments.

Results

By comparing the initial and final assessment results we have been able to demonstrate statistically significant differences in the measured variables in the experimental group. No statistically significant differences in the measured variables were reported for the control group at the initial and final assessments. Moderate negative correlation was observed between the BMI results with the irisin concentration results in the EG at the initial assessment and no correlation at the final assessment. Weak positive correlation was observed between the BMI results with the irisin concentration in the CG at the initial and final assessment.

Conclusion

Further studies are necessary to observe the regulation of irisin concentration and explain mechanisms underlying these effects.

The effect of a comprehensive care and rehabilitation program on enhancing pelvic floor muscle functions and preventing postpartum stress urinary incontinence

This study was to investigate the incidence and the risk factors of postpartum stress urinary incontinence (SUI), and the effect of comprehensive care and rehabilitation program (CCRP) on preventing postpartum SUI.In stage I, 479 puerperae were recruited within 1 week postpartum, then the postpartum SUI incidence at 8th week and its risk factors were investigated. In stage II, 240 vaginal delivery puerperae were enrolled within 1 week postpartum and randomly assigned to CCRP group or control group as 1:1 ratio. The postpartum SUI incidence and pelvic floor muscle function indexes were evaluated at 8th week.In stage I, the postpartum SUI incidence was 25.7%, and SUI puerperae presented with higher body mass index (BMI), vaginal delivery rate, newborn weight, and larger newborn head diameter compared with non-SUI puerperae. Besides, the vaginal delivery, the elevated age and BMI were independent risk factors for postpartum SUI. In stage II, the postpartum SUI incidence in CCRP group was decreased compared with control group, and the vaginal resting pressure, vaginal squeezing pressure, and vaginal contraction duration were increased in CCRP group compared to control group at 8th week postpartum.The incidence of postpartum SUI is 25.7%, and the vaginal delivery, increased age, and BMI are independent risk factors for postpartum SUI. More importantly, CCRP strengthens pelvic floor muscle functions and decreases postpartum SUI incidence in puerperae.

Impact of Hysterectomy on Urethral Suspension with Transobturator Sling for Treatment of Stress Urinary Incontinence in Women

Urinary stress incontinence is a condition that increases with age, influenced by many factors, mainly anatomical pathological ones, determined by changes of muscular pelvic floor, but also by hormonal and local neurological modifications. The aim of the study was an overview of the efficacy of stress urinary incontinencetherapy with transobturatorurethralsling suspension in patients with or without prior hysterectomy. Additionally, we evaluated the effectiveness and the rate of side effects of this method. The study group consisted of 100 patients and, within it, 32 patients (group A)underwent a hysterectomy.We noticed an improvement of symptoms, a reduced discomfort and an increase of quality of life, more prominent in group B (patients without previous hysterectomy) (p=0,0012, p=0,17 respectively, p=0,03). We consider that transobturator approach in treating stress urinary incontinence is a simple, rapid and effective procedure and, not lastly, modern technique that assures a significant improvement of symptomsand quality of life for the patients; positioning the sling along to the insufficient pubourethral ligaments reinforces the structures supporting the urethra; this approach is minimally-invasive with rapid recovery, reduced hospitalization, is cost effective and involves minimal risks of infection, bleeding, etc. moreover, the transobturator tension free sling has some advantages (no pain or tension). The rate of success of the treatment is significantly lower in patients with prior hysterectomy.