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Xu P, Jin Y, Guo P, Xu X, Wang X, Zhang W, Mao M, Feng S. Barriers and enablers of pelvic floor rehabilitation behaviours in pregnant women with stress urinary incontinence: a qualitative analysis using the theoretical domains framework. BMC Pregnancy Childbirth 2023; 23:300. [PMID: 37118702 PMCID: PMC10148524 DOI: 10.1186/s12884-023-05633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/21/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Stress urinary incontinence during pregnancy is closely related to the occurrence of postpartum and long-term urinary incontinence. Early pelvic floor management is of great significance in promoting the recovery of pelvic floor tissues in pregnant women. However, effective management of urinary incontinence is far from achievable owing to the low adherence of pregnant women in partaking in pelvic floor rehabilitation. As a comprehensive framework for behavioural theory, the Theoretical Domain Framework allows for comprehensive identification of behavioural determinants. Using Theoretical Domain Framework, this study aimed to identify barriers and enablers of pelvic floor rehabilitation behaviours in pregnant women with stress urinary incontinence. METHODS A descriptive, qualitative design was used in this study. Face-to-face semi-structured interviews were conducted with pregnant women with stress urinary incontinence based on the Theoretical Domain Framework. The data were analysed using a combination of inductive and deductive methods. RESULTS Twenty pregnant women with stress urinary incontinence were interviewed. Seven themes were summarised and used to explain the pelvic floor rehabilitation behaviours of pregnant women with stress urinary incontinence. The seven themes were (1) individual knowledge and experience of pelvic floor management, (2) judgments about expected outcomes, (3) interactions of interpersonal situations, (4) environment, resources, and decision-making processes, (5) personal goal-setting and efforts towards behaviour change, (6) emotional influences on decision-making, and (7) personal characteristics. Besides the "Optimism" domain, 13 of the 14 Theoretical Domains Framework domains were found to influence pregnant patients' pelvic floor rehabilitation behaviours after deductive mapping of themes to the Theoretical Domains Framework. In addition, the inductive analysis generated a theme of personal characteristics that did not map to any of the Theoretical Domains Framework domains. CONCLUSIONS The pelvic floor rehabilitation behaviours of pregnant women with stress urinary incontinence are complex and are affected by many factors. The findings confirm the need for multiple interventions to support pelvic floor management in pregnant women with stress urinary incontinence, focusing on enhancing knowledge and skills in pelvic floor care and using appropriate behaviour change techniques (such as prompts) to provide a supportive environment.
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Affiliation(s)
- Ping Xu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Ying Jin
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Pingping Guo
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Xuefen Xu
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Xiaojuan Wang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Wei Zhang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Minna Mao
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Suwen Feng
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
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Bick D, Bishop J, Coleman T, Dean S, Edwards E, Frawley H, Gkini E, Hay-Smith J, Hemming K, Jones E, Oborn E, Pearson M, Salmon V, Webb S, MacArthur C. Antenatal preventative pelvic floor muscle exercise intervention led by midwives to reduce postnatal urinary incontinence (APPEAL): protocol for a feasibility and pilot cluster randomised controlled trial. Pilot Feasibility Stud 2022; 8:231. [PMID: 36273227 PMCID: PMC9588215 DOI: 10.1186/s40814-022-01185-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022] Open
Abstract
Background Antenatal pelvic floor muscle exercises (PFME) in women without prior urinary incontinence (UI) are effective in reducing postnatal UI; however, UK midwives often do not provide advice and information to women on undertaking PFME, with evidence that among women who do receive advice, many do not perform PFME. Methods The primary aim of this feasibility and pilot cluster randomised controlled trial is to provide a potential assessment of the feasibility of undertaking a future definitive trial of a midwifery-led antenatal intervention to support women to perform PFME in pregnancy and reduce UI postnatally. Community midwifery teams in participating NHS sites comprise trial clusters (n = 17). Midwives in teams randomised to the intervention will be trained on how to teach PFME to women and how to support them in undertaking PFME in pregnancy. Women whose community midwifery teams are allocated to control will receive standard antenatal care only. All pregnant women who give birth over a pre-selected sample month who receive antenatal care from participating community midwifery teams (clusters) will be sent a questionnaire at 10–12 weeks postpartum (around 1400–1500 women). Process evaluation data will include interviews with midwives to assess if the intervention could be implemented as planned. Interviews with women in both trial arms will explore their experiences of support from midwives to perform PFME during pregnancy. Data will be stored securely at the Universities of Birmingham and Exeter. Results will be disseminated through publications aimed at maternity service users, clinicians, and academics and inform a potential definitive trial of effectiveness. The West Midlands–Edgbaston Research Ethics Committee approved the study protocol. Discussion Trial outcomes will determine if criteria to progress to a definitive cluster trial are met. These include women’s questionnaire return rates, prevalence of UI, and other health outcomes as reported by women at 10–12 weeks postpartum. Progress to a definitive trial however is likely to be prevented in the UK context by new perinatal pelvic health service, although this may be possible elsewhere. Trial registration 10.1186/ISRCTN10833250. Registered 09/03/2020
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Affiliation(s)
- D Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7AL, UK.
| | - J Bishop
- University of Birmingham, Birmingham, UK
| | - T Coleman
- University of Leicester, Leicester, UK
| | - S Dean
- University of Exeter, Exeter, UK
| | - E Edwards
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - H Frawley
- University of Melbourne, Melbourne, Australia
| | - E Gkini
- University of Birmingham, Birmingham, UK
| | | | - K Hemming
- University of Birmingham, Birmingham, UK
| | - E Jones
- University of Birmingham, Birmingham, UK
| | - E Oborn
- University of Warwick, Coventry, UK
| | | | - V Salmon
- University of Exeter, Exeter, UK
| | - S Webb
- Royal College of Midwives, London, UK
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Araya-Castro P, Roa-Alcaino S, Celedón C, Cuevas-Said M, de Sousa Dantas D, Sacomori C. Barriers to and facilitators of adherence to pelvic floor muscle exercises and vaginal dilator use among gynecologic cancer patients: a qualitative study. Support Care Cancer 2022; 30:9289-9298. [PMID: 36065026 PMCID: PMC9444700 DOI: 10.1007/s00520-022-07344-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/24/2022] [Indexed: 12/24/2022]
Abstract
Objective Women with gynecologic cancer may suffer from pelvic floor dysfunction (PFD). Before radiotherapy, prehabilitation with pelvic floor muscle exercises (PFME) and vaginal dilator (VD) might prevent it and foster sexual life. This study aims to explore the experience of gynecologic cancer patients getting external beam radiation treatments regarding barriers to and facilitators of adherence to a prehabilitation program to prevent PFD. Methods This qualitative research with thematic content analysis included 11 women with gynecologic cancer and different levels of adherence to PFME and VD. Participants were interviewed based on a semi-structured script. The information was analyzed manually, assisted with Nvivo12® software, and triangulated with open coding. Results High self-motivation, desire to improve their health, symptoms of improvement, availability of time, the desire to resume sexual life, and the support of the partner were facilitators of adherence. The instructional exercise audio, clarity of the information, and closer communication with the physical therapist were also valued. The main barriers were general malaise secondary to oncological treatments, forgetfulness, lack of time, misinformation, lack of coordination with the treatment team, discomfort with the VD, and a feeling of shame. Feedback from the attending physician was a facilitator when present or a barrier when absent. Conclusion These barriers and facilitators should be considered when designing and implementing preventive programs with PFME and VD. Behavioral counselling should consider the desire to remain sexually active; in such cases, including the partner in the therapeutic process is appraised. Otherwise, the focus should be on benefits for maintenance of pelvic floor function.
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Affiliation(s)
- Paulina Araya-Castro
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.,Programa de Doctorado en Educación, Universidad Internacional Iberoamericana, Campeche, México
| | - Sonia Roa-Alcaino
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | | | | | - Cinara Sacomori
- Programa de Doctorado en Educación, Universidad Internacional Iberoamericana, Campeche, México. .,Universidad Bernardo O´Higgins, Santiago, Chile.
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Tunuguntla HSGR, Tunuguntla R, Kathuria H, Sidana A, Chaudhari N, Verma S, Shivanand I. App-based Yoga of Immortals: A Novel, Easy-to-use Intervention in the Management of Urinary Incontinence. Urology 2022; 167:73-81. [PMID: 35788018 DOI: 10.1016/j.urology.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the effectiveness Yoga of Immortals (YOI) intervention in participants with urinary incontinence (UI) of all types. YOI uniquely combines specific yogic postures, breathing exercises, sound therapy & meditation and is practiced by many for general well-being. MATERIALS AND METHODS In this App-based cohort study, a survey was sent to the YOI app subscribers. Those who identified with UI and consented were sent the ICIQ-UI- SF (for mean symptom score & severity of UI), and the ICIQ-LUTS-QOL (for impact of UI on QOL) Questionnaires at baseline, 4, and 8 weeks. Global impression of improvement was assessed by PGI-I scale. RESULTS 258/422 participants (18-74 years) were included and showed significant decrease in mean scores on the ICIQ-UI-SF (4.06 ± 0.24 at baseline; 2.90 ± 0.22 at 4-weeks [p ≤ 0.001] and 3.44 ± 0.23 at 8 weeks [p ≤ 0.001]) and ICIQ-LUTS-QOL (28.36± 0.74 at baseline; 24.46± 0.70 at 4-weeks [p ≤ 0.001] and 25.78± 0.70 at 8 weeks [p≤ 0.001]). Additionally, the 55-60 year subgroup also had significant decrease in mean scores on ICIQ-LUTS-QOL (25.06 ±1.20 at base line; 21.69 ± 1.07 at 4 weeks [p ≤ 0.01] and 22.28 ± 0.96 at 8 weeks [p ≤ 0.01]). CONCLUSION YOI intervention resulted in significant improvement in mean scores on ICIQ-LUTS-QOL; ICIQ-UI-SF; frequency and severity of urinary leak; and daily life activity. Majority of the participants felt 'very much better' on PGI-scale. Being app- based, it has the added advantage of the ability to be used anytime and anywhere.
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Affiliation(s)
- Hari Siva Gurunadha Rao Tunuguntla
- Department of Surgery, Division of Urology, Director, Section of Female Pelvic Medicine and Reconstructive Surgery, Voiding Dysfunction, Functional Urology, Neuro-Urology, Male Lower Genitourinary Reconstruction, Genitourinary Prosthetics, and Urodynamics, Robert Wood Johnson Medical School & Robert Wood Johnson University Hospital, 1, RWJ Place, New Brunswick, NJ 08901, USA.
| | - Renuka Tunuguntla
- Hunterdon Medical Center, Center for Healthy Aging, 121 Route 31, Suite 1000, Fleminton, NJ 08822, USA.
| | - Himanshu Kathuria
- Department of Pharmacy, National University of Singapore, Singapore 117543, Republic of Singapore.
| | - Abhinav Sidana
- Division of Urology, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267.
| | | | - Sadhna Verma
- The Cincinnati Veterans Administration Hospital & University of Cincinnati College of Medicine, 234 Goodman Street, Cincinnati, OH 45267-0761.
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Sobhgol SS, Smith CA, Thomson R, Dahlen HG. The effect of antenatal pelvic floor muscle exercise on sexual function and labour and birth outcomes: A randomised controlled trial. Women Birth 2022; 35:e607-e614. [PMID: 35277369 DOI: 10.1016/j.wombi.2022.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pelvic floor muscle exercises (PFME) are recommended for treatment of urinary incontinence with less evidence available about the effect on female sexual function (FSF) and childbirth. AIM To investigate the effect of antenatal PFME on FSF during pregnancy and the first three months following birth as a primary outcome, and on labour and birth outcomes as a secondary outcome. METHOD 200 nulliparous women were randomised to control (n = 100) and intervention (n = 100) groups. The women in the intervention group (IG) undertook PFME from 20 weeks gestation until birth and had routine antenatal care, while those in the control group (CG) received routine antenatal care only. The Female Sexual Function Index (FSFI) was used to measure FSF at 36 weeks gestation and three months postnatal. Baseline characteristics and childbirth data were also collected and analysed using SPSS. RESULTS There were no statistically significant differences between the two groups in terms of FSF scores during pregnancy and on childbirth outcomes. Sexual satisfaction was slightly higher in the CG [Mean ± SD, CG: 4.35 ± 1.45 vs. IG: 3.70 ± 1.50, (P = 0.03)] at three months after birth. However, 50% of women adhered to the PFME, and 40% of women did not resume sex by three months after the birth. CONCLUSION Though some trends were observed, the results showed no effect of PFME on sexual function or labour and birth outcomes. This needs to be interpreted considering the 50% adherence to PFME. More research is recommended.
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Affiliation(s)
- Sahar S Sobhgol
- School of Nursing and Midwifery, Western Sydney University, Locked bag 1797, Penrith, NSW 2751, Australia.
| | - Caroline A Smith
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW, Australia.
| | - Russell Thomson
- Graduate Research School and the Centre for Research in Mathematics and Data Science, Western Sydney University, Australia.
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked bag 1797, Penrith, NSW 2751, Australia.
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Moossdorff-Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Urinary incontinence 6 weeks to 1 year post-partum: prevalence, experience of bother, beliefs, and help-seeking behavior. Int Urogynecol J 2021; 32:1817-1824. [PMID: 33484286 PMCID: PMC8295159 DOI: 10.1007/s00192-020-04644-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/09/2020] [Indexed: 01/28/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Post-partum, women often experience urinary incontinence (UI). However, the association between experienced UI bother and UI beliefs and help-seeking behavior is less known. Therefore, we aim to investigate the prevalence of self-reported UI, the level of experienced bother and beliefs, to explain help-seeking behavior for UI in women in the Netherlands from 6 weeks to one year post-partum. METHODS A digital survey among post-partum women, shared on social media, was used for recruitment. The survey consists of: 1. demographic variables, 2. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), 3. ICIQ Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol), and 4. questions on beliefs and help-seeking behavior. For analysis, descriptive statistics and the independent samples t-test were used to determine differences between help- and non-help-seekers. RESULTS 415 women filled in the survey. The mean age was 30.6 years (SD 4.0, range 21-40) of which 48.2% was primiparous. The overall prevalence of UI was 57.1% (95% confidence interval (CI) (52.3-61.8)). Primiparous women reported a statistically significantly lower overall prevalence than multiparous women, 52.0% and 61.9% respectively (p = .043). UI was reported as bothersome in 38% of women, 25% of all women sought help. Help-seeking women showed significantly higher scores for bother, measured by the ICIQ-UI SF, than non-help seekers (p = .001). CONCLUSIONS More than half of all post-partum women in the Netherlands from 6 weeks to one year post childbirth experience UI (57.1%), 38% classified their UI as bothersome. In total 25% of UI women sought professional help.
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Affiliation(s)
| | - Bary C M Berghmans
- Pelvic Care Unit Maastricht, CAPHRI, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | | | - Esther M J Bols
- Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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Moossdorff-Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior. Int Urogynecol J 2021; 32:695-701. [PMID: 33078344 DOI: 10.1007/s00192-020-04566-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/02/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Pregnancy and delivery are thought to induce urinary incontinence (UI), but its clinical impact is less known. Therefore, we investigated the prevalence of self-reported UI, level of experience of bother, and beliefs to gain a greater understanding of help-seeking behavior in adult pregnant women. METHODS A digital survey shared on social media was used for recruitment. The survey consists of: (1) demographic variables, (2) International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), (3) ICIQ Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol), and (4) questions on beliefs and help-seeking behavior. For analysis, descriptive statistics and the independent samples t-test were used to determine differences between help- and non-help-seekers. RESULTS Four hundred seven women were eligible for data analysis. The prevalence of UI rises from 55.1% in the first to 70.1% in the third trimester, with an overall prevalence of 66.8%. Nearly 43.0% of the respondents reported UI occurring once a week or less; 92.5% of women lost a small amount; 90% reported slight to moderate impact on quality of life. Only 13.1% of the respondents sought help for their UI. The main reasons for not seeking help were: minimal bother and the idea that UI would resolve by itself. Help-seeking women showed significantly higher scores than non-help-seeking women regarding ICIQ-UI SF (p < 0.001), ICIQ-LUTSqol (p ≤ 0.001), and interference in daily life (p < 0.001). CONCLUSIONS During pregnancy, UI affects two out of three women, but only one in eight women sought professional help. Non-help-seeking women experience less bother.
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Flandin-Crétinon S, Roelens I, Sellier Y, Bader G, Carbonnel M, Ayoubi JM. [Assessment of pelvic floor muscle training programs and urinary incontinence in women: A literature Review]. ACTA ACUST UNITED AC 2019; 47:591-598. [PMID: 31255837 DOI: 10.1016/j.gofs.2019.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Pelvic floor rehabilitation is efficient for the first line treatment of urinary incontinence in women. However, several questions remain as regards the best pelvic floor muscle training program to recommend. The objective was perform a literature review regarding the muscular strengthening program to recommend to treat stress or mixed urinary incontinence in women. METHODS We performed a systematic review of studies on the topic using Medline's database covering the 10 last years. Among the 1130 articles that were identified, we retained 6 for our analysis. RESULTS Given the heterogeneity of the exercise programs, it was impossible to exhaustively and comparatively analyze their efficacies. However, a significant improvement is noted when the exercises are based on the muscular training principles of the American College of Sports Medicine. They combine long and short contractions with the practice of the knack in situations of pressure exertion and are part of a self-rehabilitation program based on the needs of the patient and the individual's progression. CONCLUSION Current knowledge does not allow us to recommend an optimal muscle training program to treat female urinary incontinence. Research must be conducted to evaluate different muscular training regimens but also their integration into a program based on personal needs as well as factors of adherence to the treatment of patients.
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Affiliation(s)
- S Flandin-Crétinon
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; Service de gynécologie obstétrique, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - I Roelens
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - Y Sellier
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - G Bader
- Chirurgie uro-gynécologique, clinique Hartmann, 92200 Neuilly-sur-Seine, France
| | - M Carbonnel
- Service de gynécologie obstétrique, hôpital Foch, 92150 Suresnes, France.
| | - J-M Ayoubi
- École de sages-femmes, hôpital Foch, 92150 Suresnes, France; Service de gynécologie obstétrique, hôpital Foch, 92150 Suresnes, France; UFR des Sciences de la Santé Simone Veil, Université de Versailles-St-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
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Abstract
Although common in women, mixed urinary incontinence (MUI) is under-reported and under-treated. It is linked to concomitant disturbances, which may be due to childbirth, ageing, or other medical conditions, in the complex bladder-urethra coordinated system of urine storage and emptying. Primary care physicians can evaluate MUI through history and simple clinical assessment or they can avail of more complex device and tools, such as urodynamic assessment. There is a wide range of therapeutic options. The recent proliferation of new drug treatments and surgical devices for urinary incontinence offers innovative strategies for therapy but products risk being introduced without long-term safety and efficacy assessment. Direct-to-consumer advertising has increased public awareness of MUI.
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Affiliation(s)
- Massimo Porena
- Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Ospedale S. Maria della Misericordia. Loc. S. Andrea delle Fratte, Perugia, 06100 Italy
| | - Elisabetta Costantini
- Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Ospedale S. Maria della Misericordia. Loc. S. Andrea delle Fratte, Perugia, 06100 Italy
| | - Massimo Lazzeri
- Department of Medical-Surgical Specialties and Public Health, Urology and Andrology Section, University of Perugia, Ospedale S. Maria della Misericordia. Loc. S. Andrea delle Fratte, Perugia, 06100 Italy
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