Dissertations / Theses: 'Female stress urinary incontinence'

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Pagorek, Stacey. "PREVALENCE OF SPORTS-RELATED STRESS URINARY INCONTINENCE IN THE FEMALE COLLEGIATE ATHLETE." UKnowledge, 2019. https://uknowledge.uky.edu/rehabsci_etds/57.

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Urinary incontinence is a health condition that is associated with involuntary leakage of urine. Stress urinary incontinence (SUI) describes involuntary leakage of urine on effort or exertion and can impact one’s ability to participate in activities and affect quality of life. Furthermore, clinical management of this health condition is challenging as individuals who experience urinary incontinence often do not report this concern to a health care provider. Stress urinary incontinence is not typically a health concern associated with young, healthy athletes. However, researchers have begun to examine the presence of this health condition amongst both a younger population and in athletes. Therefore, the purpose of this study is to assess the prevalence of stress urinary incontinence in collegiate female athletes. This study involved the development of an electronic survey tool to assess the prevalence of SUI in the female collegiate athlete. Female collegiate athletes from six different NCAA Division I schools were asked to complete the survey. The overall response rate for the survey was 32.6% (333/1020). Results indicate that SUI does in fact occur in NCAA Division I collegiate female athletes. Overall, 68.5% of female collegiate athletes surveyed reported ever experiencing SUI. During daily life activities (cough, sneeze, laugh), 54.2% of female collegiate athletes reported experiencing SUI. During participation in their sport, 40.0% of female collegiate athletes reported experiencing SUI, referred to as sports-related SUI. When reporting SUI experienced during either sport participation or during other exercise-based activities, 58.2% of female collegiate athletes reported SUI. The proportion of female athletes reporting sports-related SUI varied by sport. The highest prevalence of leakage in sport was reported by gymnasts (80%) and the lowest prevalence was reported by those who participated in rifle (0%). Over half (52.3%) of female athletes who reported sports-related SUI said their symptoms first began in high school. While majority of female collegiate athletes stated they did not avoid their sport because of SUI, one-fifth (20.5%) of athletes with sports-related SUI reported they alter how they move in their sport out of concern for leakage. The impact of sports-related SUI on other aspects of life (family, social, or school life) were reported to be minimal. Athletes who experience sports-related SUI are most likely to tell either a teammate (49%) or no one (36%). Very few female athletes have told someone in healthcare about this concern: doctor (3%), athletic trainer (4%); physical therapist (1%). Furthermore, only 3% of female collegiate athlete with sports-related SUI reported ever seeking treatment and only 25.8% reported they would find value in seeing a healthcare provider to discuss SUI. Most (76.7%) female collegiate athletes, whether they reported SUI or not, stated they had never been instructed on exercises to strengthen the pelvic floor muscles and 60.6% reported they would find educational programs involving exercises to decrease or prevent SUI beneficial. In conclusion, SUI does occur in the female collegiate athlete and is often not reported to healthcare providers. Based on this information, the general practice of screening athletes for relevant health conditions during pre-participation physicals may need to include additional questions for SUI. Further investigation needs to explore how to best engage and educate female collegiate athletes on the subject of SUI and how to successfully communicate with and address those with the condition.

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Abdel-Fattah, Mohamed. "Evaluation of transobturator tension free vaginal tapes in management of female urodynamic stress incontinence." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=230504.

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Mostafa, Alyaa. "Evaluation of single incision mini-slings in surgical management of female stress urinary incontinence." Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=217882.

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Objectives: To compare single incision mini-slings (SIMS) versus standard mid-urethral sling (SMUS) in the surgical management of female stress urinary incontinence (SUI) with regards; efficacy, safety and cost-effectiveness. Methods: A multicentre randomised controlled trial (RCT) comparing SIMS-Ajust® with SMUS-TVT-OTM (1-year follow-up) was performed. In addition, a systematic review and meta-analysis of RCTs comparing SIMS versus SMUS (1-3 years follow-up) was performed, incorporating the results of the RCT. Both studies assessed post-operative pain, time to return to normal activities and work, patient-reported and objective cure rates, peri-operative complications and impact on pre-operative urgency, women's quality of life (QoL), sexual function and cost effectiveness. Results: For the RCT, 137 women were randomised (SIMS-Ajust® [n=69] vs. TVT-OTM [n=68]). The SIMS Ajust® group had significantly lower post-operative pain-profile within the first four weeks (p <0.001). There were no significant differences in patient-reported success rate (p >0.999), objective success rate (p >0.999) or re-operation rates (p= 0.721) at 1-year follow-up. For the systematic review, 670 articles were identified, and 26 RCTs (n=3308 women) were included. After excluding RCTs evaluating TVT-SecurTM (recently withdrawn from clinical practice), there were no significant differences between SIMS and SMUS in patient-reported cure rates (RR 0.94, 95% CI 0.88, 1.00) and objective cure rates (RR 0.98, 95% CI 0.94, 1.01) at a mean follow-up of 18.6 months. SIMS had significantly lower post- 1 operative pain scores (WMD -2.94; 95% CI -4.16, -1.73), and earlier return to normal activities and work (WMD -5.08; 95% CI -9.59, -0.56; and WMD -7.20; 95% CI -12.43, -1.98, respectively). Conclusion: Adjustable anchored SIMS-Ajust® appears to have more favourable recovery, pain and cost effectiveness outcomes than SMUS-TVT-OTM, whilst having similar effectiveness outcomes, at 1-year follow-up. Generally, SIMS appear to have equivalent outcomes compared with SMUS at a mean follow-up of 18-months, in terms of patient-reported cure, objective cure and impact on women's QoL and sexual function. Consequently, SIMS represent a promising group of procedures in the treatment of women with SUI, and merits further research especially in terms of longer term outcomes.

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Weber, Lebrun Emily Elise. "Factors Associated with Subjective Improvement Following Midurethral Sling Procedures for Stress Urinary Incontinence: A Masters Thesis." eScholarship@UMMS, 2010. https://escholarship.umassmed.edu/gsbs_diss/466.

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Background Female stress urinary incontinence (SUI) greatly affects quality of life. The midurethal sling (MUS) procedure has been widely accepted as the standard of care treatment for SUI, although there is little information regarding patients' subjective reports of symptom improvement. Objectives The objective of this study was to identify clinical and demographic characteristics that predict subjective symptom improvement following MUS procedures in women with SUI. Materials and Methods The study design was retrospective cohort. Subjects included women who underwent MUS between 2006 and 2008, returned mailed surveys and met our predefined inclusion criteria. Pre-operative data included demographics, prior surgery, co-morbid diseases, urodynamics and concomitant reconstructive surgery. Subjective improvement was measured by score improvement on the UIQ-7, UDI-6, the UDI stress subscale and Question 3 of the UDI, "Do you experience urine leakage related to physical activity, coughing, or sneezing?" Results The mean age of the study sample was 57 years, parity was 2.5 and BMI was 28. Subjects with lower MUCP demonstrated more improvement on the UIQ-7. ΔUDI-6 stress subscale scores were more sensitive to symptom change than either the ΔUDI-6 or ΔUIQ-7. Older, menopausal subjects with urethral hypermobility and concomitant vaginal suspension showed less improvement than subjects without these characteristics. After controlling for urethral straining angle, PVR, menopause and time out from surgery, older age and concomitant vaginal suspension were associated with persistent post-op symptoms on the UDI-6 Question 3 and age remained the only variable associated with persistent symptoms on the UDI-6 stress subscale. Conclusion Concurrent vaginal suspension and advancing age were risk factors for persistent symptoms following MUS procedures in patients with SUI. Symptoms may recur after 24 post-operative months. Clinicians are encouraged to provide additional preoperative counseling to those women who are at greatest risk for persistent symptoms.

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Valpas, A. (Antti). "Evaluation of laparoscopic colposuspension and the tension-free vaginal tape procedure in the surgical treatment of female stress urinary incontinence." Doctoral thesis, University of Oulu, 2005. http://urn.fi/urn:isbn:9514278275.

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Abstract Though not a life threatening condition, involuntary loss of urine is a miserable situation. It has a multidimensional effect on the afflicted individuals, both men and women – and for the society. The purpose of this study was to evaluate two modern, minimally invasive surgical techniques for the treatment of female stress urinary incontinence (SUI). The techniques evaluated were laparoscopic colposuspension with mesh and staples (LCM) and the tension-free vaginal tape procedure (TVT). The study consisted of four parts. The first part (Study I) was an observational retrospective follow-up study. Data on the first forty patients operated on with LCM at Oulu University Hospital were collected. Patients had SUI or mixed urinary incontinence (MUI) with predominantly stress incontinence. The Studies II–IV were parts of a randomized, multicenter clinical trial, where LCM was compared with TVT. According to the predefined inclusion criteria 128 SUI women were randomly allocated into two treatment groups: 70 patients received TVT treatment as allocated and 51 LCM. There were seven drop-outs after randomization. After one year of follow-up the cure and improvement rate of the patients operated with LCM were ~ 90%. Also a significant improvement was found in Urinary Incontinence Severity Scores (UISS). At base line the score was 12.1 and after one year follow-up 2.7 (p < 0.001). The bladder perforation rate was 15%. In Study II immediate cure rates and complications of LCM and TVT were studied. After six weeks of follow-up there was no difference in cure rates (~ 90%) between the procedures. There was no difference in complication rates. A significant difference was found in the use of anti-inflammatory / opioid drugs in the immediate post-operative period to relief the pain in favour for TVT. Hospital care was also significantly shorter after TVT than LCM. After one year of follow-up (Study III) TVT was found to give better result both objectively and subjectively. Negative stress test result was recorded in 85.7% in the TVT group and 56.9% in the LCM group. A significant difference was also found, when Visual Analoque Scale (VAS), King's College Health Questionnaire (KHQ) and UISS were used as outcome measures, in the favour of TVT. When 48-hour pad test was used as outcome measure there was no statistically significant difference between the groups. The cost-effectiveness (Study IV) of TVT was found to be better than that of LCM after one year of follow-up. In conclusion, the results of this study suggest, that TVT procedure is on the whole a cost-effective alternative for LCM in the treatment of female SUI.

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Wahlström, Gunilla, and Kerstin Jonsson. "Yngre kvinnors upplevelse av hur urinläckage påverkar livssituationen." Thesis, Mid Sweden University, Mid Sweden University, Mid Sweden University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-9770.

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Background: Among young women vary the presence of urinary leakage between 28-80% depending on the study and the sport practiced. Poor support in the upper part of the urethra and urinary bladder base is considered the common cause of stress urinary incontinence. Supports are given by the pelvic floor muscles and the key muscles to prevent incontinence. Urinary leakage occurs more frequent in women who engaged in sports that provide a high abdominal pressure. Pelvic floor training is considered to be an effective and safe method to treat stress urinary incontinence and is recommended in the literature as the first treatment action. Aim: To examine young active women's experience of urinary incontinence affects their lives. Method: A qualitative design with tape-recorded interviews and semi-structured open questions were used as data collection method. A strategic selection was made. Six young active elite sportswomen interviewed. A qualitative content analysis was conducted. Results: Four categories were identified: manageable, social limitations, emotional and communication. Main findings shows that young women do not talk about urinary leakage as a problem, they have different ways to cope. Women experience a fear of urinary leakage shall be affected without prior notice and to lose control. The risk of urinary leakage gives concentration difficulties in training. The study shows a great lack of information. Weighted understanding: Among young women, there may be a risk that they are more affected by urinary leakage than middle-aged and older women, in terms of their experience of urinary leakage and leak impact on their lives. This in view of the ideals which today makes high demands and is difficult to live up to. Women get often their first information on the basin floor exercise to prevent urinary leakage at childbirth. This information should take place earlier.

Bakgrund: Hos unga elitidrottare varierar förekomsten av urinläckage mellan 28-80 % beroende på studie och vilken sport som utövas. Dåligt stöd i övre delen av urinröret och urinblåsans botten anses vara den valigaste orsaken till ansträngningsinkontinens. Stödet ges av bäckenbottenmuskulaturen och dess viktiga muskler för att förhindra inkontinens. Urinläckage förekommer oftare hos kvinnor som utövar sporter som ger ett högt buktryck. Bäckenbottenträning anses vara en effektiv och säker metod för att behandla ansträngningsinkontinens och rekommenderas i litteraturen som första behandlingsåtgärd. Syfte: Att undersöka yngre aktiva idrottande kvinnors upplevelse av om urininkontinens påverkar deras livssituation. Metod: En kvalitativ metod med bandade intervjuer och halvstrukturerade öppna frågor användes som datainsamlingsmetod. Ett strategiskt urval gjordes. Sex yngre kvinnliga aktiva elitidrottare intervjuades. En kvalitativ innehålls analys utfördes. Resultat: Fyra kategorier identifierades: Hanterbarhet, sociala begränsningar, Emotionellt och kommunikation. Huvudesultatet visar att yngre kvinnor inte pratar om urinläckage som ett problem, de hade olika sätt att hantera situationen. Kvinnorna upplevde en rädsla för att urinläckage skulle ske utan förvarning och för att tappa kontrollen. Risk för urinläckage gav koncentrationssvårigheter vid träning. Studien visar en stor informationsbrist. Sammanvägd förståelse: Hos yngre kvinnor kan det finnas en risk för att de påverkas mer av urinläckage än medelålders och äldre kvinnor, när det gäller upplevelsen av urinläckage och läckagets påverkan på livssituationen. Detta med tanke på de ideal som idag ställer stora krav och är svåra att leva upp till. Kvinnor får oftast sin första information om bäcken botten träning för att förebygga urinläckage vid barnafödande. Denna information bör ske tidigare.

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Czyrnyj, Catriona. "UROKIN: A Novel Software for Kinematic Analysis of Urogenital Motion Using Transperineal Ultrasound Imaging." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36147.

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Dynamic transperineal ultrasound (TPUS) video allows for kinematic analysis of urogenital morphology and mobility, however, measures are often limited to peak displacements of anatomical landmarks and are vulnerable to error incurred by probe rotation during imaging. This thesis aimed to (1) develop an algorithm to calculate kinematic curves of urogenital landmark motion from TPUS video and to (2) investigate the error incurred in these kinematic measures due to in-plane ultrasound probe rotation. UROKIN, a semi-automated software, was developed and, as a proof of concept, was used to identify differences in urogenital kinematics during pelvic floor muscle maximum voluntary contractions between women with and without stress urinary incontinence. A mathematical model revealed that the error incurred by TPUS probe rotation in the x- (anterior-posterior) and y- (cranial-caudal) directions, was a factor of: r, the radius of rotation; Ɵ, the in-plane angular probe rotation; and α, the angular deviation between the anatomical planes and the coordinate system in which error was calculated. As an absolute measure, the error incurred by in-plane probe rotation is reduced to a factor of only r and Ɵ. Moving forward, UROKIN must be adapted to include findings from (1), and must be tested for validity and reliability.

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Oremus, Mark 1968. "Surgery versus collagen to treat female stress urinary incontinence : physician beliefs and requirements for treatment & a modeled cost-effectiveness analysis." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30719.

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The Surgery Collagen Incontinence Trial (SCIT) is a randomized controlled trial evaluating the comparative efficacy of surgery versus collagen injection to treat female stress urinary incontinence (SUI). This thesis investigated two issues from SCIT: (1) the trial investigators' use of a consensus estimate that assumed collagen would be preferred as a first line treatment if it was at most 20% less efficacious than surgery; and (2) the cost-effectiveness of surgery and collagen.
A physician survey was conducted to help verify the SCIT investigators' consensus estimate. Respondents on average believed surgery was more efficacious than collagen, and they generally had stronger beliefs in the ability of surgery to meet their requirements for remaining the first line treatment for SUI. However, on average, respondents indicated a willingness to use collagen if it was at most approximately 23% less efficacious than surgery. The survey also provided baseline data for future research into how SCIT's results may or may not play a role in changing the views of clinicians.
The cost-effectiveness analysis was based on a risk-benefit model (decision-tree) that delineated the success rates, side-effects and complication rates of both surgery and collagen. Probabilities from the physician survey and the published literature were used in the model. Collagen was found to be less costly than surgery, but also less efficacious. Until more is known about collagen's long-term durability, the injection material will probably not gain coverage under Canada's provincial health insurance plans.

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Oremus, Mark. "Surgery versus collagen to treat female stress urinary incontinence, physician beliefs and requirements for treatment & a modeled cost-effectiveness analysis." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0034/MQ64424.pdf.

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Hoşcan, Burak Perk Hakkı. "Stres üriner inkontinans tedavisi tedavisinde ekstrakorporeal manyetik innervasyon /." Isparta : SDÜ Tıp Fakültesi, 2004. http://tez.sdu.edu.tr/Tezler/TT00199.pdf.

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Schmidt, Adriana Prato. "Tratamento conservador da incontinência urinária de esforço feminina : estudo comparativo entre reeducação vesical e treinamento da musculatura do assoalho pélvico com biofeedback." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/174826.

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Base teórica A incontinência urinária (IU) é um sintoma comum, afetando mulheres em todas as idades, com prevalência estimada em 30%. A incontinência urinária aos esforços (IUE) pode representar cerca de metade dos casos. O treinamento da musculatura do assoalho pélvico (TMAP), associado a medidas comportamentais e reeducação vesical constitui a primeira linha de tratamento. Apesar dos bons resultados em curto e médio prazo, pode haver perda de motivação e adesão ao tratamento em longo prazo. Técnicas complementares como o biofeedback (BIO) podem auxiliar no treinamento inicial e contribuir para melhores resultados, mas permanece indefinido o perfil de casos que pode realmente se beneficiar desta abordagem. Novos estudos e a implementação de dispositivos facilitadores do tratamento são necessários, pois a adesão é etapa fundamental para manutenção dos resultados. Objetivo Determinar o efeito do TMAP associado ao BIO comparados ao treinamento vesical (TV), considerando resultados com questionários de sintomas, qualidade de vida (QV) e função sexual (FS). Investigação adicional a partir de dados do diário miccional (DM), avaliação da funcionalidade dos músculos do assoalho pélvico por meio de palpação manual e perineométrica do assoalho, gerando informações adicionais sobre o efeito de ambos os tratamentos. Métodos Ensaio clínico randomizado, paralelo, aberto, incluindo mulheres acima de 18 anos com IUE na ausência de prolapso genital. Recrutamento de casos de forma consecutiva em ambulatório de uroginecologia, com alocação aleatória para TV ou BIO, sendo comparadas a resposta aos sintomas, força muscular, escores de QV e FS ao final de 3 meses de tratamento supervisionado com fisioterapeuta. Para o cálculo amostral foi considerada a detecção de uma diferença de 42 pontos percentuais entre os grupos e estimadas 26 pacientes em cada grupo para um α=0,05 e β-80%. Resultados Ao final do estudo, das 53 pacientes inicialmente recrutadas, 28 pacientes foram analisadas, 14 em cada grupo. Ambos os grupos apresentaram melhores resultados em número de perdas diárias (P<0.001), micções noturnas (P<0.002) e no questionário de sintomas (p<0.001). Na FS, não houve diferença individual e entre os grupos. Alguns domínios do questionário de qualidade de vida foram significativamente melhores nas pacientes que fizeram o treinamento vesical (TV), mas a percepção geral de saúde não se modificou de forma significativa ao longo do tempo e entre os grupos TV (P=0.157) e BIO (P=0.795). Apesar de ter havido melhora subjetiva da contração perineal, esse achado não se correlacionou com aumento de força muscular (rs=0.428 P=0.144). Conclusão No presente estudo, os resultados em ambos os grupos foram equivalentes em termos de melhora clínica, nas ferramentas de medida utilizadas, não sendo possível demonstrar um efeito significativo do biofeedback. O desenvolvimento de tecnologias para melhorar a adesão e motivação dos pacientes para o tratamento conservador segue sendo um desafio atual.
Objective: To compare the effect of pelvic exercises combined with biofeedback, against bladder training, using questionnaires on symptoms, quality of life, and sexual function. Methods: Randomized clinical trial. Women over the age of 18 with stress urinary incontinence, but without genital prolapse, were recruited at a urogynecology clinic and assigned to bladder training or pelvic floor restoration at home with biofeedback. Results for muscle strength and symptoms, quality of life, and sexual function questionnaires were compared after 3 months of physiotherapist-supervised treatment. Results: Fourteen patients in each group were analyzed at the end of the study. Both groups exhibited improved results for number of daily leakages (P<0.001), nighttime micturitions (P<0.002) and symptoms (P<0.001). For sexual function, there were no individual or intragroup differences. Some quality of life domains were significantly better in the bladder training patients, but perceived general health did not change significantly and did not differ between the BT (P=0.157) and BIO (P=0.795) groups. Improvements in perineal contraction were not correlated with increased muscle strength (rs=0.428 P=0.144). Conclusion: The two methods had equivalent results, but larger patient samples could change certain findings. It remains a challenge to develop technologies to improve patients’ motivation and adherence to conservative treatment. Registration: Plataforma ReBec (Brazilian Clinical Trials Register - http://www.ensaiosclinicos.gov.br/). Reference code REQ:7854.

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Poza, Barrasús José Luis. "Estudio de cohortes prospectivo del tratamiento quirúrgico de la incontinencia urinaria de esfuerzo femenina mediante bandas suburetrales transobturadoras." Doctoral thesis, Universitat Autònoma de Barcelona, 2020. http://hdl.handle.net/10803/671294.

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Estudi de cohorts prospectiu de 10 anys de duració, de les pacients intervingudes d’incontinència urinària d’esforç (IUE) mitjançant banda suburetral transobturadora (TOT), des de març de 2004 fins al desembre de 2006, a la Unitat del Sòl Pelvià del Servei de Ginecologia de l’Hospital Universitari Vall d’Hebron. Es van incloure un total de 565 pacients. Els resultats de la cirurgia van incloure factors objectius i subjectiu i es van dividir en: Curació, Milloria i Fallada. Les complicacions es van considerar en tres moments: Intraoperatòries, A curt termini (1 mes de la cirurgia). Els factors de risc analitzats han estat: Edat; Índex de Massa Corporal (IMC); Cirurgia prèvia per IUE; Cirurgia associada per a la correcció del prolapse genital (POP); Diagnòstic urodinàmic de la IUE; Via d’inserció de la TOT; i Cirurgià que realitzava la intervenció. La incidència de fallada global es va analitzar amb corbes de supervivència de Kaplan-Meier. La influència dels factors de risc sobre els resultats o les complicacions es van analitzar mitjançant regressió logística univariable i multivariable. Les comparacions de les variables categòriques es van realitzar mitjançant test de X2 o test exacte de Fisher. Resultats: Al darrer control, la Curació/Milloria va ser d’un 78%; Fallada per IUE un 8,8%; i Fallada per incontinència urinària d’urgència (IUU) un 13,3%. La probabilitat que una pacient resti curada o millorada després de la TOT és d’un 83,8% al primer any; d’un 77,6% al 5è any; i d’un 73,2% al 10è any. La fallada per IUE es detecta sobretot durant el primer any posterior a la intervenció, restant estable durant els següents anys. Els factors de risc de fallada van ser: Edat > 70 anys (HR 2,42) [C.I.95% 1,24-4,75]; Obesitat II (HR 2,31) [C.I.95% 1,14-4,69] i Obesitat III (HR 3,36) [C.I.95% 1,32-8,52]; i antecedent de cirurgia prèvia per IUE (HR 1,36) [C.I.95% 1,13-1,63]. La Incontinència urinària oculta va actuar com a factor protector per a fallada (HR 0,11) [C.I.95% 0,32-0,37]. La incidència de complicacions detectades en les pacients va ser: 4,80% intraoperatòries; 19,30% postoperatòries precoces (majoritàriament retencions urinàries durant la primera setmana posterior a la cirurgia); i un 4,1% de complicacions tardanes (1,76% de erosió-exposició, i 2,47% de seccions per disfunció de buidatge vesical). Els factors de risc associats a les complicacions postoperatòries immediates han estat: la cirurgia associada per POP (OR 1,75) [C.I.95% 1,10-2,78], i la via d’inserció de la TOT (OR 1,86) [1,22-2,85]. No s’han detectat factors de risc associats a les complicacions intraoperatòries o postoperatòries tardanes. Un 34,69% de les pacients amb fallada per IUE van voler una nova cirurgia, i se’ls va realitzar un implant de banda suburetral retropubiana (TVT); els resultats de la segona cirurgia van ser: Curació-Milloria en el 58,8% i Fallada per IUE en el 41,2%. No es van trobar diferències esta estadísticament significatives al comparar els grups de pacients amb fallada per IUE reintervingudes o no, ni entre els grups de pacients amb fallada per IUE i fallada per IUU. Conclusions: La banda suburetral transobturadora ha estat una tècnica eficaç i segura en les pacients de la cohort. L’edat, l’obesitat II i III i l’antecedent de cirurgia prèvia per IUE van actuar com a factor de risc de fallada, mentre que la incontinència urinària oculta es va mostrar com a factor protector. Només un 34% de les pacients amb fallada per IUE són reintervingudes de nou.
El objetivo principal de este estudio es conocer la eficacia y seguridad de la TOT a largo plazo, 10 años. Como objetivo secundario se ha establecido analizar los factores de riesgo que pueden influir en el resultado y complicaciones de la técnica quirúrgica. Material y métodos: Estudio de cohorte prospectivo de 10 años de duración, de las pacientes intervenidas por IUE mediante TOT, desde marzo de 2004 hasta diciembre de 2006, en la Unidad de Suelo Pélvico del Servicio de Ginecología del Hospital Universitario Vall d’Hebron. Un total de 565 pacientes fueron finalmente incluidas en el estudio. Los resultados de la cirugía incluyen factores objetivos y subjetivos, y se dividieron en: Curación, Mejoría, y Fallo. Las complicaciones se consideraron en 3 momentos: Intraoperatorias, A corto plazo (< 1 mes posterior a la cirugía), y a largo plazo (en cualquier momento del control postoperatorio > a 1 mes de la cirugía). Los factores de riesgo analizados han sido: Edad; IMC; Cirugía previa por IUE; Cirugía asociada para la corrección del POP; Diagnóstico urodinámico de la IUE; Vía de inserción de la TOT; y cirujano que realizaba la intervención. La incidencia de fallos global se analizó mediante curvas de supervivencia de Kaplan-Meier. La influencia de los factores de riesgo sobre los resultados o las complicaciones se analizaron mediante regresión logística univariable y multivariable. Las comparaciones de las variables categóricas se realizaron mediante test de X2 o test exacto de Fisher. Resultados: A último control la curación-mejoría fue de un 78%; Fallo por IUE un 8,8%; y Fallo por IUU un 13,3%. La probabilidad de que una paciente permanezca curada o mejorada tras la TOT es de un 83,8% al primer año; de un 77,6% al 5º año; y de un 73,2% al 10º año. El fallo por IUE se detecta sobre todo durante el primer año posterior a la intervención, permaneciendo estable durante los siguientes años. Los factores de riesgo para fallo fueron: Edad > 70 años (HR 2,42) [C.I.95% 1,24-4,75]; Obesidad II (HR 2,31) [C.I.95% 1,14-4,69] y Obesidad III (HR 3,36) [C.I.95% 1,32-8,52]; y antecedente de cirugía previa por IUE (HR 1,36) [C.I.95% 1,13-1,63]. La Incontinencia urinaria oculta actuó como factor protector para fallo (HR 0,11) [C.I.95% 0,32-0,37]. La incidencia de complicaciones detectadas en las pacientes fue: 4,80% intraoperatorias; 19,30% postoperatorias precoces (mayoritariamente retenciones urinarias en la primera semana posterior a la cirugía); y un 4,1% de complicaciones tardías (1,76% de erosión-exposición, y 2,47% de secciones por disfunción de vaciado vesical). Los factores de riesgo asociados a las complicaciones postoperatorias inmediatas han sido: la cirugía asociada por POP (OR 1,75) [C.I.95% 1,10-2,78], y la vía de inserción de la TOT (OR 1,86) [1,22-2,85]. No se han detectado factores de riesgo asociados a la complicaciones intraoperatorias o postoperatorias tardías. Un 34,69% de las pacientes con fallo por IUE desearon nueva cirugía, a las que se les realizó una banda suburetral retropubiana (TVT); los resultados de la segunda cirugía fueron de: Curación-mejoría en el 58,8% y Fallo por IUE en el 41,2%. No se han encontrado diferencias estadísticamente significativas al comparar los grupos de pacientes con fallo por IUE reintervenidas o no, ni entre los grupos de pacientes con fallo por IUE y fallo por IUU.
Material and methods: It is a 10-year prospective cohort study, of female patients who have undergone TOT surgical procedure because of a SUI, from March 2004 to December 2006, in the Pelvic Floor Unit from Vall d'Hebron University Hospital. A total of 565 patients were finally included in the study. The results from the surgery include objective and subjective items which were divided into: total healing, improvement and failure. Surgical complications have been considered at three different times: intraoperatively, short-term (<1 month after surgery) and long-term (at any time after the first month postoperatively). The risk factors analyzed included are: age, BMI, previous SUI surgeries, associated genital prolapsed surgery, urodynamics diagnosis of SUI, sling type of insertion route and surgeon who performed the intervention. Overall failure incidence was analyzed using Kaplan-Meier survival curves. The influence of risk factors on outcomes and complications was analyzed using univariate and multivariate logistic regression. Categorical variables were compared based on the X2 test or Fisher's exact test. Results At the last follow-up, the cure-improvement rate was 78%; SUI failure rate was 8.8% and UUI failure rate was 13.3%. The probability that a patient might remain healed or improved after the TOT insertion is 83.8% the first year, 77.6% until the 5th year and 73.2% ten years after the surgery. Failure, because of persistent SUI, is detected in most of the cases during the first year after the TOT insertion and it remains stable during the following years. The risk factors to present a failure are the following: age> 70 years (HR 2.42) [C.I.95% 1.24-4.75], obesity II (HR 2.31) [C.I.95% 1.14-4.69] and Obesity III (HR 3.36) [C.I.95% 1.32-8.52], and a history of previous SUI surgery (HR 1.36) [C.I.95% 1.13-1.63]. Hidden urinary incontinence (UI) shows to act as a protective factor for failure (HR 0.11) [C.I.95% 0.32-0.37]. The complication rate detected in the patients is: 4.80% intraoperative, 19.30% early postoperatively (mainly urinary retention during the first week) and 4.1% late complication rate (1.76% erosion-exposure, and 2.47% sections due to bladder emptying dysfunction). The risk factors associated with immediate postoperative complications demonstrated are these surgeries which associated prolapse surgery (OR 1.75) [95% CI 1.10-2.78] and the route of TOT insertion (OR 1.86 ) [1.22-2.85]. No other risk factors have been found to be associated with intra or postoperative complications. Meanwhile, a 34.69% of the patients who have suffered from a SUI failure have requested a second new surgery, considering the best option a retropubic tension-free vaginal Tape (TVT). Finally, the results obtained from this second sling surgery are a 58.8% healing-improvement and 41.2% SUI failure. No statistically significant differences were found between the groups of patients who suffered from a SUI failure compared to the ones who suffered from a UUI failure. When we focused on SUI failure, there is no differences statistically significant between those who had received a second surgery compared to those who didn’t. Conclusions: In conclusion, the TOT surgery has been demonstrated widely to be an effective and safe technique in our group of patients. Age, obesity grade II or III and a previous history of SUI surgery, seem to play as risk factors to suffer from a TOT failure; while, on the other hand, hidden UI acts as a protective factor. Only 34% of our patients who had reported a SUI failure requested a second surgery.

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Mummery, Christine C. "Efficacy of physiotherapy treatment for female urinary incontinence." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0020/MQ47075.pdf.

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14

Khullar, Vikram. "Ultrasound imaging of the female lower urinary tract." Thesis, King's College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391595.

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15

Spirka, Thomas A. "Finite Element Modeling of Stress Urinary Incontinence Mechanics." Cleveland State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=csu1291495865.

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16

Quinn, Martin. "Vaginal ultrasound of the lower urinary tract." Thesis, University of Bristol, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240026.

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17

Cutone, Benjamin. "Female urinary incontinence and treatment rates among a Medicare population." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12340.

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Thesis (M.S.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Introduction and Hypothesis: The objective ofthis study was to determine the treatment rates of urinary incontinence (UI) in women 65 years old and older by education, poverty, and socioeconomic status (SES). Additionally, it was investigated ifhaving a discussion with a health care provider about UI had any effect on treatment rates. Methods: The publicly available 2007-2009 Medicare Health Outcome Survey data was examined in regards to four items that query about UI. All women 65 years old and older who provided data on UI and level of education were included in the analysis. United States Census Bureau data were used to establish poverty and SES variables. Results: In total, 87,805 women met inclusion criteria and 43.2% reported experiencing some UI in the past 6-months with only 28.6% receiving any treatment for UI. Women with a college education who self-reported either a "small" or "big" UI problem were more likely to receive treatment for their UI (OR = 0.84 (95% CI 0.79, 0.89)) and (OR= 0.77 (95% CI 0.69, 0.86). Women with a college education and any magnitude ofUI were also more likely to discuss their UI problem with a health care provider (OR = 0.93 (95% CI 0.88, 0.97)) and (OR= 0.80 (95% CI 0.72, 0.89)). For women with a small UI problem, a discussion with a provider was most impactful in regards to treatment for women without a college education. For women with a big UI problem, a discussion was most beneficial to treatment for women with a college education. Conclusion: UI is a prevalent condition among women 65 years old and older. Women without a college education are disadvantaged in regards to receiving any treatment for UI. Treatment rates may be improved among less educated women if providers initiate discussions regarding UI during the clinical encounter.

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Berglund, Anna-Lena. "A holistic view of urinary stress incontinence in women." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 1995. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96892.

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The present study group consists of 45 women with genuine stress incontinence who were selected for surgical treatment and randomized either to retropubic urethrocystopexy (n=30) or pubococcygeal repair (n=15). The preoperative assessment included medical history, gynecological examination, urine analysis and culture, residual urine, pad test, frequency-continence charts, water urethrocystoscopy, continence test and cystometry with analysis of micturition. Moreover, five semistructured interviews were performed with the women and two with their partner. The following questionnaires were used measuring a) personality characteristics: Karolinska Scales of Personality (KSP), Eysenck Personality Inventory (EPI), b) depression: Beck Depression Inventory (BDI) and c) social support: Interview Schedule for Social Interaction (ISSI). The results have shown that there was no difference in the subjective cure rate between the two surgical methods (73% vs. 80 % respectively). The bladder volume had increased in both groups and the intravesical pressure of the bladder filled to maximum had increased in the pubococcygeal repair group. Other urodynamic variables were unchanged by the operation. Pad tests have demonstrated that 67 % of the women in the urethrocystopexy group and 47 % in the pubococcygeal repair group ceased to leak urine. Postoperatively, 63 % of the women in the urethrocystopexy group needed high doses of analgesics compared with only 33 % in the pubococcygeal repair group. Among the women experiencing severe to very severe pain dysphoric subjects were overrepresented. Postoperative residual urine was a minor nursing problem in both groups. Women with SUI of long duration scored significantly higher than controls on the KSP scales of somatic anxiety, psychic anxiety, psychasthenia, suspicion and on the EPI lie-scale. There was no significant difference in sexual activity before and after surgery. One or two sexual dysfunctions within the desire, excitement, orgasmic and resolution phase were reported by the majority of women both before and after surgical intervention. The cured women reported a higher level of overall activities before surgery than the improved (i.e. not cured) women, whereas post surgery both the cured and the improved women obtained about the same level of activities. Regarding social support, no differences between the cured or improved women occured as concerns attachment. The cured women showed a higher degree of adequacy of social integration compared with the improved women. In order to delineate predictive factors for the surgical outcome the following variables were investigated: age of patient, duration of urine leakage, parity, personality, psychological and social factors. The following predictors of the outcome of surgical treatment emerged: duration of stress incontinence, neuroticism and age of patient. The results of the present study indicate the ecessity of a multidisciplinary approach to the treatment and nursing of women with SUI.

Diss. (sammanfattning) Umeå : Umeå universitet, 1995

digitalisering@umu

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19

Pierson, Wanda Jane. "A study of the effect of stress incontinence and bladder retraining on older women's perceived self-esteem." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27730.

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The purpose of this descriptive study was to determine the existence of a relationship between perceptions of global self-esteem and stress incontinence episodes in a group of older women participating in a bladder retraining protocol. A convenience sample of fifteen older women was obtained. The participants constituted a group of well older women who ranged in age from 63 years to 82 years. All participants were living in the community and experiencing urinary incontinence. The University of British Columbia Model for Nursing was the conceptual framework which guided the focus of the study. The model views the individual as a behavioural system composed of nine interrelated and interdependent subsystems. This study focused on the interrelationship of the excretory and ego-valuative subsystems. The theory of self-efficacy, as outlined by Bandura provided the method by which this study was operationalized. Self-efficacy is the product of personal efficacy—an individual's judgement of the effectiveness of an executed course of action in achieving a desired outcome. The enactive, persuasive, and emotive modes of influence were utilized to provide efficacy information. Data were collected on three occasions using four instruments. The first instrument involved collection of selected demographic variables and was completed during the initial interview. A continence assessment and the Rosenberg self-esteem scale were completed during the initial and final interviews. An interview guide was used during a telephone contact. The telephone contact occurred four days following the first interview; the final interview occurred fourteen days after the first. The data were summarized, compared and described using measures of central tendency and frequency distributions. Paired t-tests were performed on selected variables to determine if there was a difference between pre and post intervention interview score. These tests demonstrated no significant differences in scores. Study findings indicated that at the end of the two week trial 53% of the women were able to identify a change in their voiding habits. Four of the participants (26.7%) stated that they were completely continent at the completion of the two week trial and four other participants (26.7%) indicated that $ some type of positive change had occurred. Three women (20%) identified a negative change in their continence status. Global self-esteem scores, as measured by the Rosenberg self-esteem scale, remained relatively stable during the two week trial period. Scores appeared to be unaffected by a change in continence status. This may be due to the many successful normalizing strategies subjects had developed to hide the evidence of the symptom of urinary incontinence.
Applied Science, Faculty of
Nursing, School of
Graduate

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Hägglund, Doris. "Att leva med urinläckage : en longitudinell populationsstudie om livskvalitet hos kvinnor och hur de hanterar sitt urinläckage /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/uu/fulltext/nbn_se_uu_diva-2542.pdf.

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Balog, Brian Michael. "Brain-Derived Neurotrophic Factor Mediates Recovery from Stress Urinary Incontinence." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1602113592326106.

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22

Garley, Ailyn. "A case series to pilot cognitive behaviour therapy for female urinary incontinence." Thesis, Lancaster University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422963.

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23

McNally, Donal Stewart. "Pressure measurement in the investigation and treatment of urinary stress incontinence." Thesis, University of Exeter, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.253561.

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24

Dragomir, Anca Dana Schroeder Jane C. "Uterine location of leiomyomata risk factors and relation to stress urinary incontinence /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2007. http://dc.lib.unc.edu/u?/etd,1223.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2007.
Title from electronic title page (viewed Mar. 26, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology." Discipline: Epidemiology; Department/School: Public Health.

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25

Wise, Brian George. "A clinical evaluation of maximal electrical stimulation in the management of female urinary incontinence." Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.362656.

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26

Jackson, Simon. "Oestrogen supplementation in postmenopausal urinary stress incontinence : effect secondary to altered collagen pathophysiology?" Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390374.

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27

Tegerstedt, Gunilla. "Clinical and epidemiological aspects of pelvic floor dysfunction /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-065-6/.

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28

Murray, A. "A critical study of the application of the fluid bridge test before, during and after surgery for stress incontinence in women." Thesis, University of Liverpool, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384350.

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29

Nyyssönen, V. (Virva). "Transvaginal mesh-augmented procedures in gynecology:outcomes after female urinary incontinence and pelvic organ prolapse surgery." Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526205632.

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Abstract Problems of female urinary incontinence and pelvic organ prolapse are common. Traditional operative techniques in the treatment of these conditions have unsatisfactory efficacy outcomes and involve complications. Attempts have been made to solve this problem with synthetic meshes, but with the use of meshes mesh-related complications have appeared. The situation is difficult because the number of different meshes, techniques and instrumentations is numerous. The present study was conducted to investigate the safety issues and complication rates of four structurally different polypropylene meshes used in transvaginal surgery when treating female urinary incontinence and apical or posterior vaginal prolapse. Vaginal mesh exposures were under special interest. Subjective outcome and patient satisfaction of tension-free vaginal tape (TVT) and transobturator tape (TOT) methods in the treatment of female urinary incontinence were reported. Objective and subjective cures of posterior intravaginal sling (PIVS) and Elevate®Posterior procedures were investigated. The incidence of vaginal mesh exposure varied between different meshes. The highest exposure incidence, 16–25%, was found with heavyweight microporous multifilament mesh. The lowest mesh exposure incidence, 0.9%, was seen with lightweight macroporous monofilament mesh. The subjective cures of the TVT and TOT procedures were 84% and 80%, and patient satisfaction rates were 79% and 74%, respectively. The objective cure of posterior IVS was only 69% and patient satisfaction rate 62%, while Elevate®Posterior reached 84–98% objective cure rate, depending on the definition used. Subjective efficacy of this procedure was 86%. According to this study, the use of heavyweight microporous multifilament should be abandoned because of the intolerably high vaginal mesh exposure incidence. The subjective efficacy and patient satisfaction of TVT and TOT procedures are satisfactory. Both objective and subjective cure rates of posterior IVS are poor, whereas the Elevate®Posterior technique with lightweight macroporous monofilament mesh presents promising results
Tiivistelmä Virtsankarkailu ja emättimen monimuotoiset laskeumat ovat naisilla yleisiä. Näitä vaivoja perinteisillä leikkaustekniikoilla hoidettaessa leikkaustulokset ovat olleet epätyydyttäviä sekä tehon että komplikaatioiden ilmaantuvuuden osalta. Ongelmaa on yritetty ratkaista synteettisien verkkojen avulla, mutta verkkojen käytön myötä niihin on havaittu liittyvän myös ongelmia. Tilannetta hankaloittaa myös erilaisten verkkomateriaalien, tekniikoiden ja instrumentaatioiden runsaslukuisuus. Tässä tutkimuksessa selvitettiin neljän rakenteeltaan erilaisen polypropyleenistä valmistetun verkon turvallisuutta ja komplikaatioiden esiintyvyyttä hoidettaessa verkkoavusteisesti naisen virtsankarkailua ja emättimen pohjukan tai emättimen takaseinämän laskeumaa. Erityisenä kiinnostuksen kohteena olivat verkkoihin liittyvät eroosiot. Virtsankarkailun hoidon subjektiivinen teho ja potilastyytyväisyys selvitettiin käytettäessä tension-free vaginal tape- (TVT) ja transobturator tape (TOT) -tekniikoita. Laskeumien hoidon objektiivinen ja subjektiivinen teho arvioitiin käytettäessä posterior intravaginal sling- (PIVS) ja Elevate®Posterior -tekniikoita. Verkon eroosioiden ilmaantuvuus vaihteli rakenteeltaan erilaisten verkkojen välillä siten, että tiivistä mikroporoottista multifilamenttinauhaa käytettäessä eroosioiden ilmaantuvuus oli 16–25 %, kun taas kevyttä makroporoottista monofilamenttiverkkoa käytettäessä eroosioprosentti oli 0.9. TVT-menetelmällä saavutettiin 84 %:n ja TOT menetelmällä 80 %:n subjektiivinen teho. TVT-potilaista hoitoon tyytyväisiä oli 79 % ja TOT-potilaista 74 %. Posteriorinen IVS saavutti vain 69 %:n objektiivisen tehon pohjukan laskeuman hoidossa. Potilastyytyväisyys oli samaa luokkaa, 62 %. Sen sijaan Elevate®Posterior-menetelmää käytettäessä saavutettiin käytetystä tehon määritelmästä riippuen 84–98 %:n objektiivinen teho. Subjektiivinen teho tällä menetelmällä oli 86 %. Tämän tutkimuksen perusteella tiiviin mikroporoottisen multifilamenttiverkon käyttöön liittyvä verkkoeroosioiden määrä on sietämättömän suuri. Vakiintuneiden TVT- ja TOT-menetelmien subjektiivinen teho ja potilastyytyväisyys ovat hyväksyttäviä. PIVS-metodia käytettäessä sekä objektiivinen että subjektiivinen tulos on huono, kun taas Elevate®Posterior-menetelmän ja siinä käytetyn kevyen verkon käytöstä saadut tulokset ovat lupaavia

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Sjöström, Malin. "Internet-based treatment of stress urinary incontinence : treatment outcome, patient satisfaction, and cost-effectiveness." Doctoral thesis, Umeå universitet, Allmänmedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-84405.

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Background Stress urinary incontinence (SUI) is the leakage of urine when coughing, sneezing, or on exertion. It affects 10-35% of women, and can impair quality of life (QOL). First-line treatment is pelvic floor muscle training (PFMT). However, access barriers and embarrassment may prevent women from seeking care. There is a need for new, easily accessible ways to provide treatment. Aim To evaluate the treatment outcome, patient satisfaction, and cost-effectiveness of an Internet- based treatment programme for SUI. Methods We recruited 250 community-dwelling women aged 18-70 years, with SUI ≥1/week via our website. Participants were randomised to 3 months of PFMT with either an Internet-based programme (n=124), or a programme sent by post (n=126). We had no-face-to face contact with the participants, but the Internet group received individually tailored e-mail support from an urotherapist. Treatment outcome was evaluated after 4 months with intention-to-treat analysis. After treatment, we telephoned a strategic selection of participants (Internet n=13, postal n=8) to interview them about their experiences, and analysed the results according to grounded theory principles. We also performed a cost-utility analysis with a 1-year societal perspective, comparing the treatment programmes with each other and with a no-treatment alternative. To scrutinize our measure of QOL, we performed a reliability study of the ICIQ-LUTSqol questionnaire. Results Participants in both intervention groups achieved highly significant improvements (p<0.001) with large effect sizes (>0.8) in the primary outcomes symptom score (ICIQ-UI SF: mean change Internet 3.4 [SD 3.4], postal 2.9 [3.1]), and condition-specific QOL (ICIQ-LUTSqol: mean change Internet 4.8 [SD 6.1], postal 4.6 [SD 6.7]); however, the differences between the groups were not significant. Compared with the postal group, more participants in the Internet group perceived they were much or very much improved after treatment (40.9%, vs. 26.5%, p=0.01), reduced their use of incontinence aids (59.5% vs. 41.4%, p=0.02), and indicated satisfaction with the treatment programme (84.8% vs. 62.9%, p<0.001). Results from the interviews fell into three categories: about life with SUI and barriers to seeking care; about the treatments and the patient-provider relationship; about the sense of empowerment many women experienced. A core category emerged: “Acknowledged but not exposed.” The extra cost per quality-adjusted life year (QALY) gained through use of the Internet-based programme compared with the postal programme was €200. The extra cost per QALY for the Internet-based programme compared with no treatment was €30,935. The condition-specific questionnaire ICIQ-LUTSqol is reliable in women with SUI, with high degrees of agreement between overall scores (Intraclass correlation coefficient 0.95, p<0.001). Conclusion Internet-based treatment for SUI is a new, effective, and patient-appreciated treatment alternative, which can increase access to care in a sustainable way.

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Yip, Clare. "The contribution of pelvic muscle and ligament weaknesses to the development of stress urinary incontinence." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/37905.

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The symptoms of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) are incited by strenuous activities, such as a valsalva maneuver, cough or lifting heavy objects. SUI is characterized by weakened bladder neck support and urine leakage. POP is characterized by the displacement of pelvic organs into the vaginal space. In women, the symptoms of SUI and POP often coexist, yet their relationship remains ambiguous. The POP-related defects that are relevant to SUI are unknown and are yet to be examined. Damages in pelvic floor muscles and cardinal and uterosacral ligaments are potential defects leading to SUI, since they are commonly found in SUI patients with POP symptoms. These defects can be objectively evaluated using Pelvic Muscle Strength test and Pelvic Organ Prolapse Quantification (POPQ) test. This study aims to explore the contribution of pelvic muscle and ligament weaknesses to the development of SUI by developing a biomechanical model of a female pelvic support system. The model simulates the behavior of a pelvic system during a valsalva maneuver, and it incorporates muscle strength score and POPQ points. Patient data were collected and implemented into the model to estimate the material parameters that describe the stiffness properties of the vaginal and ligament tissues for clinical patients. Using the model with parameters, the effect of varied degree of muscular and ligament weaknesses on the changes in the bladder neck and apical vaginal supports were assessed for the patients. The estimated vaginal and ligament parameters were shown to vary, illustrating the diverse material properties of pelvic tissues in individuals. In modeling, simulated conditions of defective muscles and ligaments were demonstrated to contribute to bladder neck and vaginal apex prolapse, consistent with the clinical conditions of POP; alternatively, simulated conditions of restored muscular and ligament supports were shown to help re-establish both bladder neck and vaginal apex supports. The results exhibit the impact of compromise of pelvic muscles and ligaments on the development of SUI and vaginal apex prolapse and suggest a mechanism of how pelvic muscles and vaginal apex rehabilitation impact SUI and vaginal apex supports in patients with coexisting POP symptoms.

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Gill, Bradley Cameron. "Neurotrophin Therapy Improves Recovery from Postpartum Stress Urinary Incontinence Following Simulated Childbirth Injury in Rats." Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1336054611.

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Brooks, Kaylee. "Characteristics Predictive of Successful Pelvic Floor Muscle Training Outcomes Among Women with Stress Urinary Incontinence." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36667.

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Physiotherapist-supervised pelvic floor muscle (PFM) training is the recommended first-line treatment for women with stress urinary incontinence (SUI); however, only up to 50% of women are cured with this treatment. The primary objective of this study was to develop a predictive model of successful physiotherapy intervention outcomes among women with SUI using predictors that are accessible to clinicians. The secondary objective of this study was to run a preliminary investigation of morphologic differences between women with SUI who were cured with a physiotherapy intervention and those who were not cured, using a subset of ultrasound imaging data. Seventy-nine women with SUI were assessed at baseline on measures of demographic data (i.e. age, body mass index, etc.), 3-day bladder diary, 30-minute standardized pad test, clinical assessments of PFM strength and tone, and transperineal ultrasound assessments of PFM morphology. Women then attended a 12-week physiotherapy intervention and returned for a follow-up assessment. The multivariate logistic regression model was significant (p < .001) with two predictors: baseline ICIQ-FLUTS UI subscale (SUI severity; p = .01) and parity (p = .06). A significant ROC curve for the ICIQ-FLUTS UI subscale (p ˂ .01) predicts physiotherapy intervention outcomes with 55.6% sensitivity and 80.8% specificity at a cut-off score of 7.50. Women most likely to be cured with a physiotherapy intervention were those with lower scores on the ICIQ-FLUTS UI subscale and those who have given birth to fewer children. Significant differences were found in a subset of data between women with SUI who are cured with the physiotherapy intervention and women who are not cured on morphologic measures in standing of bladder neck height at peak cough (p = .03), descent of the bladder neck during maximal Valsalva maneuver (MVM; p = .04), levator hiatus circumference at rest (p = .03) and at maximal voluntary contraction in both standing and supine (MVC; p = .01; p = .03). Variables that were trending towards significance included bladder neck height in standing at rest, levator plate length (LPL) at maximal excursion during a cough and MVM in standing, and mid-urethral wall cross-sectional area. These significant differences indicate potential value in using ultrasound imaging outcomes as predictors of a cure with physiotherapy intervention in future models, and a combination of demographic, clinical, and morphologic variables may build a more robust predictive model.

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Angelini, Kimberly. "A Cross-sectional Exploration of Lower Urinary Tract Storage Symptoms Among a Sample of Female Undergraduate College Students." Thesis, Boston College, 2018. http://hdl.handle.net/2345/bc-ir:108091.

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Thesis advisor: Katherine Hutchinson
Lower urinary tract (LUTS) storage symptoms, including overactive bladder (OAB) and urinary incontinence (UI), are common conditions among women with significant health and economic consequences. Much of the existing literature on LUTS focuses on older, often postmenopausal women, and there is limited research available about prevalence, incidence and severity of LUTS in young women. For many young women in the United States, the period from the late teens through early twenties coincides with the period of emerging adulthood and college enrollment. The unique factors influencing women at this stage of development may be influential in understanding prevalence and correlates of OAB and UI later in the life-course. The purpose of this cross-sectional descriptive survey-based study was to explore and describe the experience of urinary storage symptoms, specifically OAB and UI, among female undergraduate college students, and to identify associated factors. Qualtrics online platform was used to create and distribute the survey to a sample of 1,800 female college undergraduate students at a private Catholic university in the northeast. Two instruments previously used to assess LUTS, the ICIQ-FLUTS and LUTS Tool, were combined into the Urinary Symptoms Scale with a one-week recall. Twelve items assessed LUTS storage symptoms of OAB and UI. The final sample consisted of 456 female undergraduate college students with a mean age of 20.3-years-old. The sample was predominantly White non-Hispanic. Most commonly reported symptoms included urgency (47.6%), frequency (52.6%), urinary incontinence (21.3%), stress urinary incontinence (28.8%), and urge urinary incontinence (16.4%). Total severity scores were low and highly skewed towards the lower range (M = 3.31; SD = 3.91). Participants with symptoms, most commonly reported experiencing symptoms rarely or sometimes during the past week. Perceived bother from urinary symptoms mean scores were low (M = 1.77) but extended the full range on a 0 to 10 scale. In this study, perceived bother from urinary symptoms as well as perceived impact of urinary symptoms on activities of daily life (ADLs) were significantly associated with care-seeking and use of self-management strategies. Interestingly, LUTS storage symptom severity was not significantly associated with care-seeking, but it was related to use of self-management strategies in this population. Perception of overall health, history of constipation/IBS, sexual activity, delayed toileting behaviors, and premature toileting behaviors were significant in multivariate analyses when controlling for other factors. Further research on the relationship of these factors and LUTS storage symptoms is needed. This study represented a first step in understanding college women’s experiences with LUTS storage symptoms and identifying the unique personal, behavioral and environmental factors associated with LUTS. The study found that OAB and UI symptoms are common among female college undergraduates. In addition, a number of personal and behavioral factors were found to be associated with LUTS storage symptoms. Given that many health-related behaviors established during college years may persist later in adulthood, identifying experiences and influences of young women’s LUTS storage symptoms is important in informing future research and practice recommendations
Thesis (PhD) — Boston College, 2018
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing

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Lord, Helen Elizabeth. "A randomised controlled equivalence trial comparing tension-free vaginal tape (TVT) with suprapubic urethral support sling (SPARC)." University of Western Australia. Faculty of Medicine and Dentistry and Health Sciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0086.

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[Truncated abstract] Approximately 35% of women worldwide have stress incontinence, which is defined as involuntary leakage of urine on effort, exertion, or on sneezing and coughing. There are various surgical techniques for stress incontinence; however, minimally invasive operations are increasingly being chosen by surgeons and their patients. Of these procedures, tension-free vaginal tape (TVT) has a cure rate of approximately 90% and is now perceived as the standard technique for stress incontinence. Reported complications of TVT include arterial laceration, bladder perforation, bowel perforation, de novo urgency, dyspareunia, excessive blood loss, haematoma, nerve injuries, urethral erosion, urge incontinence, urinary tract infection, vascular injury, vaginal mesh erosion, voiding dysfunction and death. Suprapubic urethral support sling (SPARC) is a very similar minimally invasive operation and early indications suggested that the success rate for treating stress incontinence was expected to be identical or better than those obtained with the earlier TVT approach, with possibly fewer adverse perioperative events. Our trial sought to establish equivalence between TVT and SPARC in relation to short-term complications and efficacy. OBJECTIVES The primary outcome was bladder perforation. Secondary outcomes were blood loss, voiding difficulty, urgency, and cure of stress incontinence symptoms. METHOD A randomised controlled one-sided equivalence trial (RCT) was conducted in Perth, Western Australia during 2003 and 2004 by researchers in the School of Population Health, University of Western Australia (UWA) and King Edward Memorial Hospital (KEMH). Patients were recruited from the public Urology/Urogynaecology Clinic at the primary women's hospital and the consultant surgeons' private practices. ... However, acute urinary retention requiring a return to theatre to loosen the tape (TVT 0%, SPARC 6.5%; OR: [infinity], 95% CL: 2.2, [infinity]; p=0.002) and subjective short-term cure (TVT 87.1%, SPARC 76.5%; OR: 2.07, 95% CL: 1.13, 3.81; p=0.03) were statistically significantly different. CONCLUSIONS The results are consistent with clinical equivalence between TVT and SPARC in relation to the incidence of bladder perforation. No statistically significant difference was found between TVT and SPARC in blood loss, urgency or short-term objective cure of stress incontinence at the six week post-discharge visit to the surgeon. However, the tapes were more difficult to adjust correctly in SPARC procedures and a statistically significant number of patients required a return to theatre for loosening of the tape (TVT 0/147, 0% and SPARC 10/154, 6.5%, p=0.002). Compared with SPARC, TVT was statistically significantly higher for subjective short-term cure. In ii relation to vaginal mesh erosion, TVT was lower than SPARC, though not statistically significantly. Overall, voiding difficulty (loosening of the tape), urgency and vaginal mesh erosion were the most important clinical problems. This randomised controlled trial demonstrates the importance of testing new devices which appear to be similar, but which may have clinically relevant differences. A follow up study to assess the long-term efficacy of tension-free vaginal tape and suprapubic urethral support sling and associated complications is planned.

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Pires, Telma Filipa Rodrigues Pereira. "Effects of pelvic floor muscles training on prevention and treatment of stress urinary incontinence in pregnant." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/16541.

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Mestrado em Fisioterapia
Introduction: Stress urinary incontinence (SUI) is the most common type of urinary incontinence (UI) in pregnant women and is known to have detrimental effects on the quality of life (QoL). Pelvic floor muscle training (PFMT) is considered the first-line treatment and prevention of SUI in pregnant women. Since there are few randomized controlled trial studies (RCT) in this population, it is important to check the effectiveness of another randomized protocol of the PFMT. Objectives: This study aimed to verify the effects of PFMT between the Intervention Group (IG) and the Control Group (CG) and exploring the effects with and without PFMT, in pregnant women. Methods: Participated in this RCT, pregnant women (aged 21-44 years), having been applied two questionnaires: King's Health Questionnaire (KHQ's) and Broome Pelvic Muscle self-efficacy Scale. The amount of urine was assessed using the modified pad test (20 minutes) and the muscular strength of the Pelvic Floor Muscles (PFM) was measured with Oxford Grading Scale. There were two moments of assessment, T1: 1st time of evaluation (pre- delivery) and T2: 2nd time of evaluation (6 weeks after delivery). The IG was added an exercise plan with duration of six weeks, applicable in Preparation for childbirth classes and at home exercise plan for 9 weeks. Results:The loss of urine, quantified by the Pad test significantly reduced, 0.86±0.83at T1 to 0.50±0.67at T2 in IG (p= 0.021). The degree of muscle contraction, measured by the Oxford Grading Scale, increased significantly in IG (p<0.001) from 3.59±0.85 to 4.82 ± 0:39 and did not change significantly in the CG (p=0.609). The total KHQ and severity of symptoms were observed significant improvements in both groups (p <0.05). As for the scale of Broome - Total scale women's IG improved significantly (p = 0.001 and p = 0.031, respectively) while in CG women no significant change (p> 0.05). Conclusion: PFMT can prevent and treat SUI, and recommend strength training of the PFM during pregnancy, two times per week for at least 6-9 weeks, making it extremely relevant for clinical practice.
Enquadramento: A Incontinência Urinária de Esforço (SUI) é o tipo mais comum em mulheres grávidas, tendo implicações prejudiciais para a qualidade de vida. O treino dos músculos do pavimento pélvico (PFMT) é considerado um tratamento de primeira linha para a SUI. Uma vez existirem poucos estudos randomizados controlados (RCT) nesta população, é importante verificar a eficácia de mais um protocolo randomizado de PFMT. Objetivos: Este estudo teve como objetivos verificar os efeitos do treino dos músculos do pavimento pélvico entre o grupo de intervenção (IG) e o grupo controle (CG) e explorar os efeitos com e sem treino dos músculos do pavimento pélvico, em mulheres grávidas. Métodos: Participaram neste RCT, mulheres grávidas (com idades compreendidas entre os 21-44 anos), tendo sido aplicados dois questionários: King´s Health Questionnaire (KHQ’s) e Broome Pelvic Muscle Self-Efficacy Scale. A quantidade de urina foi avaliada através do pad-test modificado (20minutos) e a força muscular dos músculos do pavimento pélvico (PFM) foi medida com o Oxford Grading Scale. Houve dois momentos de avaliação, a 1ª avaliação (T1), no período pré-parto e a 2ª avaliação (T2), 6 semanas após o parto. Ao IG foi acrescentado um plano de exercícios com duração de 6 semanas, aplicável nas aulas de preparação para o parto, com supervisão e um plano de exercícios ao domicílio, durante 9 semanas, sem supervisão. Resultados: A perda de urina, quantificada pelo pad test, reduziu significativamente, de 0.86±0,83 em T1 para 0.50±0.67 em T2 no IG (p = 0.021). O grau de contração muscular, avaliado pelo Oxford Grading Scale, aumentou significativamente no IG (p <0.001) de 3.59±0,85 para 4.82±0.39 e não sofreu alterações significativas no GC (p=0.609). No KHQ total e severidade dos sintomas observaram-se melhorias significativas em ambos os grupos (p <0,05). Quanto à escala de Broome – Total, as mulheres do IG melhoraram significativamente (p=0.001 e p=0.031, respetivamente) e nas mulheres do CG não se verificaram nenhumas alterações significativas (p> 0,05). Conclusão: O PFMT pode prevenir e tratar a SUI, e recomenda-se o treino da força do PFM durante a gravidez, 2 vezes por semana durante pelo menos 6-9 semanas, tornando-se de extrema relevância para a prática clínica.

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Franzén, Karin. "Interventions for urinary incontinence in women : survey and effects on population and patient level." Doctoral thesis, Örebro universitet, Hälsoakademin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-12631.

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Urinary Incontinence is a common health problem that can cause both severe medical and social problems, resulting in negative impact on different aspects of Quality of Life. In 2000, the Swedish Council on Health Technology Assessment (SBU) published a systematic review, “Treatment of Urinary Incontinence” where multiple knowledge gaps in the field of UI, all of considerable clinical importance, were pointed out.Several of these knowledge gaps have been the starting points for the projects in this thesis. The overall aim has been to study the impact of different interventions for urinary incontinence in women on the population level but also on the patient group level, for assessessing the significance of UI on general living conditions and to validate instruments to measure quality of life to be used as part of the evaluation of treatment effectiveness. Paper I: A population-based study where UI amongst women was found to be commonly associated with different psychosocial problems and an expressed feeling of vulnerability. Paper II: A population-based study where informative material on UI to the general public in order to increase knowledge and encourage self management was found promising for meeting increasing demands and optimizing healthcare resources. Paper III: A randomized controlled trial where both electrical stimulation and drug therapy reduced the number of micturitions and improved QoL in women with urge or urge incontinence, but electrical stimulation was not found to be superior to drug therapy. Paper IV: A prospective cohort study where the international questionnaires UDI-6 and IIQ-7 after translation and validation, showed good responsiveness and were easy to administer and to fill out. The UDI-6 scale did not accomplish the same solid result in the psychometrical analysis as the IIQ-7 scale but both scales showed good responsiveness and can thereby be recommended for clinical use.

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Rahmanou, Philip. "Assessment of lower urinary tract function in women with urodynamic stress incontinence with and without detrusor overactivity." Thesis, Imperial College London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.589995.

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There are many diagnostic tests available to help evaluate urethral sphincter and bladder dysfunction in patients with urinary incontinence. The most commonly used tests are multichannel cystometry, urethral pressure profilometry, leak point pressure, bladder diaries, pad tests and quality of life questionnaires. More recently, measurements of opening detrusor pressure obtained during pressure f1ow urodynamic studies have claimed to offer a suitable alternative to tests predicting urethral sphincter insufficiency. There have been very few studies evaluating the validity and reliability of these investigations in assessing lower urinary tract in women. The initial part of this thesis provides a review of the normal and abnormal bladder and urethral function. It also presents an overview of the investigation and management of women with lower urinary tract dysfunction. The remainder of this thesis aims to determine the reliability of the various tests currently available. This is done by assessing their reproducibility using test re-test analysis, on the same subject, in two different visits. The different tests are compared in a larger number of subjects, to establish any correlation that may be evident between them. Furthermore, I have compared different subgroups of patients with urodynamic stress incontinence, with or without detrusor overactivity, and assessed the effect they have on the reproducibility of urodynamic studies, urethral function tests and other commonly used bladder investigations. In the last section, the relevance of the study findings are discussed, final conclusions are made and suggestions for future research considered.

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Irazabal, Flores Alessandra Milagros, and cante Giancarlo Yaya. "Association between physical activity and stress urinary incontinence in sportswomen from a private university in Lima - Peru." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/655774.

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Introduction Urinary incontinence in young sportswomen is a common disorder that interferes with sports practice. Objective: To determine if there is an association between physical activity and stress urinary incontinence in sportswomen from a private university. Methodology: Analytical cross-sectional study, developed in sportswomen from the Peruvian University of Applied Sciences. The International Physical Activity Questionnaire - short version (IPAQ –SF) was used to determine the level of physical activity and the Abbreviated Form of the International Incontinence Consultation Questionnaire (ICIQ - SF) to determine stress urinary incontinence. Results: Of the 92 athletes analyzed in the study, 75% performed high physical activity, 47.8% presented urinary incontinence, of which 63.3% belonged to stress urinary incontinence. In the bivariate analysis between physical activity and stress urinary incontinence, 46% of the athletes who performed high physical activity presented stress urinary incontinence compared to 10% who performed moderate or low physical activity, being significant (p < 0.05). In the multivariate analysis, it was evidenced that women who perform high physical activity have 7.92 times more prevalence of stress urinary incontinence than women who perform moderate or low physical activity, being significant (p = 0.04) and adjusted to the age variables, kind of sport and sport time. Conclusion: An association was found between high-intensity Physical Activity and Stress Urinary Incontinence in female university athletes.
Introducción: La incontinencia urinaria en mujeres jóvenes deportistas es un trastorno frecuente y que interfiere con la práctica deportiva. Objetivo: Determinar si existe asociación entre la actividad física y la incontinencia urinaria por esfuerzo en mujeres deportistas de una universidad privada. Metodología: Estudio transversal analítico, desarrollado en las mujeres deportistas de la Universidad Peruana de Ciencias Aplicadas. Se utilizó el Cuestionario Internacional de Actividad Física – versión corta (IPAQ –SF) para determinar el nivel de actividad física y el Formulario abreviado del cuestionario de Cuestionario Internacional de Incontinencia de formato corto (ICIQ – SF) para determinar la incontinencia urinaria por esfuerzo. Resultados: De las 92 deportistas analizadas en el estudio, el 75% realizaba actividad física alta, el 47, 8% presentaron incontinencia urinaria, de las cuales el 63.3% pertenecían a incontinencia urinaria por esfuerzo. En el análisis bivariado entre la actividad física y la incontinencia urinaria por esfuerzo, el 46% de las deportistas que realizaba actividad física alta presentaban incontinencia urinaria por esfuerzo en comparación con el 10 % que realizaba actividad física moderada o baja, siendo significativo (p<0.05). En el análisis multivariado, se evidenció que las mujeres que realizan actividad física alta tienen 7.92 veces más prevalencia de Incontinencia Urinaria por Esfuerzo que las mujeres que realizan actividad física moderada o baja, siendo significativo (p=0.04) y ajustado a las variables edad, tipo de deporte y tiempo de deporte. Conclusión: Se encontró asociación entre la Actividad Física de alta intensidad con la Incontinencia Urinaria por Esfuerzo en deportistas mujeres universitarias.
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Spjuth, Sofia, and Sara Elomri. "The Nurse's Role in the Care of Females with Urinary-incontinence in South Africa : - An empirical study." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-42639.

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Summary Background: Urinary incontinence is a condition in which the patient experience involuntary leakage of urine. It is a significant global health issue which annually affect millions of people. However, statistics on prevalence and epidemiology on the condition is limited, which might be as the condition is considered stigmatizing in many populations. Aim: The aim of this empirical study was to describe the nurse’s role in the care of females with urinary incontinence. Method: A qualitative study with semi-structured interviews was the most appropriate method to use. Twelve nurses was interviewed, the data was analysed with an inductive approach and content analysis. Result: Three main themes were identified; To give emotional support, Providing knowledge and access to information and The nurse’s interaction with the female. The findings show that the role of the nurse in the care of females with urinary incontinence is more complex than expected. Conclusion: The result indicates that the role of the nurse is an important part for the female to feel secure and understood. The emotional support provided by the nurses' is a central element of the care. It is important to increase the knowledge about the condition since the female’s often feel ashamed to talk about their condition.

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Khaida, Lina Sarah. "Prevalência e fatores de risco da incontinência urinária em atletas de diferentes modalidades desportivas: revisão bibliográfica." Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/6723.

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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: a prática desportiva leva a muitos benefícios físicos e psicológicos, mas, paradoxalmente, a sua exigência poderá causar disfunções, nomeadamente génito-urinárias. Objetivo: avaliar a prevalência e os fatores de risco da incontinência urinária (IU) em atletas de diferentes modalidades desportivas. Metodologia: a pesquisa foi realizada nas bases de dados Scielo e PubMed, fundamentada em artigos compreendidos entre os anos de 2007 e 2017, avaliados segundo a escala Critical Appraisal Skills Programme (CASP). Resultados: nesta revisão foram incluídos 11 estudos, com um total de 3666 participantes do sexo feminino, atletas e sedentárias, com uma média de idades de 24,49±6,75 anos. As atletas, independentemente da modalidade ou do nível desportivo, são mais suscetíveis de desenvolver incontinência urinária do que as mulheres sedentárias. Conclusão: as atletas de distintas modalidades apresentam uma grande variabilidade quanto à prevalência da incontinência urinária. Nos desportos gravitacionais, os que incluem saltos, foi observada uma maior prevalência de IU. A competição, o impacto e o volume de atividade física realizada poderão ser fatores potenciadores ou fatores de risco para o aparecimento de IU.
Background: sports practice draws away many physical and psychological benefits but, paradoxically, its requirement can cause dysfunctions, notably genito-urinary. Objectives: assess the prevalence and the risk factors of urinary incontinence among athletes of different sports modality. Methodology: the survey was conducted in Scielo and PubMed databases, based on articles dated between 2007 and 2017, evaluated according to the Critical Appraisal Skills Program (CASP) scale. Results: 11 studies were included in this revision, with a total of 3666 participants, women athletes and sedentary women, with a medium age of 24,49±6,75 years old. Women athlete, regardless of the sport modality or sports level, are more likely to develop an urinary incontinence than sedentary women. Conclusion: athletes of different modalities present a large variability in the prevalence of urinary incontinence. In gravitational sports, which include jumps, a higher prevalence of UI has been noticed. Competition, impact and volume of physical activity can be potential factors or risk factors of appearance of UI.
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Clark, Linnette. "Effect of transverse abdominus muscle activation on a pelvic muscle exercise program in women with stress urinary incontinence." Thesis, NSUWorks, 2008. https://nsuworks.nova.edu/hpd_pt_stuetd/12.

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Purpose: The literature indicates that normal healthy women can increase the strength of the pelvic floor muscles (PFMs) by simultaneously contracting the transverse abdominus (TrA) muscle. This study investigated the relationship of the PFMs and the TrA in women with stress urinary incontinence (SUI). Subjects: 15 women with SUI, verified by scores on the Questionnaire of Urinary Incontinence Diagnosis (QUID), were randomly assigned, blocked by age, into 2 exercise groups. The 6 women in the PFM only group had a mean age of 63 years and the 9 women in the PFM+TrA group had a mean age of 49 years. Method: For 2 weeks, all women were trained by rehabilitative ultrasound imaging (RUSI) to correctly contract the TrA or relax the TrA during a PFM contraction depending upon the group assignment. Each woman was examined using the PERFECT scheme and prescribed a patient-specific PFM exercise program. The exercise protocols required 6 weeks of supervised patient specific exercises. Data collection occurred at 3 time periods (before intervention, after intervention, and follow-up) and included: measurement of TrA thickness changes and PFM lift by RUSI, PFM strength and endurance with pressure perineometry, number of incontinence episodes and pad use from bladder diaries, and quality of life (QOL) measurements using the Incontinence Impact Questionnaire (IIQ) and the Patient Specific Functional Scale (PSFS). Results: MANOVA identified no significant difference after interventions between groups. All women significantly improved in PFM strength (PConclusion: PFM exercises done in isolation or with recruitment of the TrA increased PFM strength, endurance, lift and decreased incontinence in women with SUI. Recommendations: Women with SUI can benefit from physical therapists prescribing PFM exercises in isolation or in combination with TrA contractions.

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Nilsson, Margareta. "Female urinary incontinence : impact on sexual life and psychosocial wellbeing in patients and partners, and patient-reported outcome after surgery." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-55006.

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Background: Urinary incontinence (UI) and urgency are common conditions and can have a profound influence on many aspects of life. Approximately one in four women has UI and one in ten has daily symptoms. Knowledge is lacking, however, on the impact of UI and urgency on the lives of affected women and their partners and on the situation of women with urinary leakage one year postoperatively. Aims: To study the consequences of female UI and urgency for patients and their partners on quality of life (QoL), the partner relationship, and their sexual lives. Also to evaluate the success rates of three operation methods: tension-free vaginal tape (TVT), tension-free vaginal tape-obturator (TVT-O), and transobturator tape (TOT) for stress urinary incontinence (SUI), with a particular focus on women who still have urinary leakage one year after surgery. Methods: Women seeking healthcare for UI and/or urgency and their partners were invited to answer questionnaires. The women completed disease-specific questionnaires and both the women (n = 206) and their partners (n = 109) answered questions about their psychosocial situation, partner relationship, and sexual life. Patient-reported outcomes one year after surgery with TVT, TVT-O, or TOT (n = 3334) were derived from the Swedish National Quality Register for Gynaecological Surgery. Results: Most of the women reported that their urinary problems negatively affected their physical activities, and almost half reported negative consequences for their social life. Women aged 25–49 years were less satisfied with their psychological health, sexual life, and leisure than women aged 50–74 years. One third of both the women and their partners (all the partners were men) experienced a negative impact on their relationship, and sexual life was negatively affected in almost half of the women and one in five of their men. Coital incontinence was reported in one third of the women. Most of their men did not consider this a problem, but the majority of the affected women did. Satisfaction with outcome of the operation did not differ between TVT, TVT-O, and TOT, but TVT showed a higher success rate for SUI than TOT did. Higher age, higher body mass index, a diagnosis of mixed urinary incontinence, and a history of urinary leakage in combination with urgency each constitute a risk for a lower operation success rate. After one year, 29% of the women still had some form of UI, but half of these were satisfied with the outcome and most reported fewer negative impacts on family, social, working, and sexual life than before the operation. Conclusions: Female UI and/or urgency impaired QoL, particularly in young women, and had negative effects on partner relationships and on some partners’ lives. Sexual life was also affected, more often in women with UI and/or urgency than in their partners. At one-year follow-up after surgery, about one third of the women still had some form of UI, but the negative impact on their lives was reduced. A challenge for health care professionals is to initiate a dialogue with women with urinary symptoms about sexual function and what surgery can realistically be expected to accomplish.

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Henley, Janet. "Exploration of the process of changing district nursing practice to reflect research findings in the management of female urinary incontinence." Thesis, Queen Margaret University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.394549.

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Pinho, Maria Teresa Silva Castanheira. "A intervenção fisioterapêutica e sua eficácia na incontinência urinária de stress: uma revisão bibliográfica." Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/7022.

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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: A incontinência urinária (IU) afeta milhões de pessoas em todo em todo mundo, sendo que maioritariamente são mulheres de todas as idades. A incontinência urinária de stress (IUS) é a forma mais comum e afeta a qualidade de vida, a função sexual, a socialização e o estado emocional. A abordagem conservadora inclui Fisioterapia, considerada a primeira linha de tratamento. Objetivo: Identificar os vários procedimentos fisioterapêuticos no tratamento da incontinência urinária de stress e consequentemente analisar a eficácia destes procedimentos. Metodologia: Foi realizada uma pesquisa nas bases de dados/motores de busca: Pubmed, PEDro e Web of Science. Após a seleção dos estudos, segundo os critérios de inclusão e exclusão, foi avaliada a qualidade metodológica através da Critical Appraisal Skills Programme (CASP). Resultados: Foram selecionados 9 artigos, que englobam 1517 mulheres diagnosticadas com IUS. Apesar da diversidade de intervenções e protocolos utilizados, todas tiveram melhorias significativas no tratamento da IUS. Conclusão: A Fisioterapia parece ser eficaz no tratamento da IUS, uma vez que todas as intervenções estudadas apresentaram resultados positivos.
Background: Urinary incontinence (UI) affects millions of people worldwide, most of whom are women of all ages. Stress urinary incontinence (SUI) is the most common form and affects quality of life, sexual function, socialization and emotional state. Physical therapy is included in the conservative approach, which is considered the first line of treatment. Objectives: Identify several physiotherapeutic procedures in the treatment of stress urinary incontinence and analyze the effectiveness of these procedures. Methodology: A search was performed in the Pubmed, PEDro and Web of Science databases. After selecting the studies according to the inclusion and exclusion criteria, the methodological quality was evaluated through the Critical Appraisal Skills Program (CASP). Results: A total of 9 articles were selected, comprising 1517 women diagnosed with SUI. Despite the diversity of interventions and protocols used, all interventions had significant improvements in SUI treatment. Conclusion: Physical therapy seems to be effective in the treatment of SUI as all interventions have been successful.
N/A

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Majid, Oneeb. "Population pharmacokinetic-pharmacodynamic modelling and optimal experimental design of Ro115-1240 in healthy subjects and stress urinary incontinence patients." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493915.

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Stress urinary incontinence (SUI) is a distressing condition characterised by urine leakage upon physical effort, coughing or sneezing and may affect up to half of adult women. Despite this there are no globally approved pharmacotherapies. A common approach is the targeting of lower urinary tract (LUT) α₁-adrenoceptors, which however can lead to unwanted increases in blood pressure and reflex bradycardia.

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Janse, van Rensburg Karina. "Pre-operative urodynamic studies : is there value in predicting post-operative stress urinary incontinence in women undergoing prolapse surgery." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85662.

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Thesis (MMed)-- Stellenbosch University, 2013.
ENGLISH ABSTRACT: Aims of the study Urodynamic studies (UDS) have been suggested to be performed as part of the pre-operative work-up of patients undergoing prolapse surgery. Some women with POP have occult stress urinary incontinence (OSUI) and even if subjectively continent, have a higher incidence of developing de novo stress urinary incontinence (SUI). The aim of this study was to describe the outcome of a group of patients who had pre-operative UDS and manual prolapse reduction. Methods This was a retrospective descriptive study including all women who had prolapse surgery during the period January 2006 to December 2011. Patients received routine pre-operative UDS and manual reduction of prolapse, performed at maximum bladder capacity determined by UDS. Patients demonstrating urodynamic SUI or OSUI were offered a concomitant anti-incontinence procedure. Post-operative follow-up data included symptoms of SUI and clinical evidence of SUI. Results The final group consisted of 131 women. The mean age of the patients was 57 years (range 33 to 79) and parity 3.6 (range 0 to 7). The mean body mass index was 32 (range 19 to 53). Twenty-four (18.3%) women had demonstrable SUI on clinical examination at initial presentation in the clinic. At the time of urodynamic studies, forty patients (30.5%) had evidence of SUI determined by either UDS and/ or cough test in the standing position at maximum bladder capacity. Ninety-one women (69.5%) had no evidence of UI on UDS, of which 20(15.3%) demonstrated OSUI (SUI on manual reduction of prolapse at maximal bladder capacity determined by UDS). Of the 40 women with UI on UDS, 36 had 1-step surgery (combination of anti-incontinence procedure and prolapse repair) and 4 had prolapse surgery alone. Of the 20 women with OSUI on UDS, 16 had 1-step (combined) surgery and 4 prolapse surgeries only. Of the 4 who had prolapse surgery alone, 3 complained of post-operative SUI. In the group with no SUI on UDS and manual reduction of POP, 69 of the 71 women had follow-up data. Only 1 had demonstrable SUI on examination. The manual reduction test had a sensitivity of 42.9% and a specificity of 98.5% (95% CI, 92.0-99.9%). The positive predictive value was 75.0% (95% CI, 19.4-99.3%), with a high negative predictive value of 94.4% (95% CI, 86.2-98.8%). Conclusion The numbers in our study are too small to determine sensitivity and positive predictive value of UDS and manual prolapse reduction for the detection of OSUI. However, our data shows promise in identifying POP patients without OSUI, which is a complement of the hypothesis. We recommend that UDS can be performed pre-operatively in women undergoing prolapse surgery, to identify patients with urodynamic stress incontinence. Manual reduction of the prolapse at maximum bladder capacity can then be done to identify a subgroup of patients without OSUI. Future research is needed on the true predictive value of reduction stress testing with larger numbers.
AFRIKAANSE OPSOMMING: Doel van die studie Urodinamiese studies (UDS) word voorgestel as deel van die pre-operatiewe ondersoeke voor prolaps chirurgie gedoen word. Sommige vroue met genitale prolaps het verborge druklek, en selfs as hulle subjektief kontinent is, het hulle ‘n groter insidensie van de novo druklek. Die doel van die studie was om die uitkoms van ‘n groep pasiënte wat pre-operatiewe UDS en manuele prolaps reduksie gehad het, te beskryf. Metodes Die studie was ‘n retrospektiewe beskrywende studie. Al die pasiënte wat prolapse chirurgie in die tydperk Januarie 2006 tot Desember 2011 gehad het, is ingesluit. UDS en manuele prolaps reduksie tydens maksimale blaaskapasiteit, bepaal deur UDS, was deel van die roetine pre-operatiewe ondersoeke. In die gevalle waar urodinamiese druklek of verborge druklek demonstreer is, is die opsie van ‘n meegaande prosedure vir kontinensie tydens prolaps chirurgie aangebied. Post-operatiewe opvolg inligting het simptome van druklek en kliniese bewys van druklek ingesluit. Resultate Die finale groep was 131 vroue reikwydte. Die gemiddelde ouderdom van die pasiënte was 57 jaar (reikwydte 33 - 79) en pariteit 3.6 (reikwydte 0 - 7). Die gemiddelde liggaamsmassa indeks was 32 (reikwydte 19 - 53). Vier-en-twintig (18.3%) vroue het aantoonbare druklek gehad met kliniese ondersoek tydens die eerste kliniek afspraak. Tydens UDS het 40(30.5%) pasiënte druklek getoon tydens UDS en/ of hoestoets in die staande posisie teen maksimale blaaskapasiteit. Een-en-negentig (69.5%) het geen tekens van urinêre inkontinensie tydens UDS demonstreer nie, waarvan 20(15.3%) verborge druklek demonstreer het (druklek met reduksie van prolapse tydens maksimale blaaskapasiteit, bepaal deur UDS). Veertig pasiënte het urodinamiese druklek gehad, waarvan 36 een-stap chirurgie (‘n kombinasie van prolaps herstel en meegaande kontinensie prosedure) en 4 prolaps chirurgie alleenlik gehad het. Uit die 20 vroue met verborge druklek tydens UDS, het 16 een-stap (kombinasie) chirurgie en 4 prolaps chirurgie alleen gehad. Uit die 4 wat prolaps chirurgie alleen gehad het, het 3 post-operatiewe klagtes van druklek gehad. In die groep wat geen inkontinensie tydens UDS en manuele prolaps reduksie gehad het nie, het 69 van die 71 vroue opvolg data gehad. Druklek kon net by een pasiënt met ondersoek demonstreer word. Die manuele reduksie toets het ‘n sensitiwiteit van 42.9% en ‘n spesifisiteit van 98.5% (95% CI, 92.0-99.9%) gehad. Die positiewe voorspellingswaarde was 75.0% (95% CI, 19.4-99.3%), en die negatiewe voorspellingswaarde was 94.4% (95% CI, 86.2-98.8%). Gevolgtrekking Die getalle in ons studie was te min om te bepaal wat die sensitiwiteit en positiewe voorspellingswaarde van UDS and manuele prolaps reduksie is om verborge druklek te demonstreer. Die belowende data om pasiënte te identifiseer met genitale prolaps sonder verborge druklek (‘n kompliment van die hipotese). UDS kan pre-operatief gedoen word in pasiënte wat prolapse herstel chirurgie benodig, om pasiënte met urodinamiese druklek te identifiseer. Manuele reduksie van die prolaps tydens maksimum blaas kapasiteit kan dan volg, om ‘n subgroep van pasiente sonder verborge druklek, uit te ken. Verdere navorsing, met groter getalle word benodig om die werklike voorspellende waarde van die reduksie toets te ondersoek.

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Laycock, Josephine. "Assessment and treatment of pelvic floor dysfunction : physiotherapy in the management of pelvic floor dysfunction in relation to female urinary incontinence." Thesis, University of Bradford, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316501.

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Thiel, Marcelo. "Analise quantitativa da fibrose e semiquantitativa da reação inflamatoria de quatro diferentes slings sinteticos." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308661.

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Orientadores: Cassio Luis Zanettini Riccetto, Paulo Cesar Rodrigues Palma
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-06T21:41:51Z (GMT). No. of bitstreams: 1 Thiel_Marcelo_D.pdf: 2563508 bytes, checksum: cb0427728a1aecf6795c3443f2f0cea9 (MD5) Previous issue date: 2006
Resumo: OBJETIVOS: Analisar quantitativamente, com método estereológico, a densidade de fibras colágenas formadas após implante de quatro diferentes tipos de sling;verificar por análise histopatológica a reação inflamatória. MATERIAS E MÉTODOS: Realizou-se o estudo em 70 ratas da raça Wistar, divididas em 3 grupos (A,B,C): No grupo A (30 ratas) implantou-se uma faixa de silicone e outra de submucosa intestinal suína, de 8x 4 mm, no tecido subcutâneo da parede abdominal. No grupo B (30 ratas), implantou-se, da mesma maneira, uma faixa de copolímeros de poligalactina com ácido poliglicólico e outra de polipropileno monofilamentar, de 8x 4 mm. Sutura com fio de nylon 5/0, fixou as faixas e, no grupo C (10 ratas), denominado controle, realizou-se dissecção do subcutâneo e aplicação do mesmo fio, sem implante de material. A coloração de Picro-Sirius, empregada apenas no 90° dia de pós-operatório, permitiu análise das fibras colágenas e a de Hematoxilia-eosina, o estudo histopatológico da reação inflamatória. Nos dias 7, 30 e 90 de pós-operatório, sacrificaram-se 10 ratas de cada grupo. RESULTADOS: No 7° dia, todos os materiais induziram moderada reação inflamatória, sem diferença com o controle. No 30° dia, os copolímeros de poligalactina com ácido poliglicólico apresentaram a menor reação inflamatória, sem diferença com o controle. Neste período, polipropileno monofilamentar e silicone produziram inflamação moderada, enquanto que na submucosa intestinal suína, a intensidade foi severa. No 90° dia, a reação inflamatória, nos copolímeros de poligalactina com ácido poliglicólico, foi maior que antes, porém menor do que a do polipropileno monofilamentar e silicone, que permaneceram semelhantes entre si. Novamente, o grau de inflamação na submucosa intestinal suína continuou o maior de todos. Na análise estereológica, a densidade. de fibras colágenas dos copolímeros de poligalactina com ácido poliglicólico e polipropileno monofilamentar foi significativamente menor (61 % e 65% respectivamente) do que o silicone (85%) e submucosa intestinal suína (86%). CONCLUSÕES: Polipropileno monofilamentar foi o melhor material inabsorvível, pois induziu menos reação inflamatória que os outros materiais testados. Como a submucosa intestinal suína foi completamente removida, a intensa reação fibrótica que produz, toma-se útil, e responsável pelo suporte suburetral após a cirurgia
Abstract: OBJECTIVES: To analyse quantitatively, using stereological methods, the density of the collagen fibres induced by four types of sling materials, and verify by a histopathological analysis the corresponding inflammatory reaction, as fibrosis secondary to sling implantation is considered responsible for restoring urethral support and re-establishing continence in women with stress urinary incontinence, and new synthetic materials that promote adequate fibrosis with the least intensity and duration have been proposed to substitute the aponeurotic sling. MATERIALS AND METHODS: The study comprised 70 isogenic white Wistar rats divided into three groups: group A (30 rats) had 8 x 4 mm strips of silicone and porcine small intestine submucosa (SIS) implanted in the abdominal subcutaneous tissues; group B (30 rats) had 8 x 4 mm strips of polycaprolactone and polylactic acid copolymers and monofilament polypropylene (PLP) implanted the abdominal subcutaneous layer; while a control group of 10 rats had dissection and suturing with 5/0 Nylon in the abdominal subcutaneous layer, as used to fix the strips in the other rats. Picro-Sirius staining was used to assess collagen fibres, and haematoxylin-eosin for the histopathological study. At 7, 30 and 90 days after surgery, 10 rats from each group were killed and assessed. RESULTS: Afier 7 days all the materials induced a moderate inflammatory reaction that did not differ from that in the control group. At 30 days there was no difference between the control and polycaprolactone and polylactic acid copolymers, having the least inflammatory reaction. PLP and silicone produced a moderate inflammatory reaction, while the porcine SIS induced a more intense reaction. At 90 days there was a more intense inflammatory reaction in polycaprolactone and polylactic acid copolymers than before but it was less than with PLP and silicone, which again were no different. During this period the inflammatory reaction induced by SIS was greater. The stereological analysis indicated that collagen fibres induced by polycaprolactone and polylactic acid copolymers and PLP were less dense (61% and 65%, respectively), and significant1y less than with silicone (85%) and SIS (86%). CONCLUSION: PLP was the best nonabsorbable material as it induced a less intense inflammatory reaction than the other tested materials. As porcine SIS was completely absorbed the intense fibrosis induced is useful, as it is exclusively responsible for the urethral support later after surgery
Doutorado
Cirurgia
Mestre em Cirurgia

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Moonat, Shweta. "Investigation of neural correlates of bladder control using functional magnetic resonance imaging (fMRI) in patients with overactive bladder (OAB)." Master's thesis, Temple University Libraries, 2008. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/217452.

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Electrical Engineering;
M.S.E.E.;
Overactive bladder (OAB) is considered to be a disorder of the urinary bladder and is defined by the International Continence Society Terminology Committee as "urgency, with or without urge incontinence, usually with frequency and nocturia". There is some preliminary evidence using functional magnetic resonance imaging (fMRI) that the brain response to bladder filling in OAB patients is abnormal. The purpose of this research is to determine whether there are Central Nervous System (CNS) differences in modulating bladder function that contribute to, or are themselves the cause of the symptoms in OAB patients. We further investigated the pharmacological fMRI changes
Temple University--Theses

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