Academic literature on the topic 'Urinary incontinence. Sick'

Background: Urinary incontinence is a common condition in pregnancy and postpartum. There are more than a thousand articles on urinary incontinence (UI) in pregnancy but very limited literature from Indian subcontinent is available. Incidence and prevalence figures of UI in association with pregnancy vary substantially. Not many reviews have focused solely on incidence and prevalence of UI in association with pregnancy. Prevalence of UI in pregnancy ranges from 32% to 64%.Methods: A cross sectional observational study was conducted in the department of obstetrics and gynecology, MGM Medical College and M.Y. Hospital, Indore over the period of 6 months on 1000 pregnant women who were following antenatal care (ANC) clinic. Pregnant women, who were severely sick, diagnosed with kidney or urinary infection and vaginal infections women were excluded from the study. The data were collected using a structured questionnaire. After the purpose of the study was explained, written consent was obtained from each voluntary participant. This study was approved by institutional ethical committee. The data was recorded in predesign coded case report form and statistical analysis was performed using the STATA 12.1.Results: In the present study the prevalence of urinary incontinence reported is 16.4% of women during pregnancy.Conclusions: In this study the prevalence of UI during current pregnancy was found to be lower compared to previous studies conducted. The previous history of surgery, constipation, obesity and respiratory problems were found to be significantly associated with UI during pregnancy.

Introduction The pelvic floor is made of a mutually connected system that consists of muscles, connecting tissue and nerve components. Damage to any of these elements creates dysfunction which is exerted through stress, urinary incontinence, prolapse of genital organs and faecal incontinence. Objective The primary aim of this study was to present the possibility of objective assessment of pelvic floor muscle force in healthy and sick women using a newly designed instrument, the vaginal dynamometer, as well as to establish the correlation between the values of pelvic floor muscle force obtained by the vaginal dynamometer and digital palpation method. Methods The study included 90 female patients, age 20-58 years. One group of respondents was made of healthy women (who gave birth, and those who have not given birth), while the other one consisted of sick women (who suffered from incontinence or prolapse of genital organs, operated on or not). The pelvic floor muscle strength of every woman was measured with a newly-constructed device for measuring and monitoring of the pelvic floor muscle force in women, the vaginal dynamometer. Then it was compared with the valid clinical digital palpation (palpation with two fingers) based on the scale for measuring muscle contractions with the digital palpation - the digital pelvic assessment rating scale. The vaginal dynamometer consists of a redesigned speculum which is inserted into the vagina and a sensor for measuring the force. Results Statistically significant linear correlation was found in the values of the measured muscle force with the vaginal dynamometer and ratings produced by digital palpation (r=0.92; p<0.001). Mean value of the muscle force of the healthy women measured by the vaginal dynamometer was 1.44?0.38 daN and that value of the sick women was 0.78?0.31 daN (t=8.89 for df=88; p<0.001). Mean value of the ratings produced by digital palpation in healthy women was 4.10 (95% of trust limits 3.83- 4.37), while the value in sick women was 2.41 (95% of trust limits 2.10-4.16) (Z=-6.38; p<0.001). Conclusion The vaginal dynamometer has been presented as an attempt to overcome the limitations of the previously presented techniques for muscle force measurement. The application of the vaginal dynamometer in clinical practice makes objective and numerical assessment of pelvic floor muscle force possible, independent of the subjective assessment of the examiner. The usage of this instrument enables not only the diagnostics of women's pelvic floor muscle problem, but also the objective monitoring of rehabilitation gynecological medicine results.

Introduction: Constipation is a common problem in children with worldwide prevalence between 0.7% and 29.6%.Materials and Methods: Total number of children was 232 out of which 16 were discarded due to loss in follow up. Inclusion criteria: Any child aged one month to ten years presenting with constipation. We used NASPGHAN definition of constipation. Exclusion criteria: Critically sick and hemodynamically unstable patients were excluded from the study. Data were collected for age, sex, duration of constipation, symptoms and signs such as stool frequency, stool consistency, pain during defecation, presence of blood in stool, fecal and urinary incontinence, and presence of fecal impaction or an abdominal mass. Clinical evaluation (history and physical examination) of all patients was done by the same physician to avoid bias in clinical finding. Polyethylene glycol (PEG) was tried in all patients in a dose of 0.3 to 2.1g/kg. Response was defined as passage of at least one semisolid stool without discomfort with use of PEG for at least 4 weeks.Results: In our prospective study done on 232 patients with constipation over three year period (dividing patient’s into1month to 5months, 6months to 5year and 6 years to 10 years) revealed that constipation is mostly prevalent in 6 months to 5 year age group with slight male preponderance. Most of them had symptom onset after six months of age. Commonest symptom was hard stool in general (79.6%) but prevalence of pain abdomen increases with age and peaks in above five year group. Commonest sign is palpable fecal mass. Complications-urinary dysfunction, fecal incontinence, fissure are common in older age group. Functional constipation was the commonest cause (96.2%). Hirschprung disease was diagnosed in 1.4%. Polyethylene glycol shows good response in above 6 months of age groups.Conclusion: Functional constipationis the commonest cause of constipation. Mostly affected group is six months to five years. Polyethelene Glycol is an effective treatment especially after six months. J Nepal Paediatr Soc 2016;36(3):263-267.

Abstract Background and aims Chronic pelvic pain (CPP) in women is a complex condition that can seriously impact health and quality of life. Clinical guidelines for CPP place great demands on healthcare professionals, as they require both specialized knowledge about the pelvic area and knowledge of the mechanisms of chronic pain. To ensure best possible assessment and treatment of these women it is important to bring about more knowledge of the special CPP features. The purpose of this paper is to describe the characteristics of women with CPP evaluated at the University Hospital of North Norway, and further referred to physiotherapy. The frequency of having a history of abuse or previous pelvic surgery will also be reported, and analyses performed to investigate if subjective health status differs between women with and without these experiences. Methods We collected cross-sectional data from 62 women with CPP aged 20–65 (mean age 38.0), referred to physiotherapy after assessment by medical specialists. Data were collected by semi-structured interviews for demographic variables and medical history, and self-administered questionnaires on pain intensity, sexual function, urinary incontinence (UI), anal incontinence (AI), obstructed defecation syndrome (ODS), subjective health complaints (SHC) and symptoms of anxiety and depression. Results Pain duration of more than 10 years was reported by 42%, mean pain score was 4.7/10, and analgesics were used weekly by 48%. Previous pelvic or abdominal surgery was reported by 71%, and sick leave >12 weeks the last year by 34%. Reduced sexual desire was reported by 78%, dyspareunia by 73%, UI by 54%, AI by 23%, and obstructed defecation syndrome (ODS) by 34%. More than 90% reported musculoskeletal or pseudoneurologic complaints. Anxiety and depression scores defined as requiring treatment were reported by 40%. Abuse was reported by 50%, and associated with significantly more reports of ODS (p=0.02), more SHC (p=0.02) and higher anxiety scores (p=0.009). Analgesic use and sick leave were significantly higher both among women with a history of abuse (p=0.04 and p=0.005) and among those with previous surgery (p=0.04 and p=0.02). Women with previous surgery reported significantly lower pain intensity during intercourse than those without previous surgery (p=0.008). Conclusions Women with CPP have complex symptoms and high scores for both physical and psychological complaints. Women exposed to abuse have especially high scores related to analgesic use, sick leave, ODS, anxiety and SHC. Women with previous surgery report more analgesic use and sick leave, and lower pain intensity during intercourse, than those without previous surgery. Implications This study illustrates the complexity of CPP and highlights the need for health professionals to have specialized knowledge of the possible features of the condition. Previous abuse seems to be more associated with poor scores on several health outcomes than surgery, but this needs to be investigated further.

✓ Ninety-seven children with lipomyelomeningoceles were operated on at the Hospital for Sick Children between January, 1960, and December, 1982. The most common factor that caused these patients to seek help was the cosmetic effect of the mass on their back. However, 22 patients had urinary incontinence and 15 patients had a deformed or weak leg. Sixty of the 97 patients were female and 37 were male. The patients presented for treatment between 6 days and 18½ years of age with a median age of 7½ months. Fifty-six patients presented before the age of 6 months and 35 of these were perfectly normal at the time of presentation. On the other hand, of the 41 patients who were brought for treatment after the age of 6 months, only 12 were normal prior to surgery. When patients were appropriately treated at an early age, with their spinal cords untethered and their dura securely closed with a dural graft, then they remained unchanged neurologically or even improved. However, when treatment was delayed or not done appropriately then they were left with significant neurological sequelae. Lipomyelomeningoceles are serious lesions which without appropriate therapy can result in gross impairment of neurological function.

Current scientific evidence supports the recommendation to initiate or continue the practice of physical exercise in healthy pregnant women. Group exercise programs have positive effects in improving health and well-being, as well as social support. In order to understand the scientific evidence in this field, and the outcomes in maternal health, it has generated wide interest in exploring the studies carried out with more relevant group exercise programs. The aim of this systematic review was to evaluate the available evidence on the effectiveness of group exercise programs in improving women’s and newborns health outcomes during pregnancy. Three databases were used to conduct literature searches and strict inclusion and exclusion criteria were employed. Seventeen studies were selected for analysis. All studies were randomized control trials conducted with pregnant women that evaluated the effect of group exercise programs on the health outcomes of mother and newborn. Most studies followed a supervised structured exercise program including a main aerobic part, resistance training, pelvic floor training and stretching and relaxation sections. The significant effects of the programs are related with improved maternal perception of health status, lower maternal weight gain, improved levels of maternal glucose tolerance, improved aerobic fitness and muscular strength, lower frequency of urinary incontinence, improved sick leave due to lumbopelvic pain, fewer cesarean and instrumental deliveries, higher newborn Apgar score and faster postpartum recovery. Exercise and health professionals should advise pregnant women that aerobic group exercise during pregnancy improves a wide range of health outcomes for the women and newborns.

BACKGROUND: Nurse-led pelvic floor muscle exercise and lifestyle education programs are effective first-line interventions for women with stress incontinence (SI). PURPOSE: To develop an evidence-based stress incontinence care protocol (SICP) using the Stevens Star Model of Knowledge Transformation and evaluate its effect on the frequency and quantity of urinary incontinence, quality of life, pelvic muscle self-efficacy levels, and lifestyle variables of women with SI. METHODS: An SICP was developed on the basis of the Star model. The views of an expert were consulted for testing the content validity of the protocol. Using a pretest-posttest experimental design, 68 women with SI who visited an outpatient clinical at a hospital in Turkey were prospectively enrolled in the intervention (n = 34) and control (n = 34) groups. After obtaining baseline demographic and health history information, participants completed the King’s Health Questionnaire, the Broome Pelvic Muscle Exercise Self-Efficacy Scale, a 3-day voiding diary, and a 1-hour pad test. The intervention group received an 8-week program of care according to the Star model-derived SICP, and follow-up assessments were completed by both groups after 8 and 12 weeks. RESULTS: The content validity index for the SICP was 91.9%. The intervention group had a reduced quantity and frequency of urinary leakage, reduced King’s Health Questionnaire scores, and increased Broome Pelvic Muscle Exercise Self-Efficacy Scale scores (P < .05). CONCLUSION: Care provided according to the Star model-derived SICP reduced the quantity and frequency of SI and improved the perceived pelvic muscle exercise self-efficacy and quality of life of the participants.