scholarly journals Comparison of urethral sling surgery and non-ablative vaginal Erbium:YAG laser treatment in 327 patients with stress urinary incontinence: a case-matching analysis

2021 ◽  
Author(s):  
Nobuo Okui ◽  
Hironari Miyazaki ◽  
Wataru Takahashi ◽  
Toshihide Miyauchi ◽  
Chikako Ito ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Laser Treatment ◽  
Short Form ◽  
Control Group ◽  
Abdominal Pressure ◽  
Erbium:Yag Laser ◽  
Pad Test ◽  
International Consultation ◽  
Sling Surgery

AbstractStress urinary incontinence (SUI) occurs when abdominal pressure, such as from coughing or sneezing, causes urine leakage. We retrospectively compared tension-free vaginal tape (TVT) and non-ablative vaginal Erbium:YAG laser treatment (VEL) by propensity score (PS) analysis in women with SUI. No PS analysis studies have investigated urethral sling surgery using polypropylene TVT and VEL for SUI. Data from patients aged 35–50 years who were treated for SUI and registered at several institutions were selected. Patients with medical records covering 1 year for the 1-h pad test, who completed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the Overactive Bladder Symptom Score (OABSS), were included. We analyzed 102, 113, and 112 patients in the TVT, VEL, and control groups, respectively. Compared with the control group, the TVT and VEL groups exhibited significant improvement in the 1-h pad test and ICIQ-SF. In the PS analysis, the TVT and VEL groups similarly improved in the 1-h pad test and ICIQ-SF. As for the OABSS, the VEL group showed significantly greater improvement than the TVT group. In the odds ratio analysis for the 1-h pad test, no differences in any of the parameters were observed between TVT and VEL. VEL may be considered an alternative to TVT for SUI treatment.

scholarly journals A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence

2020 ◽  
Author(s):  
Kaylee C. L. Brooks ◽  
Kevin Varette ◽  
Marie-Andrée Harvey ◽  
Magali Robert ◽  
Robert J. Brison ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle Training ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Standing Position ◽  
Muscle Training ◽  
Pad Test ◽  
International Consultation

Abstract Introduction and hypothesis The aim of this study was to prospectively identify aspects of baseline demographic, clinical, and pelvic morphology of women with stress urinary incontinence (SUI) that are predictive of cure with physiotherapist-supervised pelvic floor muscle training (PFMT). Methods Women ≥18 years old with SUI were recruited from urogynecology and pelvic health physiotherapy clinics. Participants completed a 3-day bladder diary, the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF), a standardized pad test, manual assessment of pelvic floor muscle (PFM) strength and tone, and transperineal ultrasound (TPUS) assessment of their urogenital structures at rest while in a supine position and standing, and during contraction, straining, and coughing. Participants attended six physiotherapy sessions over 12 weeks and performed a home PFMT program. The assessment was repeated after the intervention; cure was defined as a dry (≤2 g) pad test. Results Seventy-seven women aged 50 (±10) years completed the protocol; 38 (49%) were deemed cured. Based on univariate testing, four predictors were entered into a binary logistic regression model: ICIQ-UI-SF, PFM tone, bladder neck (BN) height in a quiet standing position, and BN height during a cough in a standing position. The model was significant (p < 0.001), accurately classifying outcome in 74% of participants. The model, validated through bootstrapping, performed moderately, with the area under the receiver operating characteristic curve = 0.80 (95% CI: 0.69–0.90; p = 0.00), and with 70% sensitivity and 75% specificity. Conclusions Women with better bladder support in a standing position and less severe symptoms were most likely to be cured with PFMT. Clinical trial registration #NCT01602107.

scholarly journals Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

2007 ◽  
Vol 125 (5) ◽  
pp. 265-269 ◽  
Author(s):  
Míriam Raquel Diniz Zanetti ◽  
Rodrigo de Aquino Castro ◽  
Adriana Lyvio Rotta ◽  
Patrícia Diniz dos Santos ◽  
Marair Sartori ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Subjective Evaluation ◽  
Female Stress Urinary Incontinence ◽  
Control Group ◽  
Pelvic Floor Muscle Exercises ◽  
Pad Test

CONTEXT AND OBJECTIVE: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. The aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. DESIGN AND SETTING: This was a randomized, prospective, controlled trial in the Urogynecology and Vaginal Surgery Sector, Universidade Federal de São Paulo. METHODS: Forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. They were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. Descriptive analysis was used to evaluate the population. The homogeneity of the two groups was evaluated using the Kruskal-Wallis and Chi-squared tests. The success of the two groups after treatment was evaluated using the Wilcoxon test. RESULTS: The supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. In the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. In the supervised group, 66.8% of patients did not want any other treatment. CONCLUSION: Supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.

Erbium:YAG laser treatment of female stress urinary incontinence: midterm data

2019 ◽  
Vol 31 (9) ◽  
pp. 1859-1866 ◽  
Author(s):  
Andrzej Kuszka ◽  
Marianne Gamper ◽  
Claudia Walser ◽  
Jacek Kociszewski ◽  
Volker Viereck
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Laser Treatment ◽  
Female Stress Urinary Incontinence ◽  
Erbium:Yag Laser

scholarly journals Do severe obese patients with stress urinary incontinence benefit from transobturator tape procedure? 3-year surgical outcome

2015 ◽  
Vol 9 (7-8) ◽  
pp. 546
Author(s):  
Tarik Yonguc ◽  
Ozgu Aydogdu ◽  
Ibrahim Halil Bozkurt ◽  
Tansu Degirmenci ◽  
Bulent Gunlusoy ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Patient Satisfaction ◽  
Stress Urinary Incontinence ◽  
Severe Obesity ◽  
Short Form ◽  
Transobturator Tape ◽  
Safe Procedure ◽  
Subjective Improvement ◽  
International Consultation ◽  
The Impact

Introduction: We evaluate the impact of severe obesity on surgical outcomes of the transobturator tape (TOT) procedure in patients with stress urinary incontinence (SUI).Methods: In total, 32 women with severe obesity (body mass index [BMI] >35 kg/m2) were included in the study. All patients were preoperatively evaluated with history, pelvic examination, ultrasonography, and cough stress test. All patients completed the International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) preoperatively and at the postoperative followup. Cure of incontinence was defined as being completely dry after surgery. Cure was assessed subjectively and objectively. Subjective improvement defined as an International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) score ≤12 and satisfaction with surgery. Failure was defined as having no change or worsening of urinary incontinence after surgery. Postoperative patient satisfaction was assessed using a visual analog scale.Results: The mean follow-up time and mean BMI were 40.9 ± 20.9 months and 38 ± 3 kg/m2, respectively. According to preoperative ICIQ-SF questionnaire scores, 20 patients (62.5%) had severe and 12 patients (37.5 %) had very severe urinary incontinence symptoms. No patient had slight or moderate symptoms. None of the patients experienced worsening symptoms after surgery. Objective cure, subjective cure, subjective improvement and patient satisfaction rates were 81.2%, 46.8%, 37.5%, and 84.3% respectively. Our overall complication rate was 9.3%. None of the patients experienced intraoperative complications.Conclusion: In experienced hands, TOT is an effective and safe procedure to treat SUI, with minimal complications in severe obese women.

Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence

2015 ◽  
Vol 95 (4) ◽  
pp. 417-421 ◽  
Author(s):  
Daniele Castellani ◽  
Pietro Saldutto ◽  
Vikiela Galica ◽  
Gianna Pace ◽  
Daniela Biferi ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Postmenopausal Women ◽  
Short Form ◽  
Female Stress Urinary Incontinence ◽  
Pelvic Floor Rehabilitation ◽  
Pad Test ◽  
Group 2 ◽  
Group 1

Introduction: Pelvic floor muscle training (PFMT) and electrical stimulation (ES) are conservative models of therapy for treating female stress urinary incontinence (SUI). The presence of estradiol receptors in the lower urinary tract advances the case for estradiol therapy in SUI. The aim of our study was to investigate the effects of the combination of pelvic floor rehabilitation and intravaginal estriol (IE) on SUI treatment in postmenopausal women. Material and Methods: Sixty-two women with SUI were randomized to PFMT, ES and biofeedback (Group 1) or the same treatment plus 1 mg IE (Group 2) for 6 months. Patients were evaluated with medical history, pelvic examination, urodynamics, 24-hour pad test. Urinary incontinence was evaluated using the International Consultation on Incontinence questionnaire on urinary incontinence short form and quality of life using the Incontinence Impact Questionnaire-Short Form. Results: Two patients were lost at follow-up and one discontinued the study. Mean urine leakage at the 24-hour pad test dropped from 42.3 ± 20.2 g/die to 31.5 ± 14.2 g/die in Group 1 and from 48.3 ± 19.8 g/die to 22.3 ± 10.1 g/die in Group 2. Symptoms scores and incontinence status were statistically significant better in Group 2 when compared to Group 1. Conclusion: IE added to PFMT, ES and BF is a safe and efficacious first-line therapy in postmenopausal women with SUI.

Experience after 12 Cases with the Adjustable Transobturator Male Sling for Postprostatectomy Stress Urinary Incontinence

2017 ◽  
Vol 84 (4) ◽  
pp. 251-253
Author(s):  
Andrea Vismara Fugini ◽  
Luca Giovanessi ◽  
Michelangelo Tosana
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Short Form ◽  
Cure Rate ◽  
Invasive Treatment ◽  
International Consultation ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
The Mean

Objectives The aim of the study was the prospective evaluation of the efficacy of the adjustable transobturator male system (ArgusT®) for the treatment of postprostatectomy stress urinary incontinence (PPI). Methods Twelve consecutive patients were treated with ArgusT system for PPI. All patients were comprehensively evaluated preoperatively and after 3 and 6 months regarding daily pad use, residual urine, Incontinence Quality of Life Scale (I-QoL) score and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score. Cure rate was defined as no pad use or one pad (used for security reasons). Results At 3 and 6 months, we achieved a cure rate of 91%. The mean number of pads per day decreased from 4 ± 1.3 to 0.7 ± 0.9 and 0.5 ± 0.9 after 3 and 6 months, respectively (p<0.001). Only one patient showed no significant improvement. Compared with baseline, the mean ICIQ-SF score dropped from 17.3 ± 2.8 to 2.7 ± 3.8 and 2.4 ± 3.8, at 3 and 6 months, respectively (p<0.001). The mean I-QoL score also improved significantly from 53.1 ± 20.3 to 99.5 ± 11 and 96.8 ± 12.5 after 3 and 6 months, respectively (p<0.001). Postoperative acute urinary retention was seen in one patient. Conclusions In our early experience, the ArgusT system offers effective, safe and minimally invasive treatment option for PPI.

scholarly journals Is electroacupuncture safe and effective for treatment of stress urinary incontinence in women? A systematic review and meta-analysis

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052094833
Author(s):  
Xiuhua Lai ◽  
Jiapeng Zhang ◽  
Jing Chen ◽  
Cuiwei Lai ◽  
Chunping Huang
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Elderly Women ◽  
Short Form ◽  
Systematic Evaluation ◽  
Pool Data ◽  
Efficacy And Safety ◽  
International Consultation ◽  
Standard Mean Difference ◽  
Urine Leakage

Objective Stress urinary incontinence (SUI) is prevalent worldwide, particularly among elderly women. Although electroacupuncture (EA) has been accepted by many patients and physicians in Asia, its efficacy for SUI has not been evaluated scientifically and systematically. We aimed to conduct a systematic evaluation of the efficacy and safety of EA treatment for women with SUI. Methods We retrieved publications up to February 2019 from seven databases. Randomized controlled trials for women with SUI treated by EA were included. Therapeutic effect, 1-hour urine leakage and International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) scores were the primary outcomes. The Cochrane Collection’s RevMan 5.3 software was used to pool data. Results The 15 included articles demonstrated that EA for SUI was effective (odds ratio [OR], confidence interval [CI] = 5.64, 4.19–7.59; Ι2 = 22%). ICIQ-SF scores increased (standard mean difference, CI = −0.48, −0.62 to −0.33; Ι2 = 32%) and 1-hour urine leakage decreased (OR, CI = −4.14, −4.96 to −3.33; Ι2 = 78%) in patients undergoing EA compared with those receiving sham EA, physical exercise or medication. Conclusion EA for women with SUI exhibited significant efficacy and safety for key outcomes.

Transcutaneous Temperature-Controlled Radiofrequency Treatment: Improvement in Female Genital Appearance, Sexual Dysfunction, and Stress Urinary Incontinence

2021 ◽  
Author(s):  
Sejal Ajmera Desai ◽  
Zahaan Vakil ◽  
George Kroumpouzos
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Short Form ◽  
Substantial Improvement ◽  
International Consultation ◽  
Temperature Controlled ◽  
The Aesthetic ◽  
Female Genital

Abstract Background Transcutaneous temperature-controlled radiofrequency (TTCRF) is an emerging modality for vulvovaginal rejuvenation. Still, the clinical experience with this modality is limited. Objectives The aim of this study was to examine the efficacy of TTCRF in improving female genital appearance, sexual function, and stress urinary incontinence (SUI). Methods Forty-eight patients complaining of sexual dysfunction (SD; n=41) and/or SUI (n=37) were included. Most patients had ≤3 TTCRF sessions. To evaluate the aesthetic results, photographs of the genital area taken before treatment were compared to those 6 weeks posttreatment in a blinded manner. Prior to treatment and 6 weeks after the final session, the Female Sexual Function Index (FSFI) questionnaire was administered to participants complaining of SD and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) to those with complaints/symptoms of SUI. Preprocedure were compared to postprocedure scores using paired t-test. Results Aesthetic improvement was noted in all patients. Preprocedure mean total FSFI score was 21.77, and the respective postprocedure, 25.79 (P &lt; 0.00001). Most FSFI domains improved (pre- vs post-TTCRF mean score): sexual desire (2.99 to 3.54), arousal (3.14 to 3.83), orgasm (3.14 to 4.39), pain (4.41 to 5.04) (P &lt; 0.00001 for all) and satisfaction (3.75 to 4.42; P=0.001). Mean preprocedure ICIQ-UI-SF score was 10.10 and decreased to 4.81 (P &lt; 0.00001) postprocedure. Conclusions A substantial improvement in genital appearance was observed. Assessment based on validated instruments demonstrated significant improvements in sexual function and SUI. TTCRF is a safe and effective treatment for these conditions.

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