scholarly journals Present value of the Urethral mobility test as a tool to assess Stress urinary incontinence due to Intrinsic sphincteric deficiency

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Daniela Robledo ◽  
Laura Zuluaga ◽  
Alejandra Bravo-Balado ◽  
Cristina Domínguez ◽  
Carlos Gustavo Trujillo ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Short Form ◽  
Pelvic Surgery ◽  
Urethral Hypermobility ◽  
Urethral Mobility ◽  
Composite Variable ◽  
International Consultation ◽  
Tip Test ◽  
Composite Variables

AbstractQ-tip test offers a simple approach for identifying urethral hypermobility. Considering surgical treatment, stress urinary incontinence (SUI) must be classified and the contribution of intrinsic sphincter deficiency (ISD) and/or urethral hypermobility must be determine. We believe there's a correlation between abdominal leak point pressure (ALPP) and urethral mobility degree, and the aim of this study is to explore it using Q-tip. We conducted a prospective study, between years 2014 and 2016. Females over 18 years presenting with signs and symptoms of SUI according to the 2002 ICS Standardization of Terminology were included. Assessment was made with the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), the Q-tip test and invasive urodynamics. Urethral mobility (UM) and ALPP were analyzed. We built two composite variables based on reported risk factors for ISD, defined as composite variable A (equal to a Q-tip test < 30° AND ICIQ-SF ≥ 10 points) and composite variable B (equal to low urethral mobility AND/OR hypoestrogenism AND/OR history of radiotherapy AND/OR previous pelvic surgery). Correlation analyzes were made according to the type of variable. A total of 221 patients were included. Incontinence was rated as moderate and severe by 65.3% and 6.8%, respectively. The analysis showed a 61.75%, 51.61% and 70.6% agreement between ALPP and UM, ALPP and composite variable A and ALPP and composite variable B respectively. Correlation and concordances were low (r = 0.155, r_s = − 0.053 and r_s = − 0.008), (rho_c = 0.036, k = 0.116 and k = 0.016). Neither the degree of UM, nor the composite variables, correlate or agree with urethral function tests in UDS, suggesting that the ALPP cannot be predicted using the Q-tip test or the ICIQ-SF for classifying patients with SUI.

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.

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.

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.

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.

scholarly journals The Effect of Bojungikgi-tang on Stress Urinary Incontinence: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 42 (3) ◽  
pp. 293-307
Author(s):  
Hyun-seo Nam ◽  
Tae-hyun Baek
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Medical Treatment ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Systemic Review ◽  
International Consultation

Objectives: This study investigates the effects and safety of Bojungikgi-tang for stress urinary incontinence by systemic review and meta-analysis of randomized controlled trials (RCTs).Methods: RCTs were selected from articles published until December 2019 in seven domestic and foreign databases. The quality of the literature was evaluated using Cochrane’s risk of bias (RoB) tool, and RevMan 5.3 was used to synthesize the results.Results: A total of 694 patients with stress urinary incontinence participated in eight RCTs. Meta-analysis showed that the total effective rate of treatment that combines pelvic floor muscle training (PFMT) and Bojungikgi-tang was significantly higher than that of PFMT alone. The volume of urine leakage per hour after the combined treatment was significantly lower than that of PFMT alone. The International Consultation on Insurance Questionnaire-Short Form (ICIQ-SF) scores from combining PFMT and Bojungikgi-tang were significantly lower than those for PFMT alone.Conclusion: This study suggests that Western medical treatment combined with Bojungikgi-tang for urinary incontinence from stress might be more effective in improving symptoms than conventional Western medical treatment alone. However, the number of studies included in the meta-analysis was insufficient, and the quality of the selected literature was generally low. Therefore, high-quality clinical studies on herbal medicine treatment for urinary incontinence would be required in the future.

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.

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