scholarly journals The Feasibility of a Modified Exclusive Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannomas

2018 ◽  
Vol 80 (01) ◽  
pp. 082-087 ◽  
Author(s):  
In Moon ◽  
Dongchul Cha ◽  
Sung-Il Nam ◽  
Hyun-Jin Lee ◽  
Jae Choi
Keyword(s):  
Short Form ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Operation Time ◽  
Vestibular Schwannomas ◽  
Profound Hearing Loss ◽  
Hospitalization Period ◽  
The Mean

Objective We evaluated the feasibility of an exclusive endoscopic transcanal transpromontorial approach (EETTA) for the treatment of small vestibular schwannomas (VSs) limited to the internal auditory canal (IAC), and introduced a modification without external auditory canal closure. Methods Between June 2016 and June 2017, seven patients with VS underwent surgery using a modified EETTA. Treatment outcomes, including efficacy of tumor resection, preservation of function, operation time, and quality of life (QOL), were evaluated. Results The patients preoperatively exhibited Koos Grade I/II tumors and severe-to-profound hearing loss. Gross total resection was accomplished in all cases. There were no major complications, and all patients exhibited normal facial nerve function immediately after surgery. The mean follow-up period was 12.9 months. The operation time (average 196.3 ± 64.9 minutes) and hospitalization period (average 7.4 ± 1.0 days) were favorable. Short Form-36 scores for QOL showed unremarkable results compared with previous reports. Conclusions The modified EETTA was effective in the removal of VSs in the IAC. It can be an alternative surgical option for small VSs.

Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas

2009 ◽  
Vol 111 (4) ◽  
pp. 855-862 ◽  
Author(s):  
Salvatore Di Maio ◽  
Ryojo Akagami
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
The Other ◽  
Vestibular Schwannomas ◽  
Fractionated Radiotherapy ◽  
Surgery Group ◽  
Prospective Comparison ◽  
Management Protocol

Object The best management strategy for small-to medium-sized vestibular schwannomas (VSs) remains controversial between observation, radiation, and microsurgical resection (surgery). The authors undertook a prospective observational cohort study comparing all 3 therapeutic modalities in patients with VSs, focusing on quality of life (QOL) outcomes. Methods All patients in the study completed the 36-Item Short Form Health Survey at regular intervals, with a mean follow-up of 31.8 months. Two hundred five (77.7%) of 264 patients completed questionnaires, including 47 who underwent observation, 48 who received either linear accelerator radiosurgery or fractionated radiotherapy (radiation group), and 134 who underwent surgery (of whom 37 had tumors > 3 cm in diameter). Patients allocated to the observation group had smaller tumors than those in the other groups (mean 1.3 cm; p < 0.001). Patients who received radiation were older than patients in the other groups (mean 60.0 years; p < 0.001). Results There were no baseline QOL differences between the observation, radiation, and surgery (tumors ≤ 3 cm) groups. Quality of life remained unchanged for the observation and radiation groups throughout the follow-up period. In the surgery group with tumors ≤ 3 cm, a significant improvement in total score and composite mental dimension was observed at 24 months. In the surgery group with tumors > 3 cm, there was an early improvement in composite mental dimension at 1.5 months, as well as at 24 months; total score and composite physical dimension were improved at 24 months in this group as well. Conclusions Based on the current management protocol, patients with VSs enjoy similar QOL throughout the follow-up period after undergoing observation, radiation therapy, or surgery.

scholarly journals A novel anatomical titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: A propensity-matched cohort study

2020 ◽  
Author(s):  
Haiyang Wu ◽  
Ranran Shang ◽  
Ximing Liu ◽  
Chengjing Song ◽  
Yanzhao Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Operation Time ◽  
Plate Versus ◽  
Matched Cohort ◽  
Titanium Plate ◽  
Reconstruction Plate ◽  
Quadrilateral Plate ◽  
The Mean

Abstract Background Because of the peculiar anatomy and complex geometry of this region, surgical treatment of acetabular fractures involving quadrilateral plate is a challenge to orthopaedic surgeons. Many scholars consider that quadrilateral plate exist a absolute “dangerous zone” for screw placement and have designed a variety of buttress plates to control medial displacement of the quadrilateral surface. In order to achieve the safe and effective fixation in quadrilateral plate, we have developed a novel fixation technique using a special shaped reconstruction plate combined with several buttress screws of quadrilateral plate which was called Dynamic Anterior Plate-Screw System for Quadrilateral plate (DAPSQ) since 2005(RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, a set of anatomical titanium plate(ATP group) of DAPSQ have been designed and applied for the treatment of quadrilateral plate fractures. The aim of this study was to compare the efficacy of anatomical titanium plate versus the reconstruction plate in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures, and twenty-two patients were treated with anatomical titanium plate of DAPSQ in the inclusion period(2016-2018), and were matched to 22 cases in our database of RP group(2008-2016). The primary outcome measures were quality of reduction and functional outcome. Intraoperative conditions included surgical time, bleeding, and blood transfusion and the postoperative complications were also compared. Results Of these 22 consecutive patients in ATP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture(12cases, 54.5%) according to Letournel-Judet classification. The mean follow up period was 23.1 months (range 12-37). There was no significant differences between the two groups with regards the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score(P>0.05). Compared with the RP group, the ATP group has a short operation time(245.1 minutes vs. 286.8 minutes, P = 0.020), less intraoperative blood loss(1136.4 mL vs. 1777.3mL, P = 0.014) and transfusion(780.9 vs. 1256.8mL, P = 0.035). The complication rate was 22.7% in ATP group, and there was no significantly difference compared with the RP group(54.5%)(P>0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusions The fixation of anatomical titanium plate in quadrilateral plate fractures showed similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. But the utility of anatomical titanium plate had the advantages of shorter operation time, less bleeding and transfusion which is worthy to recommend.

scholarly journals Normal Quality of Life after the Cox-Maze Procedure for Atrial Fibrillation

2008 ◽  
Vol 3 (3) ◽  
pp. 142-146 ◽  
Author(s):  
Spencer J. Melby ◽  
Andreas Zierer ◽  
Jordon G. Lubahn ◽  
Marci S. Bailey ◽  
James L. Cox ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Short Form ◽  
Maze Procedure ◽  
Medical Outcomes ◽  
Health Domains ◽  
The Mean

Objective Atrial fibrillation (AF) has been shown in numerous studies to significantly decrease patient's quality of life. The Cox-Maze procedure has excellent long-term efficacy in curing AF. However, it is unknown whether this procedure improves long-term quality of life in these patients. The purpose of this study was to examine late quality of life in patients who underwent a lone Cox-Maze procedure. Methods Between 1987 and 2003, 163 patients underwent a Cox-Maze procedure for lone AF at our institution. Of these, 68 patients agreed and completed the Medical Outcomes Study Short Form 36 Health Survey. Scores from the age-matched general U.S. population were normalized to a mean of 50 and standard deviation of 10 to facilitate comparison. Collected data were compared with the norm-based score for each domain using a one-sample t test. Four patients were removed from the analysis because of AF recurrence. Results There were 52 males (81%). Mean age was 52.6 ± 9.5 years. Preoperatively, 37 patients (58%) had paroxysmal and 25 patients (39%) had persistent or permanent AF. The mean duration of AF before surgery was 9.8 ± 8.2 years. There was no statistical difference in norm-based scores between the Cox-Maze procedure group and the age-matched general U.S. population in any of the eight health domains at a mean follow-up of 8.7 ± 3.7 years. Conclusion Our results suggest that the Cox-Maze procedure cures AF in the majority of patients, and that those patients who are cured had a normal quality of life when compared with the general population at late follow-up.

Effect of Systematic Exercise Rehabilitation on Patients With Knee Osteoarthritis: A Randomized Controlled Trial

Cartilage ◽  
2020 ◽  
pp. 194760352090344
Author(s):  
Jing Chao ◽  
Zhang Jing ◽  
Bai Xuehua ◽  
Yang Peilei ◽  
Gong Qi
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Short Form ◽  
Controlled Trial ◽  
Control Group ◽  
Exercise Rehabilitation ◽  
The Mean ◽  
Cox 2 Inhibitors

Objectives We aimed to compare the outcomes of exercise rehabilitation and conventional treatment in patients with knee osteoarthritis. Methods This trial included a total of 166 patients diagnosed with knee osteoarthritis; they were randomly divided into groups. The experimental group underwent systematic exercise rehabilitation, while the control group received naproxen ( n = 28), diclofenac ( n = 27), or celecoxib ( n = 19). Improvement in symptoms, knee function, and quality of life were compared. SPSS Statistics 24.0 was used for the data analysis. Results The mean age of patients was 56.0 ± 10.5 years, and the average follow-up time was 12 ± 2.3 weeks. No statistically significant differences were seen in age, body mass index, and sex ( P > 0.05) between the groups. The average Western Ontario and MacMaster Universities (WOMAC) scores after treatment were 84.4 ± 15.2, 108.3 ± 3.9, 107.4 ± 5.4, and 107 ± 6.0 in the exercise rehabilitation, diclofenac, naproxen, and celecoxib groups, respectively. The mean Lysholm scores were 60.3 ± 14.9, 41.0 ± 0.1, 43.5 ± 5.3, and 41.7 ± 3.6 in the exercise rehabilitation, diclofenac, naproxen, and celecoxib groups, respectively. The mean SF-36 (Short Form-36 Survey) scores were 105.4 ± 21.5, 82.5 ± 3.7, 84.2 ± 3.5, and 83.7 ± 5.0 in the exercise rehabilitation, naproxen, celecoxib, and diclofenac groups, respectively. The average ranges of knee motion were 125.0 ± 6.2°, 116.4 ± 1.4°, 114.7 ± 1.1°, and 115.7 ± 0.8° after exercise rehabilitation, diclofenac, naproxen, and celecoxib treatments, respectively. These data presented statistical differences between the groups. Conclusion Exercise better improved symptoms and quality of life in patients with knee osteoarthritis over a 12-week follow-up period than that achieved with nonsteroidal anti-inflammatory drugs and COX-2 inhibitors.

scholarly journals Preliminary analysis of quality of life (QOL) before and after surgery for female genital fistula. A prospective cohort study

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Stacy Saha ◽  
Bea Ambauen-Berger ◽  
Shirajum Munira
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Multivariable Analysis ◽  
Post Surgery ◽  
Poor Women ◽  
Health Related Qol ◽  
Health Related ◽  
The Mean

Aims: To describe the characteristics of women who come for repair of FGF, assess their QOL before & after surgery and estimate factors associated with improved quality of life. Methods: All women who came to LAMB for FGF repairin 2016 and 2017 were interviewed on admission and called for a follow-up visit 6 months after successful surgery. Sociodemographic, obstetric, and fistula-related information was collected on admission. Health related QOLwasmeasured using the 36-item short form (SF-36), and perception of stigma and discrimination were assessed on admission and at follow-up. Results: A total of 72 women were included.Mean age was 40.1 years, 49% had no education, and 42% were in the poorest wealth quintile.The mean stigma score (out of 7)went from 3.79 to 1.40 post surgery (p<0.001) and the mean discrimination score (out of 5)went from 2.2 to 0.4 (p<0.001). The mean score for all eight of the general health categories increased significantly after surgery (p<0.01 to 0.001). Poor women started lower but showed evidence of greater improvement in health related QOL compared to richer women (p<0.05)) and some evidence of greater improvement in discrimination (p<0.1). Women with no education had a larger decreasein perceived stigma (p= 0.03) compared to the educated. Conclusions:  Surgery for FGF improves quality of life, with poor women showing greater increase in health related QOL and uneducated women reporting a greater decrease in stigma.  Further multivariable analysis is needed to determine which factors remain associated with improved QOL.

scholarly journals A Modified Posterolateral Approach for the Treatment of Posterior Malleolar Fracture

2020 ◽  
Author(s):  
Fang Wenlai ◽  
Kong jianzhong ◽  
Chen mochuan
Keyword(s):  
Short Form ◽  
Operation Time ◽  
Healing Time ◽  
Posterolateral Approach ◽  
Flexor Hallucis Longus ◽  
Malleolar Fracture ◽  
Posterior Malleolar Fracture ◽  
Sf 36 ◽  
The Mean

Abstract Background: To observe the clinical effect of a modified posterolateral approach internal fixation in the treatment of posterior malleolar fracture. Method: From January 2015 to October 2018, 30 cases involving lateral and posterior malleolar fracture patient data were treated in our department. we observed operation time, fracture healing time and postoperative complications. At the time of the last follow-up, we evaluated ankle joint function by the American Orthopedic Foot Ankle Society (AOFAS) ankle- hindfoot scale, the Short Form-36 (SF-36) outcome Tools and the American Academy of Orthopaedic Surgeons (AAOS) Foot and Ankle Questionnaire. Result: In this group of 30 patients, the operation time of the patients was 80-120min (median 90min). The 25 patients were followed up for more than 1 year. 3 ~ 5 months after the operation, all the patients had bony healing. 3 cases with superficial wound infection. No other complication was found. The mean AOFAS scores at the postoperative 6-month, 12-month, and final follow-up were 78.4 (range, 72–90), 89.4 (range, 80–96), and 90.8 (range, 84–96), respectively. The mean SF-36 scores at the postoperative 12-month and final follow-up were 82.4 (range, 77.6–90.6) and 84.6 (range, 77.8–92.6), the mean AAOS scores at the postoperative 12-month and final follow-up were87.8 (range, 79–95), 90.6 (range, 82–96). Conclusion: Modified posterolateral approach avoided stripping the muscular origins of flexor hallucis longus, reduced the adhesion, and can fix the lateral and posterior malleolar fracture in the same incision, is worth popularizing in clinical.

What are the results of revised hip resurfacing arthroplasties?

2020 ◽  
Vol 102-B (10) ◽  
pp. 1289-1296
Author(s):  
Harlan C. Amstutz ◽  
Michel Le Duff
Keyword(s):  
Quality Of Life ◽  
Los Angeles ◽  
Revision Surgery ◽  
Short Form ◽  
Perioperative Complications ◽  
Hip Resurfacing ◽  
Long Term Outcome ◽  
The Mean

Aims Hip resurfacing arthroplasty (HRA) is typically indicated for young and active patients. Due to the longevity of arthroplasty, these patients are likely to undergo revision surgery during their lifetime. There is a paucity of information on the long-term outcome of revision surgeries performed after failed HRA. The aim of our study was to provide survivorship data as well as clinical scores after HRA revisions. Methods A total of 42 patients (43 hips) were revised after HRA at our centre to a variety of devices, including four HRA and 39 total hip arthroplasties (THAs). In addition to perioperative complications, University of California, Los Angeles (UCLA) hip scores and 12-Item Short-Form Health Survey questionnaire (SF-12) quality of life scores were collected at follow-up visits after the primary HRA and after revision surgery. Results The mean follow-up time after revision surgery was 8.3 years (0.3 to 19.1). The mean UCLA pain and function scores post-revision were comparable with the best scores achieved by the patients after the index HRA, but UCLA activity scores were lower after revision. SF-12 physical component scores were comparable between timepoints, but the mental component score decreased after revision. Six patients underwent unilateral re-revision surgery at a mean follow-up time of 7.8 years (0.3 to 13.7). Using the time to any re-revision as endpoint, the Kaplan-Meier survivorship was 85.3% at 13 years. Conclusion Patients undergoing revision after HRA can expect to achieve function and quality of life similar to their best after their primary surgery, while the risk of re-revision is low. Cite this article: Bone Joint J 2020;102-B(10):1289–1296.

scholarly journals A novel anatomical titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: A propensity-matched cohort study

2020 ◽  
Author(s):  
Haiyang Wu ◽  
Ranran Shang ◽  
Ximing Liu ◽  
Chengjing Song ◽  
Yanzhao Chen ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Operation Time ◽  
Acetabular Fractures ◽  
Matched Cohort ◽  
Titanium Plate ◽  
Reconstruction Plate ◽  
Quadrilateral Plate ◽  
The Mean

Abstract Background Surgical treatment of acetabular fractures involving quadrilateral plate is a challenge to orthopaedic surgeons. We have developed a novel fixation technique using a special shaped reconstruction plate combined with several buttress screws of quadrilateral plate which was also called Dynamic Anterior Plate-Screw System for Quadrilateral plate (DAPSQ) to treat acetabular fractures involving quadrilateral plate since 2005(RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, anatomical titanium plate (ATP group) of DAPSQ have been designed and applied. The aim of the study was to compare the clinical efficacy of anatomical plate and the reconstruction plate of DAPSQ in the treatment of quadrilateral plate fractures. Methods We led a propensity-matched cohort study of quadrilateral plate fractures. Twenty-two patients were included in the ATP group during the inclusion period (2016-2018), and were matched to 22 cases in our database of RP group (2008-2016). The primary outcome measures were quality of reduction and functional outcomes. Intraoperative conditions were also compared. Results Of these 22 consecutive patients in ATP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture (12cases, 54.5%) according to Letournel-Judet classification. The mean follow-up period was 23.1 months (range 12-37). There were no significant differences between the two groups with regards the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d’Aubigné score( P > 0.05). Compared with the RP group, the ATP group has a shorter operation time(245.1 minutes vs. 286.8 minutes, P = 0.020), less intraoperative blood loss (1136.4 mL vs. 1777.3mL, P = 0.014) and transfusion (780.9 vs. 1256.8mL, P = 0.035). The complication rate was 18.2% in ATP group, and there was no significantly difference compared with the RP group (36.4%)( P > 0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. Conclusion s The fixation of anatomical titanium plate in quadrilateral plate fractures showed a similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. The anatomical titanium plate of DAPSQ has the advantages of short operation time, less intraoperative bleeding and blood transfusion, and it is worth further promotion and research.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

scholarly journals Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson
Keyword(s):  
Urinary Incontinence ◽  
Cohort Study ◽  
Real World ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Healthcare Services ◽  
International Consultation ◽  
The Mean

ObjectivesThe efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.DesignProspective cohort study.ParticipantsDuring a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.InterventionThree months’ use of the app Tät, containing information, a pelvic floor muscle training programme and lifestyle advice.Main outcome measuresChange in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).ResultsOf the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.ConclusionsThe app Tät was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.

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