scholarly journals “I just wear it and I become normal”: a qualitative study of Tanzanian women’s experiences with long-term vaginal pessary use for stress urinary incontinence

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040009
Author(s):  
Karina Holm Nissen ◽  
Benjamin C Shayo ◽  
Vibeke Rasch ◽  
Gileard G Masenga ◽  
Ditte Søndergaard Linde
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Vaginal Pessary ◽  
Cost Effective Treatment ◽  
Long Term Treatment

IntroductionPrevious research has shown that vaginal pessaries are a cost-effective treatment for women worldwide suffering from stress urinary incontinence. However, little is known about African women’s experiences with vaginal pessary use. The aim of this study was to understand the experiences of vaginal pessary use among Tanzanian women who had received long-term pessary treatment for stress urinary incontinence.Methods15 semi-structured, individual interviews were conducted over a 2-month period in 2019 with Tanzanian women living in the Kilimanjaro Region who suffered from stress urinary incontinence and who had been using a pessary for at least 18 months. The interview transcripts were analysed using qualitative content analysis.ResultsThe primary motivation for seeking treatment were discomfort from symptoms, social consequences and low quality of life. Perceived benefits from pessary use included improved quality of life with reacquired abilities to perform daily activities, participate in social gatherings, feeling symptom relief and improved sexual relations. Further, some women saw pessary treatment as superior to other locally available treatment options. Perceived barriers for pessary use included shame, husband’s disapproval, limited access to treatment and lack of knowledge among the women as well as healthcare personnel.ConclusionVaginal pessaries are well-perceived as a long-term treatment method among Tanzanian women suffering from stress urinary incontinence. This method may have potential to be implemented large scale in Tanzania if combined with basic health education.

scholarly journals Long Term Quality of Life after Tension-Free Vaginal Tape-Obturator Procedure in Women with Stress Urinary Incontinence

2016 ◽  
pp. 21-25
Author(s):  
Athanasios Farfaras ◽  
Stefanos Antoniou ◽  
Panagiotis Skolarikos
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Health Related Quality ◽  
Tension Free ◽  
Tension Free Vaginal Tape ◽  
Related Quality ◽  
Health Related

Introduction: Stress urinary incontinence represents a common but strongly underestimated health problem that affects women of all ages and severely downgrades their health related quality of life. The transobturator vaginal tape (TVT-O) approach offers long term success rates, while minimizing complications. In this study, we examined quality of life of patients suffering by stress urinary incontinence and investigated whether TVT-O procedure offers considerable benefits in patient’s quality of life after 5 years of placement. Methods and results: Women with confirmed urodynamic stress urinary incontinence that underwent TVT-O procedure were included in this prospective study. Patient’s quality of life was evaluated by using the Greek version of SF-36 preoperatively and 60 months postoperatively. The outcomes demonstrated that incontinence had significant adverse effect in patient’s quality of life. However, TVT-O procedure offers a safe and efficient treatment, substantially improving both physical and mental dimension of women’s health related quality of life (P>0.05). Discussion: Stress urinary incontinence strongly impairs women’s health related quality of life, limiting their physical activities, social function and causing emotionally imbalance. Insertion of tension free vaginal tape reverses symptoms and significantly improves all health indicators associated with patient’s health related quality of life. In our study, we demonstrate that minimal invasive surgery, by using TVT-O procedure is highly effective, in long term, in improving quality of life of women with stress urinary incontinence.

scholarly journals Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Theo Malthouse ◽  
Ian Rudd ◽  
Chris Down ◽  
James Moore
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Overactive Bladder ◽  
Short Form ◽  
Mixed Urinary Incontinence ◽  
Long Term Outcomes ◽  
Bladder Symptoms

There has been an increasing interest in mesh-free surgical options for Stress Urinary Incontinence (SUI). Traditionally rectus fascia autologous slings were placed at the bladder neck but more recently they are positioned at the mid-urethra (aMUS). The long-term outcomes for these patients are described. A retrospective analysis of aMUS patients between 2009-2014 by a single surgeon for primary SUI was performed. All patients were evaluated preoperatively with urodynamics. Patient reported outcomes were collected via postal questionnaire using the ICIQ-UI short-form questionnaire, 7-point Global Impression of Improvement score, questions on pad usage, self-catheterisation, overactive bladder treatment and re-operation rates. Results included 31 patients (response rate 63.8%). The median age was 49 years and median BMI was 27. Twenty-seven per cent (27%) of patients had stress predominant mixed urinary incontinence pre-operatively. Median length of follow up was 8 years (5- 11); 60% of patients were dry and pad-free. Seventy-seven per cent (77%) found the surgery led to “much improvement” or “very much improvement” in quality of life. Thirteen per cent (13%) of patients reported a deterioration in quality of life. The median ICIQ-UI short form score was 5.5. 16.7% were taking medication and 1 patient received botulinum toxin therapy for overactive bladder symptoms. All these patients had mixed urinary incontinence on preoperative urodynamics. The re-operation rate was 13.3%. One patient was selfcatheterising. Three out of 31 (10%) had experienced pelvic pain, with 2 out of 31 (6%) experiencing dyspareunia. AMUS shows good long-term continence outcomes and is associated with low rates of de-novo overactive bladder symptoms and voiding dysfunction.

Prophylaxis in people with haemophilia

2009 ◽  
Vol 101 (04) ◽  
pp. 674-681 ◽  
Author(s):  
Massimo Franchini ◽  
Annarita Tagliaferri ◽  
Antonio Coppola
Keyword(s):  
Quality Of Life ◽  
Cost Benefit ◽  
Primary Prophylaxis ◽  
Secondary Prophylaxis ◽  
Severe Haemophilia ◽  
Duration Of Treatment ◽  
First Choice ◽  
Long Term Treatment

SummaryA four-decade clinical experience and recent evidence from randomised controlled studies definitively recognised primary prophylaxis, i.e. the regular infusion of factor concentrates started after the first haemarthrosis and/or before the age of two years, as the first-choice treatment in children with severe haemophilia. The available data clearly show that preventing bleeding since an early age enables to avoid or reduce the clinical impact of muscle-skeletal impairment from haemophilic arthropathy and the related consequences in psycho-social development and quality of life of these patients. In this respect, the aim of secondary prophylaxis, defined as regular long-term treatment started after the age of two years or after two or more joint bleeds, is to avoid (or delay) the progression of arthropathy. The clinical benefits of secondary prophylaxis have been less extensively studied, especially in adolescents and adults; also in the latter better outcomes and quality of life for earlier treatment have been reported. This review summarises evidence from literature and current clinical strategies for prophylactic treatment in patients with severe haemophilia, also focusing on challenges and open issues (optimal regimen and implementation, duration of treatment, long-term adherence and outcomes, cost-benefit ratios) in this setting.

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