scholarly journals Electroacupuncture for stress-related urinary incontinence in elderly women: data analysis from two randomised controlled studies

2020 ◽  
pp. bmjspcare-2019-002034 ◽  
Author(s):  
Biyun Sun ◽  
Yan Liu ◽  
Tongsheng Su ◽  
Yuanjie Sun ◽  
Zhishun Liu
Keyword(s):  
Urinary Incontinence ◽  
Elderly Women ◽  
Short Form ◽  
Secondary Analysis ◽  
Elderly Group ◽  
Incontinence Episode ◽  
Safe Alternative ◽  
Link Type ◽  
International Consultation ◽  
Randomised Controlled

ObjectiveTo compare the efficacy of electroacupuncture (EA) in elderly and non-elderly women with stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI).MethodsThis study was a secondary analysis of two randomised controlled trials involving 252 women with SUI and 132 women with stress-predominant MUI who were treated with the same EA regimen. Elderly women were defined as those aged >60 years. The main outcome measure was the proportion of patients with ≥50% decrease in the mean 72-hour urinary incontinence episode frequency (IEF) from baseline to week 6. Overall, 1004 women were recruited in the SUI and MUI trials. In the EA group, those with urge-predominant or balanced MUI at baseline were excluded from the current study, resulting in a sample size of 384.ResultsOut of 384 patients with SUI or stress-predominant MUI who were treated with EA, 371 completed the study. After 6-week treatment, the proportion of women who achieved ≥50% decrease in mean 72-hour IEF from baseline was 57.3% (51/89) in the elderly group and 60.70% (173/285) in the non-elderly group; the between-group difference was not significant (3.11%, 95% CI −9.83% to 16.05%; p=0.637). Similar outcomes were observed at weeks 4, 16 and 28. Both groups showed reduction in the 72 -hour IEF, amount of urine leakage (assessed by 1-hour pad test) and International Consultation on Incontinence Questionnaire-Short Form score from baseline with no significant between-group difference. No obvious EA-related adverse events were observed during the study.ConclusionEA may be an effective and safe alternative treatment for SUI or stress-predominant MUI in both elderly and non-elderly women. Age may not affect the treatment outcomes of acupuncture.Trial registration numerNCT01784172, NCT02047032.

Acupuncture for postprostatectomy incontinence: a systematic review

2020 ◽  
pp. bmjspcare-2020-002450
Author(s):  
Huan Chen ◽  
Yu Liu ◽  
Jiani Wu ◽  
Fanrong Liang ◽  
Zhishun Liu
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Narrative Analysis ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Efficacy And Safety ◽  
Postprostatectomy Incontinence ◽  
International Consultation ◽  
Randomised Controlled

BackgroundPostprostatectomy incontinence (PPI) is a clinically significant condition that is caused by surgery of prostate. Study showed that electroacupuncture can reduce urine leakage among women with stress urinary incontinence (SUI), but few was known about its efficacy and safety for men with PPI. This study aims to conduct a systematic review to evaluate efficacy and safety of acupuncture for men with PPI compared with other non-surgical treatment.MethodsSeven databases were searched for all randomised controlled trials (RCTs) on acupuncture for men with PPI up to August 2020. Risks of bias of included studies were assessed using RevMan V.5.3. Narrative analysis was conducted.ResultsSeven studies with 830 men with PPI were included in the review. Studies showed that acupuncture can significantly improve score of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form for men with urgent urinary incontinence (UUI) when compared with medicine (p<0.05). It showed a significant better overall response rate when acupuncture was combined with solifenacin for men with UUI (p<0.05), or with pelvic floor muscle training (PFMT) (p<0.001), or with PFMT and medicine together for men with UUI or SUI (p<0.01), compared with control groups. No adverse event was reported in the studies. However, the quality of evidences was considered low generally.ConclusionThe results showed that acupuncture could be beneficial for men with PPI when applied alone or as an adjunction to other conservative therapies and medicines, however, the quality of evidence was considered low and inconclusive in this review.PROSPERO registration numberThis study has been registered at PROSPERO system with ID No. CRD42019091164.

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.

Acupuncture for Prostatectomy Incontinence: Study Protocol for A Multicenter Single Blind Randomized Parallel Controlled Trial

2021 ◽  
Author(s):  
Yao Zhang ◽  
Shanqi Guo ◽  
Chaoran Wang ◽  
Xiaodi Liu ◽  
Yan Liu ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Short Form ◽  
Controlled Trial ◽  
Simple Random Sampling ◽  
Sham Acupuncture ◽  
Incontinence Episode ◽  
Composite Scale ◽  
International Consultation ◽  
Episode Frequency ◽  
Voiding Diary

Abstract Background: Urinary incontinence is a common complication after prostatectomy. Acupuncture is considered an effective treatment for prostatectomy incontinence (PPI), but evidence is still limited. We propose to evaluate the effectiveness of acupuncture in a rigorously conducted trial.Methods: Twenty hospitals will recruit 340 participants with urinary incontinence after prostatectomy in China from April 2021 to April 2022. Participants will be randomly allocated to acupuncture or sham acupuncture with a 1:1 ratio using computerized simple random sampling. The study plan consists of 1-week baseline, 6-week treatment, and 18-week follow up. Eighteen 30-mintute sessions of acupuncture or sham acupuncture treatment will be provided between weeks 1 and 6. The primary outcome is the change in the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) score at the week 6 from the baseline. Secondary outcomes include the change in volume of urine leakage at weeks 4 and 6 from a baseline measured using the 1-h Pad Test;72-h incontinence episode frequency based on a 72-h voiding diary; change in the Expanded prostate cancer Index Composite scale (EPIC-26); change in the Self-Rating Anxiety Scale; weekly consumption of pads; the severity of urinary incontinence based on a 72-h bladder diary and self-assessment of the therapeutic effect. The safety of acupuncture will also be assessed.Discussion: This trial will help to identify whether acupuncture is effective for PPI, and, if so, whether it exerts a therapeutic rather than a placebo effect.Trial Registration: The trial was registered on www.Chictr.org.cn. ChiCTR2100042500. Retrospectively registered on 22 January 2021.

scholarly journals Profile of physically active elderly women with urinary incontinence

2018 ◽  
Author(s):  
Gabriela Silva ◽  
Ana Paula Krüger ◽  
Edmundo Alves Junior ◽  
Jonas Gurgel ◽  
Alessandra Camacho
Keyword(s):  
Urinary Incontinence ◽  
Elderly Women ◽  
Short Form ◽  
Descriptive Analysis ◽  
The Elderly ◽  
Cross Sectional ◽  
Physically Active ◽  
Preventive Actions ◽  
International Consultation ◽  
Probabilistic Study

Objective: To design the profile of active elderly women with urinary incontinence (UI) participating in a physical activity program according to sociodemographic characteristics, health conditions, life habits and conditions associated with urinary loss. Methods: A quantitative, cross-sectional, non-probabilistic study of 59 active elderly women. The elderly woman whose score was ≥ 3 according to the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) was considered incontinent. A descriptive analysis was performed by calculating the absolute and relative frequencies. Results: Predominant age between 70 and 79 years (44.1%), widows (32.2%), white (59.3%), complete high school (40.6%) and living alone (52.5%) . The largest proportion never smoked (64.4%) or drank (47.5%), it did not fall in the last year (64.4%), hypertensive (55.9%), had between one and three births (71.2%), were overweight (42.4%) and it did not use an intimate protector (67.8%). Urgency UI was more frequent (50.9%), small amount losses (54.3%), frequency ≤ 1 time per week (42.6%), complaint of nocturia (81.4%) and time of UI between 1 and 4 years (64.4%). Conclusion: The study made it possible to design the profile of active elderly women with UI, which in this study resemble those found in the literature. It is important to emphasize the importance of multidisciplinary work in the search for preventive actions and specialized treatments, aiming to maintain and/or improve the quality of life of incontinent elderly.

scholarly journals Acupuncture for prostatectomy incontinence: study protocol for a multicenter single-blind randomized parallel controlled trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Yao Zhang ◽  
Shanqi Guo ◽  
Chaoran Wang ◽  
Xiaodi Liu ◽  
Yan Liu ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Short Form ◽  
Controlled Trial ◽  
Simple Random Sampling ◽  
Sham Acupuncture ◽  
Incontinence Episode ◽  
International Consultation ◽  
Episode Frequency ◽  
Voiding Diary

Abstract Background Urinary incontinence is a common complication post radical prostatectomy. Acupuncture is considered an effective treatment for post-prostatectomy incontinence (PPI), but the evidence is still limited. We propose to evaluate the effectiveness of acupuncture in a rigorously conducted trial. Methods Twenty hospitals will recruit 340 participants with urinary incontinence after radical prostatectomy in China from April 2021 to April 2022. Participants will be randomly allocated to acupuncture or sham acupuncture with a 1:1 ratio using computerized simple random sampling. The study plan consists of 1-week baseline, 6-week treatment, and 18-week follow-up. Eighteen 30-min sessions of acupuncture or sham acupuncture treatment will be provided between weeks 1 and 6. The primary outcome is the change in the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) score at the week 6 from the baseline. Secondary outcomes include the change in volume of urine leakage at weeks 4 and 6 from a baseline measured using the 1-h pad test; 72-h incontinence episode frequency based on a 72-h voiding diary; change in the Expanded prostate cancer Index Composite scale (EPIC-26); change in the Self-Rating Anxiety Scale; weekly consumption of pads; and the severity of urinary incontinence based on a 72-h bladder diary and self-assessment of the therapeutic effect. The safety of acupuncture will also be assessed. Discussion This trial will help to identify whether acupuncture is effective for PPI, and, if so, whether it exerts a therapeutic rather than a placebo effect. Trial Registration www.Chictr.org.cnChiCTR2100042500. Retrospectively registered on 22 January 2021.

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.

scholarly journals Urinary Incontinence in Physically Active Older Women of Northeast Brazil

2021 ◽  
Vol 18 (11) ◽  
pp. 5878
Author(s):  
Thais Sousa Rodrigues Guedes ◽  
Marcello Barbosa Otoni Gonçalves Guedes ◽  
Hévila Kilvia Miguel de Oliveira ◽  
Rodrigo Lopes Soares ◽  
Vitor Leandro da Cunha ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Older Women ◽  
Short Form ◽  
Prevalence Ratio ◽  
Protection Factor ◽  
Cross Sectional ◽  
Physically Active ◽  
Factors Associated ◽  
International Consultation ◽  
Loss Of Balance

Low- and moderate-impact physical activity (PA) is associated with the prevention of urinary incontinence (UI). The objective of the cross-sectional study presented herein is to analyze the factors associated with UI in physically older active women who participate in senior community groups. The variable UI was measured by the International Consultation Incontinence Questionnaire Short Form (ICIQ-SF). Socioeconomic variables were also collected, along with data on life habits and clinical history. The multivariate analysis employed Poisson’s Regression with robust variance for factors associated with UI. Of the 106 participants evaluated, 54.7% presented UI, of which stress incontinence was more frequent, with 40.6%. UI presented a statistically significant association with dizziness/loss of balance during Activities of Daily Living (ADL) (prevalence ratio-PR 1.48; 95% CI 1.06–2.07) and nocturia (PR 1.63; 95% CI 1.05–2.55). Despite PA being a protection factor, UI presented an elevated prevalence in the older population, and therefore, other biological, social, and cultural aspects could also contribute to the occurrence of UI in this age group. Moreover, physically active older women with UI presented nocturia and dizziness/loss of balance during ADL, regardless of education levels and the number of births. These findings can help improve multi-professional programs aimed at promoting, preventing, and managing UI in the public.

scholarly journals Effectiveness on mild stress and mixed urinary incontinence and impact on Quality of Life of a phytotherapic product containing astragalus, thyme, lavender, hop, equisetum, red clover, cypress and agrimonia at titrated concentrations. Results from a monocentric study

2017 ◽  
Vol 89 (4) ◽  
pp. 293
Author(s):  
Oreste Risi ◽  
Michele Manica ◽  
Rocca Carmela Lisanti ◽  
Antonio Manfredi ◽  
Giuseppe Romeo Tecci
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Short Form ◽  
Statistical Significance ◽  
Red Clover ◽  
Mixed Urinary Incontinence ◽  
Mild Stress ◽  
Slight Improvement ◽  
International Consultation

Objectives: To assess any beneficial effect on quality of life of a daily treatment with a phytotherapic product containing astragalus, thyme, lavender, hop, equisetum, red clover, cypress and agrimonia at titrated concentrations in a cohort of female patients complaining mild stress urinary incontinence (SUI) or mixed urinary incontinence (MUI). Materials and methods: 42 non-consecutive female out-patients with mild SUI or mild MUI were assessed with a clinical evaluation, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and Patients’ Perception of Intensity of Urgency Scale (PPIUS) at baseline the start of the study and after two months of therapy with the phytotherapic product. At the end of the therapy the patients also compiled Patient Global Impression of Improvement (PGI-I). Results: After the completion of the study there was a trend towards better results in each item of ICIQ-SF, but without any statistical significance with an average score in ICIQ-SF-1 of 3.12 ± 0.981 versus 3.21 ± 0.914 (p = 0.556), in ICIQ-SF-2 of 3.69 ± 1.422 versus 3.79 ± 1.372 (p = 0.68) and in ICIQ-SF-3 of 5.95 ± 1.618 versus 6.14 ± 1.670 (p = 0.462). The average reduction of PPIUS was of 0.09 (1.26 ± 1.481 versus 1.357 ± 1.509, p = 0.705). There was a reduction of average consumption of pads/die from 1.69 ± 0.636 to 1.54 ± 0.543 (p = 0.101). In relation to the PGI score, 23/42 patients (54.7%) reported no changes after the completion of the therapy, 13/42 (30.9%) reported a slight improvement, 5/42 (11.9%) were much improved and 1/42 (2.3%) was slightly worsened. Only 2/42 (4.7%) patients discontinued the treatment before of the completion of the study. We did not observe any adverse effects during the period of the study. Conclusions: The phytotherapic product seems to cause a slight improvement of the symptoms in a good rate of patients. Moreover it has a low rate of withdrawal, due to the lack of adverse events.

scholarly journals Injectable Bulking Agent to Treat Postprostatectomy Urinary Incontinence: A Safety and Effectiveness Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Janneke I. M. van Uhm ◽  
Marloes Vermeer ◽  
Henk W. Elzevier ◽  
Joop W. Noordzij ◽  
Evert L. Koldewijn ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pilot Study ◽  
Radical Prostatectomy ◽  
Treatment Option ◽  
Short Form ◽  
Treatment Success ◽  
Bulking Agent ◽  
International Consultation ◽  
Weight Test ◽  
Urine Loss

Objectives. To evaluate the safety and effectiveness of the injectable bulking agent Opsys® (Promedon, Cordoba, Argentina) for treating minimal postprostatectomy stress urinary incontinence (SUI). Patients and Methods. Single-centre, pilot study on ten male patients with SUI, < 30 g urine loss/ 24 h, more than 1 year after radical prostatectomy. Patients were treated by endoscopic transurethral injections of bulking agent in the presphincteric zone of the urethral submucosa. The results were evaluated using a pad weight test to quantify the differences in urine loss at 1, 3, and 6 months after intervention. Subsequently, the results of treatment were also evaluated by International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory Short Form (UDI-6-SF), and the Patient Global Impression of Improvement (PGI-I) at 1, 3, and 6 months after intervention. Results. The primary outcome was the absolute result of the 24-hour pad weight test after treatment. Treatment success was defined as <3 g urine loss/24 h, improvement as ≥50% decrease in urine loss/ 24h, failure as <50% decrease in urine loss/24 h, or worsening of urine loss. Success was demonstrated in one, improvement in one, and failure in eight patients one month after treatment. One patient improved and 9 failed 3 and 6 months after treatment. The median 24-hour pad weight test was higher at all three moments of follow-up (1, 3, and 6 months after treatment). The median 24-hour pad weight test was before treatment 17.3g (6.4-20.9) and 1, 3, and 6 months after treatment, respectively, 40.3g (5.9-130.6) p= 0.038, 38.3g (18.3-202.1) p= 0.014, 55.0g (16.5-314.6) p= 0.028. The ICIQ-SF was significantly higher at 3 and 6 months, respectively 15.0 (12.0-18.5) p= 0.007 and 16.0 (12.5-17.5) p=0.012 versus 10.0 (9.0-12.0) before injection. No significant differences were found between IIQ-7, UDI-6-SF, and PGI-I before and after injection. Complications occurred in four patients: two patients reported spontaneously resolved haematuria and two patients reported urinary frequency. All complications were classified as Clavien–Dindo 1. Conclusion. Injection therapy with Opsys® bulking agent is not an effective treatment option for male SUI after radical prostatectomy. It is not a safe treatment option, due to worsening urine loss after treatment.

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