Acupuncture for postprostatectomy incontinence: a systematic review

2020 ◽  
pp. bmjspcare-2020-002450
Author(s):  
Huan Chen ◽  
Yu Liu ◽  
Jiani Wu ◽  
Fanrong Liang ◽  
Zhishun Liu

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.

2021 ◽  
Vol 42 (3) ◽  
pp. 293-307
Author(s):  
Hyun-seo Nam ◽  
Tae-hyun Baek

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.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson

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.


2017 ◽  
Vol 89 (4) ◽  
pp. 293
Author(s):  
Oreste Risi ◽  
Michele Manica ◽  
Rocca Carmela Lisanti ◽  
Antonio Manfredi ◽  
Giuseppe Romeo Tecci

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.


2020 ◽  
Vol 20 (1) ◽  
pp. 45 ◽  
Author(s):  
Maisa H. Al Kiyumi ◽  
Zaleikha I. Al Belushi ◽  
Sanjay Jaju ◽  
Abdulaziz M. Al Mahrezi

Objectives: Urinary incontinence (UI) in women is a common health problem which can have a negative impact on quality of life (QOL). This study aimed to determine the prevalence, risk factors and impact of UI on the QOL of Omani women attending primary healthcare centres in Muscat, Oman. Methods: This crosssectional study was conducted at three primary healthcare centres in Muscat from April to August 2018. Women who were 20–50 years of age, not pregnant, not in the six-month postnatal period, not seriously ill and not diagnosed with pelvic organ prolapse were included. A self-administered questionnaire using the International Consultation Incontinence Questionnaire-Short Form was used to evaluate the frequency, severity and impact of UI on QOL. Results: A total of 1,070 women were included in this study (response rate = 92.5%). The mean age was 31.39 ± 7.64 years. UI was reported by 369 (34.5%) women, of whom 182 (49.3%) had stress UI, 97 (26.3%) had urgency UI, 88 (23.8%) had mixed UI and two (0.5%) had other UI. Age, body mass index (BMI), having been married or employed, hypertension, cough, constipation and vaginal or assisted vaginal delivery during the previous birth were significant risk factors for UI. Only 41 (11.1%) out of the 369 women with UI had ever sought medical advice despite the fact that more than two thirds of the women with UI reported negative effects on their QOL. Conclusion: UI is a common medical problem in Oman. Several risk factors, including age and BMI, were identified. Despite its negative consequences for QOL, women were found to be reluctant to seek medical attention for the condition.Keywords: Urinary Incontinence; Prevalence; Risk Factors; Quality of Life; Oman.


Author(s):  
Christiana Nygaard ◽  
Lucas Schreiner ◽  
Thiago Morsch ◽  
Rodrigo Saadi ◽  
Marina Figueiredo ◽  
...  

Objective To analyze the prevalence of urinary incontinence (UI) in female patients with an indication for bariatric surgery, to investigate the potential risk factors and the impact on quality of life. Methods A cross-sectional study with female patients with obesity. The evaluation consisted of a structured interview, a specific study form and quality of life questionnaires. The Poisson regression was performed to identify independent risk factors related to UI. Results A total of 221 patients were enrolled; 118 of the study participants (53.4%) reported UI episodes. Mixed UI (MUI), stress UI (SUI) only, and urgency UI (UUI) only were reported by 52.5% (62), 33.9% (40) , and 13.5% (16) of these patients respectively. The prevalence of UI was increased by 47% among the women who had given birth vaginally and by 34% of the women who had entered menopause. Vaginal delivery and menopause were identified as independent risk factors related to UI. The mean International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) score was 9.36 ± 4.9. The severity of symptoms was considered moderate in 53.3% (63) of the patients with UI. Conclusion Urinary incontinence impacts quality of life negatively, and the prevalence of UI is high among obese patients. In the present study, vaginal delivery and menopause were independently associated with UI.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Walaa W. Aly ◽  
Hala S. Sweed ◽  
Nora A. Mossad ◽  
Mohammad F. Tolba

Background/Purpose. Urinary incontinence (UI) is an important geriatric health problem, and it is linked to frailty syndrome. We had conducted a study to detect the prevalence and risk factors of UI and its effect on quality of life (QOL) among frail elderly females living in Cairo, Egypt. Methods. We carried out a cross-sectional study on 130 frail elderly females sixty years and older, attending Ain Shams Geriatrics Hospital, Cairo, Egypt. Each patient gave oral consent and then was subjected to history taking, full clinical examination, diagnosis of frailty (clinical frailty scale), assessment of UI by the Arabic version of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), assessment of QOL by using the Arabic version of Incontinence Impact Questionnaire Short Form (IIQ-7 SF), and complete urine analysis. Results. The prevalence of UI among the studied population was 80%. Mixed UI was the most prevalent type. UI was significantly associated with older age, functional impairment, multiparity, osteoarthritis, stroke, vaginal prolapse, and laxative use. All IIQ-7 subscales were higher (worse health-related QOL) for women with mixed UI. Conclusion. Urinary incontinence is prevalent in frail elderly females. Mixed UI, compared with other types, has a significant negative impact on all domains of quality of life.


Author(s):  
Damiano Pizzol ◽  
Jacopo Demurtas ◽  
Stefano Celotto ◽  
Stefania Maggi ◽  
Lee Smith ◽  
...  

Abstract Background Urinary incontinence (UI) and low quality of life (QoL) are two common conditions. Some recent literature proposed that these two entities can be associated. However, no attempt was made to collate this literature. Therefore, the aim of this study was to conduct a systematic review and meta-analysis of existing data to estimate the strength of the association between UI and QoL. Methods An electronic search of major databases up to 18th April 2020 was carried out. Meta-analysis of cross-sectional and case–control studies comparing mean values in QoL between patients with UI and controls was performed, reporting random-effects standardized mean differences (SMDs) ± 95% confidence intervals (CIs) as the effect size. Heterogeneity was assessed with the I2. Results Out of 8279 articles initially screened, 23 were finally included for a total of 24,983 participants, mainly women. The mean age was ≥ 50 years in 12/23 studies. UI was significantly associated with poor QoL as assessed by the short-form 36 (SF-36) total score (n = 6 studies; UI: 473 vs. 2971 controls; SMD = − 0.89; 95% CI − 1.3 to − 0.42; I2 = 93.5) and by the sub-scales of SF-36 and 5/8 of the domains included in the SF-36. Similar results were found using other QoL tools. The risk of bias of the studies included was generally high. Conclusions UI is associated with a poor QoL, with a strong level of certainty. This work, however, mainly based on cross-sectional and case–control studies, highlights the necessity of future longitudinal studies for better understanding the importance of UI on QoL.


2017 ◽  
Vol 84 (4) ◽  
pp. 251-253
Author(s):  
Andrea Vismara Fugini ◽  
Luca Giovanessi ◽  
Michelangelo Tosana

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.


2017 ◽  
Vol 3 (6) ◽  
pp. 636-644
Author(s):  
Birsel Canan DEMİRBAĞ ◽  
Gulpinar ASLAN ◽  
Ayşe Berivan BAKAN

Objective:  This study aims to identify urinary incontinence and its prevalence in people aged 65 and over. Methods: This descriptive study was conducted between April and June, 2017. It was conducted with 1527 volunteer people aged 65 and over who applied to A Family Health Centre. Data were collected through face-to-face interviews, using Personal Identification Form and International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF).Results: Of all the participants, 50.7% were male, and 78.8% were aged between 65 and 74. Besides, 31.2% of them had urinary incontinence, and ICIQ-SF mean score was found 11.44 ± 5.01. The most prevalent incontinence type was found to be urge urinary incontinence. ICIQ-SF total scores of elderly people with urinary incontinence were higher in those who were aged 85 and over, who were illiterate, who did not have health insurance, and who had more than one chronic disease and multiple medicine use.Conclusion: Urinary incontinence is a health problem which maintains its importance in people aged 65 and over. People in this age group do not express this problem because they feel shy; therefore, their quality of life deteriorates. 


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