Therapeutic potential of muscle growth promoters in a stress urinary incontinence model

Weakness of urinary sphincter and pelvic floor muscles can cause insufficient urethral closure and lead to stress urinary incontinence. Bimagrumab is a novel myostatin inhibitor that blocks activin type II receptors, inducing skeletal muscle hypertrophy and attenuating muscle weakness. β2-Adrenergic agonists, such as 5-hydroxybenzothiazolone derivative (5-HOB) and clenbuterol, can enhance muscle growth. We hypothesized that promoting muscle growth would increase leak point pressure (LPP) by facilitating muscle recovery in a dual-injury (DI) stress urinary incontinence model. Rats underwent pudendal nerve crush (PNC) followed by vaginal distension (VD). One week after injury, each rat began subcutaneous (0.3 mL/rat) treatment daily in a blinded fashion with either bimagrumab (DI + Bim), clenbuterol (DI + Clen), 5-HOB (DI + 5-HOB), or PBS (DI + PBS). Sham-injured rats underwent sham PNC + VD and received PBS (sham + PBS). After 2 wk of treatment, rats were anesthetized for LPP and external urethral sphincter electromyography recordings. Hindlimb skeletal muscles and pelvic floor muscles were dissected and stained. At the end of 2 wk of treatment, all three treatment groups had a significant increase in body weight and individual muscle weight compared with both sham-treated and sham-injured rats. LPP in DI + Bim rats was significantly higher than LPP of DI + PBS and DI + Clen rats. There were more consistent urethral striated muscle fibers, elastin fibers in the urethra, and pelvic muscle recovery in DI + Bim rats compared with DI + PBS rats. In conclusion, bimagrumab was the most effective for increasing urethral pressure and continence by promoting injured external urethral sphincter and pelvic floor muscle recovery.

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The Relationships of Urethral and Pelvic Floor Muscles and the Urethral Pressure Measurements in Women with Stress Urinary Incontinence

European Urology ◽

10.1159/000020132 ◽

2000 ◽

Vol 37 (2) ◽

pp. 149-155 ◽

Cited By ~ 18

Author(s):

Hann-Chorng Kuo

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Urethral Pressure ◽

Pressure Measurements

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Place of Duloxetine in Concervative Treatment Women and Men with Stress Urinary Incontinence

Health of Man ◽

10.30841/2307-5090.1.2021.232524 ◽

2021 ◽

pp. 77-84

Author(s):

Viktor Gorovyi ◽

Vladyslava Litvinets ◽

Olena Gurzhenko

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Urethral Sphincter ◽

Muscle Training ◽

External Urethral Sphincter ◽

History Of

History of introduction of duloxetine in medical practice, mechanism of action and using of duloxetine in concervative treatment women and men with stress urinary incontinence are shown. Modern structure of external urethral sphincter in women and men was shown with increasing of sphincter tone under duloxetine influence. Duloxetine recommended by International Continent Society for initial treatment women with stress urinary incontinence but this drug gives only improvement of urine continence and quality of life with side effects. Duloxetine with connection with pelvic floor muscle training gives better results than using separately duloxetine and pelvic floor muscle training. Nausuea is the most frequency side symptom after using duloxetine. Results of own investigations were shown and indications for using duloxetine in women with stress urinary incontinence were summed up. The most positive results were obtained after combination of duloxetine with pelvic floor muscle training and electrostimulation of urethral sphincter. Duloxetine for treatment men with stress urinary incontinence after radical prostatectomy is only clinical tested. Estimation of efficacy of duloxetine in treatment men with stress urinary incontinence after open prostatectomy due to benign prostatic hyperplasia is needed.

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Uzing of endourethral and intravaginal electrostimulation of urethral sphincter and pelvic floor muscles іn complex treatment of women with stress urinary incontinence without prolapse of pelvic organs

Health of Man ◽

10.30841/2307-5090.2(61).2017.116586 ◽

2017 ◽

Vol 0 (2(61)) ◽

pp. 97-99

Author(s):

В. І. Горовий

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Urethral Sphincter ◽

Complex Treatment ◽

Pelvic Organs

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The relationship of urethral and pelvic floor muscles and the urethral pressure measurements in women with stress urinary incontinence

Current Opinion in Urology ◽

10.1097/00042307-200009000-00032 ◽

2000 ◽

Vol 10 (5) ◽

pp. 489

Author(s):

Andrea Tubaro

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Urethral Pressure ◽

Pressure Measurements ◽

Relationship Of ◽

The Relationship

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The effect of intravaginal electrical stimulation on the quality of life and changes in function and anatomy of pelvic floor in women with stress urinary incontinence

Advances in Rehabilitation ◽

10.2478/rehab-2013-0024 ◽

2012 ◽

Vol 26 (1) ◽

pp. 5-11

Author(s):

Carneiro Erica ◽

Araùjo Nazete ◽

Cader Samaria ◽

Fonseca Aluizio ◽

Bittencourt Leila ◽

...

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Electrical Stimulation ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Detrusor Muscle ◽

Intravaginal Electrical Stimulation ◽

Urine Loss

Abstract Introduction: Urinary incontinence (UI), according to the Committee of the International Continence Society Standards, is defined as any involuntary urine loss associated to exertion conditions. This urine loss can be called Stress Urinary Incontinence (SUI) and when the detrusor muscle becomes inactive Material and methods: The goal of this study was verifying intravaginal electrical stimulation effects on bladder floor mobility, pelvic floor muscles´ width, their contraction ability and the quality of life of 40 women whose age ranged from 35 to 55 and who were diagnosed with Stress Urinary Incontinence disorder. They were split into two groups: Geletro (underwent 16 perineal electrical stimulation sessions) and control group, Gc (no intervention). The variables were respectively evaluated by the following instruments: transvaginal ultrassonography (Toshiba trademark), Phenix electromyographic biofeedback and King´s Health Questionnaire. Results: The results were bladder floor mobility reduction (Δ% = -9,13%, p=0,0930), width increase on pelvic floor muscles (Δ% = 11,64%, p= 0,2924), both not significant, muscle strength increase due to biofeedback (Δ% =60,49%, p= 0,0001) and to AFA* (Δ% = 24,53%, p=0,0001), and significant decrease of all questionnaire scores: DOM 1 (Δ% = -50,00%, p = 0,000), DOM 2 (Δ% = -55,14%, p= 0,005), DOM 3 (Δ% =-74,98 %, p= 0,002), DOM 4 (Δ% = -73,87%, p= 0,002), DOM 5 (Δ% = -68,91%, p= 0,001), DOM 6 (Δ% = -85,90%, p= 0,000), DOM 7 (Δ% = -72,48%, p= 0,014), DOM 8 (Δ% =-71,88 %, p= 0,030), DOM 9Δ% =-73,29 %, p= 0,023) Conclusions: The Geletro group in comparison to the Gc which showed that intravaginal electrical stimulation improved the pelvic floor anatomically and functionally and also the quality of life of Geletro group. Stress Urinary Incontinence improvement could only be subjectively demonstrated.

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Electromyographic characteristics of pelvic floor muscles in women with stress urinary incontinence following sEMG-assisted biofeedback training and Pilates exercises

PLoS ONE ◽

10.1371/journal.pone.0225647 ◽

2019 ◽

Vol 14 (12) ◽

pp. e0225647 ◽

Cited By ~ 3

Author(s):

Daria Chmielewska ◽

Magdalena Stania ◽

Katarzyna Kucab–Klich ◽

Edward Błaszczak ◽

Krystyna Kwaśna ◽

...

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Biofeedback Training

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Incontinência Urinária de Esforço e Disfunção Sexual Feminina: O Papel da Reabilitação do Pavimento Pélvico

Acta Médica Portuguesa ◽

10.20344/amp.12012 ◽

2019 ◽

Vol 32 (11) ◽

pp. 721

Author(s):

Andreia Preda ◽

Susana Moreira

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Sexual Dysfunction ◽

Sexual Function ◽

Pelvic Floor ◽

Negative Impact ◽

Pelvic Floor Muscles ◽

Function Evaluation ◽

Pelvic Floor Rehabilitation ◽

Urine Leakage

Introduction: The prevalence of urinary incontinence in Portuguese women is 21.4% and has a very negative impact on quality of life including women’s sexual activity. Pelvic floor rehabilitation is the first line treatment used in stress urinary incontinence and may be a tool in the treatment of sexual dysfunction in women with urinary incontinence. The aim of this review is to ascertain whether pelvic floor rehabilitation can improve sexual function in women with stress urinary incontinence.Material and Methods: We reviewed 12 articles in PubMed using the keywords: ‘urinary incontinence’, ‘female sexual dysfunction’ and ‘pelvic floor physical therapy’.Results: Pelvic floor rehabilitation is linked to a decrease in frequency of urinary leakage episodes as well as an improvement of coital incontinence. Furthermore, sexual function evaluation scores post-treatment revealed a positive change. Higher parity, higher adherence to treatment, improvement in the strength of pelvic floor muscles, and a decrease in the frequency of urine leakage were associated with higher improvement in sexual function.Discussion: Sexual function should be considered in the approach of urinary incontinence and standard tools of evaluation are essential tools for clinical assessment and follow-up. More evidence is required to identify the role of pelvic floor rehabilitation in sexual dysfunction of Portuguese women with urinary incontinence.Conclusion: Pelvic floor rehabilitation improves sexual function of women with stress urinary incontinence not only because it decreases the episodes of urine leakage but also because it strengthens pelvic floor muscles.

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