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 ◽  
...  

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.

Author(s):  
Mohsen Ayati ◽  
Erfan Amini ◽  
Mohammad Reza Nowroozi ◽  
Seyed Ali Momeni ◽  
Solmaz Ohadian Moghadam ◽  
...  

Background: To evaluate the efficacy of Bioceram injection in men with severe stress urinary incontinence following radical prostatectomy. Methods: A total of 18 patients underwent retrograde injection of Bioceram for severe stress urinary incontinence following radical prostatectomy. Evaluation by pad test, international consultation on the Incontinence Questionnaire - Short Form (ICIQ-SF) and American Urology Association Symptom Score - Quality of Life (AUASS-QOL) was performed before and after injection therapy. Patients were considered cured if they were using no pads or only one safety pad per day. Results: Of 18 patients, 14 had received postoperative external beam radiation therapy. Furthermore, 5 patients required transurethral incision due to simultaneous stricture of the urethrovesical anastomosis. The baseline daily pad count changed from a mean of 6.1± 0.8 to 5.3 ± 1.7 (p = 0.010). None of the patients were cured and only 3 patients showed signs of improvement following injection. Conclusion: In patients with severe urinary incontinence, treatment with bulking agent injection is associated with modest efficacy.


2016 ◽  
Vol 10 (6) ◽  
pp. NP127-NP135 ◽  
Author(s):  
Marcos E. Fernández-Cuadros ◽  
Javier Nieto-Blasco ◽  
Antonia Geanini-Yagüez ◽  
Daniel Ciprián-Nieto ◽  
Bárbara Padilla-Fernández ◽  
...  

The aim of the current study was to determine the demographic characteristics and risk factors associated with male urinary incontinence (UI) and to assess the effectiveness and the effect on the quality-of-life of a pelvic floor muscle training (PFMT) protocol with electromyography-biofeedback (EMG-BFB) with surface electrodes. A prospective, quasi-experimental before-and-after study with a sample of 61 men out of 372 patients referred to the Pelvic Floor Unit from October 2005 to June 2012 was performed. The protocol consisted of 20 sessions of EMG-BFB supervised by a physiotherapist twice a week. The session durations were 30 minutes (118 work/rest cycles of pelvic muscles). Work lasted 3 seconds and rest 7 seconds. Patients were given standards of conduct and questionnaires (International Consultation on Incontinence–Short Form and Incontinence Quality-of-Life Measure) at the beginning and at the end of the treatment. The average age was 64.85 ± 14.34 years; 44.3% ( n = 27) had benign prostatic hypertrophy, 41.9% ( n = 25) had prostate malignant neoplasm, 86.9% ( n = 53) had undergone prostatectomy, 16.4% ( n = 10) had undergone abdominal surgery. Abdominal surgery and radical prostatectomy were significantly associated with UI ( p < .05). Stress urinary incontinence was the most common type of UI (86.67%), followed by mixed urinary incontinence (8.33%) and urge urinary incontinence (5%). A significant improvement ( p < .05) in both International Consultation on Incontinence–Short Form and Incontinence Quality-of-Life Measure questionnaires was observed when making comparisons regarding the results before and after the EMG-BFB treatment protocol. These results support that male UI is significantly associated with urological and abdominal surgery (including radical prostatectomy) and that EMG-BFB for PFMT improves incontinence and quality of life (social embarrassment, limiting behavior, and psychosocial impact) in the three types of UI on an overall basis.


2021 ◽  
Author(s):  
Yue Duan ◽  
Kangjie He ◽  
Xiangnan Yang ◽  
Zheng Zhu ◽  
Di Dai ◽  
...  

Abstract Purpose: To explore the effectiveness of micturition interruption exercise in improving the incidence of urinary incontinence after radical prostatectomy.Materials and Methods: With a retrospective case-control study, 96 patients admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University from August 2016 to August 2020 and underwent radical prostatectomy were collected as the subjects. Those patients who used micturition interruption exercise (n=48)were set as the observation group, and the control group was collected according to the ratio of 1:1, the patients used Kegel exercise (n=48). To compare the rehabilitation of urinary incontinence in patients and the effect of training compliance on rehabilitation.Results: The recovery time of urinary incontinence in the observation group was significantly shorter than that of the control group. In the observation group, 83.3% of patients with training compliance reached an average or above, while the control group only accounted for 58.3%. International Consultation on Incontinence Questionnaire Short-Form score of the observation group was lower than that of the control group after surgery. Spearman analysis suggests that there is a negative correlation between the postoperative urinary incontinence recovery time and compliance with the micturition interruption exercise.Conclusions: Micturition interruption exercise could improve the patient's exercise compliance and shorten the recovery time of urinary incontinence after radical prostatectomy.


Author(s):  
Mariana Ferreira Vaz Gontijo Bernardes ◽  
Sabrina de Cássia Chagas ◽  
Lívia Cristina de Resende Izidoro ◽  
Denny Fabricio Magalhaes Veloso ◽  
Tânia Couto Machado Chianca ◽  
...  

ABSTRACT Objective: to assess the level of urinary incontinence and its impact on the quality of life of patients undergoing radical prostatectomy. Method: cross-sectional study carried out with prostatectomized patients. The data were collected from the following instruments: sociodemographic questionnaire, Pad Test, International Consultation on Incontinence Questionnaire - Short Form and King Health Questionnaire. Data were submitted to descriptive and bivariate statistical analysis. The level of significance was set at 0.05. Results: a total of 152 patients participated, with a mean age of 67 years. Among incontinent patients, there was a predominance of mild urinary incontinence. Urinary incontinence had a very severe impact on the general assessment of quality of life in the first months and severe impact after six months of surgery. The greater the urinary loss, the greater the impact on the quality of life domains Physical Limitations, Social Limitations, Impact of Urinary Incontinence and Severity Measures. Most participants reported no erection after surgery and therefore did not respond to the question of the presence of urinary incontinence during sexual intercourse. Conclusion: the present study evidenced the occurrence of urinary incontinence after radical prostatectomy at different levels and its significant impact on the quality of life of men, which reveals the need of interventions for controlling it.


2021 ◽  
Author(s):  
Kangjie He ◽  
Xiang-nan Yang ◽  
Zheng Zhu ◽  
Di Dai ◽  
Jia-cheng Zhang ◽  
...  

Abstract PurposeTo explore the effectiveness of micturition interruption exercise in improving the incidence of urinary incontinence after radical prostatectomy.Materials and MethodsMaterials and Methods: With a retrospective case-control study, 96 patients admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University from August 2014 to August 2020 and underwent radical prostatectomy were collected as the subjects. Those patients who used micturition interruption exercise (n=48)were set as the observation group, and the control group was collected according to the ratio of 1:1, the patients used Kegel exercise (n=48). To compare the rehabilitation of urinary incontinence in patients and the effect of training compliance on rehabilitation.ResultsThe recovery time of urinary incontinence in the observation group was significantly shorter than that of the control group. In the observation group, 83.3% of patients with training compliance reached an average or above, while the control group only accounted for 58.3%. International Consultation on Incontinence Questionnaire Short-Form score of the observation group was lower than that of the control group after surgery. Spearman analysis suggests that there is a negative correlation between the postoperative urinary incontinence recovery time and compliance with the micturition interruption exercise.ConclusionsMicturition interruption exercise could not only improve the compliance of patients with exercise, but also significantly shorten the recovery time of urinary incontinence after radical prostatectomy.


2018 ◽  
Vol 38 (2) ◽  
pp. 726-733 ◽  
Author(s):  
Kazuaki Machioka ◽  
Yoshifumi Kadono ◽  
Renato Naito ◽  
Kazufumi Nakashima ◽  
Masashi Iijima ◽  
...  

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Yao Zhang ◽  
Shanqi Guo ◽  
Chaoran Wang ◽  
Xiaodi Liu ◽  
Yan Liu ◽  
...  

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.


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.


Author(s):  
Thais Sousa Rodrigues Guedes ◽  
Marcello Barbosa Otoni Gonçalves Guedes ◽  
Hévila Kilvia Miguel de Oliveira ◽  
Rodrigo Lopes Soares ◽  
Vitor Leandro da Cunha ◽  
...  

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.


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