Comparing the Effect of Tolterodine, Biofeedback (Pelvic Floor Muscles Training) and Drug plus Biofeedback on Quality of Life and Urge Urinary Incontinency in Patients Referred to Imam Khomeini Hospital in 2014

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.

Download Full-text

Effect of Kegel Exercises on Pelvic Floor Muscle Disorders in Prenatal and Postnatal Women - A Literature Review

Current Women s Health Reviews ◽

10.2174/1573404816999200930161059 ◽

2020 ◽

Vol 16 ◽

Author(s):

Eric Lawer Torgbenu ◽

Christopher O. Aimakhu ◽

Emmanuel Komla Senanu Morhe

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Disorders ◽

Pelvic Floor Muscle ◽

Pelvic Floor Muscles ◽

Muscle Disorders ◽

Kegel Exercises ◽

Postnatal Women

Background: Pelvic floor disorders affect many women globally. Objective: To provide a critical appraisal of the literature on the effects of pelvic floor disorders on the quality of life and functioning of pregnant and postnatal women. Methods: Available literature was reviewed and summarized to discuss the definitions, pelvic floor anatomy, dysfunctions, and the mechanism of the condition, and more specifically, on the strengthening exercises for the pelvic floor muscles. Results: Pelvic floor disorder is an important public health concern because of the high prevalence, deleterious effects on pregnancy, and its outcomes as well as impacts on the health care system. They include genuine urinary incontinence, bladder and bowel incontinence, pelvic pain, weakness of the pelvic muscles, weakness of the muscles of the core stability, as well as the prolapse of pelvic organs. Pregnancy and subsequent vaginal delivery are associated causes of pelvic floor muscle disorders. Approximately 60% and 50% of community settlers and residents of nursing homes respectively are affected by urinary incontinence and the numbers increase with hysterectomy. Multiple birth, obesity, chronic coughs, overweight babies, and heavy lifting are associated risk factors. Treatment of pelvic floor muscle disorders should involve an increased physical activity prescription among women diagnosed with weaker pelvic floor muscles, engaging the multidisciplinary team, increasing the quality of life and functioning of women during and after pregnancy. Training aimed at strengthening the pelvic floor muscles is beneficial and prevention of dysfunctions. Conclusion: Structured and well organised pelvic floor muscle training regimen also known as Kegel exercises are important in preventing disorders of the pelvic floor during pregnancy and after delivery.

Download Full-text

Corrigendum to “Assessment of pelvic floor muscles in sportswomen: Quality of life and related factors” [Physical Therapy in Sport (2020) 151–156]

Physical Therapy in Sport ◽

10.1016/j.ptsp.2021.01.013 ◽

2021 ◽

Vol 49 ◽

pp. 50

Author(s):

Telma Pires ◽

Patrícia Pires ◽

Helena Moreira ◽

Ronaldo Gabriel ◽

Sara Viana ◽

...

Keyword(s):

Quality Of Life ◽

Physical Therapy ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Related Factors

Download Full-text

The Impact of Pelvic Floor Muscles Exercises with and without Synergistic Muscles on Quality of Life of Women with Stage I Stress Urinary Incontinence

10.20944/preprints201702.0097.v1 ◽

2017 ◽

Author(s):

Magdalena Ptak ◽

Agnieszka Brodowska ◽

Sylwester Ciećwież ◽

Iwona Rotter

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Gynecologic Oncology ◽

Pelvic Floor Muscles ◽

International Consultation ◽

Stage 1 ◽

The Impact

Stress urinary incontinence (SUI) influences the quality of life of women. The research applied ICIQ LUTS qol (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life) as a tool to measure the quality of life (QOL) of patients with stage 1 SUI in many areas. 140 perimenopausal women who participated in a urodynamic test at Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University, Police, Poland in the years 2013-2015 were enrolled in the study. Patients were divided into two groups: A and B. Two questionnaires were applied: the author’s original questionnaire and the standardized ICIQ LUTS qol. Gymnastic plans were recommended 4 times per week for the period of 3 months. The plan for group A included the exercises of pelvic floor muscles (PFM) with the simultaneous tension of the transverse abdominal muscle (TrA) and for group B included the exercises of PMF without TrA. The evaluation of the quality of life of patients with stage 1 SUI with the use of ICIQ LUTS qol among patients from groups A and B after therapy showed a significant improvement in most areas. More impact is observed in the physiotherapy of both PFM with TrA.

Download Full-text

Effectiveness of pelvic floor muscles training on females’ sexual function throughout pregnancy and postpartum

Clinical Nursing Studies ◽

10.5430/cns.v8n2p21 ◽

2020 ◽

Vol 8 (2) ◽

pp. 21

Author(s):

Tyseer Marzouk ◽

Hanan Nabil

Keyword(s):

Quality Of Life ◽

Sexual Function ◽

Pelvic Floor ◽

Intervention Group ◽

Pelvic Floor Muscles ◽

Control Group ◽

Sexual Quality Of Life ◽

Pregnancy And Postpartum

Objective: This study aimed to evaluate effectiveness of pelvic floor muscles training on females’ sexual function throughout pregnancy and postpartum.Methods: A quasi experimental research design was applied at the antenatal clinic of Mansoura University hospital, Egypt. A purposive sample of 72 nulliparous singleton pregnant client free from any connotation affect sexual practice was studied. The subjects were allocated into two groups; control group received conventional antenatal and postnatal care, while the intervention group received the same care besides performing pelvic floor muscle exercise at 20 weeks pregnancy until 10-12 weeks postpartum. Female sexual function, sexual quality of life, and strength of the pelvic floor muscle contraction were evaluated at baseline, at 28-30 weeks gestation, and at 10-12 weeks postpartum, by using the female sexual function index scale, sexual quality of life-female, and the Oxford grading scale.Results: The total female sexual quality of life index scores in the intervention group were higher than those of the control group at the pregnancy and postpartum follow ups (22.3 ± 6.9 vs. 15.9 ± 6.8 & 26.0 ± 6.7 vs. 13.5 ± 6.3 respectively; p < .001). The sexual quality of life-female scores were significantly higher in the intervention group than in the control group at the pregnancy follow up evaluation (54.2 ± 15.9 vs. 36.9 ± 9.7 respectively, p < .001) and at the postpartum follow up evaluation (59.8 ± 13.5 vs. 30.3 ± 7.0 respectively, p < .001). The pelvic floor muscles strength was significantly better in the intervention group than in the control group at the pregnancy follow up evaluation and at the postpartum follow up evaluation.Conclusions: Pelvic floor muscle training during early gestation weeks was an effective tool for improvement of the female sexual function, sexual quality of life-female, and pelvic floor muscles strength during pregnancy and postpartum. Thus, it should be encouraged for pregnant mothers at early weeks and continued till postpartum.

Download Full-text

PHYSIOTHERAPEUTIC ACTIVITY IN THE TREATMENT OF PENETRAL GENE PAIN / PENETRATION WITH A FOCUS ON THE MANUAL THERAPY APPROACH IN WOMEN AT MENACME

Health and Society ◽

10.51249/hes01.05.2021.480 ◽

2021 ◽

Author(s):

Caroline Sant’Anna Cunha

Keyword(s):

Quality Of Life ◽

Sexual Function ◽

Pelvic Floor ◽

Pelvic Pain ◽

Manual Therapy ◽

Pelvic Floor Muscles ◽

World Health ◽

Short Period

Genital-pelvic pain / penetration disorder (DGPP) includes vaginismus, dyspareunia and vulvodynia, where the following symptoms are present: Presence of fear or anxiety related to vulvovaginal or pelvic pain in anticipation, during or as a result of vaginal penetration, in addition to the presence of tension or hardening of the pelvic floor muscles during the attempt of vaginal penetration. Adequate sexual function is considered an important factor for quality of life, being recognized by WHO (World Health Organization) regarding the presence of sexual dysfunction as a public health problem, recommending its investigation for causing important changes in quality of life and in the relationship with your partner. It is identified that the role of the physiotherapist becomes relevant in the process of identification and rehabilitation of genito-pelvic pain, justifying the importance of studies on this topic. In order to analyze the role of the physiotherapist in the treatment of pelvic genital pain / penetration with a focus on the approach of manual therapy in women at menacme, a narrative review of the literature was carried out, where 17 articles were used as a basis for research and data collection. During the analysis of the articles, it was defined that DSFs tend to appear in the female fertile phase, causing pain and discomfort. In the reviews covered in this study, it was analyzed that DGPP is a complex syndrome in which the sensation and intensity of pain are felt in different places. With this the diagnosis becomes difficult taking into account the shame and / or blocking of the woman in reporting a sexual complaint. Through a physical therapy assessment, in order to check the tone and function of the pelvic floor muscles, the existence and location of tender points, as well as the understanding of voluntary contractions and rests of these muscles, a therapeutic planning with the use of interventions is outlined. specific measures in self-relaxation and anxiety control techniques, improving body awareness. It is concluded that there is effectiveness in exploring self-knowledge to improve the quality of life of women who suffer from this problem, providing positive results in a short period, thus contributing to the improvement of the sexual function of women with DSFs (Female Sexual Dysfunctions).

Download Full-text

THERAPEUTIC OPPORTUNITIES OF NON-SURGICAL TREATMENT IN PATIENTS WITH URINARY INCONTINENCE

Knowledge International Journal ◽

10.35120/kij3202261m ◽

2019 ◽

Vol 32 (2) ◽

pp. 261-266

Author(s):

Galina Мratskova ◽

Rumen Deliev

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Pelvic Floor ◽

Conservative Therapy ◽

Pelvic Floor Muscles ◽

Transversus Abdominis ◽

Therapeutic Exercises ◽

Botulinum Toxin Therapy ◽

Over Time

Urinary Incontinence (UI) is a significant medical and social problem which affects both sexes. It can lead to a reduction in social contacts and physical activity, associated with poor self-assessment of the health status, impairment of emotional and mental well-being, reduction of sexual relations and depressive symptomatology. It is a significant reason for lower quality of life. In women, urinary incontinence is more common than in men. There are a number of reasons why urinary incontinence may occur: after surgery in small pelvis, pregnancy, vaginal delivery, hysterectomy, menopause, extreme obesity, chronic cough, constipation, some medications (muscle relaxants, sedative, antihypertensive agents, ACE inhibitors, antiacids) and others. Age factors leads to increased rate of incontinence, which has a large social and financial impact. It reflects the quality of life and it is a significant financial problem, both personal and for the health insurance system.The purpose of this review article is to investigate the therapeutic opportunities of non-surgical and physiotherapeutic treatment of patients with urinary incontinence.The treatment of urinary incontinence is strictly individual and depends on the type of incontinence, its severity and the reasons for its occurrence. It can be conservative and operative. The disease often does not progress over time and the conservative therapy is well tolerated, effective and safe. Non-surgical and physiotherapeutic treatment (behavioral therapy, the reduction of body mass, bladder training, lifestyle change, kinesitherapy for the pelvic floor muscles, biofeedback therapy, electrostimulation of skeletal pelvic floor muscles (ES), vaginal cones, mechanical devices, medication therapy, Botulinum toxin therapy) is the first choice and is preferred by most patients and it is well tolerated and effective. The application of physiotherapeutic methods of treatment requires the preparation of an individual rehabilitation program, which must be consistent with rehabilitation potential of the patient. The principles of gradual increase in the type and number of repetitions in therapeutic exercises, the continuity of kinesitherapy and the appropriate combination with electrostimulation procedures of the pelvic floor muscles are applied. It is considered, that the strengthening of the pelvic floor muscles is achieved through three levels of action: increasedg compression on the urethra, suppor of the bladder neck and improvement of the coordination of contractions of m. transversus abdominis and pelvic floor muscles. For electrostimulation, devices allowing percutaneous, intravaginal or intrarectal stimulation, usually with biphasic current, and low frequency and optimal intensity allowing painless contraction, are used.Conclusion: The urinary incontinence (UI) is highly prevalent and causes significant levels of morbidity, especially in women. The treatment for urinary incontinence is strictly individual and depends on the type of incontinence, the severity and the reasons for its occurrence. A stepwise approach treatment is recommended. The disease often does not progress over time, the conservative therapy is well tolerated, effective and safe.

Download Full-text

Assessment of pelvic floor muscles in sportswomen: Quality of life and related factors

Physical Therapy in Sport ◽

10.1016/j.ptsp.2020.02.015 ◽

2020 ◽

Vol 43 ◽

pp. 151-156

Author(s):

Telma Pires ◽

Patrícia Pires ◽

Helena Moreira ◽

Ronaldo Gabriel ◽

Sara Viana ◽

...

Keyword(s):

Quality Of Life ◽

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Related Factors

Download Full-text

Efficacy of a personalised pelvic floor muscle training programme on urinary incontinence after radical prostatectomy (MaTchUP): protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2018-028288 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028288 ◽

Cited By ~ 6

Author(s):

Paul Hodges ◽

Ryan Stafford ◽

Geoff D Coughlin ◽

Jessica Kasza ◽

James Ashton-Miller ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Urinary Incontinence ◽

Radical Prostatectomy ◽

Pelvic Floor ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Pelvic Floor Muscles ◽

Muscle Training

IntroductionProstate cancer is the most common cancer in men. Prostatectomy is the most common treatment. Morbidity from prostatectomy is high—80% of men experience urinary incontinence which negatively impacts the quality of life. Postsurgical pelvic floor muscle training is commonly prescribed but recent systematic reviews found no evidence of efficacy. We propose a new treatment that commences preoperatively and targets functional training of specific pelvic floor muscles that contribute to urinary continence. Assessment and biofeedback using transperineal ultrasound imaging assists in training. This will be compared against conventional training (maximal pelvic floor muscle contraction assessed by digital rectal examination) and no training. Embedded physiological studies will allow the investigation of moderation and mediation of the treatment effect on the outcomes.Methods and analysisThis randomised clinical trial will include 363 men scheduled to undergo radical prostatectomy for prostate cancer. Participants will be randomised into urethral training, conventional training and no training groups. Clinical data will be collected at baseline (1–2 weeks presurgery) and postsurgery after catheter removal, weekly to 3 months (primary endpoint) and monthly to 12 months. Outcomes include 24-hour pad weight test (primary), incontinence, quality of life and cost-effectiveness data. Neuromuscular control measures of pelvic floor muscles will be measured at baseline, postsurgery, 6 weeks, 3 and 12 months. Study assessors and statisticians will be blinded to the group allocation.Ethics and disseminationThis study is registered with the Australian New Zealand Clinical Trials Registry and has ethical approval from the university and host hospital ethics committees. Trial outcomes will be shared via national/international conference presentations and peer-reviewed journal publications.Trial registration numberACTRN12617000788370; Pre-results.

Download Full-text