The effectiveness of a digital pelvic floor training program in thetreatment of urinary incontinence – a real-world evaluation (Preprint)

2019 ◽  
Author(s):  
Sabine Keim ◽  
Alexandra von Au ◽  
Lina Maria Matthies ◽  
Stephanie Wallwiener ◽  
Sarah Brugger ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
University Hospital ◽  
First Line ◽  
First Line Therapy ◽  
A Value ◽  
Pelvic Floor Training ◽  
Significant Impairment ◽  
Pelvic Floor Weakness

BACKGROUND Background: Many women experience urinary incontinence (UI) during andafter pregnancy due to pelvic floor weakness. First-line therapy is conservative treatment, which nowadays can be facilitated by using digitalsolutions. OBJECTIVE The aim ofthe present study was to investigate the efficacy and effectiveness of pelvinain patients with existing UI. METHODS Methods: In the present observational study we analyzed the effectivenessof pelvina, a certified digital pelvic floor training course, in reducing UI symptoms by regularly applying “The Questionnaire for Urinary Incontinence Diagnosis” (QUID) and furthermore examining quality of life (QoL) by conducting the SF-6D. RESULTS Results: In this prospective study, 373 patients with a median age of 36 years (IQR 33 - 47 years) were included. At baseline the patients had a median QUID of 11 (IQR 11 - 15). During the course, incontinence improved significantly to a QUID of 5 (IQR 2 – 11; p<0.001). Additionally, the patients had also shown a significant impairment in their QoL at baseline with a value of 19 (IQR 16 - 22) in SF-6D. After completing the course, the QoL had risen to 24 (IQR 20 - 26). CONCLUSIONS Conclusion: Use of the certified digital pelvic floor course pelvinasignificantly reduces existing UI due to pelvic floor weakness over the timespan of the course. At the same time QoL is significantly improved. CLINICALTRIAL The present study was approved by the ethics committee of the Heidelberg University Hospital (S-392/2019)

ДИАГНОСТИКА ХРОНИЧЕСКИХ ИНДУЦИРОВАННЫХ КРАПИВНИЦ

2019 ◽  
Author(s):  
E.Yu. Borzova
Keyword(s):  
Biological Therapy ◽  
Meta Analysis ◽  
Treatment Algorithm ◽  
The Novel ◽  
First Line ◽  
Systemic Reactions ◽  
Significant Impairment ◽  
Challenge Tests ◽  
First Line Treatment

Хронические индуцированные крапивницы имеют важное социально-экономическое значение вследствие риска развития системных реакций и значительного снижения качества жизни пациентов. Диагностика хронических индуцированных крапивниц основывается на анамнестических данных и проведении провокационных тестов. Современный протокол ведения больных хронической крапивницей включает применение неседативных антигистаминных препаратов. Международные согласительные документы по лечению крапивницы рекомендуют 4-кратное увеличение суточной дозы неседативных антигистаминных препаратов при их неэффективности в стандартных дозах. Данные мета-анализа указывают на эффективность омализумаба при хронических индуцированных крапивницах. В перспективе ожидается расширение арсенала генно-инженерной биологической терапии хронических индуцированных крапивниц.Chronic inducible urticarias are characterized by the risks of systemic reactions and a significant impairment of patients quality of life. The diagnosis of chronic inducible urticarias relies on the patients history and the challenge tests. A treatment algorithm for the management of chronic inducible urticarias includes nonsedating antihistamines as a first-line treatment. The international guidelines for the management of chronic inducible urticarias recommend updosing of nonsedating antihistamines up to four fold if standard doses are not effective. The meta-analysis suggests the efficacy of omalizumab in chronic inducible urticarias. In the prospect, the novel options of biological therapy for chronic inducible urticarias are expected.

scholarly journals The Use of Disposable Tampons as Visual Biofeedback in Pelvic Floor Muscle Training

2019 ◽  
Vol 16 (12) ◽  
pp. 2143 ◽  
Author(s):  
María Zahara Pintos-Díaz ◽  
Paula Parás-Bravo ◽  
Cristina Alonso-Blanco ◽  
César Fernández-de-las-Peñas ◽  
María Paz-Zulueta ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Sexual Relations ◽  
Muscle Training ◽  
Visual Biofeedback ◽  
Quality Life ◽  
The Impact

Background: Urinary incontinence represents a complex problem which commonly affects women and influences their physical, mental and social wellbeing. The objective was to determine the effect of pelvic floor muscle training using a tampon as visual biofeedback. Methods: A non-randomized clinical trial involving 60 women >18 years of age, both with, and without, urinary incontinence. All women exercised with a program involving visual biofeedback using disposable tampons at home for three months. The compliance rate was 76.8 ± 24.1 An electromyographic assessment of the pelvic floor was performed and assessments of the impact of the exercise program. Results: 54.5% of women without incontinence and 81.6% of women incontinence reported improvements (p = 0.041). In both groups, there was increased quality life (p > 0.05). The women without incontinence experienced greater improvement in the quality of their sexual relations (Pre 6.8 ± 1.4–Post 7.2 ± 1.0). Conclusions: After the intervention, a high percentage of women showed a statistically significant improvement in their symptoms. The participants reported an increase in quality of life and the women without incontinence reported an improvement in quality of their sexual relations. Our findings suggest that visual BFB for training the PFM may be beneficial for women with or without incontinence.

scholarly journals Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

2007 ◽  
Vol 125 (5) ◽  
pp. 265-269 ◽  
Author(s):  
Míriam Raquel Diniz Zanetti ◽  
Rodrigo de Aquino Castro ◽  
Adriana Lyvio Rotta ◽  
Patrícia Diniz dos Santos ◽  
Marair Sartori ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Subjective Evaluation ◽  
Female Stress Urinary Incontinence ◽  
Control Group ◽  
Pelvic Floor Muscle Exercises ◽  
Pad Test

CONTEXT AND OBJECTIVE: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. The aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. DESIGN AND SETTING: This was a randomized, prospective, controlled trial in the Urogynecology and Vaginal Surgery Sector, Universidade Federal de São Paulo. METHODS: Forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. They were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. Descriptive analysis was used to evaluate the population. The homogeneity of the two groups was evaluated using the Kruskal-Wallis and Chi-squared tests. The success of the two groups after treatment was evaluated using the Wilcoxon test. RESULTS: The supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. In the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. In the supervised group, 66.8% of patients did not want any other treatment. CONCLUSION: Supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.

scholarly journals 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

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.

scholarly journals URINARY INCONTINENCE;

2017 ◽  
Vol 24 (06) ◽  
pp. 824-827
Author(s):  
Ambreen Amna ◽  
Farkhunda Nadeem ◽  
Pushpa Srichand
Keyword(s):  
Urinary Incontinence ◽  
Stress Incontinence ◽  
Urinary Fistula ◽  
University Hospital ◽  
Persistent Symptoms ◽  
Grade 3 ◽  
Time Of Admission ◽  
Study Setting

Background: Genitourinary fistula remains a major cause of morbidity worldwide.Approximately 2 million of women suffer from urinary leakage. Since the establishment ofGenito urinary Fistula center at Isra University Hospital –Hyderabad Sindh. We are able to shareour experience of fistulous women at the time of admission and at follow up visit. Objectives:To determine the different types of urinary incontinence in a woman after genitourinary fistularepair. Study Design: A Follow-up Descriptive study. Study Setting: This Study was done atFistula center Isra University Hospital Hyderabad GU – 11 from January 2011 to December2013. All the women who were admitted with true incontinence followed by Obstetrical andmajor gynecological surgeries were included. However women with stress incontinence andurge incontinence and women who are not willing to include in the study were excluded.Result: Out of one hundred and ten (110) women included in this study, 59 (53.6%) were foundto have obstetrical fistula, while 43 (39%) were suffering from Iatrogenic fistula. Continencestatus were explored at follow up visit. Out of 110 women, 108 (98.18%) & 96 (87.27 %) werehaving no signs of incontinence on examination at first visit and after six week and secondvisit after three month respectively. Only 7 % women fell into incontinence grade 2 at six weekfollow up and only one percent had persistent symptoms of stress incontinence at 3 monthrespectively. Women fall on incontinence grade 3, 4 and 5 were completely cured at 3 month.Conclusion: Success rate of genitor- urinary fistula repair is 98 %. Majority of women (96 %)on short term follow up at 6 weeks showed improved urinary symptoms. Moreover on follow upvisit at 3 months, these women reported improved quality of life and social reintegration afterfistula closure.

Development of atrial fibrillation catheter ablation and ablation strategies

ESC CardioMed ◽  
2018 ◽  
pp. 2168-2173
Author(s):  
Gerhard Hindricks ◽  
Nikolaos Dagres ◽  
Philipp Sommer ◽  
Andreas Bollmann
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Antiarrhythmic Drug ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
First Line ◽  
Ventricular Ejection Fraction ◽  
First Line Therapy

Catheter ablation has evolved to an established therapy for patients with symptomatic atrial fibrillation (AF). Complete pulmonary vein isolation currently is the best endpoint for catheter ablation. This can be achieved with balloon-based cryoablation as well as by point-by-point radiofrequency ablation supported by non-fluoroscopic mapping technologies—both technologies seem equally effective. AF catheter ablation is indicated in patients with symptomatic AF usually after failure of antiarrhythmic drug therapy. Selected patients with AF and tachycardia-induced heart failure may benefit from ablation by a significant improvement of left ventricular ejection fraction. The success rate (i.e. freedom from AF and atrial tachycardia) after a single procedure is approximately 50–60% for patients with paroxysmal AF and 40% for patients with persistent AF. With multiple procedures, freedom from AF can be achieved in up to 80% of patients with paroxysmal AF and 60% of patients with persistent AF. When performed after failed rhythm control attempts with antiarrhythmic drugs, catheter ablation is superior to a further attempt with antiarrhythmic drug medication. When applied as first-line therapy, catheter ablation tends to be slightly superior to first-line antiarrhythmic drug treatment. The complication rate of AF catheter ablation is 5–7%; severe complications occur in 2–3% (cardiac tamponade, periprocedural stroke, atrio-oesophageal fistula). Catheter ablation significantly improves quality of life but has no proven effect on mortality and/or stroke. Thus, in general, oral anticoagulation should be continued long term even if ablation is considered successful.

scholarly journals Unexpected benefits and potential therapeutic opportunities of tension free vaginal tape for stress urinary incontinence

2013 ◽  
Vol 27 (1) ◽  
pp. 6 ◽  
Author(s):  
Chendrimada Madhu ◽  
Penelope Harber ◽  
David Holmes
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Pelvic Floor ◽  
Stress Incontinence ◽  
Urinary Symptoms ◽  
Pelvic Floor Function ◽  
Vaginal Symptoms ◽  
Tension Free ◽  
Floor Function

Urinary incontinence is a debilitating problem in women with significant effects on quality of life. The tension free vaginal tape (TVT) improves urinary symptoms and achieves a high rate of patient satisfaction. The aim of the study was to evaluate the effect of TVT on vaginal symptoms, pelvic floor function and in turn quality of life. We hypothesize that the TVT is associated with an improvement in pelvic floor function. A prospective questionnaire- based analysis was conducted over a period of ten months in patients undergoing the TVT procedure. The International Consul - tation on Incontinence Modular Questionnaire - Vaginal Symptoms questionnaire was used to evaluate the vaginal symptoms pre-operatively and 6 months post-operatively. The results were compared to assess for any significant differences. A total of 31 patients were recruited for the study. There was a statistically significant improvement in vaginal symptoms score at 6 months in women undergoing TVT along with an improvement in urinary symptoms. This study suggests a positive impact of TVT insertion on vaginal symptomatology, which is an exciting prospect influencing patient counseling for treatment options of urinary stress incontinence. This finding may have an impact on performing concomitant surgeries for stress incontinence and pelvic organ prolapse. There is a need for further large–scale research to explore this aspect of unexpected benefit from the TVT.

scholarly journals Effect of Pelvic-Floor Muscle Exercise Position on Continence and Quality-of-Life Outcomes in Women With Stress Urinary Incontinence

2006 ◽  
Vol 86 (7) ◽  
pp. 974-986 ◽  
Author(s):  
Diane F Borello-France ◽  
Halina M Zyczynski ◽  
Patricia A Downey ◽  
Christine R Rause ◽  
Joseph A Wister
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Treatment Outcomes ◽  
Pelvic Floor Muscle ◽  
Life Outcomes ◽  
Pelvic Floor Muscle Exercise ◽  
Pfm Strength

AbstractBackground and Purpose. Pelvic-floor muscle (PFM) exercises are effective in reducing stress urinary incontinence (SUI), but few studies have investigated the effect of specific exercise variables on treatment outcomes. This study explored the effect of exercise position on treatment outcomes in women with SUI. Subjects and Methods. Forty-four women were randomly assigned to exercise in the supine position only or in both supine and upright positions. Bladder diary, pad test, urodynamic test, quality-of-life (Incontinence Impact Questionnaire [IIQ]), and PFM strength outcomes were obtained at baseline and after treatment. Results. Exercise position did not affect outcomes. After data from both groups were collapsed, statistically significant improvements with treatment were observed in bladder diary, IIQ, PFM strength, and urodynamic test results. Discussion and Conclusion. Exercise position did not differentially affect treatment outcomes. However, women in this study achieved a mean 67.9% reduction in the frequency of SUI episodes and improvements in other study outcomes. [Borello-France DF, Zyczynski HM, Downey PA, et al. Effect of pelvic-floor muscle exercise position on continence and quality-of-life outcomes in women with stress urinary incontinence. Phys Ther. 2006;86:974–986.]

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