Physiotherapeutic Approach in Stress Urinary Incontinence with Prolapsed Uterus: A Case Report

The International Continence Society (ICS) describes incontinence as an objectively demonstrable loss of urine which is not voluntary and that is a social and/or sanitary issue. The complaint of leakage of urine, which is not voluntary on an effort made, on exertion, on sneezing or while coughing is described as Stress urinary incontinence (SUI). The intra-abdominal increases as the effort or exertion increases, and the urethral sphincter is not capable to sustain a pressure greater than the pressure applied on the urinary bladder. Eventually, leakage of urine occurs during the daily activities like lifting, laughing, jumping, while sneezing or coughing. In women, stress urinary incontinence is most common category of incontinence of urine. Even though it isn’t a lethal illness. SUI has a number of negative effects on women's quality of life, including restricting social interaction and relationship and the personal relationships but also physical activity. Cystocele is the weakness of pubocervical fascia, which makes the urinary bladder to descend downwards and backwards against the anterior wall of the vagina. If this is a not taut then it will protrude. In more extreme cases a pouch of bladder sets up which holds on to the residual urine. The conservative treatment, a nonsurgical therapy, includes ameliorating the living standards, urinary bladder training, pelvic floor muscle exercises and strengthening. Kegel exercises are the most effective form of strengthening muscles of pelvic floor in addition are a noninvasive therapy and the use of vaginal weights or cones are not included. The rehabilitation and strengthening muscles of pelvic floor is facilitated and promote urine storage. The combination of Kegel’s exercise along with other interventions for a span of six weeks has shown a significant improvement in the symptoms.

Role of the community nurse in Parkinson's disease and lower urinary disorders

Parkinson's disease (PD) is an incurable and progressive neurodegenerative disorder. People with PD also have increased muscle weakness and the typical symptoms of tremor, stiffness, slowness, balance problems and/or gait disorders. Other symptoms may include an overactive bladder, urgency and nocturia which can often lead to incontinence. Treatment options vary are dependent on the cause of the incontinence and should focus on improving Quality of life with a multi-pronged diagnosis-specific approach that takes into consideration a patient's ability to comply with treatment. The article looks at the role of the community nurse in caring for patients with PD and lower urinary disorders. They have a key role in assessment of patients and supporting families with tailor made bladder training such as establish a regular toilet routine, education about pelvic floor exercises or supply of incontinence products.

Safety and efficacy of mirabegron and solifenacin in elderly patient with overactive bladder

Lower urinary tract symptoms, including urgency, urgency incontinence, pollakiuria and nocturia are common in the elderly people and has significant impact on quality of life. Pharmacological treatment is recommended when conservative management, such as fluid intake normalization or bladder training, does not alleviate symptoms. Antimuscarinics were often used as the I line treatment for OAB, as these drugs block the activity of the muscarinic M2/M3 receptors in the bladder and provide a significant clinical benefit for OAB symptoms in the elderly people, but their side effects are common, often leading to treatment discontinuation. Mirabegron, a β3-adrenoceptor agonist, shows similar efficacy to antimuscarinic drugs without the risk of anticholinergic effects.

Effect Of Combination Of Kegel's Exercise And Bladder Training In Reducing Urine Inncontinency Episodes In Elderly In Persahabatan Hospital, Jakarta

The aging process is defined by the change in the behavior of organisms according to age, which typically results in a decrease in the ability to survive and take care of themselves. This deterioration can, in humans, be influenced by biological, psychological, social, functional and spiritual factors. Urinary incontinence is a condition that typically affects the elderly, and has a huge impact on the daily lives of sufferers. This study considers the effect of a combination of Kegel’s exercises and bladder training in decreasing episodes of urinary incontinence in the elderly. This study uses a Quasi-experimental design with a Pretest-Posttest with Control Group design. The results demonstrate that there are significant differences in the average frequency of urination, hold time and frequency of urinary incontinence between the first and second measurements in the treatment group (each value p=0.0001). The combination of Kegel’s exercise and bladder training is proven to decrease the episode of urinary incontinence in the elderly. Keywords: Kegel’s Exercise, Bladder Training, Urine Inncontinency

Profile of Muscle Strength and Physical Performance with the Incidence of Urinary Incontinence in Elderly Women

Introduction: The 200 million people in the world experience urinary incontinence. In general, with increasing age, the capacity of the bladder decreases. The remaining urine in the bladder tends to increase and irregular contraction of the bladder muscles becomes more frequent. This situation often makes the elderly experience problems with the fulfillment of urine elimination needs, namely urinary incontinence. Efforts to overcome urinary incontinence in the form of bladder training programs are aimed at developing muscle tone and bladder sphincter so that it can function optimally. Objective: Knowing the profile of muscle strength and physical performance with the incidence of urinary incontinence in elderly women. Methods: This research was a retrospective descriptive study based on the results of filling out the questionnaire and evaluating it directly. Based on tabulated data, 38 elderly women were selected as the study sample. Results: There were (42.1%) urinary incontinence on elderly with very poor left hand muscle strength and (50%) urinary incontinence on elderly with very poor right hand muscle strength. In physical performance with urinary incontinence as many as (57.8%) were normal and (42.1%) were poor. Conclusions: Muscle strength and physical performance can be used as a measurement to early detection of the urinary incontinence. Keywords: urinary incontinence; muscle strength; physical performance; descriptive retrospective study

A smartphone application to support bladder training in children and adolescents with daytime urinary incontinence: Design, development, and user testing of URApp (Preprint)

BACKGROUND Daytime urinary incontinence (UI) is common in childhood and often persists into adolescence. UI in adolescence is associated with a range of adverse outcomes including depressive symptoms, peer victimisation, poor self-image, and problems with peer relationships. First line conservative treatment for UI is bladder training (standard urotherapy) which is aimed at establishing a regular fluid intake and a timed schedule of toilet visits. Success of bladder training is strongly dependent on good adherence, which can be challenging for young people. OBJECTIVE This paper describes the development of a smartphone app (URApp) which is aimed at improving adherence to bladder training in young people aged 11-20 years old. METHODS URApp was designed using participatory co-design methods and was guided by the Person-Based Approach to intervention design. Core app functions were based on clinical guidance and included setting a ‘daily drinking goal’, recording fluid intake and toilet visits, reminders to drink and go to the toilet, and recording progress towards drinking goals. The development of URApp comprised four stages: (i) review of current smartphone apps for UI; (ii) participatory co-design workshops with young people with UI to gather user requirements for the app and to develop wireframes; (iii) development of the app prototype; and (iv) user testing of the URApp prototype, qualitative interviews with 23 young people aged 10-19 years with UI and/or urgency and eight clinicians. The app functions and additional functionality to support adherence and behaviour change were iteratively optimised throughout the app development process. RESULTS Young people who tested URApp judged it to be a helpful way of supporting their adherence to a timed schedule of toilet visits and drinking. They reported high levels of acceptability and engagement. Preliminary findings indicated that some young people experienced improvements in their bladder symptoms including a reduction in UI. Clinicians reported that URApp was clinically appropriate and aligned to bladder training best practice guidelines. URApp was deemed age appropriate with all clinicians reporting they would use it within their own clinics. Clinicians felt URApp would be of particular benefit for patients whose symptoms were not improving or were not engaging with their treatment plans. CONCLUSIONS The next stage is to evaluate URApp in a range of settings including paediatric continence clinics, primary care and schools to test whether it could be an effective (and cost-effective) solution to provide personalised support for young people to improve their adherence to bladder training, and therefore reduce UI.