Role of physiotherapy in preventing tears rolling down the legs in an eight year old girl: A case report

Urinary incontinence in children is an underdiagnosed symptom in India with a prevalence of 7%. An appropriate diagnosis and early intervention can help prevent the progression of the disorder. Here we present a case reportof an 8-year-old girl referred for physiotherapy with the chief complaint of urinary incontinence. She had a wide bladder neck along with leaking urine and a small bladder capacity. She was managed conservatively with medications and comprehensive physiotherapeutic assessment and management that included a combination of electrotherapy, pelvic floor training, balance and postural exercises and other interventions that gave a positive outcome in terms of eliminating the dribbling episodes and improvement in her quality of life.

Efficacy of Yun-Type Optimized Pelvic Floor Training Therapy for Middle-Aged Women With Severe Overactive Bladder: A Randomized Clinical Trial

Background: This study aimed to evaluate the clinical efficacy of Yun-type optimized pelvic floor training therapy for middle-aged women with severe overactive bladder (OAB).Methods: This randomized, observer-blinded, parallel-group controlled clinical trial included 108 middle-age women with severe OAB and assigned them to the intervention group (treated with combination of Yun-type optimized pelvic floor training with solifenacin for 12 weeks) and control group (treated with solifenacin for 6 weeks and, after 2 weeks of elution, received the combination of Yun-type optimized pelvic floor training and solifenacin for 6 weeks). The outcomes associated with OAB, pelvic floor muscle (PFM) function, and sexual function were compared after 6 and 12/14 weeks of treatment.Results: The primary variables were OAB-associated outcomes, including overactive bladder symptom score (OABSS), urgent urination, urine, nocturia, urge urinary incontinence, patient's perception of bladder condition, urogenital distress inventory-6, incontinence impact questionnaire-7, voiding volume, average flow rate, and maximum flow rate. The secondary variables were indicators related to PFM function and sexual function. These indicators were significantly improved in both groups after interventions. Notably, the improvements in most of these indicators were superior in the intervention group than in the control group after 6 weeks and 12/14 weeks of treatment.Conclusions: The use of Yun-type optimized pelvic floor training adds to the benefits of solifenacin regarding severe OAB-associated outcomes, PMF function, and sexual function in middle-aged women with severe OAB. Combining Yun-type optimized pelvic floor training with traditional drug therapies may improve clinical outcomes in patients with severe OAB.Trial Registration: ChiCTR-INR-17012189.

Knowledge into action: proposing an evidence-based group prenatal exercise prescription

Aims: In accordance with the American College of Obstetricians and Gynaecologists recommendations for exercise during pregnancy, this article provides an evidence-based prescription for a group-based prenatal exercise programme. Methods: This prescription has been tested in 21 randomized controlled trials. This short report outlines in detail the seven components included in each session (warm-up, aerobic training, resistance training, coordination and balance, pelvic floor training, cool-down, and final discussion). Results: Using the 26-item behaviour change taxonomy proposed by Abraham and Michie, we identified common techniques that are employed in each session to provide a rationale for the high-programme adherence. Conclusions: This session model can be replicated to design prenatal exercise programmes with high adherence and that can be offered by trained exercise professionals.

Penile Rehabilitation and Treatment Options for Erectile Dysfunction Following Radical Prostatectomy and Radiotherapy: A Systematic Review

After radical prostatectomy (RP) or radiotherapy (RT) for prostate cancer, erectile dysfunction (ED) is the main complication next to urinary incontinence, affecting quality of life. The pathophysiology of ED after these treatments is believed to include neuropraxia causing reduced oxygenation and structural changes of the tissue in the corpora cavernosa. Next to the option of sparing the nerves during RP, research has been focusing on methods for penile rehabilitation after RP and RT, since it occurs often, even after nerve-sparing techniques were used. In animal studies, the use of phosphodiesterase type 5 inhibitors (PDE5i) after cavernous nerve damage is supported, but results in human studies are contradictory. Non-medical treatment options such as vacuum device therapy, hyperbaric oxygen therapy, yoga, aerobic, or pelvic floor training may be helpful, but evidence is scarce. Clear guidelines for penile rehabilitation are not yet available. However, care and support for ED after RP and RT is highly demanded by a large group of patients, so measures have to be taken even though the evidence is not strong yet. In this systematic review, an overview of the literature for penile rehabilitation and treatment options for ED after RP and RT is provided, using only randomized controlled trials (RCT).

A Supervised Pelvic Floor Training Program Has Minimal Effect on the Prevalence of Postpartum Diastasis Recti Abdominis: A Critically Appraised Paper

Focused Clinical Question: For postpartum primiparous women, will a 16-week, supervised, targeted pelvic floor muscle training program result in a reduced prevalence of diastasis recti abdominis versus education only at discharge? Clinical Bottom Line: We can neither recommend nor caution against a targeted pelvic floor muscle training program to reduce the prevalence of postpartum diastasis recti abdominis.

Bridging the gap between perioperative pelvic floor training and urologic surgeries with risk of incontinence by digital technologies: a survey. (Preprint)

BACKGROUND Pelvic floor training (PFT) is the gold standard for conservative treatment of male stress urinary incontinence. OBJECTIVE To evaluate patients´ perspective at risk of incontinence on PFT and application of digital technologies for PFT. METHODS Patients undergoing transurethral surgery of the prostate (group I), radical prostatectomy (group II) or treatment at a specialized incontinence outpatient clinic (group III) were surveyed anonymously. Chi-Square test and Kruskal-Wallis-analysis were used for statistical analysis. RESULTS 180 patients were included in the final analysis. In group I (n=35) no patient underwent PFT prior to transurethral surgery. 23.5% of patients in group II (n=51) and 95.7% of patients in group III (n=94) performed PFT. 11.4% in group I, 80.4% in group II and 91.5% in group III have been advised to perform PFT by their urologist. Regarding the information level on PFT, patients from group I (median 1, range 0-5) are less satisfied than patients from group II (median 3, 0-9) or group III (median 5, range 0-10, p<0.001). 88.6% of patients from group I are willing to perform PFT as preventive treatment or to avoid incontinence surgery, 100% from group II and 68.4% from group III (p<0.001). The likelihood to use digital PFT is higher in group I (median: 9, range 0-10) and II (median: 9, range 0-10) than in group III (median: 4, range 0-10, p<0.001). CONCLUSIONS Patients at risk of incontinence currently have limited access to PFT, although they are willing to perform PFT. Digital PFT is highly accepted by patients preoperatively and might be a valuable tool to increase PFT participation.