Investigation of the effectiveness of magnetic field therapy in women with urinary incontinence: Literature review

Objective: Magnetic stimulation (MS) provides a novel strategy for the treatment of urinary incontinence (UI), although its efficacy remains uncertain. This systematic review both evaluated the effects of MS treatment on UI and investigated its impacts on female patients’ life quality. Methods: A review of the literature that was conducted in EMBASE, PubMed, Google Scholar, and the Cochrane Library (2016–2021) with the search terms; Incontinence of stress OR urge of urination OR Urinary incontinence mixed type. The search was carried out for all randomised controlled trials (RCTs) in English. A manual search has also been conducted for the reference lists of the studies found. Seven studies, with a total of 523 patients (475 patients with SUI), 12 urge urinary incontinence. The study included patients with (UUI) and 36 patients with mixed urinary incontinence (MUI). A total of 10 male patients were excluded from the study. In the included studies, The International Incontinence Questionnaire-Short Form was used to investigate the effects of MS therapy on UI symptoms (ICIQ-SF). Results: According to the literature review, MS is an effective therapy option for female patients with UI. Still, to establish the efficacy of MS in this area, more large-scale, high-quality RCTs with extended follow-up periods that use consistent stimulation modalities and evaluate comparable outcomes are needed. Conclusion: MS treatment leads to an improvement in the symptoms of UI, in addition to an associated Improved quality of life for patients, without any reported side effects, while the longer-term treatment outcomes must be determined by long-term trials.

The Effect of OnabotulinumtoxinA on the Symptoms and Quality of Life in Women with Urge Urinary Incontinence

Objectives: To determine the effect of OnabotulinumtoxinA intradetrusor injection on quality of life (QOL) and symptoms of women with urge urinary incontinence. Methods: Twenty five postmenopausal patients with urge urinary incontinence, underwent cystoscopy and 200 U OnabotulinumtoxinA intradetrusor injections (0.5 cc at each injection). The effects of botox have been evaluated on urge urinary incontinence and quality of life. Results: The mean urge urinary incontinence per day was 7.25 which decreased to 2.87 (month 1) and 3.12 (month 6); P value = 0.019. The mean of nocturnal episodes was 3 which decreased to 0 and 1in the first and sixth months, respectively (P = 0.007). Baseline mean I-QOL total score was 43.37 which reached 82.12 (month 1) and 78.87 (month 6); P < 0.001. Conclusions: OnabotulinumtoxinA significantly decreased urinary urge incontinence and nocturia at month 1 and 6. The quality of life of patients has improved.

Urinary symptoms and urodynamic findings before and after vaginal surgery for pelvic organ prolapse

To ascertain the difference in urodynamic findings, specifically bladder sensation, and urinary symptoms after vaginal surgery for Pelvic Organ Prolapse (POP). Retrospective data analysis of 126 women who underwent vaginal surgery for POP without simultaneous anti-incontinence procedure from January 2013 to April 2019 at Siriraj Hospital, Thailand. Baseline characteristics, intraoperative details and pre and post-operative urinary symptoms and urodynamic findings were recorded. There was no significant difference in the pre and post-operative first desire to void, at 158±53 mL and 162±64 mL, respectively (p=0.518). Incidence of increased bladder sensation was also unchanged, from 46.0% to 46.8% (p=1.00). Post-operative urodynamic stress incontinence was significantly increased, from 15.9% to 31.0% (p=0.003), as was the incidence of weak bladder contractility index (<100), from 47.3% to 61.8% (p=0.005). Significant improvements in post-operative urge urinary incontinence, urgency and voiding dysfunction were noted, from 50.8% to 31.7% (p=0.001), 63.5% to 38.9% (p<0.001) and 42.9% to 5.6% (p<0.001), respectively. No significant difference in bladder sensation after vaginal surgery for POP repair was noted. However, urinary symptoms significantly improved after surgery.

Clinical profile of Female Urinary Incontinence: A Hospital Based Study

Aim: To determine the prevalence of urinary incontinence of women attending gynae outdoor patient department. Method: It is a prospective cross sectional study conducted at Paropakar Maternity and Women’s Hospital for three months. Types of incontinence, their presentation, associated factors, age and parity were the variables studied. Data were analyzed by descriptive statistics. Results: Out of 950 gynaecological out-patients, 97 had urinary incontinence(10.2%); 34.1% were in 50- 59 years and 37.2% were multipara. Stressurinary incontinence (SUI) was the most common incontinence (56.7%) followed by mixed urinary incontinence (22.7%) and urge urinary incontinence (20.6%). Common complaints were leakage during coughing (63.6%) and sneezing(18.2%) in SUI;urgency and frequency were main problem in mixed and urge urinary incontinence. Three-fourth cases had associated medical conditions and rest had gynecological factors. Conclusions: Urinary incontinence is common in the fifth decade of life of women and more than half had stress incontinence.

Validity and Reliability Measurement of Bengali Translated Questionnaire for Urinary Incontinence Diagnosis

Objective: The aim of this study was to translate and verify the validity and reliability of the Bengali translated questionnaire for Urinary Incontinence Diagnosis (QUID), to ensure the diagnosis of urinary incontinence in Bangladesh.Material and Methods: Adaptation and psychometric properties testing of the Bengali-QUID were conducted with 67 respondents. Twenty respondents were included for pre-testing and adaptation; whereas, 47 respondents were considered for test-retest reliability. The content validity of the questionnaire was measured by expert opinion. Cornbach’s alpha statistical test was used to measure the internal consistency of the questionnaire, while the test-retest reliability was measured using the Intra-Class Correlation (2,1) model.Results: Content validity for all items of the questionnaire was >0.75. In addition, the Cronbach's Alpha values for interitem correlation for Stress Urinary Incontinence and Urge Urinary Incontinence were (α>0.8) and (α>0.7), respectively. Furthermore, the reliability of the Bengali-QUID questionnaire had an Intra-class correlation score of 0.76.Conclusion: This study demonstrated that the Bengali version of QUID questionnaire was highly valid, and reliable for diagnosis of urinary incontinence among Bangladeshi women.

Effect of polyfluoroalkyl chemicals on the occurrence of urge urinary incontinence: a population-based study

Background: The artificial fluorinated group of compounds polyfluoroalkyl chemicals (PFCs) has been applied extensively in daily life for decades, and is present in food, drinking water, and indoor dust. The nephrotoxicity of PFCs has been widely studied for its characteristics of being mainly excreted through passing urine and affecting urodynamics. This work aimed to investigate the relationship between PFCs and the occurrence of urge urinary incontinence (UUI) in the United States (US) population. Methods: There were 3157 eligible female participants retrieved from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2014. A logistic regression model was used to examine the relationship between UUI and eight kinds of PFCs. The dose–response relationship was investigated through restricted cubic spline analysis in this retrospective study. Results: Of the 3157 eligible female participants, 913 self-reported a history of UUI. Total PFCs, perfluorohexane sulfonic acid (PFHS), 2-(N-methyl-perfluorooctane sulfonamido) acetate (MPAH), and perfluorononanoic acid (PFNA) correlated positively with the occurrence of UUI after adjusting for age, race, education, vigorous recreational activities, hypertension, diabetes, body mass index (BMI), creatinine, and estimated glomerular filtration rate (eGFR). Based on the results of sub-group analysis, the increasing tertiles contained odds ratios [OR; 95% confidence intervals (CI)] of 1.25 (95% CI, 1.03–1.51, p = 0.026) and 1.56 (95% CI, 1.29–1.89, p < 0.001) for total PFCs compared with the lowest tertile. The OR for PFHS, MPAH, and PFNA were 1.75, 1.71, and 1.41 respectively, in the highest tertile. Conclusion: This study investigated the relationship between PFCs and UUI in female and found total PFCs, PFHS, MPAH, and PFNA were positively correlated with the risk of UUI. The results will contribute to developing individualized treatment for female patients suffering UUI.

Feasibility, Safety and Efficacy of Fractional Micro-Ablative CO2 Vaginal (FxCO2) Laser Treatment and Platelet-Rich Plasma (PRP) in Women with Urge Urinary Incontinence

Background: Urge urinary incontinence (UUI) is the involuntary loss of urine associated with urgency, frequency, and nocturia. Current management involves behavioural therapies, which can be time-consuming and costly to the patient, and medications, which can have side effects. Fractional micro-ablative CO2 laser (FxCO2) and platelet-rich plasma (PRP) are two novel approaches that may offer symptomatic relief for women with UUI. Objectives: To evaluate the feasibility, safety, and efficacy of FxCO2 vaginal laser treatment and PRP in women with refractory UUI with urinary function and sexual function as secondary outcome measures. Study Design: This was a single-centre prospective cohort study. Participants with UUI underwent three treatments of transvaginal FxCO2 laser and PRP, administered at 4–6-week intervals. Outcomes were assessed with the Australian Pelvic Floor Questionnaire (APFQ) at baseline (T1), 3-6 months (T2), and ≥12 months follow-up (T3). The 12-month follow up data were obtained by face-to-face visit or follow up telephone call. The primary outcome was change in UUI symptoms. Secondary outcomes were related to overall bladder function and sexual function. Outcomes were assessed using Wilcoxon signed-rank test. Results: In this study, 121 participants underwent treatment with FxCO2 laser and PRP for UUI. There was a significant reduction in the average severity of all self-reported measures of primary and secondary outcomes from T1 to T2 (p<0.02). Improvements in all bladder function outcomes remained statistically at T3 (p<0.04). There were no adverse events in this cohort. Conclusion: This study suggests that FxCO2 laser with PRP appears to be a safe, feasible, and effective treatment for UUI, bladder function, and sexual function. FxCO2 laser and PRP may have a role as an alternative therapy for severe and refractory UUI.