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This is a case report of a patient who developed urinary incontinence after undergoing abdominal hysterectomy. This was successfully treated with Ayurvedic treatment procedures. A 63-year-old lady was suffering from uri- nary incontinence, which developed after hysterectomy. It did not subside even after undergoing trans vaginal taping. She was treated with Ayurvedic procedures and medicines for a period of 2 and a half months from 4th of March 2016 to 26th of May 2016. Matrabasti (medicated enema) and Madhutailika basti (enema treatment with honey and oil), along with other palliative medicines – Sukumara ghrita, Chandraprabha vati, Shilajatu, Maha- kalyanaka kashaya, Mamsapachaka ghana vati and Mahatiktaka ghrita were given to the patient. Urinary incon- tinence reduced to dribbling of urine after Matra basti and after the second course of Basti (medicated enema), that is after one and half months, patient stopped using diapers and was relieved from incontinence. This case report summarises the effective management of urinary incontinence by adopting basti (enema) treatment along with other palliative ayurvedic medicine.
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Background: Urinary incontinence has an estimated incidence of 25-50% in the adult female population. It has a profound physical and psychosocial impact, compromising women抯 quality-of-life (QoL). The suburethral sling is currently considered the surgical treatment of choice for stress urinary incontinence (SUI). The present study aimed to evaluate the impact of urinary incontinence on women抯 QoL before and after transobturator suburethral sling surgery, as well as the effectiveness of surgical treatment.Methods: A prospective longitudinal, observational and analytical study was performed between June and December 2021. The study population included 64 women with urinary incontinence, to whom the King's Health Questionnaire (KHQ) was applied, before and after surgery.Results: Of the 64 women included in the study, 59.4% (n=38) had SUI and 40.6% (n=26) had mixed urinary incontinence (MUI). There was an improvement in the global KHQ score in 96.9% (n=62) of subjects, with a statistically and clinically significant impact on QoL (p<0.001). Patients with MUI had higher preoperative KHQ global scores, reflecting a more substantial impact on their QoL. Surprisingly, postoperative improvement in QoL was equally significant, both clinically and statistically (p<0.001), with no differences when comparing to isolated sui patients (p>0.05).Conclusions: QoL assessment questionnaires help to quantify individual impact of urinary incontinence and identify which patients benefited most from treatment. This study not only enhances our understanding of the true impact of urinary incontinence on QoL, but also emphasizes the effectiveness and importance of this minimally invasive surgery in improving the QoL of patients with SUI as well as MUI.
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Introduction Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer. Objective Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training. Methods This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention. Expected results The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.
Introducción El ejercicio terapéutico juega un rol importante en la población con cáncer, ya que mejora la función, la calidad de vida y reduce los síntomas del tratamiento contra el cáncer. Hay poca evidencia clínica sobre los efectos del ejercicio hipopresivo en mujeres con cáncer ginecológico. Objetivo Evaluar los efectos de cuatro semanas de ejercicio hipopresivo asociado con entrenamiento de fuerza muscular y ejercicios aeróbicos sobre la fatiga, los síntomas de incontinencia urinaria, la función sexual y la calidad de vida en mujeres tratadas por cáncer ginecológico, en comparación con un grupo que realizará entrenamiento convencional. Métodos El escenario para este estudio de ensayo clínico aleatorizado y simple ciego es el Laboratorio de Investigación Clínica, Departamento de Kinesiología, en una Universidad Chilena. Las pacientes serán asignadas aleatoriamente a un grupo experimental de ejercicios hipopresivos asociados con entrenamiento de fuerza muscular y ejercicios aeróbicos, o a un grupo de control de entrenamiento de fuerza muscular y ejercicios aeróbicos. Se realizarán doce sesiones de telerehabilitación. Participarán mujeres mayores de 18 años con cáncer ginecológico a quienes se les haya indicado radioterapia o quimioterapia. Se evaluarán la fatiga, la calidad de vida, los síntomas de incontinencia urinaria y la función sexual antes y después de la intervención. Resultados esperados Los resultados de este ensayo clínico tienen importantes implicaciones en términos del tratamiento específico para la población con cáncer y generan nuevas técnicas en la práctica de kinesiólogos especializados en oncología. Se espera que el ejercicio hipopresivo reduzca los síntomas de incontinencia debido a la activación neuromuscular de los músculos del suelo pélvico. Sin embargo, se necesitan más estudios para confirmar los efectos beneficiosos de los ejercicios hipopresivos, ya sea en rehabilitación presencial o a distancia.
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Background: The menopausal transition, which occurs when a woman transitions from reproductive to post-reproductive life, is an important turning point in the female life cycle. The prevalence of menopausal symptoms has been shown to vary widely across various Asian research. It's critical to comprehend the connection between menopausal women's health and well-being and physical performance, fear of falling, and urine incontinence in order to design effective therapies.Methods: The study was approved for conduct by the ethical committee. 195 women in the 45� age range participated in this 1.5-year observational analytical study, which was conducted in a community setting.Results: Statistical package for the social sciences (SPSS) version 20.0 was used to analyze the data, and a significance level of less than 0.05 was regarded as statistically significant.Conclusions: Transition through menopause is associated with lowered physical performance, high concern fear of fall in postmenopausal compared to premenopausal and perimenopausal while urinary incontinence varies across different stages of menopause.
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Objective: To identify the prevalence of incontinence-associated dermatitis (IAD) and its associated factors in critically ill patients. Method: A cross-sectional, quantitative study conducted in the Intensive Care Unit of a private hospital in São Paulo, involving 93 patients who met the eligibility criteria. Data collection took place on a single day in December 2016, with a thorough review of medical records and assessments of hospitalized patients. A three-part instrument was used: 1) sociodemographic data, 2) urinary and fecal elimination, and 3) characterization of IAD. The analysis was performed using descriptive and inferential statistics. Results: Of the 93 patients, 50.5% were women, aged 19 to 104 years. IAD was identified in 40.9% of patients, with a higher prevalence in the intensive care unit (66.7%). Erythema was the most common manifestation (89.4%), and the perianal region was the most affected area (76.3%). The use of antibiotics (p=0.004), corticosteroids (p=0.001), mechanical restraint (p=0.006), fecal incontinence (p<0.001), and urinary incontinence (p=0.026) were significantly associated with IAD. Conclusion: The high prevalence of IAD observed in this study underscores the importance of continuous education and the implementation of evidence-based protocols for managing critically ill patients. (AU)
Objetivo: Identificar la prevalencia puntual de la dermatitis asociada a la incontinencia (DAI) y sus factores asociados en pacientes críticos. Método: Estudio transversal y cuantitativo realizado en un Centro de Cuidados Intensivos de un hospital privado en São Paulo, con 93 pacientes que cumplieron con los criterios de elegibilidad. La recolección de datos se realizó en un solo día en diciembre de 2016, mediante una evaluación minuciosa de los registros médicos y de los pacientes hospitalizados. Se utilizó un instrumento con tres partes: 1) datos sociodemográficos, 2) eliminación urinaria y fecal, y 3) caracterización de la DAI. El análisis se realizó mediante estadística descriptiva e inferencial. Resultados: De los 93 pacientes, el 50,5% eran mujeres, con edades entre 19 y 104 años. La DAI se identificó en el 40,9% de los pacientes, con mayor prevalencia en la unidad de cuidados intensivos (66,7%). El eritema fue la manifestación más común (89,4%) y la región perianal la más afectada (76,3%). El uso de antibióticos (p=0,004), de corticosteroides (p=0,001), la contención mecánica (p=0,006), la incontinencia fecal (p<0,001) y urinaria (p=0,026) se asociaron significativamente con la DAI. Conclusión: La alta prevalencia de DAI en este estudio resalta la importancia de la educación continua y la aplicación de protocolos basados en evidencia en el manejo de pacientes críticos. (AU)
Objetivo: Identificar a prevalência pontual da dermatite associada à incontinência (DAI) e seus fatores associados em pacientes críticos. Método: Estudo transversal e quantitativo realizado em um Centro de Terapia Intensiva de um hospital privado em São Paulo, envolvendo 93 pacientes que atenderam aos critérios de elegibilidade. A coleta de dados ocorreu em um único dia em dezembro de 2016, com a avaliação minuciosa dos prontuários e pacientes internados. Utilizou-se um instrumento com três partes: 1) dados sociodemográficos, 2) eliminação urinária e fecal, e 3) caracterização da DAI. A análise foi feita por estatística descritiva e inferencial. Resultados:Dos 93 pacientes, 50,5% eram mulheres, com idades entre 19 e 104 anos. A DAI foi identificada em 40,9% dos pacientes, com maior prevalência na Unidade de Terapia Intensiva UTI (66,7%). Eritema foi a manifestação mais comum (89,4%) e a região perianal foi a mais afetada (76,3%). O uso de antibióticos (p=0,004), de corticoides (p=0,001), a restrição mecânica (p=0,006), a incontinência fecal (p<0,001) e a urinária (p=0,026) foram significativamente associados à DAI. Conclusão: A alta prevalência de DAI neste estudo destaca a importância da educação permanente e da aplicação de protocolos baseados em evidências no manejo de pacientes críticos. (AU)
Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Diaper Rash , Intensive Care Units , Urinary Incontinence , Prevalence , Fecal Incontinence , Enterostomal TherapyABSTRACT
Objetivo: Relatar a atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço. Métodos: Estudo observacional, do tipo relato de caso, seguindo duas fases, onde a primeira foi a coleta de dados e levantamento do histórico clínico do paciente, e segunda fase foi descrever a atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço. Resultados: Na primeira etapa revelou-se o diagnóstico de incontinência urinária por esforço. Foram aplicados o diário miccional, a terapia comportamental, a cinesioterapia e a eletroestimulação. Conclusão: A atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço compreende a implementação do tratamento conservador, perpassando pela prevenção, estimulação da mudança comportamental e manejo de tecnologias para fortalecimento da musculatura do assoalho pélvico. (AU)
Objective: To report the role of the nurse stomatherapist in the management of stress urinary incontinence. Methods: Observational study, of the case report type, following two phases, where the first was the collection of data and survey of the patients clinical history, and the second phase was to describe the role of the nurse stomatherapist in the management of stress urinary incontinence. Results: In the first stage the diagnosis of stress urinary incontinence was revealed. Were applied the mictional diary, behavioral therapy, kinesiotherapy and electrostimulation. Conclusion: The role of the nurse stomatherapist in the management of stress urinary incontinence includes the implementation of conservative treatment, through prevention, stimulation of behavioral change and management of technologies for strengthening the pelvic floor muscles. (AU)
Objetivo: Informar sobre el papel de la enfermera estomaterapeuta en el tratamiento de la incontinencia urinaria de esfuerzo. Métodos: Estudio observacional, del tipo case report, siguiendo dos fases, donde la primera fue la recolección de datos y relevamiento de la historia clínica de la paciente, y la segunda fase fue describir la actuación de la enfermera estomaterapeuta en el manejo de la incontinencia urinaria de esfuerzo. Resultados: En la primera etapa se reveló el diagnóstico de incontinencia urinaria de esfuerzo. Se aplicaron el diario miccional, la terapia comportamental, la cinesiterapia y la electroestimulación. Conclusión: La actuación del enfermero estomaterapeuta en el manejo de la incontinência urinaria de esfuerzo comprende la aplicación del tratamiento conservador, pasando por la prevención, la estimación del cambio de comportamiento y el manejo de tecnologías para el fortalecimiento de la musculatura del assoalado pelviano. (AU)
Subject(s)
Urinary Incontinence, Stress , Nursing , Enterostomal TherapyABSTRACT
Objective: The aim of the present study was to compare pelvic floor muscles (PFM) contraction variables between women with and without stress urinary incontinence (SUI). Materials and Methods: This cross-sectional study evaluated the PFM of 17 healthy women and 17 women with SUI during a single test session using a vaginal dynamometer. Outcomes: peak time (time at which peak force occurred after the onset of contraction), passive force (baseline), maximum contraction force, impulse of contraction, average force and endurance time. Dada was recording during a single test session using a vaginal dynamometer. Results: The following PFM contraction variables were evaluated: Analysis of covariance (ANCOVA) with the Bonferroni post hoc test was used to compare the dynamometric data between groups (control and SUI), considering age and number of childbirths as co-variables. Significant difference was observed between groups with regard to endurance (F = 4.87, P < .03; ANCOVA test), whereas no significant differences were found for the other variables analyzed. Conclusion: The endurance time of PFM contraction is shorter in women with SUI, whereas variables related to the intensity of pelvic floor muscle contraction force and time from the onset to peak contraction of these muscles are similar between women with and without stress urinary incontinence.
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A incontinência urinária é definida como qualquer tipo de perda involuntária de urina. Essa condição afeta muitas mulheres e pode apresentar impacto significativo na qualidade de vida dessa população. Nesse sentido, este estudo teve como objetivo descrever a proporção de mulheres com incontinência urinária e seu impacto na qualidade de vida. Trata-se de um estudo observacional transversal. A amostra da pesquisa foi composta por mulheres atendidas em uma clínica-escola de fisioterapia de uma universidade particular do interior do estado de São Paulo. A coleta de dados foi realizada presencialmente, com a aplicação de uma ficha geral para reunir informações sobre o perfil sociodemográfico e clínico, bem como do instrumento International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), para avaliar a incontinência urinária e seu impacto na qualidade de vida das participantes. Os dados foram tabulados em planilha Excel e analisados estatisticamente com o programa JAMOVI. O nível de significância adotado para os testes estatísticos foi de p < 0,05. Participaram da pesquisa 35 mulheres, das quais 62,85% apresentaram ocorrência de perda involuntária de urina. Dentro desse grupo, 81,81% relataram perda de qualidade de vida devido à incontinência urinária. Infere-se que a incontinência urinária apresenta elevada prevalência e impacto na qualidade de vida das mulheres, sendo fundamental a adoção de medidas que visem prevenir e tratar essa condição.
Urinary incontinence is defined as the involuntary emission of urine. This condition affects many women and can significantly impact their quality of life. Thus, this cross-sectional observational study aimed to describe the proportion of women with urinary incontinence and its impact on quality of life. The research sample comprised women treated at a physical therapy school clinic at a private university in inner São Paulo State. Data were collected in person using a general form to gather information on participants' sociodemographic and clinical profile and the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) instrument to assess urinary incontinence and its impact on quality of life. Data were tabulated on an Excel spreadsheet and statistically analyzed on JAMOVI. The significance level adopted for statistical tests was p < 0.05. This research included 35 women, of which 62.85% involuntary emitted urine. Within this group, 81.81% reported a loss of quality of life due to urinary incontinence. Urinary incontinence has a high prevalence and impact on the quality of life of women, entailing the adoption of measures to prevent and treat this condition.
La incontinencia urinaria se define como la pérdida involuntaria de orina. Esta condición afecta a muchas mujeres y puede impactar significativamente la calidad de vida de esta población. En este sentido, este estudio tuvo como objetivo describir la proporción de mujeres con incontinencia urinaria y su impacto en la calidad de vida. Se trata de un estudio observacional transversal. La muestra de la investigación estuvo compuesta por mujeres atendidas en una clínica de fisioterapia de una universidad privada del interior del estado de São Paulo, Brasil. Se recolectaron los datos de manera presencial mediante un formulario general para recopilar información sobre el perfil sociodemográfico y clínico, y el instrumento International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) para evaluar la incontinencia urinaria y su impacto en la calidad de vida de las participantes. Los datos fueron tabulados en una hoja de cálculo Excel y analizados estadísticamente mediante el programa JAMOVI. El nivel de significación adoptado para las pruebas estadísticas fue p < 0,05. En la investigación participaron 35 mujeres, de las cuales el 62,85% presentó pérdida involuntaria de orina. Dentro de este grupo, el 81,81% refirió pérdida de calidad de vida por incontinencia urinaria. Se infiere que la incontinencia urinaria tiene una alta prevalencia e impacto en la calidad de vida de las mujeres, por lo que es imprescindible adoptar medidas para prevenir y tratar esta condición.
Subject(s)
Humans , Female , Quality of Life , Urinary Incontinence , Prevalence , Women's HealthABSTRACT
Objective: To investigate the factors associated with urinary incontinence in older adults living in nursing homes. Methods: This was an exploratory, cross-sectional, observational, and quantitative study using exploratory and path analysis (PA). Eighty-six older adults living in nursing homes in the city of Salvador, Brazil, and the city of Brasília, Brazil, were included. Data were collected from January to March 2020, before the Covid-19 pandemic. The following variables were evaluated: sex, age group, functional performance, global cognitive function, comorbidities, and health conditions. Results: Urinary incontinence was associated with educational level, marital status, hypertension, one or more difficulties in basic activities of daily living, mood, insomnia, loss of appetite, fecal incontinence, and difficulty swallowing. In the PA, depression and difficulty swallowing were directly associated with urinary incontinence, and urinary incontinence was directly and significantly associated with insomnia and fecal incontinence. Conclusion: Given the variety of social and health components associated with urinary incontinence, it is necessary to assess, prevent, treat, and rehabilitate this condition in Brazilian nursing homes. Interventions in urinary incontinence demand integrated actions in functional, clinical, and mental health aspects to promote the well-being of older adults living in nursing homes. (AU)
Objetivo: Investigar os fatores associados à incontinência urinária em pessoas idosas institucionalizadas segundo a Análise de Caminhos. Metodologia: Trata-se de um estudo transversal. Foram avaliados 86 idosos em Instituições de Longa Permanência para Idosos brasileiras de Salvador (BA) e Brasília (DF), no período entre janeiro e março de 2020, período pré-pandemia de COVID-19. Os fatores analisados incluíram: sexo, faixa etária, desempenho funcional, desempenho cognitivo global, comorbidades e condições de saúde. Resultados: Observou-se que a incontinência urinária esteve associada ao nível de escolaridade, estado civil, hipertensão, uma ou mais dificuldades nas atividades básicas da vida diária, humor, insônia, perda de apetite, incontinência fecal e dificuldade de deglutição. Na Análise de Caminhos, os sintomas depressivos e as dificuldades de deglutição tiveram associação direta com a incontinência urinária, e a incontinência urinária teve associação direta e significativa com a insônia e a incontinência fecal. Conclusão: Dada a variedade de componentes sociais e de saúde associados à incontinência urinária, é necessário avaliar, prevenir, recuperar e reabilitar essa condição nas Instituições de Longa Permanência para Idosos brasileiras. Intervir na incontinência urinária requer ações integradas nos aspectos funcionais, clínicos e de saúde mental, que podem favorecer o bem-estar das pessoas idosas institucionalizadas. (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Urinary Incontinence , Homes for the Aged , Physical Functional PerformanceABSTRACT
OBJETIVO: Estimar a prevalência de incontinência urinária em mulheres que realizam de atividade física e os fatores associados. MÉTODOS: Pesquisa de abordagem quantitativa e transversal. Participaram da pesquisa mulheres com idade acima de 20 anos e que realizam algum tipo de atividade física funcional. Na coleta de dados aplicou-se um questionário estruturado composto por dados sociodemográficos e clínicos. Para análise utilizou-se o Teste do Qui-Quadrado e Teste exato de Fisher. RESULTADOS: A prevalência de incontinência urinária feminina, as quais realizam atividade física foi de 21,9% e o exercício preeminente de perda involuntária de urina foi pular (55%). A faixa etária prevalente foi de 30 a 39 anos (40,2%), solteiras (47,6%), ensino superior completo (56,1%), raça branca (46,3%). O fator de risco associado e significativo foi a infecção urinária (p=0,005) e a prática de atividade física (p=0,001). CONCLUSÃO: Detectou-se que mulheres que praticam atividades físicas, em maior prevalência com pulos ou impactos, apresentam incontinência urinária. E o fator associado a eliminação involuntária de urina foi a infecção urinária.
OBJECTIVE: To estimate the prevalence of urinary incontinence in women who perform physical activity and associated factors. METHODS: Research with a quantitative and cross-sectional approach. Women aged over 18 years and who perform some type of physical activity participated in the research. In data collection, a structured questionnaire was applied, consisting of sociodemographic and clinical data. For analysis, the chi-square test and Fisher's exact test were used. RESULTS: The prevalence of female urinary incontinence, which perform physical activity was 21.9% and the preeminent exercise of involuntary loss of urine was jumping (55%). The prevalent age group was 30 to 39 years old (40.2%), single (47.6%), complete higher education (56.1%), white race (46.3%). The associated and significant risk factor was urinary infection (p=0.005) and the practice of physical activity (p=0.001). CONCLUSION: It was detected that women who practice physical activities, with a higher prevalence with jumps or impacts, have urinary incontinence. And the factor associated with involuntary elimination of urine was urinary tract infection.
Subject(s)
Urinary Incontinence , Women , ExerciseABSTRACT
INTRODUCCIÓN: La incontinencia urinaria impacta de forma negativa la calidad de vida de quienes la padecen y puede perjudicar las actividades laborales, siendo causante de presentismo en las profesionales de salud. Esto puede implicar la disminución en la calidad de la atención y seguridad de la/el paciente. El objetivo del presente estudio es explorar la autopercepción de las trabajadoras de salud que padecen incontinencia urinaria como factor predisponente de presentismo. MÉTODOS: Estudio mixto de carácter exploratorio-descriptivo. La muestra fue seleccionada de forma no probabilística e intencionada por criterio y conveniencia con un tamaño de 14 voluntarias, considerando la saturación de la información. Para el proceso y análisis de datos temáticos se consideraron los criterios de confiabilidad definidos por Guba. RESULTADOS: Muestra con edad media de 38,9 + 7,1 años y un puntaje de SPS-6 medio de 15,8 + 3,5 puntos, mostrando mayor alteración en la dimensión de evitar la desconcentración. Las narrativas presentes en el caso estudiado aportaron información relevante de cómo la incontinencia urinaria afecta el desempeño laboral de las trabajadoras de salud a través de la interrupción en su jornada, disminución en la calidad de la atención clínica, como también el aumento de su ansiedad respecto a su entorno. CONCLUSIONES: Dado que la incontinencia urinaria y el presentismo son experiencias subjetivas y multidimensionales, al igual que el efecto negativo en el desempeño laboral, se recomienda un estudio que permita identificar variables predictoras y las pérdidas económicas asociadas a esta condición. Con ello se buscaría establecer mejoras en el ambiente laboral, así como en el autocuidado de funcionarias, procurando mayores beneficios y mejores niveles de eficiencia en la organización.
INTRODUCTION: Urinary incontinence negatively impacts the quality of life and can harm work activities, causing presenteeism in health professionals and decreasing the quality of care and patient safety. The objective of this study is to explore the self-perception of health workers who suffer from urinary incontinence as a predisposing factor for presenteeism. METHODS: Mixed study of an exploratory-descriptive nature. The sample was selected in a non-probabilistic and intentional way by criterion and convenience with a size of 14 volunteers, considering the saturation of the information. Reliability criteria defined by Guba for the process and analysis of thematic data were considered. RESULTS: The sample had a mean age of 38.9 + 7.1 years and a mean SPS-6 score of 15.8 + 3.5 points, showing alteration in the dimension of avoiding deconcentration. The narratives in the case study provide relevant information on how urinary incontinence affects the work performance of health workers through the interruption in their day, decreases the quality of clinical care, and increases their anxiety regarding their environment. CONCLUSIONS: Urinary incontinence and presenteeism are subjective, and multidimensional experiences affect work performance. Therefore, further studies are recommended to identify predictor variables and the economic losses associated with this condition to establish improvements in the work environment and the self-care of female employees seeking greater benefits and better levels of efficiency in the organization.
Subject(s)
Humans , Female , Adult , Middle Aged , Quality of Life , Urinary Incontinence , Chile , Causality , Surveys and Questionnaires , Reproducibility of Results , PresenteeismABSTRACT
Objective:To analyze the effect of biofeedback electrical stimulation on the prevention of stress urinary incontinence and pelvic floor muscle strength during postpartum rehabilitation.Methods:A total of 200 parturients who gave birth in Ningde Municipal Hospital of Ningde Normal University from October 2021 to April 2022 were included as research objects and divided into the control group and the observation group according to different rehabilitation programs, with 100 cases in each group. The control group was given routine rehabilitation, and the observation group was given biofeedback electrical stimulation on the basis of the control group, the parturients in the two groups were treated for 3 months. The occurrence of stress urinary incontinence in the two groups was compared, and the pelvic floor muscle strength before and after treatment were compared between the two groups. The scores of International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) were compared between the two groups.Results:The total incidence of stress urinary incontinence in the observation group was lower than that in the control group: 4.00%(4/100) vs. 15.00%(15/100), there was statistical difference( χ2 = 9.00, P<0.05). After treatment, the muscle strength grade, class Ⅰ muscle fiber, class Ⅱ muscle fiber and average voltage of pelvic floor muscle in the observation group were higher than those in the control group: (3.85 ± 0.27) grades vs. (3.74 ± 0.32) grades, (10.23 ± 1.17) μV vs. (8.84 ± 1.13) μV, (11.56 ± 0.19) μV vs. (10.98 ± 0.24) μV, (18.12 ± 3.24) μV vs. (14.69 ± 3.01) μV, there were statistical differences ( P<0.05). After treatment, the scores of ICI Q-SF and PFIQ-7 in the observation group were lower than those in the control group: (7.02 ± 1.26) scores vs. (8.26 ± 1.15) scores, (18.96 ± 4.31) scores vs. (24.17 ± 5.62) scores, there were statistical differences ( P<0.05). Conclusions:The application of biofeedback electrical stimulation in postpartum rehabilitation can reduce the incidence of stress urinary incontinence, improve postpartum pelvic floor muscle strength, and reduce the impact of stress urinary incontinence and pelvic floor muscle disorder on daily life.
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Objective:To investigate the diagnostic value of pelvic floor ultrasound combined with electromyography physiological parameters for postpartum stress urinary incontinence(SUI)of different degrees and pelvic floor function of primipara.Methods:A total of 160 SUI patients who admitted to Yan'an hospital of Kunming City from January 2019 to January 2022 were selected,and they were divided into abnormal group(110 cases)and normal group(50 cases)according to pelvic floor function(the muscle voltage values of different muscle fibers).The SUI was graded according to the Chinese Guidelines for Diagnosis of Urological Diseases and the International Incontinence Advisory Committee's Incontinence Questionnaire(ICI-Q-SF).The posterior horn(α)of bladder and urethra at rest,the displacements of the bladder neck on y-axis(△y)and x-axis(△x)after the rest to the fatigue action,the proximal urethral rotation angle after the rest to the fatigue action(γ),the posterior horn of bladder and urethra(β)after the fatigue action were observed.The electromyography was used to draw and record the pelvic floor myoelectric activity signals of the patients of two groups at five stages(pre baseline rest period,class II muscle fiber systole period,class II and I muscle fiber systole period,class I muscle fiber systole period and post baseline rest period).And then,the muscle voltage values of different muscle fibers on the surface of pelvic floor were quantified.Results:There was no statistically significant difference in Δ x between patients with postpartum SUI of different degrees.There were significant differences in △y,α,β and γ between patients with postpartum SUI of different degrees(F=7.162,7.655,14.998,2.758,P<0.05).The differences of the means of muscle voltages of pre and post baseline rest period,and class I muscle fiber systole period among patients with postpartum SUI of different degrees were not significant.The differences of the means of muscle voltages of class II,and the class II and I muscle fiber systole period among patients with postpartum SUI of different degrees were significant(F=12.062,24.501,P<0.05),respectively.There was no statistically significant difference in △x between the two groups.The △y,α,β and γ of abnormal group were significantly higher than those of normal group(t=8.991,8.691,9.389,27.552,P<0.05),respectively.There were no statistically significant differences in the means of muscle voltage values of the pre and post baseline rest period,and class I muscle fibers systole period between the two groups.The means of muscle voltage values of class II,and class II and I muscle fibers systole period in the abnormal group was significantly higher than them in the normal group(t=9.613,14.452,P<0.05),respectively.The sensitivities of △y,α,β,γ,the means of class II muscle fibers systole period,and the means of class II and I muscle fibers systole period of pelvic floor ultrasound and electromyography physiological parameters were respectively 71.60%,79.40%,81.40%,91.20%,83.30%and 82.40%,and the specificities of them were respectively 41.40%,37.90%,37.90%,60.30%,41.40%,and 44.80%in diagnosing postpartum SUI of different degrees of primipara.The sensitivity and specificity of the combined diagnosis of them were respectively 92.20%and 82.80%in diagnosing postpartum SUI of different degrees of primipara.The sensitivities of △y,α,β,γ,the means of class II muscle fibers systole period,and the means of class II and I muscle fibers systole period of pelvic floor ultrasound and electromyography physiological parameters were respectively 79.10%,77.30%,88.20%,89.10%,77.30%,87.30%,and the specificities of them were respectively 64.00%,64.00%,52.00%,46.00%,70.00%and 66.00%in diagnosing pelvic floor function of primipara.The sensitivity and specificity of the combined diagnosis were respectively 98.20%and 80.00%in diagnosing pelvic floor function of primipara.Conclusion:Pelvic floor electromyography physiological parameters and pelvic floor ultrasonic parameters have a certain value in diagnosing postpartum SUI of different degrees and pelvic floor function,and the value of the combined diagnosis of them is higher.
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Pelvic floor dysfunction is a group of clinical syndromes that occur due to structural damage and dysfunction of the pelvic floor.These syndromes include pelvic organ prolapse, urinary incontinence and pelvic pain.Elderly women have a high prevalence of pelvic floor dysfunction, with approximately 50% being affected.The symptoms of this condition have a significant impact on the quality of life in the elderly population.Therefore, it is crucial to evaluate the severity of symptoms and their impact for the diagnosis and treatment of pelvic floor dysfunction in elderly women.To aid in this evaluation, symptom and quality of life questionnaires are important tools in clinical care.However, the wide range of clinical questionnaires available for pelvic floor dysfunction, which are not specifically tailored to elderly women, has caused confusion among clinicians regarding their selection, utilization, and evaluation.This article utilizes CiteSpace to identify key research areas and frequently used questionnaires in the field.It also introduces methods for applying and assessing symptom and quality of life surveys, with the aim of enhancing clinicians' proficiency in evaluating pelvic floor dysfunction, particularly in elderly women.
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Objective:To investigate the efficacy and safety of en-bloc Holmium laser enucleation of the prostate (HoLEP) with an early apical mucosa dissection technique for the treatment of benign prostate hyperplasia (BPH).Methods:The clinical data of 215 patients treated with HoLEP for BPH from January 2020 to January 2023 in the Department of Urology, Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. According to different treatment methods, the patients were divided into study group ( n=112) and control group ( n=103). Patients in the study group were treated by the en-bloc HoLEP with an early apical mucosa dissection technique, while patients in the control group were treated by the classical two or three-lobes HoLEP. The primary endpoints included the rates of urinary incontinence at 1-month, 3-month, and 6-month after surgery in two groups of patients. The secondary endpoints included operative time, hemoglobin decrease, dissected prostate weight, postoperative indwelling catheter time, postoperative hospital stay, and international prostate symptom score (IPSS), quality of life (QoL), Qmax, and postvoid residual urine (PVR) at 3-month and 6-month after surgery. The measurement data were tested by Shapiro-Wilk normality test. The normal distribution of the measurement data were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used for comparison between two groups. Measurement data of skewness distribution were expressed as median (interquartile distance) [ M( Q1, Q3)], and Wilcoxon or Mann-Whitney U test were used for comparison between two groups. The count data in the two groups were compared by the Chi-square test. Results:The incidence of urinary incontinence in the study group was 9.0% (10/112) and 3.6% (4/112) at 1-month and 3-month after surgery, which was significantly lower than those in the control group [18.5% (19/103) and 11.7% (12/103)], and the differences were statistically significant ( P< 0.05). Urinary incontinence in two groups recovered completely 6-month after surgery. The operation time of the study group was (68.74±23.71) min, which was lower than that of the control group [(88.04±25.43) min], and the difference was statistically significant ( P<0.05). There were no significant differences in hemoglobin decrease, dissected prostate weight, postoperative indwelling catheter time, postoperative hospital stay in the two groups ( P> 0.05). The IPSS, QoL, Qmax and PVR of the two groups were significantly improved at 3-month and 6-month after surgery ( P< 0.05), but there was no significant difference between the two groups ( P> 0.05). Conclusion:En-bloc HoLEP with an early apical mucosa dissection technique is safe and reliable in treating BPH, and has advantages over classic HoLEP in terms of short-term urinary continence rates, shortening operation time.
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Background@#Stress urinary incontinence (SUI) is a complex condition with a multifactorial etiology that makes its concepts challenging to teach. This study aimed to assess the efficacy of simulation-based training (SBT) with an anatomic teaching model in improving the understanding of SUI among gynecologic residents-in-training. @*Objective@#The primary objective of this study was to evaluate the efficacy of SUI simulation-based teaching in enhancing the learning experience for gynecologic residents-in-training. The secondary objective was to gather feedback from participants with the intent to further enhance existing teaching methodologies.@*Materials and Methods@#This was a descriptive prospective study within a single institution, involving gynecologic residents-in-training. Participants were given an anatomic teaching tool to construct, followed by an SUI lecture. Pre- and posttest Multiple Choice Questions were administered to assess the efficacy of the teaching tool in improving the participants’ understanding of SUI. Frequency and percentages were used to describe the categorical variables, whereas continuous variables were described using mean and standard deviation. Paired t-test was used to compare the pre- and posttest scores. ANOVA was used to compare the pre- and posttest scores of participants by year level. A P < 0.05 is statistically significant. A separate Likert-scale questionnaire, to evaluate changes in participant’s self-assessment on learning, response to teaching content and resources, and overall feedback of the SBT was used.@*Results@#There were 50 gynecologic residents-in-training that were included in the study. The mean posttest score is significantly higher (6.4 vs. 3.48) than the pretest score, with a mean difference of 3.48. The mean posttest score is significantly different between the year levels with a P < 0.05, with senior residents-in-training performing best. Although participants with only gynecologic conferences as SUI reference performed best, the mean pre- and posttest scores were not statistically different with respect to SUI education exposure. With the use of an anatomic SUI model, the number of correct answers for questions pertaining to anatomy, physiology, and pathophysiology was consistently higher in the posttest scores as compared to the pretest scores but did not reach statistical significance. The majority of participants strongly agree to recommend the course to a colleague.@*Conclusion@#This study supports the use of simple, low-fidelity physical teaching tools in improving the understanding of SUI in gynecologic residents-in-training. Considering the ease of production, improved test scores, and participants’ enthusiasm, the incorporation of the anatomic teaching tool for its use in SUI education should be encouraged.
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ObjectiveTo explore the efficacy of Solifenacin in the treatment of children with idiopathic overactive bladder (OAB). MethodsThe study included 67 children with idiopathic OAB treated in the urology clinic of our hospital from March 2022 to March 2023. After at least 2-week-long behavioral therapy showed no significant therapeutic effect, 52 of the cases in the trial group were given oral Solifenacin 5 mg once daily and the other 15 cases in the control group continued the behavioral therapy. The cases in trial group were subdivided into OAB-dry group (27 cases without urinary incontinence) and OAB-wet group (25 cases with urinary incontinence). The 3-day micturition diary, OAB Symptom Scores (OABSS) and the adverse reactions were recorded and analyzed before, at Weeks 2, 4, 8 and 12 after the treatment. ResultsOf all the 67 cases who completed a 3-month follow-up, 44 were cured including 41 in the trial group and 3 in the control group, 4 presented with adverse reactions. After the 3-month follow-up, the OABSS declined markedly in trial group than in control group (Z=4.524, P<0.001); the cure rates in trial group and control group are 78.8% and 20% respectively, with significant difference (χ2=15.367, P<0.001). At each follow-up,we found increased mean voided volume (F=9.707, P<0.001), reduced mean voiding frequency during daytime (F=3.837, P=0.009) and decreased voiding urgency (χ2=482.835, P<0.001). After the 3-month follow-up, the cure rates in OAB-dry group and OAB-wet group are 81.5% and 76% respectively, with no significant difference (χ2=0.234, P=0.629). ConclusionsIn children with idiopathic OAB, oral Solifenacin 5 mg once daily could significantly increase mean voided volume, reduce mean voiding frequency during daytime, relieve symptoms of urinary urgency and lead to fewer adverse reactions, but is not significantly effective for the treatment of urinary incontinence in OAB-wet children .
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【Objective】 To evaluate the efficacy and safety of intravaginal fractional superpulse CO2 laser in the treatment of mild to moderate female stress urinary incontinence (SUI), so as to provide reference for the treatment options for female SUI. 【Methods】 A total of 41 female mild-to-moderate SUI patients confirmed at the Department of Urology, The First Affiliated Hospital, Air Force Medical University, during Aug.2019 and Nov.2020 were involved.All patients received 3 intravaginal fractional superpulse CO2 laser treatments (1/month).The improvement of urinary incontinence symptoms after treatment was evaluated with International Consultation on Incontinent Questionnaire Short Form (ICI-Q-SF).The motion of bladder neck and rotation angle of bladder and urethra were measured with pelvic ultrasound before and after treatment.The therapeutic effects, pain and patients’ satisfaction were evaluated, and adverse reactions such as bleeding, infection and scar were observed. 【Results】 Three months after treatment, urinary incontinence symptoms improved to varying degrees, the ICI-Q-SF score decreased, the motion of bladder neck [ (28.70±3.11) mm vs.(19.10±4.54) mm] and the vesicourethral rotation angle [(52.78°±15.79°) vs.(41.56°±13.24°)] significantly decreased (P<0.05).The total effective rate was 100.0%.No patients complained severe pain during treatment.All patients were satisfied with the treatment.No adverse reactions such as bleeding, infection or scar occurred. 【Conclusion】 Intravaginal fractional superpulse CO2 laser is effective and safe in the treatment of mild to moderate female SUI, but the long-term efficacy still needs further observation.
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Stress urinary incontinence (SUI) and underactive bladder (UAB) are common types of lower urinary tract dysfunction in women.As the treatment mechanisms of the two conditions are contradictory, the treatment of SUI patients complicated with UAB remains a difficult clinical problem.In order to improve the treatment rate of such patients and promote research, this paper reviews the latest domestic and overseas diagnostic criteria of UAB, summarizes the treatment experience of conventional midurethral sling (tension-free vaginal tape or outside-in transobturator tape) and adjustable sling procedures (transobturator adjustable tape or Remeex system) combined with medication or intermittent catheterization, and the application prospects of cutting-edge technologies such as stem cell injection, cytokine therapy and gene therapy, so as to provide reference for clinicians and researchers.
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Urinary incontinence(UI)is a common health problem in adult women,which can lead to urinary tract infection,depression,sleep disorders,etc.UI has become a medical problem affecting adult women worldwide,and its prevalence has always been at a high level.Although the research on UI continues to deepen,its etiology is still unclear.Therefore,study of the prevalence of adult female UI and related risk factors is of great significance for the prevention and treatment of UI and the improvement of the quality of life of UI patients.This paper reviews the literature reports on adult female UI at home and abroad in recent years,and summarizes the risk factors of adult female UI,in order to provide relevant basis for further research.