Prevalence and risk factors of urinary incontinence in Khon Kaen menopausal women.

OBJECTIVE: To determine the prevalence and risk factors of urinary incontinence in menopausal women. STUDY DESIGN: Prospective Descriptive study. SETTING: Menopausal clinic and gynecological outpatient unit, Department of Obstetrics and Gynecology, Srinagarind Hospital, Faculty of Medicine Khon Kaen University. STUDY POPULATION: Menopausal women attending the menopausal clinic and gynecological outpatient unit. MATERIAL AND METHOD: Between April 23 and July 15, 2004, 229 menopausal women were interviewed by pre-validated questionnaire and in-depth interview to determine the prevalence and risk factors of urinary incontinence. RESULTS: The average age of the study group was 55.8 years. The prevalence of urinary incontinence was 38.86%, the most common type was mixed urinary incontinence (82.02%) followed by stress urinary incontinence (12.36%), and urge urinary incontinence (5.62%). The risk factors of urinary incontinence were vaginal delivery, menopause before 50 years old, and postmenopausal women who had never used hormone therapy. CONCLUSION: The prevalence of urinary incontinence in menopausal women was 38.86%. Mixed urinary incontinence was the most common type. Associated risk factors were vaginal delivery, menopause before 50 years old, and postmenopausal women who had never used hormone therapy.

Effect of hormone therapy on lipid profile in menopausal women.

OBJECTIVE: To study lipid profile of menopausal women with hormone therapy. MATERIAL AND METHOD: Two hundred and sixty eight menopausal women in good health conditions, separated into natural and surgical menopause group, received service at Menopausal clinic in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University since 1996-2004. They regularly took a single type of hormone therapy for about 12 months and obtained blood cholesterol levels for pre- and post-hormone therapy of about 12 months period. The data were analyzed with SPSS v. 10.0.5. RESULTS: The average age of the sample groups were 50.91 +/- 5.93 years and 52.83 +/- 5.28 respectively. Both sample groups have similar mean level of cholesterol levels during pretreatment period. Surgical menopausal group has greater HDL level than the naturally menopausal group with the average level of 64.24 +/- 15.32 mg/ dl. and 58.80 +/- 17.20 mg/dl. respectively. However after taking hormone therapy, blood cholesterol level was significantly changed in both groups. The mean level of LDL decreased (8.59% and 11.49% respectively) and mean level of HDL increased (15.43% and 6.89% respectively). CONCLUSIONS: Hormone therapy in menopausal women can improve cholesterol levels by decreasing LDL and increasing HDL with statistical significance (p < 0.05).

Preoperative vaginal preparations for abdominal hysterectomy for the prevention of febrile morbidity: savlon douching vs povidone-iodine painting.

OBJECTIVE: To compare the effectiveness between savlon solution was douching and povidone-iodine solution painting for reducing febrile morbidity after total abdominal hysterectomy. Study design: Clinical trial. MATERIAL AND METHOD: One hundred and fifty patients at Srinagarind Hospital were scheduled for total abdominal hysterectomy (TAH). All subjects were non-randomly allocated to receive either savlon (1:1000 solutions) douching or povidone-iodine (1% solution) painting as pre-operative vaginal preparations. They also received Cefazolin 1 gm. intravenously before the operation. The principal outcome of the study was febrile morbidity. RESULTS: The overall rate of febrile morbidity was 21 percent. The incidence of febrile morbidity in the savlon vs. povidone-iodine groups was 16 (12/75) and 25 (19/75) percent, respectively. No statistically significant difference was found between the two groups (p-value = 0.16). The odds ratio was 1.78 (95%CI 0.79 to 3.99) and adjusted odds ratio was 2.09(95%CI 0.86 to 5.10) CONCLUSION: The effectiveness between savlon solution douching and povidone-iodine solution painting in conjunction with a prophylactic antibiotic before TAH for reducing febrile morbidity was not significant different.

Evaluation of female sterilization at Srinagarind Hospital.

A retrospective study of female sterilization at Srinagarind Hospital since 1978 until 2002 revealed 35,094 cases those were in the period of 25 years. These operations were performed by physicians, medical students and trained nurses in 21,383; 8,465 and 5,246 cases respectively. The presented cases were post partum tubal resection, interval tubal resection and cesarean section with tabul resection in 25,706; 4,4244 and 4,964 cases respectively. There were 350 cases of complication. The most common complication was tubal complications. Pregnancy post tubal resection were 74 cases or 0.21 percent. Different operators had statistically significant complication rates with Pearson chi square and Fisher exact test. Wound complication and pelvic pathology or operative difficulties were 2 types of statistically significant complications. Different types of operations had statistically significant complication rates. Six types of complications were tubal complication, wound complication, pregnancy, pelvic pathology or operative difficulties, bowel injury, and bladder injury.