The effect of pelvic floor muscle training on sexual function in men with lower urinary tract symptoms after stroke.

BACKGROUND: Erectile dysfunction and lower urinary tract symptoms (LUTS) are common sequelae in men after stroke. OBJECTIVE: The objective of this study was to evaluate the effect of pelvic floor muscle training (PFMT) on measured erectile function as an indicator of sexuality in men with LUTS after stroke. METHOD: A sample of 516 men with stroke was invited to participate in this single-blinded, randomized controlled trial according to in- and exclusion criteria. This resulted in 31 participants who were randomized to either a Treatment Group (n = 16) or a Control Group (n = 15). The intervention included 12♣weeks of PFMT. The effect was measured on the International Index of Erectile Function (IIEF-5) questionnaire. RESULTS: Thirty participants (median age: 68 years; interquartile range: 60-74 years) completed the study, 15 in each group. The results of the IIEF-5 sum score showed a significant improvement (P < 0.04) from pre-test to post-test in the Treatment Group, but not in the Control Group. Within pre-test and 6-month follow-up, the median sum score decreased in both groups, worsened in the Control Group [Treatment Group, 3 (17%) versus Control Group, 5 (31%)]. There were differences between the groups at post-test and at follow-up, but they were not statistically significant. CONCLUSION: The results showed that, as measured by erectile function in men with LUTS after stroke, PFMT may have short-term and long-term effect, although no statistically significant effect was demonstrated between the groups.

Reference values of maximum walking speed among independent community-dwelling Danish adults aged 60 to 79 years: a cross-sectional study.

OBJECTIVES: To establish reference values for maximum walking speed over 10 m for independent community-dwelling Danish adults, aged 60 to 79 years, and to evaluate the effects of gender and age. DESIGN: Cross-sectional study. SETTING: Danish companies and senior citizens clubs. PARTICIPANTS: Two hundred and fifty-two adults (167 women, 85 men) with a mean age of 70 [standard deviation (SD) 4] years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Results for the 10-m walk test (10 MWT) were used to establish reference values. RESULTS: The mean reference value for maximum walking speed over 10 m for all participants was 1.94 (SD 0.31) m/second. Reference values for women aged 60 to 69 years and 70 to 79 years were 1.96 (SD 0.26) and 1.81 (SD 0.29) m/second, respectively. Reference values for men aged 60 to 69 years and 70 to 79 years were 2.10 (SD 0.35) and 2.01 (SD 0.30) m/second, respectively. Significant differences (P<0.01) were observed in the age and gender categories. Men were found to walk faster than women, and individuals aged 60 to 69 years walked faster than individuals aged 70 to 79 years. CONCLUSIONS: This study established the reference values for maximum walking speed over 10 m among independent community-dwelling Danish adults aged 60 to 79 years. The study results showed significant differences in maximum walking speed for different ages and between men and women.

Validity of the Danish Prostate Symptom Score questionnaire in stroke.

OBJECTIVE: To determine the content and face validity of the Danish Prostate Symptom Score (DAN-PSS-1) questionnaire in stroke patients. MATERIALS AND METHODS: Content validity was judged among an expert panel in neuro-urology. The judgement was measured by the content validity index (CVI). Face validity was indicated in a clinical sample of 482 stroke patients in a hospital-based, cross-sectional survey. RESULTS: I-CVI was rated >0.78 (range 0.94-1.00) for 75% of symptom and bother items corresponding to adequate content validity. The expert panel rated the entire DAN-PSS-1 questionnaire highly relevant (S-CVI = 1.00). No experts suggested items omitted or improved. The response rate was 84% and face validity had an acceptable level of completed response for each symptom items (96-98%) and bother items (93-96%) indicating that all items were well interpreted. CONCLUSION: The DAN-PSS-1 questionnaire appears to be content and face valid for measuring lower urinary tract symptoms after stroke.

Is there a long-lasting effect of pelvic floor muscle training in women with urinary incontinence after ischemic stroke? A 6-month follow-up study.

The aim of this study was to evaluate the long-lasting effect of pelvic floor muscle training (PFMT) in women with urinary incontinence after stroke measured by quality of life parameters. Twenty-four (24/24) women with urinary incontinence after stroke, who had completed a prospective, randomised controlled and single-blinded trial evaluating the effect of 12 weeks PFMT, were included in this follow-up study. The follow-up assessments were done by telephone interview 6 months after the intervention. The effect was evaluated by The Short Form 36 (SF-36) Health Survey Questionnaire and Incontinence Impact Questionnaire (IIQ). Twenty-four subjects completed the study. In the treatment group, the SF-36 showed a trend to a long-lasting effect in one of the eight domains and the IIQ showed a tendency to decreased impact of UI in two sub-scales compared to the control group. Our data indicated that PFMT may have a long-lasting effect measured by quality of life parameters.

[General practitioners' knowledge of and attitude to assessment and treatment of women with urinary incontinence. A questionnaire among general practitioners in Denmark]. / Alment praktiserende laegers viden om og holdninger til undersøgelse og behandling af kvinder med urininkontinens. En spørgeskemaundersøgelse blandt alment praktiserende laeger i Danmark.

INTRODUCTION: Urinary incontinence is a common problem for adult women, and the need for assessment and treatment of incontinence is expected to increase in the future. The aim of this study was to elucidate the general practitioners' (GPs) knowledge about and attitude to women with urinary incontinence. METHODS: A questionnaire was posted to 1700 randomly selected GPs in 1998 and 1999. RESULTS: A total of 1071 (63%) GPs responded at least once. Five hundred (29%) returned the questionnaire both years. About 50% expressed a positive interest in the management of urinary incontinence. Only 24% felt that their knowledge was sufficient to manage incontinence. About 50% and 66% of the GPs would probably refer a patient with stress incontinence or urge incontinence to a specialist. The GPs' proposals for assessment and treatment were mainly consistent with good clinical practice. There were only minor changes in knowledge and attitude from 1998 to 1999. DISCUSSION: GPs' interest in urinary incontinence is moderate and management is characterised by a high referral rate to a specialist. Most GPs. consider their knowledge to be inadequate. There is need for education to ensure sufficient knowledge and to change the attitude, so that first-line assessment and treatment of urinary incontinence is carried out in general practice.