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Yu Y, Ma M, Zhou Q. The relationship between vaginal microenvironment and pelvic dysfunctional diseases in Chinese women: a systematic review and meta-analysis. Int Urogynecol J 2023; 34:2849-2858. [PMID: 37650904 DOI: 10.1007/s00192-023-05635-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The aim of this review is to synthesize existing evidence on the combined effects of the vaginal microenvironment on pelvic dysfunctional diseases. METHODS This systematic review was conducted in accordance with the PRISMA guidelines. The PubMed, Embase, Cochrane Library, Web of Science, Wanfang, and China Knowledge Network (CNKI) databases were systematically searched up to January 2023 using the following MeSH terms: "pelvic organ prolapse", "stress urinary incontinence" and "vaginal microenvironment", "microenvironment", "vaginal cleanliness", "vaginitis", "lactobacillus" and other related keywords. Study methods were limited to case-control studies or cross-sectional studies. Quality assessment was performed using the Newcastle-Ottawa scale, and meta-analysis of the included literature was performed using Review Manager 5.3. RESULTS A total of eight articles were included in this systematic review (SR) and meta-analysis (MA), which involved a total of 7298 study participants. The pooled results of this meta-analysis showed that the vaginal microenvironment (number of vaginal lactobacilli, leukorrhea cleanliness, and presence of vaginitis) were all statistically significantly associated with pelvic dysfunctional diseases in Chinese women. CONCLUSION This review indicates that the vaginal microenvironment has an impact on the development of PFD in Chinese women. TRIAL REGISTRATION The protocol of this systematic review (SR) and meta-analysis (MA) has been registered in PROSPERO databases with the Registration number of CRD42023407251.
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Affiliation(s)
- Ye Yu
- The First Clinical College of Medicine, Chongqing Medical University / The First Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400010, China
| | - MingRong Ma
- The First Clinical College of Medicine, Chongqing Medical University / The First Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400010, China
| | - Qin Zhou
- The First Clinical College of Medicine, Chongqing Medical University / The First Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400010, China.
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Kijmanawat A, Saraluck A, Manonai J, Wattanayingcharoenchai R, Aimjirakul K, Chinthakanan O. Mobile Application Based Pelvic Floor Muscle Training for Treatment of Stress Urinary Incontinence: An Assessor-Blind, Randomized, Controlled Trial. J Clin Med 2023; 12:7003. [PMID: 38002618 PMCID: PMC10672388 DOI: 10.3390/jcm12227003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/26/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
A first-line treatment for stress urinary incontinence (SUI) is pelvic floor muscle training (PFMT) for at least three months. The key problem is that patients do not understand the importance of these exercises and their effectiveness. Mobile health apps offer new possibilities to increase treatment adherence. This study compared a reduction in SUI, exercise adherence, and quality of life in PFMT with animation vs. standard instruction. A prospective, single-blind, randomized control trial was collected. SUI patients were randomized into the application or control groups confirmed using a one-hour pad test. In the intervention group, the PFMT application was applied via mobile phone (PFMT with animations, recording system, and reminder system). The standard exercise protocol was similar in both groups. Additional follow-up was conducted at 4, 8, and 12 weeks. A total of 51 participants were randomized to the application (n = 26) and control groups (n = 25), respectively. At the 12-week follow-up, there was no significant difference between the two groups in terms of SUI cure rate, SUI severity by pad test, and daily SUI episodes from the bladder diary (p-value of 0.695, 0.472, and 0.338, respectively). The mean PFME adherence in the application group was higher than the control group at 8 weeks (66.3 ± 13.6 vs. 52.7 ± 16.6, p = 0.002) and 12 weeks (59.1 ± 13.9 vs. 37.8 ± 11.0, p = 0.001). The application group reported no difference from the conventional PFMT group in terms of improvements in SUI cure rate, symptom severity, and quality of life effects at 12-week follow-up. However, the improvement evaluated by the mean difference in SUI episodes and quality of life effects (ICIQ-UI SF) reported a better outcome in the mobile app group. The PFMT application has been proven to be an effective tool that improves PFMT adherence.
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Affiliation(s)
| | | | | | | | | | - Orawee Chinthakanan
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.K.); (A.S.); (J.M.); (R.W.); (K.A.)
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Wang XX, Zhang L, Lu Y. Advances in the molecular pathogenesis and cell therapy of stress urinary incontinence. Front Cell Dev Biol 2023; 11:1090386. [PMID: 36846586 PMCID: PMC9944745 DOI: 10.3389/fcell.2023.1090386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Stress urinary incontinence (SUI) is very common in women. It affects patients' mental and physical health, and imposed huge socioeconomic pressure. The therapeutic effect of conservative treatment is limited, and depends heavily on patient persistence and compliance. Surgical treatment often brings procedure-related adverse complications and higher costs for patients. Therefore, it is necessary to better understand the potential molecular mechanisms underlying stress urinary incontinence and develop new treatment methods. Although some progress has been made in the basic research in recent years, the specific molecular pathogenic mechanisms of SUI are still unclear. Here, we reviewed the published studies on the molecular mechanisms associated with nerves, urethral muscles, periurethral connective tissue and hormones in the pathogenesis of SUI. In addition, we provide an update on the recent progresses in research on the use of cell therapy for treating SUI, including research on stem cells therapy, exosome differentiation and gene regulation.
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Affiliation(s)
- Xiao-xiao Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Lei Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
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Li C, Yang M, Qu Z, Ruan S, Chen B, Ran J, Shu W, Chen Y, Hou W. Effect of electroacupuncture on the degradation of collagen in pelvic floor supporting tissue of stress urinary incontinence rats. Int Urogynecol J 2022; 33:2233-2240. [PMID: 35226143 PMCID: PMC9343271 DOI: 10.1007/s00192-022-05106-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/16/2022] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To examine the changes induced by electroacupuncture in stress urinary incontinence (SUI) rats, including the urodynamics and collagen degradation-related cytokine molecular biological expression changes, and to explore the effect and mechanism of EA treatment in SUI. METHODS Female SPF Sprague-Dawley rats were randomly assigned to five groups (n = 10): sham, model, electroacupuncture control, electroacupuncture, and blocker. The leak point pressure (LPP) and maximum bladder capacity (MBC) were measured for each group of rats, and collagen I, collagen III, matrix metalloproteinases (MMPs), and tissue inhibitor of metalloproteinase (TIMPs) in the anterior vaginal wall of rats in each group were determined by reverse transcription-polymerase chain reaction and western blotting. The data were analyzed by one-way analysis of variance or Kruskal-Wallis test. RESULTS Electroacupuncture Shenshu (BL23) and Huiyang (BL35) increased the LPP and MBC in SUI rats (P < 0.05). Electroacupuncture treatment significantly increased the protein expression of collagen I and collagen III in the anterior vaginal wall of SUI rats (P < 0.05) and significantly reduced the protein expression of MMP1, MMP2, and MMP9 (P < 0.05). CONCLUSIONS Electroacupuncture stimulation can alleviate the signs of SUI, and its mechanism is related to the degradation of collagen in the anterior vaginal wall.
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Affiliation(s)
- Chaonan Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Mengyi Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Zhiyu Qu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Shuoquan Ruan
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Bingli Chen
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Jinchuan Ran
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Wen Shu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China
| | - Yuelai Chen
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China.
| | - Wenguang Hou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110, Ganhe Road, Shanghai, 200437, China.
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Yakit Ak E, Oskay U. Evaluation of incontinence women aged 20 or older living in Diyarbakir. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eda Yakit Ak
- Atatürk Health Services Vocational School Dicle University Diyarbakır Turkey
| | - Umran Oskay
- Department of Women's Health and Gynecological Nursing, Florence Nightingale Faculty of Nursing Istanbul University‐Cerrahpasa Istanbul Turkey
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Mazo GZ, Santos KMD, Freitas CSD, Cielo A, Braz MM, Pivetta HMF. Correlação entre incontinência urinária, disfunção sexual e avaliação subjetiva da contração muscular perineal em idosas fisicamente ativas. FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/21000528012021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Incontinência urinária (IU) e disfunção sexual feminina (DSF) são disfunções que afetam a qualidade de vida. Com a mudança na pirâmide etária brasileira, a prevalência de tais disfunções tende a aumentar. O objetivo deste estudo foi estabelecer a relação entre a IU, a DSF e a contração muscular perineal em idosas ativas fisicamente. Trata-se de estudo transversal, do qual participaram 35 idosas ≥60 anos. Inicialmente foram aplicados a ficha diagnóstica e os questionários International Consultation on Incontinence Questionnaire - Short Form (ICIQ-UI-SF) e Female Sexual Function Index (FSFI). Em seguida foram avaliados os músculos do assoalho pélvico (MAP) por meio do toque vaginal, de acordo com o que propõe o esquema perfect. Entre as idosas, 20% apresentaram ambas as disfunções dos MAP. No total, 17 (48,6%) apresentavam IU e 16 (45,7%) DSF. Observou-se diferença significativa no número de partos vaginais (p=0,028) e no item rapidez do esquema perfect (p=0,033) entre as idosas com e sem DSF. Não houve diferença estatística entre os grupos com e sem IU. A análise apontou uma correlação inversamente proporcional entre a gravidade da IU e a função sexual nas idosas incontinentes (p=0,008; r=−0,622), de forma que, para cada aumento na gravidade da IU pelo ICIQ-SF, diminuiu-se 0,507 de função sexual avaliada pelo FSFI (p=0,034; r=0,516). Há uma associação entre IU e DSF em idosas fisicamente ativas. Algumas idosas apresentam ambas as disfunções dos MAP, apesar de serem ativas fisicamente. Dessa forma, é necessário reforçar a importância de avaliações minuciosas, da atividade física orientada e da atuação multiprofissional em saúde.
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Xue K, Palmer MH, Zhou F. Prevalence and associated factors of urinary incontinence in women living in China: a literature review. BMC Urol 2020; 20:159. [PMID: 33054777 PMCID: PMC7559450 DOI: 10.1186/s12894-020-00735-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/05/2020] [Indexed: 12/15/2022] Open
Abstract
Background This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence rates and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that can have a significant impact on women's physical and mental health and quality of life. In addition, women with UI may experience socioeconomic burdens due to UI’s effect on their ability to work and function in society. Although researchers from many countries have reported prevalence rates and associated factors for UI, little is known about the prevalence of UI in China’s large female population. Language may act as a barrier to the inclusion of published studies in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in China and in Chinese language. Methods The authors retrieved research studies from the Wanfang database using the following search terms: "Subject: (Female) × Subject: (Urinary incontinence) × Subject: (Prevalence) × Date: 2013 to 2019". Searches employed the China National Knowledge Infrastructure Database, VIP Database for Chinese Technical Periodicals and China Biology Medicine Database. The authors also used PubMed to search English-language studies published in Chinese journals on UI in Chinese women. Results This literature review includes 48 articles published between January 2013 and December 2019. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7 to 69.8%, representing 43–349 million women, respectively. For women aged 17–40 years, 41–59 years, and 60 years and older, prevalence rates ranged from 2.6–30.0, 8.7–47.7, to 16.9–61.6%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17–40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41–59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors. Conclusions About 43–349 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI incidence and prevalence rates. Little is known about the prevalence rates and associated factors for UI among young (aged 17–40) Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.
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Affiliation(s)
- Kaikai Xue
- School of Nursing, Xuzhou Medical University, Xuzhou, China.,School of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, China
| | - Mary H Palmer
- School of Nursing, University of North Carolina at Chapel Hill, CB 7460, Chapel Hill, USA
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Xuzhou, China.
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