[Algorithms and urinary incontinence in the elderly. Assessment, treatment, recommendations and levels of evidence. Review]

A Prospective Study of the Quality of Life of Patients with Stress Incontinence before and after a Transobturator Tape (TOT) Procedure-Preliminary Report

Background: Urinary incontinence (UI) is a significant social problem. The latest figures show that it affects as many as 17–60% of the female population, and it is one of the most common chronic diseases. Incontinence substantially decreases the quality of patients’ lives. The transobturator tape (TOT) procedure is the gold standard in surgical treatment due to its high efficacy and low complication rate. Objective: The aim of this study was to assess the quality of life (QoL) of patients with stress incontinence before and after the TOT procedure. Method: The study included 57 patients diagnosed with stress incontinence on the basis of ultrasonography and history. The QoL before and after surgery was measured using the Incontinence Impact Questionnaire (IIQ-7) and the Incontinence Quality of Life (I-QOL) standardised questionnaires. Results: The IIQ-7 scores for each question were higher (indicating poorer quality of life) before surgery than after surgery. The results for almost all domains were statistically significant. The I-QOL results also showed that, in most cases, the quality of patients’ lives improved after the surgery. Statistically significant changes were observed in all three questionnaire domains of avoidance/limiting behaviour, psychosocial impact, and social embarrassment. Conclusion: Surgical treatment of stress incontinence with TOT results in resolution of bothersome symptoms in the majority of patients, leading to improved comfort in life.

Urinary incontinence in postmenopausal women - causes, symptoms, treatment

Urinary incontinence (UI) is an important social problem that affects more than 50% of postmenopausal women. The number of patients increases from year to year. According to recent data, UI affects women twice as often as men. This condition occurs in about 20-30% of young women, 30-40% in middle age and up to 50% of women in old age. There are five types of urinary incontinence. The etiology of the problem of incontinence is not fully understood, because the problem can affect men and women of all ages and can be due to many changes in the human body. International Continence Society Guidelines indicate that treatment of urinary incontinence should begin with conservative treatment. Surgical treatment should be used when conservative treatment will not bring positive results. According to guidelines, conservative treatment should include pharmacotherapy, physiotherapy, and behavioral therapy. Numerous scientific reports indicate efficacy of physiotherapy in the treatment of urinary incontinence. Most recent reports indicate that physiotherapy gives a positive result in up to 80% of patients with stage I or stress urinary incontinence (SUI) and mixed form, and in 50% of patients with stage II SUI. Urinary incontinence is an interdisciplinary problem because in addition to the sphere directly related to medicine, it also concerns the economic and social spheres. The latest data show that incontinence in postmenopausal women occurs more often than other civilization diseases such as diabetes, hypertension or depression.

The Effect of Pelvic Floor Muscle Training On Incontinence Problems After Radical Prostatectomy

The aim of the current study was to determine the effect of pelvic floor muscle exercises (PFME/Kegel) training administered to patients scheduled for robot-assisted radical prostatectomy on postprocedural incontinence problems.

This study was a randomized controlled trial. Pelvic floor muscle exercises were applied to the procedure group three times a day for 6 months. No exercises were applied to the control group. Incontinence and quality-of-life assessments of the 60 patients in the experimental and control groups were performed on months 0 (10 days after removal of the urinary catheter), 1, 3, and 6 through face-to-face and telephone interviews.

Total Incontinence Consultation on Incontinence-Short Form scores, which provide an objective criterion for the evaluation of individuals with incontinence problems, decreased over time. This decrease was statistically highly significant in the third and sixth months.

Pelvic muscle floor exercises are suitable for patients experiencing incontinence after radical prostatectomy.