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Hao J, Yao Z, Remis A, Huang B, Li Y, Yu X. Pelvic floor muscle training in telerehabilitation: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:1753-1764. [PMID: 38340157 DOI: 10.1007/s00404-024-07380-x] [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: 11/20/2023] [Accepted: 01/07/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE This systematic review aims to identify, critically appraise, and summarize current evidence regarding the feasibility and efficacy of pelvic floor muscle training in telerehabilitation. METHODS Three bibliographic databases, PubMed, Embase, and Scopus were searched from inception to October 1, 2023. Clinical trials assessing the feasibility and efficacy of pelvic floor muscle training in telerehabilitation were eligible for inclusion. The Physiotherapy Evidence Database scale and National Institutes of Health Study Quality Assessment Tool were used for methodological quality assessment. Study selection, data extraction, and quality assessment were completed by two independent reviewers. Meta-analyses were performed to determine the effects of pelvic floor muscle training in telerehabilitation. RESULTS Five randomized controlled trials and three single cohort clinical trials were included in this review. Four studies were evaluated as good quality, and four as fair. Pelvic floor telerehabilitation was well tolerated and demonstrated good patient compliance and satisfaction. Pooled analysis indicated significant effects of pelvic floor telerehabilitation on the severity of urinary incontinence with a large effect size, pelvic floor muscle strength with a large effect size, and quality of life with a medium effect size. CONCLUSION This systematic review demonstrates that pelvic floor muscle training in telerehabilitation is a feasible and effective approach and highlights its efficacy in patients with urinary incontinence. This review supports the application of pelvic floor muscle training in telerehabilitation and informs further clinical and research endeavors to incorporate digital health technologies in managing pelvic floor dysfunction.
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Affiliation(s)
- Jie Hao
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Zixuan Yao
- Department of Rehabilitation Medicine, Institution of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Science, Beijing, 100051, People's Republic of China.
| | - Andréas Remis
- Health Research Association of Keck Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Biying Huang
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Yanfei Li
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Xin Yu
- Department of Rehabilitation Medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, People's Republic of China
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Fehm T, Stübs FA, Koch MC, Mallmann P, Dannecker C, Dietl A, Sevnina A, Mergel F, Lotz L, Ehret A, Gantert D, Martignoni F, Cieslik JP, Menke J, Ortmann O, Stromberger C, Oechsle K, Hornemann B, Mumm F, Grimm C, Sturdza A, Wight E, Loessl K, Golatta M, Hagen V, Dauelsberg T, Diel I, Münstedt K, Merz E, Vordermark D, Lindel K, Wittekind C, Küppers V, Lellé R, Neis K, Griesser H, Pöschel B, Steiner M, Freitag U, Gilster T, Schmittel A, Friedrich M, Haase H, Gebhardt M, Kiesel L, Reinhardt M, Kreißl M, Kloke M, Horn LC, Wiedemann R, Marnitz S, Letsch A, Zraik I, Mangold B, Möckel J, Alt C, Wimberger P, Hillemanns P, Paradies K, Mustea A, Denschlag D, Henscher U, Tholen R, Wesselmann S, Beckmann MW. Diagnosis, Therapy and Follow-up of Cervical Cancer. Guideline of the DGGG, DKG and DKH (S3-Level, AWMF Registry No. 032/033OL, May 2021) – Part 2 with Recommendations
on Psycho-oncology, Rehabilitation, Follow-up, Recurrence, Palliative Therapy and Healthcare Facilities. Geburtshilfe Frauenheilkd 2022; 82:181-205. [DOI: 10.1055/a-1671-2446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/17/2021] [Indexed: 10/19/2022] Open
Abstract
Abstract
Aim This is an update of the interdisciplinary S3-guideline on the Diagnosis, Therapy and Follow-up of Cervical Cancer (AWMF Registry No. 032/033OL), published in March 2021. The
work on the updated guideline was funded by German Cancer Aid (Deutsche Krebshilfe) as part of the German Guideline Program in Oncology. The guideline was coordinated by the German
Society of Gynecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) and the Working Group on Gynecological Oncology (Arbeitsgemeinschaft
Gynäkologische Onkologie, AGO) of the German Cancer Society (Deutsche Krebsgesellschaft, DKG).
Method The process used to update the 2014 S3-guideline was based on an appraisal of the available evidence using the criteria of evidence-based medicine, adaptations of existing
evidence-based national and international guidelines or – if evidence was lacking – on the consensus of the specialists involved in compiling the update. After an initial review of the
current literature was carried out according to a prescribed algorithm, several areas were identified which, in contrast to the predecessor version from September 2014, required new
recommendations or statements which would take account of more recently published literature and the recent appraisal of new evidence.
Recommendations The short version of this guideline consists of recommendations and statements on palliative therapy and follow-up of patients with cervical cancer. The most
important aspects included in this updated guideline are the new FIGO classification published in 2018, the radical open surgery approach used to treat cervical cancer up to FIGO stage IB1,
and the use of the sentinel lymph node technique for tumors ≤ 2 cm. Other changes include the use of PET-CT, new options in radiotherapy (e.g., intensity-modulated radiotherapy, image-guided
adaptive brachytherapy), and drug therapies to treat recurrence or metastasis.
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Affiliation(s)
- Tanja Fehm
- Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Frederik A. Stübs
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Martin C. Koch
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | | | | | - Anna Dietl
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Anna Sevnina
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Franziska Mergel
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Laura Lotz
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Anne Ehret
- Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | | | | | - Jan Menke
- SHG-Kliniken Völklingen, Klinik für Radiologie, Völklingen, Germany
| | - Olaf Ortmann
- Arbeitsgemeinschaft Deutscher Tumorzentren, Germany
| | - Carmen Stromberger
- Charité – Universitätsmedizin Berlin, Klinik für Radioonkologie und Strahlentherapie, Berlin, Germany
| | - Karin Oechsle
- Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik, Hamburg, Germany
| | - Beate Hornemann
- Universitätsklinikum Dresden, Psychoonkologischer Dienst, Dresden, Germany
| | - Friederike Mumm
- Medizinische Klinik und Poliklinik III und Comprehensive Cancer Center (CCC München LMU), Klinikum der Universität München, LMU München, München, Germany
| | - Christoph Grimm
- Abteilung für allgemeine Gynäkologie und gynäkologische Onkologie, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medizinische Universität Wien, Wien, Austria
| | - Alina Sturdza
- Universitätsklinikum AKH-Wien, Klinik für Radioonkologie, Wien, Austria
| | - Edward Wight
- Universitätsspital Basel, Frauenklinik, Basel, Switzerland
| | - Kristina Loessl
- Universitätsklinik Bern, Klinik für Radio-Onkologie, Bern, Switzerland
| | - Michael Golatta
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Germany
| | - Volker Hagen
- St. Johannes Hospital Dortmund, Klinik für Innere Medizin II, Dortmund, Germany
| | - Timm Dauelsberg
- Universitätsklinikum Freiburg, Klinik für Onkologische Rehabilitation, Freiburg, Germany
| | - Ingo Diel
- Praxisklinik am Rosengarten, Mannheim, Germany
| | | | - Eberhard Merz
- Zentrum für Ultraschalldiagnostik und Pränatalmedizin Frankfurt, Frankfurt am Main, Germany
| | - Dirk Vordermark
- Universitätsklinikum Halle (Saale), Klinik für Strahlentherapie, Halle (Saale), Germany
| | - Katja Lindel
- Städtisches Klinikum Karlsruhe, Klinik für Radioonkologie und Strahlentherapie, Karlsruhe, Germany
| | | | | | - Ralph Lellé
- Universitätsklinikum Münster, Frauenklinik, Münster, Germany
| | - Klaus Neis
- Frauenärzte am Staden, Saarbrücken, Germany
| | | | | | | | | | | | | | | | | | | | - Ludwig Kiesel
- Universitätsklinikum Münster, Frauenklinik, Münster, Germany
| | - Michael Reinhardt
- Pius Hospital Oldenburg, Klinik für Nuklearmedizin, Oldenburg, Germany
| | - Michael Kreißl
- Universitätsklinikum Magdeburg, Klinik für Radiologie und Nuklearmedizin, Magdeburg, Germany
| | - Marianne Kloke
- Kliniken Essen-Mitte, Klinik für Palliativmedizin, Essen, Germany
| | | | - Regina Wiedemann
- Fliedner Fachhochschule Düsseldorf, Pflegewissenschaft, Düsseldorf, Germany
| | - Simone Marnitz
- Universitätsklinikum Köln, Klinik für Radioonkologie, Cyberknife- und Strahlentherapie, Köln, Germany
| | - Anne Letsch
- Universitätsklinikum Schleswig-Holstein, Klinik für Innere Medizin II, Kiel, Germany
| | - Isabella Zraik
- Kliniken Essen-Mitte, Klinik für Urologie, Essen, Germany
| | | | | | - Céline Alt
- Wolfgarten Radiologie Bonn, Bonn, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, Technische Universität Dresden and National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
| | - Peter Hillemanns
- Medizinische Hochschule Hannover, Frauenklinik, Hannover, Germany
| | - Kerstin Paradies
- Konferenz onkologischer Kranken- und Kinderkrankenpflege (KOK), Germany
| | | | | | - Ulla Henscher
- Hochtaunus Kliniken, Frauenklinik, Bad Homburg, Germany
| | - Reina Tholen
- Deutscher Verband für Physiotherapie (ZVK) e. V., Germany
| | | | - Matthias W. Beckmann
- Universitätsklinikum Erlangen, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
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Morse CI, Higham K, Bostock EL, Jacques MF. Urinary incontinence in men with Duchenne and Becker muscular dystrophy. PLoS One 2020; 15:e0233527. [PMID: 32469921 PMCID: PMC7259643 DOI: 10.1371/journal.pone.0233527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/06/2020] [Indexed: 01/30/2023] Open
Abstract
The prevalence of urinary incontinence in Duchenne and Becker muscular dystrophy (D/BMD) is reported to be between 15–29%, this however includes ages across the lifespan, and with no description of impact on daily life. The present study, aimed to determine the prevalence of urinary incontinence in men with D/BMD, and to identify which aspects of daily life were impacted by urinary incontinence. Twenty-seven adult males, 11 with BMD and 16 with DMD, aged 20–57 years, volunteered to participate in this study. Six questionnaires were completed to provide an overview of participant mobility, urinary incontinence and distress caused by urinary incontinence. These included: The Barthel index of disability, International Consultation on Incontinence Questionnaire—Urinary Incontinence Form, Incontinence Impact Questionnaire Short Form, The Urogenital Distress Inventory, and the Brooke and Vignos scale. The prevalence of urinary incontinence within the present men with D/BMD was 37%, assessed as urine leakage of once a week or more. Those with urinary incontinence all reported only a “small amount” of urine leakage, with urinary incontinence frequency of once a week in 5/10 participants, two or three times a week in 2/10 participants, and once a day in 3/10 participants. Of those with urinary incontinence 8/10 experienced some impact on their daily life from urine leakage including travel (4/10), social aspects (5/10), and emotional aspects (8/10). All participants with urinary incontinence were bothered by some aspect, including urine leakage (9/10), and frequent urination (4/10). In conclusion, 37% of the present men with D/BMD experience urinary incontinence on a weekly or daily basis and negatively impacted aspects of life related to travel, social and emotional wellbeing. Urine leakage, and frequent urination should be considered a meaningful problem by care providers, and discussed openly with those with D/BMD.
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Affiliation(s)
- Christopher I. Morse
- Department of Sport and Exercise Sciences, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
- * E-mail:
| | - Katie Higham
- Department of Sport and Exercise Sciences, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Emma L. Bostock
- Musculoskeletal Physiology Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Matthew F. Jacques
- School of Life Sciences, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
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García-Sánchez E, Ávila-Gandía V, López-Román J, Martínez-Rodríguez A, Rubio-Arias JÁ. What Pelvic Floor Muscle Training Load is Optimal in Minimizing Urine Loss in Women with Stress Urinary Incontinence? A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4358. [PMID: 31717291 PMCID: PMC6887794 DOI: 10.3390/ijerph16224358] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/02/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022]
Abstract
Pelvic floor muscle training is commonly used for urine loss. However, research studies have not determined which training load is the most effective for women with stress urinary incontinence (SUI). Moreover, none of the previous reviews or studies have described the total effectiveness of pelvic floor muscle training (PFMT) with an objective test such as the pad test. The objectives were to analyze the effectiveness of pelvic floor muscle training in women with SUI and to determine which training load produces the greatest adaptations for decreasing urine loss. The search was conducted in three databases (PubMed, Web of Science and Cochrane), for randomized controlled trials (RCTs) that evaluated the effects of PFMT. Studies were included if they met the following criteria: participants were women; were older than 18; had SUI; were treated with PFMT; and the assessments of the effects were measured with a pad test. Finally, 10 articles (293 women) analyzed the pad test in women with SUI who performed PFMT. The meta-analysis showed that PFMT, independent of the protocol used in the study, resulted in decreased urine loss in women suffering from SUI. However, for large effects, the program should last 6-12 weeks, with >3 sessions/week and a length of session <45 min.
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Affiliation(s)
- Esther García-Sánchez
- Department of Exercise Physiology, Universidad Católica de Murcia, 30107 Murcia, Spain; (E.G.-S.); (V.Á.-G.); (J.L.-R.)
- Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, 30003 Murcia, Spain
- Health Sciences PhD program, Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Vicente Ávila-Gandía
- Department of Exercise Physiology, Universidad Católica de Murcia, 30107 Murcia, Spain; (E.G.-S.); (V.Á.-G.); (J.L.-R.)
| | - Javier López-Román
- Department of Exercise Physiology, Universidad Católica de Murcia, 30107 Murcia, Spain; (E.G.-S.); (V.Á.-G.); (J.L.-R.)
- Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, 30003 Murcia, Spain
| | - Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Science, Faculty of Science, Alicante University, 03690 Alicante, Spain;
| | - Jacobo Á. Rubio-Arias
- Faculty of Sports, UCAM, Universidad Católica de Murcia, 30107 Murcia, Spain
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Virtuoso JF, Menezes EC, Mazo GZ. Effect of Weight Training with Pelvic Floor Muscle Training in Elderly Women with Urinary Incontinence. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2019; 90:141-150. [PMID: 30945991 DOI: 10.1080/02701367.2019.1571674] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 01/03/2019] [Indexed: 05/27/2023]
Abstract
PURPOSE To determine if weight training combined with pelvic floor muscle training is more efficient than pelvic floor muscle training alone for the treatment of urinary incontinence (UI) symptoms in elderly women. METHOD This was a two-arm, parallel, randomized controlled trial. Twenty-six women with stress UI participated in the study. The intervention group (IG) underwent training with moderate intensity weights combined with pelvic floor muscle training, whereas the control group (CG) only underwent pelvic floor muscle training. Intervention occurred twice a week over 12 weeks. The International Consultation on Incontinence Questionnaire-Short Form was used as the main measure. Scores of zero defined the absence of symptoms. The absence of symptoms was evaluated at 4 weeks, 12 weeks, and 1 month after the end of treatment. Moreover, activities related to UI and the use and change of daily protection were investigated. RESULTS The rate of absence of symptoms was significantly higher in IG after 4 weeks (58.3%) compared to CG (14.8%). The relative risk was 4.1 (95% confidence interval [CI] [1.08, 16.06]). Although no intention-to-treat analysis was performed, there was no difference in the evaluations after the interventions. CONCLUSION Compared to pelvic floor muscle training alone, the combination of weight training and pelvic floor muscle training provided earlier improvement of UI in elderly women.
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Efficacy and Safety of Incontinence Surgery According to the Surgeon's Specialty and Performance of a Preoperative Urodynamic Study. Int Neurourol J 2018; 22:305-312. [PMID: 30599502 PMCID: PMC6312978 DOI: 10.5213/inj.1836104.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/21/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose The aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon’s specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset. Methods We enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon’s specialty and whether a preoperative UDS was performed. Results The hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103–1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon’s specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122–1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed. Conclusions This population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon’s specialty and that the reoperation rate according to the surgeon’s specialty varied based on whether a preoperative UDS was performed.
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Davenport MH, Nagpal TS, Mottola MF, Skow RJ, Riske L, Poitras VJ, Jaramillo Garcia A, Gray CE, Barrowman N, Meah VL, Sobierajski F, James M, Nuspl M, Weeks A, Marchand AA, Slater LG, Adamo KB, Davies GA, Barakat R, Ruchat SM. Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis. Br J Sports Med 2018; 52:1397-1404. [PMID: 30337466 DOI: 10.1136/bjsports-2018-099780] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To examine the relationships between prenatal physical activity and prenatal and postnatal urinary incontinence (UI). DESIGN Systematic review with random effects meta-analysis and meta-regression. DATA SOURCES Online databases were searched up to 6 January 2017. STUDY ELIGIBILITY CRITERIA Studies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ["exercise-only"] or in combination with other intervention components [e.g., dietary; "exercise + co-intervention"]), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcome (prenatal or postnatal UI). RESULTS 24 studies (n=15 982 women) were included. 'Low' to 'moderate' quality evidence revealed prenatal pelvic floor muscle training (PFMT) with or without aerobic exercise decreased the odds of UI in pregnancy (15 randomised controlled trials (RCTs), n=2764 women; OR 0.50, 95% CI 0.37 to 0.68, I2=60%) and in the postpartum period (10 RCTs, n=1682 women; OR 0.63, 95% CI 0.51, 0.79, I2=0%). When we analysed the data by whether women were continent or incontinent prior to the intervention, exercise was beneficial at preventing the development of UI in women with continence, but not effective in treating UI in women with incontinence. There was 'low' quality evidence that prenatal exercise had a moderate effect in the reduction of UI symptom severity during (five RCTs, standard mean difference (SMD) -0.54, 95% CI -0.88 to -0.20, I2=64%) and following pregnancy (three RCTs, 'moderate' quality evidence; SMD -0.54, 95% CI -0.87 to -0.22, I2=24%). CONCLUSION Prenatal exercise including PFMT reduced the odds and symptom severity of prenatal and postnatal UI. This was the case for women who were continent before the intervention. Among women who were incontinent during pregnancy, exercise training was not therapeutic.
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Affiliation(s)
- Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Taniya S Nagpal
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Rachel J Skow
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Laurel Riske
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Casey E Gray
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Nick Barrowman
- Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Victoria L Meah
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Frances Sobierajski
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Marina James
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Megan Nuspl
- Alberta Research Centre for Health Evidence, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ashley Weeks
- School of Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andree-Anne Marchand
- Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada
| | - Linda G Slater
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | - Kristi B Adamo
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Gregory A Davies
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Technical University of Madrid, Madrid, Spain
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada
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Ostrovsky DA. Electroacupuncture Reduces Incontinence Episodes in Women With Stress Urinary Incontinence. Explore (NY) 2018; 14:96-98. [DOI: 10.1016/j.explore.2017.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Quality-of-Life Outcomes Following Surface Electromyography Biofeedback as an Adjunct to Pelvic Floor Muscle Training for Urinary Incontinence: A Case Report. ACTA ACUST UNITED AC 2017; 41:73-82. [PMID: 29375282 DOI: 10.1097/jwh.0000000000000065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background A non-invasive treatment for urinary incontinence (UI) is surface electromyography (sEMG) biofeedback with pelvic floor muscle (PFM) training. A lack of consensus and evidence exists on the Quality of Life (QoL) outcomes following sEMG biofeedback using surface electrodes at the perineum compared to the more invasive intravaginal probe. This case report examines QoL using sEMG biofeedback at the perineum with PFM training for UI. Study Design Single subject case report. Case Description The patient was a 61-year-old woman diagnosed with UI. Her chief complaints were nocturia, urine leakage with urgency, and urine leakage with sneezing and coughing. Physical therapy (PT) treatment focused on behavioral modification, PFM strengthening with and without sEMG biofeedback, and therapeutic exercises with PFM contractions. Outcomes At four weeks from baseline, the patient's PFM strength increased from 2/5 to 4/5 based on the Modified Laycock Scale. Her PFM endurance contraction improved from two seconds to ten seconds. The International Continence Impact Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) score decreased from 6 to 0, the Incontinence Impact Questionnaire - Short Form (IIQ-7) score decreased from 14.3 to 0, and the 3 Incontinence Questions (3IQ) responses did not change. Discussion The outcomes from this case report demonstrate a brief course of PT treatment consisting of perineal sEMG biofeedback in conjunction with PFM training demonstrated clinically meaningful improvements in incontinence-related QoL, in addition to improvements in motor function in a woman with mixed UI and nocturia.
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Multimodal Physical Therapy Intervention for Urinary Incontinence and Overactive Bladder in the Older Adult. TOPICS IN GERIATRIC REHABILITATION 2016. [DOI: 10.1097/tgr.0000000000000121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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11
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Bladder Control Problems in Elders. TOPICS IN GERIATRIC REHABILITATION 2016. [DOI: 10.1097/tgr.0000000000000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Effectiveness of Pelvic Floor Muscle Training for Urinary Incontinence. J Wound Ostomy Continence Nurs 2016; 43:291-300. [DOI: 10.1097/won.0000000000000227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jung HB, Kim HJ, Cho ST. A current perspective on geriatric lower urinary tract dysfunction. Korean J Urol 2015; 56:266-75. [PMID: 25874039 PMCID: PMC4392025 DOI: 10.4111/kju.2015.56.4.266] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 02/09/2015] [Indexed: 01/17/2023] Open
Abstract
Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction.
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Affiliation(s)
- Ha Bum Jung
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyung Jee Kim
- Department of Urology, Dankook University College of Medicine, Cheonan, Korea
| | - Sung Tae Cho
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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Visser E, de Bock GH, Messelink EJ, Schram AJ, Kollen BJ, la Bastide-van Gemert S, van den Heuvel ER, Berger MY, Dekker JH. Active encouragement of older women with urinary incontinence in primary care to undergo diagnosis and treatment: a matched-pair cluster randomized controlled trial. Maturitas 2014; 80:212-9. [PMID: 25534171 DOI: 10.1016/j.maturitas.2014.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The URINO trial investigated the effect of offering treatment to older women with urinary incontinence in the general population, who had not sought help on their own initiative. STUDY DESIGN In a cluster randomized trial, 14 general practitioners were matched into pairs and randomly allocated to an intervention or a control group. Women aged ≥ 55 years registered in the participating practices were asked about urinary incontinence via a postal questionnaire. Patients in the intervention group were assessed and treated whereas patients in the control group received standard care. MAIN OUTCOME MEASURES Primary outcome was improvement (yes or no) of the severity of symptoms at 12-month follow-up measured with the Incontinence Severity Index. Secondary outcomes were the number of incontinence episodes per day and quality of life. The primary analysis was on an intention-to-treat basis with multiple imputation of missing data. A logistic regression model with correction for cluster randomization was fitted to estimate odds ratios (ORs). RESULTS At 12 months, the severity of symptoms had improved in more patients in the intervention group (n166) than in the controls (n184) (OR 1.9; 95% CI 1.1-3.3). Also, the number of patients with fewer episodes of incontinence had increased (OR 2.5; 95% CI 1.5-4.1). No between-group differences in changes in quality of life were apparent (p0.14). CONCLUSIONS It is recommended to encourage women in the general population aged ≥ 55 years with urinary incontinence to undergo diagnosis and treatment.
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Affiliation(s)
- Els Visser
- Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Embert J Messelink
- Department of Urology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Aaltje J Schram
- Department of Gynaecology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Boudewijn J Kollen
- Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
| | - Sacha la Bastide-van Gemert
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Edwin R van den Heuvel
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Marjolein Y Berger
- Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
| | - Janny H Dekker
- Department of General Practice, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
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Kargar Jahromi M, Talebizadeh M, Mirzaei M. The effect of pelvic muscle exercises on urinary incontinency and self-esteem of elderly females with stress urinary incontinency, 2013. Glob J Health Sci 2014; 7:71-79. [PMID: 25716389 PMCID: PMC4796457 DOI: 10.5539/gjhs.v7n2p71] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 08/03/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction: Millions of women are afflicted with stress urinary incontinence. Urinary incontinence is mentioned as one of the geriatric syndromes, together with pressure ulcers, functional decline, falls, and low self-esteem. The aim of the present study was to determine the effect of pelvic muscle exercises on urinary incontinency and self- esteem of elderly females with stress urinary incontinency in Shiraz, Iran, 2013. Material and Method: In this interventional study, 50 old females aged 60-74 years were chosen among the members of Jahandidegan center, and they were asked to sign the informed consent form and complete the demographic questionnaire. Then, Quid questionnaire was used for choosing the type of incontinence in the elderly females. Next, the participants completed the ICIQ and self-esteem questionnaires. Then, they were randomly assigned to case and control groups. Each participant took part in 8 training classes. Finally, the subjects filled the ICIQ and self-esteem questionnaires before and 2 months after the intervention. Result: The results is shown that after the intervention, ICIQ score has a significant difference between the two groups (P=0.001). Also, after the treatment, self-esteem average scores of studied unit indicated a significant statistical difference in experimental group. In other words, the training sessions improved the score of self-esteem in the experimental group (P<0.001) versus control group (P=0.08). Conclusion: Pelvic muscle exercises were an empowerment mechanism for incontinent women in improving their quality of life and self-esteem, so recommended that such these exercising programs be used in elderly health care centers as a factor to improve health promotion of elderlies ’that are suffering from urinary incontinence.
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Satisfaction in patients undergoing concurrent pelvic floor surgery for stress urinary incontinence and pelvic organ prolapse. Female Pelvic Med Reconstr Surg 2014; 20:23-6. [PMID: 24368484 DOI: 10.1097/spv.0000000000000051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Simultaneous repair of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) is common. In these cases, determinants of patient satisfaction are complicated given that surgical success may be achieved in one component but not the other. We sought to assess satisfaction in patients undergoing multiple pelvic surgeries. METHODS We performed a review of 89 women undergoing concomitant POP repair and midurethral sling (MUS) placement. Focus was placed on patient-reported satisfaction rates. Validated measures were used to evaluate outcomes after MUS [International Consultation on Incontinence Questionnaire (ICIQ)-Female Lower Urinary Tract Symptoms, SUI item; pad use] and POP repair (ICIQ-Vaginal Symptoms; POPQ stage). RESULTS At 1-year evaluation, 78 (88%) women reported satisfaction. Assessment identified combined cure of both POP/SUI in 64 (72%) patients, in contrast to failure of MUS, POP repair, and both repairs in 15 (17%) patients, 9 (10%) patients, and 1 (1%) patient, respectively. Subset analysis revealed dissatisfaction in 5% (3/64) of patients achieving complete cure of both SUI and POP. In contrast, 40% (6/15) were dissatisfied if there was failure to cure SUI, 22% (2/9) if failure to cure POP, and the patient with failure of both was not dissatisfied. The ICIQ-Vaginal Symptoms domain score for vaginal bulge was the only assessed outcome demonstrating a statistical relationship with patient-reported satisfaction. CONCLUSIONS Among women achieving cure of both SUI and POP via concurrent surgical repair, 95% reported satisfaction. Interestingly, a variety of outcomes measures fail to correlate with satisfaction. Further, in patients with complete cure of concurrent pelvic surgeries, a percentage still report dissatisfaction, highlighting the complicated nature of patient satisfaction.
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Comparing Resisted Hip Rotation With Pelvic Floor Muscle Training in Women With Stress Urinary Incontinence. ACTA ACUST UNITED AC 2014. [DOI: 10.1097/jwh.0000000000000008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Teel S. Identifying urinary incontinence in the home setting. Part 2: treatment and related care of incontinence. HOME HEALTHCARE NURSE 2013; 31:378-388. [PMID: 23817474 DOI: 10.1097/nhh.0b013e3182976091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This is Part 2 of a 2-part series for treating urinary incontinence in the home care setting. Part 1 addresses the assessment, diagnosis, and strategies in the treatment of urinary incontinence; including a case study.
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Affiliation(s)
- Sarah Teel
- Peak Performance Sports and Physical Therapy, 2009 Neuse Blvd., New Bern, NC 28560, USA.
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Franke H, Hoesele K. Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women. J Bodyw Mov Ther 2013; 17:11-8. [DOI: 10.1016/j.jbmt.2012.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 04/12/2012] [Accepted: 04/29/2012] [Indexed: 11/29/2022]
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Farage MA, Miller KW, Ledger W. Confronting the challenges of postmenopausal urogenital health. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/ahe.10.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The global population is aging, especially in Western industrialized nations. In the USA, 38% of adults are over the age of 45 and 13% of adults are over the age of 65 years. Moreover, postmenopausal women now comprise 60% of adults aged over 65 years of age, a proportion that will rise as the population ages. This article reviews some of the more common urogenital health issues among older women. Changes to urogenital morphology and physiology are discussed, highlighting the impact on tissue atrophy, sexuality, prevalence of certain vulvar dermatoses, susceptibility to infection and urinary continence. We review treatment approaches, challenge some of the current paradigms and discuss the need for future research.
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Affiliation(s)
| | - Kenneth W Miller
- Feminine & Adult Care, The Procter & Gamble Company, Cincinnati, OH, USA
| | - William Ledger
- The New York Presbyterian Hospital, Weill Medical College of Cornell University, NY, USA
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Liebergall-Wischnitzer M, Hochner-Celnikier D, Lavy Y, Manor O, Shveiky D, Paltiel O. Randomized Trial of Circular Muscle Versus Pelvic Floor Training for Stress Urinary Incontinence in Women. J Womens Health (Larchmt) 2009; 18:377-85. [DOI: 10.1089/jwh.2008.0950] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Y. Lavy
- Obstetrics and Gynecology, Hadassah/Hebrew University, Jerusalem, Israel
| | - O. Manor
- Braun School of Public Health and Community Medicine, Hadassah/Hebrew University, Jerusalem, Israel
| | - D. Shveiky
- Obstetrics and Gynecology, Hadassah/Hebrew University, Jerusalem, Israel
| | - O. Paltiel
- Braun School of Public Health and Community Medicine, Hadassah/Hebrew University, Jerusalem, Israel
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Use of transabdominal ultrasound imaging in retraining the pelvic-floor muscles of a woman postpartum. Phys Ther 2008; 88:1208-17. [PMID: 18772276 DOI: 10.2522/ptj.20070330] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Postpartum stress urinary incontinence (SUI) often compromises a woman's ability to participate in normal daily routines or physical activities. Pelvic-floor muscle (PFM) training has been shown to be effective in improving urinary incontinence. Transabdominal ultrasound (TAUS) imaging is a new, noninvasive method for assessing the function of the PFMs. This case report describes the use of TAUS imaging in the strengthening of a patient's PFMs. CASE DESCRIPTION The patient was a 29-year-old woman experiencing SUI with high-impact activities following a history of 2 vaginal deliveries, 1 resulting in a grade III perineal laceration. Intervention included PFM training with the use of TAUS imaging. A 1-year follow-up examination was performed to assess the long-term functional outcomes experienced by the patient. The patient's ability to maintain a PFM contraction during motor tasks was documented throughout the course of treatment to demonstrate her gain in PFM control. OUTCOMES The patient gained strength in her PFMs, enabling her to maintain a PFM contraction during various motor tasks. She was able to return to a running program with no SUI symptoms. Her satisfaction level was high at 1 year. DISCUSSION The use of TAUS imaging was a helpful assessment and biofeedback tool for re-education and rehabilitation of the PFMs for this patient.
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Outcomes Following Sling Surgery: Importance of Definition of Success. J Urol 2008; 180:998-1002. [DOI: 10.1016/j.juro.2008.05.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Indexed: 11/21/2022]
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