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Shang X, Fu Y, Jin X, Wang C, Wang P, Guo P, Wang Y, Yan S. Association of overweight, obesity and risk of urinary incontinence in middle-aged and older women: a meta epidemiology study. Front Endocrinol (Lausanne) 2023; 14:1220551. [PMID: 37886637 PMCID: PMC10598345 DOI: 10.3389/fendo.2023.1220551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Aims The aim of this meta-analysis is to evaluate the potential correlation between obesity and overweight, and the vulnerability to urinary incontinence (UI) in women aged middle-aged and above. Methods We searched PubMed, Cochrane Library, and Embase for observational studies published between the inception of the databases and April 25, 2023. A fixed-effects model was used when the P>0.1 and the I2 ≤ 50%. In cases where I2 ≥ 50% (indicating significant heterogeneity), a random-effects model was applied. For the purpose of evaluating publication bias, a funnel plot and Egger's test were used. Stata 14.0 was used for all statistical analyses. Findings This meta-analysis includes 16 observational studies, covering29,618 individuals. The pooled analysis shows that being overweight(25 kg/m2≤BMI<30kg/m2) in middle-aged and elderly women is more likely to develop UI (OR=1.27; 95% CI: 1.17-1.37; I2 = 51.8%, P=0.013). Middle-aged and elderly women with obesity(30 kg/m2≤BMI<35 kg/m2) are significantly more likely to develop UI (OR=1.60; 95% CI: 1.42-1.81; I2 = 71.8%, P=0.000). In addition, the results indicated a higher probability of UI in middle-aged and older women with obesity class II (BMI≥35 kg/m2) (OR=1.85; 95% CI: 1.59-2.16; I2 = 48.1%, P=0.103). In subgroup analysis, there is no direct relationship between the obesity in middle-aged and elderly women and an increased risk of stress urinary incontinence (SUI) (OR=1.31; 95% CI: 0.99-1.74; I2 = 63.7%, P=0.011). In middle-aged and elderly women with obesity are more likely to develop urgent urinary incontinence (UUI) (OR=2.11; 95% CI: 1.54-2.89; I2 = 80.2%, P=0.000). Conclusion In this meta-analysis, overweight and obesity are associated with an increased risk of UI in middle-aged and elderly women. Obesity and overweight are independent risk factors for UI, as demonstrated by this study. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023421986.
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Affiliation(s)
- Xin Shang
- First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yu Fu
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaoqin Jin
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Chenxiao Wang
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ping Wang
- First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Panpan Guo
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ying Wang
- Department of Geriatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuxun Yan
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Cox JM, Sánchez-Polán M, Mota P, Barakat R, Nagpal TS. A scoping review exploring stigma associated with postpartum urinary incontinence. Int Urogynecol J 2023; 34:1997-2005. [PMID: 37060372 DOI: 10.1007/s00192-023-05526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/19/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Postpartum urinary incontinence (UI) is prevalent, yet health-seeking behaviours for prevention and treatment are markedly low. Health-related stigma refers to conditions that may be socially devalued and considered deviating from "expected norms" and is a barrier to equitable health care. It may be plausible that stigma is associated with postpartum UI and leads to avoiding health-seeking behaviours, which this scoping review sought to examine and summarize. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews was followed. The following keywords were used to develop a search strategy: Postpartum, Urinary Incontinence and Stigma. The search was carried out on PubMed, PsycInfo, Scopus, CINAHL, Web of Science and ProQuest Dissertation and Theses Global. All study designs (clinical trials, observational studies, qualitative studies) were eligible for inclusion. Data were extracted and mapped to identify causal factors of postpartum UI stigma and implications for outcomes and behaviours. RESULTS Twelve studies were included. Most studies utilized questionnaires assessing constructs related to quality of life that also captured potential stigma, or interviews. Sources of postpartum UI stigma included community values surrounding UI and self-stigma, whereby participants directed stereotypes associated with urinary leakage towards themselves. Implications of postpartum UI stigma included negative mental emotions such as shame and embarrassment, which led to avoiding situations where they needed to disclose symptoms, including in health care environments. CONCLUSIONS Future research requires a purposeful assessment of postpartum UI stigma to learn from lived experience how to mitigate stigma and improve quality of care.
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Affiliation(s)
- Jordyn M Cox
- Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Patrícia Mota
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisboa, Portugal
- Univ Lisboa, Fac. Motricidade Humana, CIPER, LBMF, 1499-002, Lisboa, Portugal
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Taniya S Nagpal
- Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada.
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Perlow A, Joyce CJ, Bennis S, Mueller ER, Fitzgerald CM. Toileting Behaviors and Lower Urinary Tract Symptoms Among Female Physicians and Medical Students. Urogynecology (Phila) 2023; 29:678-686. [PMID: 37490707 DOI: 10.1097/spv.0000000000001333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
IMPORTANCE A greater understanding of the relationship between toileting behaviors and lower urinary tract symptoms (LUTS) has the potential to generate awareness and improvement of overall bladder health in specific populations. OBJECTIVE The aim of the study was to investigate the prevalence and correlation between maladaptive toileting behaviors and LUTS among female medical trainees and attending physicians. STUDY DESIGN We surveyed female medical students, residents, fellows, and attending physicians at an academic hospital, capturing demographics, voiding behaviors, LUTS, and fluid intake using the Bristol Female Lower Urinary Tract Symptoms Short Form, the Toileting Behavior-Women's Elimination Behaviors, and the Beverage Intake Questionnaire. RESULTS A total of 146 medical students and physicians participated in the study. Eighty-three percent reported at least 1 LUTS, most commonly storage symptoms, particularly incontinence (30%, stress urinary incontinence > urgency urinary incontinence). Altered toileting behaviors included "worrying about public toilet cleanliness" (82%), "emptying the bladder before leaving home" (81%), "delaying emptying their bladder when busy" (87%), and "waiting until they could not hold urine any longer" (57%). Total Toileting Behavior-Women's Elimination Behaviors scores were significantly associated with total Bristol Female Lower Urinary Tract Symptoms scores (β = 0.27; 95% CI, 0.12-0.42; P<0.01). This remained true after adjusting for total fluid intake in medical students (β = 0.41, P<0.01) and resident physicians (β = 0.28, P = 0.03) but was not correlated among attending physicians (β = -0.07, P = 0.77). CONCLUSIONS Female physicians and medical students experience a high prevalence of LUTS. Many engage in maladaptive toileting behaviors, which highly correlate with LUTS (especially among medical students and residents) and may lead to impaired bladder health.
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Affiliation(s)
- Aaron Perlow
- From the Loyola University Stritch School of Medicine, Maywood, IL
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Szatmári É, Makai A, Prémusz V, Balla BJ, Ambrus E, Boros-Balint I, Ács P, Hock M. Hungarian Women's Health Care Seeking Behavior and Knowledge of Urinary Incontinence and Pelvic Organ Prolapse: A Cross-sectional Study. Urogynecology (Phila) 2023; 29:02273501-990000000-00101. [PMID: 37195642 PMCID: PMC10637302 DOI: 10.1097/spv.0000000000001367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
IMPORTANCE Adequate knowledge about pelvic floor disorders could lead to increased health care-seeking behavior, improved symptoms, and quality of life. OBJECTIVES The aims of the present study were to evaluate Hungarian women's knowledge about pelvic floor disorders and to assess health care-seeking behavior. STUDY DESIGN We conducted a cross-sectional survey from March to October 2022 using self-administered questionnaires. The Prolapse and Incontinence Knowledge Questionnaire was used to assess Hungarian women's knowledge about pelvic floor disorders. The International Consultation of Incontinence Questionnaire-Short Form was used to gather information about the symptoms of urinary incontinence. RESULTS Five hundred ninety-six women were included in the study. Urinary incontinence knowledge was deemed proficient in 27.7% of participants, while pelvic organ prolapse knowledge was deemed proficient in 40.4% of participants. Greater urinary incontinence knowledge was significantly associated (P < 0.001) with higher level of education (P = 0.016), work in a medical field (P < 0.001), and ever practiced pelvic floor muscle training (P < 0.001), whereas greater pelvic organ prolapse knowledge was significantly associated (P < 0.001) with higher level of education (P = 0.032), work in a medical field (P < 0.001), ever practiced pelvic floor muscle training (P = 0.017), and ever had pelvic organ prolapse (P = 0.022). Of the 248 participants who reported a history of urinary incontinence, only 42 (16.93%) women sought care. Care seeking was higher among women who were more knowledgeable about urinary incontinence and among women with more severe symptoms. CONCLUSIONS Hungarian women had limited knowledge about urinary incontinence and pelvic organ prolapse. Health care seeking among women with urinary incontinence was low.
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Affiliation(s)
- Éva Szatmári
- From the Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Alexandra Makai
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Viktória Prémusz
- From the Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Béla József Balla
- Babeş-Bolyai University, Faculty of Physical Education and Sport, Cluj-Napoca, Romania
| | - Eszter Ambrus
- Harkány Thermal Rehabilitation Center, Harkány, Hungary
| | - Iuliana Boros-Balint
- Babeş-Bolyai University, Faculty of Physical Education and Sport, Cluj-Napoca, Romania
| | - Pongrác Ács
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Márta Hock
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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Shabani F, Montazeri M, Alizadeh A, Bani S, Hassanpour S, Nabighadim M, Mirghafourvand M. The relationship between urinary incontinence with sexual function and quality of life in postmenopausal women. Post Reprod Health 2023; 29:15-23. [PMID: 36749321 DOI: 10.1177/20533691231155734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Urinary incontinence has a significant impact on the psychosocial well-being of postmenopausal women. This study aimed to determine the relationship between urinary incontinence with sexual function and quality of life. METHOD It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic and obstetrics characteristics, female sexual function index (FSFI), Menopause-Specific Quality of Life (MENQOL), and Urinary Incontinence Diagnosis (UIDQ). Independent sample t-test and general linear model (GLM) were used to compare the quality of life and sexual function score between the two groups of women with and without stress, urgency, and mixed urinary incontinence. RESULTS Independent sample t-test showed a significant difference in the quality of life and sexual function between women with and without stress, urgency, and mixed urinary incontinence (p < 0.05). Based on the GLM with adjusting the socio-demographic and obstetrics characteristics, women without stress incontinence reported a lower mean score of MENQOL (B = - 23.38; 95% CI = -30.1 to -16.6; p < 0.001) and a higher mean score of sexual function (B = 4.5; 95% CI = 2.1-7.0; p < 0.001) compared to women with stress incontinence; a lower MENQOL score and a higher sexual function score indicate better condition. However, there was no significant relationship between urgency and mixed incontinence with quality of life and sexual function (p > 0.05). CONCLUSION As urinary incontinence remarkably affects sexual function and quality of life of postmenopausal women, health care providers should consider better solutions for this issue in their work program.
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Affiliation(s)
- Fatemeh Shabani
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Alizadeh
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soheila Bani
- Physical Medicine and Rehabilitation Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Hassanpour
- Women's Reproductive Health Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsan Nabighadim
- Department of Medicine, Faculty of Medicine, 48413Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
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Reddy D, Zulfeen M, Pandey D. Stress incontinence combined score (SICS): A novel combined grading system to assess the severity of stress urinary incontinence in women. Eur J Obstet Gynecol Reprod Biol 2022; 278:57-65. [PMID: 36115261 DOI: 10.1016/j.ejogrb.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Natural history of urinary incontinence (UI) in women is a less understood domain. Stratifying severity of stress urinary incontinence (SUI) can be an important tool to understand the natural history, prognosticate the disease and plan optimal management. Present study was aimed to test a novel score (Stress Incontinence Combined score: SICS) with the currently popular tools International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and Incontinence Symptom Index (ISI) scores. MATERIAL AND METHODS This was a prospective study conducted at a university teaching hospital, over a period of 2 years. After screening women for SUI, SICS was administered. The novel SICS score was then compared with ICIQ-UI SF and ISI. RESULTS A total of 1750 women, attending various OPDs in a tertiary care hospital, were screened for urinary incontinence. The prevalence of UI and SUI was 26.6% and 12.8% respectively. The agreement between ISI and SICS was 81.7%, while the ICIQ- UI SF agreed with the SICS in 80.8% of the cases. AUROC analysis done showed that a score of 10 or more on the SICS (total score 16) could diagnose high-grade SUI with a sensitivity of 97%, specificity of 96% (Reference: ISI), and a sensitivity of 100%, and specificity of 93% (Reference: ICIQ- UI SF) CONCLUSION: SICS is the first of its kind tool, developed to specifically grade the severity of SUI, while incorporating both subjective and objective measures, with excellent reliability and reproducibility.
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Affiliation(s)
- Deepa Reddy
- KMC Manipal, Manipal Academy of Higher Education, Manipal (MAHE), India
| | | | - Deeksha Pandey
- KMC Manipal, Manipal Academy of Higher Education, Manipal (MAHE), India.
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Yang C, Feng Z, Chen Z, Xu D, Li Y, Lai K, Yi F. The risk factors for urinary incontinence in female adults with chronic cough. BMC Pulm Med 2022; 22:276. [PMID: 35850673 PMCID: PMC9295435 DOI: 10.1186/s12890-022-02069-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/07/2022] [Indexed: 12/05/2022] Open
Abstract
Background Female patients with chronic cough are more likely to suffer from urinary incontinence (UI). However, there are few data in regard of risks related with UI in female adults with chronic cough. Method We recruited female adult patients with chronic cough from the cough specialist clinic. Demographic information and clinical characteristics including age, BMI, duration of cough, severity of cough, nature and timing of cough, cough triggers, concomitant symptoms, comorbidities and UI condition were collected. The demographics and clinical features of patients with UI and those without UI were compared. Result A total of 700 female patients with the main symptom of chronic cough were included, of whom 351 (50.1%) presented with UI. As compared with patients without UI, patients with UI showed a longer mean age (years) (49.5 vs. 42.4, p < 0.001), a more severe cough symptom (median of cough Visual Analogue Scale: 65 vs. 50, p < 0.001), a higher prevalence of chronic sinusitis (17.6% vs. 8.6%, p = 0.002), and combined with a higher incidence of abdominal muscle pain due to cough (39.6% vs. 18.7%, p < 0.001).In addition, patients in UI group whose cough were more easily triggered by exercise (28.2% vs. 17.2%, p = 0.048). Multivariate logistic regression analysis indicated the above five variables were risk factors for UI in female adult patients with chronic cough. Conclusion Urinary incontinence is a common complication in female patients with chronic cough. Older age, severe cough, combing with a higher proportion of chronic sinusitis and abdominal muscle pain, a cough easily triggered by exercise are identified as risk factors for urinary incontinence. We should pay more attention to female chronic coughers with these risk factors in clinics. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-02069-w.
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Affiliation(s)
- Cunzhen Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China
| | - Zien Feng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China
| | - Zhiyin Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China
| | - Dongting Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China
| | - Yuling Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China
| | - Kefang Lai
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China.
| | - Fang Yi
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 28 middle Qiaozhong Rd, Liwan District, Guangzhou, Guangdong, People's Republic of China.
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Ansari Z, White S. Managing incontinence in low-and middle income-countries: A qualitative case study from Pakistan. PLoS One 2022; 17:e0271617. [PMID: 35839232 PMCID: PMC9286225 DOI: 10.1371/journal.pone.0271617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Incontinence is a complex health and social issue, which involves the involuntary loss of urine or faeces or both. Individuals with disabilities are particularly vulnerable to incontinence. The management of incontinence has largely been overlooked in low and middle-income settings (LMICs). This study aimed to explore the incontinence management strategies employed by disabled people with severe incontinence and their caregivers in Sindh Province, Pakistan. Methods Incontinence management was explored through in-depth interviews with people with incontinence (PWI) and their caregivers, photovoice, and a market survey and product attribute assessment. Data was analysed thematically through inductive coding and evaluated against existing disability and caregiver frameworks. Results Incontinence management affected all aspects of daily life for PWI and caregivers. Effective management of incontinence was prioritised because caregivers viewed it to be part of their familial duty and a requirement for the household to remain pure in the eyes of God. Coping strategies included strict adherence to routines, reducing food and drink intake, creative uses of locally available natural resources, and a heavy reliance on soap and water for maintaining hygiene. Products such as adult diapers were largely unavailable, costly and were not deemed suitable for regular use. There were no social or medical interventions in the region to support incontinence management. The main impacts of incontinence on the household were social isolation, stigma, role shifts within the family, the development of physical ailments among caregivers, and decreased income. Conclusion The complex health, psychological, social, economic, and cultural impacts of incontinence are exacerbated in LMICs due a lack of recognition of the condition, the absence of social or medical interventions and limited access to basic WASH infrastructure, and assistive devices or products. Appropriate solutions need to be developed in partnership with PWI and caregivers and need to be contextualised, affordable and sustainable.
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Jaffar A, Tan CE, Mohd-Sidik S, Admodisastro N, Goodyear-Smith F. Persuasive Technology in an mHealth App Designed for Pelvic Floor Muscle Training Among Women: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e28751. [PMID: 35315777 PMCID: PMC8984823 DOI: 10.2196/28751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/03/2021] [Accepted: 02/02/2022] [Indexed: 02/06/2023] Open
Abstract
Background Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is potentially effective for delivering PFMT to pregnant women. Persuasive technology in the development of such mobile apps may facilitate behavior change by improving adherence to the exercises. The Capability, Opportunity, and Motivation–Behavior (COM-B) model is potentially useful in selecting the appropriate interventions to be incorporated into the apps. Objective This review of mHealth apps for PFMT aims to describe the principles of persuasion used for each app and to propose mHealth app design features based on the COM-B model. Methods A systematic literature search was conducted to answer three main research questions: what are the available mHealth apps for PFMT in the published literature, what persuasive strategies were used in their studies how were they mapped to the COM-B model, and how effective were the selected persuasive strategies for PFMT adherence? We searched PubMed, CINAHL, Web of Science, Scopus, and local Malaysian databases such as MyCite and MyMedR for articles reporting mHealth apps used for the delivery of PFMT. We included original articles reporting experimental and cross-sectional studies, including pilot or feasibility trials. Systematic and narrative reviews were excluded. Narrative and thematic syntheses were conducted on the eligible articles based on the research questions. The Cochrane risk of bias tool and the Risk of Bias Assessment Tool for Non-randomized Studies were used to assess study bias. Results Of the 169 records from the initial search, 10 (5.9%) articles meeting the selection criteria were included in this review. There were 8 mHealth apps designed for the delivery of PFMT. The Tät, which used 3 categories of persuasive system design, improved PFMT adherence and was cost-effective. Only 1 app, the iBall app, used all categories of persuasive system design, by including social support such as "competition" in its design. The Diário Saúde app was the only app developed using operant conditioning. All apps incorporated Tailoring and Expertise as part of their PSD strategies. Only 3 apps, the Diário Saúde, Tät, and Pen Yi Kang demonstrated improved PFMT adherence. Conclusions Persuasive technology used in mobile apps may target desired behavior change more effectively. The persuasive system design can be mapped to the COM-B model to explain its effectiveness on behaviour change outcomes.
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Affiliation(s)
- Aida Jaffar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,Primary Care Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
| | - Chai-Eng Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Novia Admodisastro
- Software Engineering & Information System Department, Faculty of Computer Science & Information Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Felicity Goodyear-Smith
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
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Abedin S, Arunachalam D. How does autonomy of women influence maternal high-risk fertility? Evidence from a nationwide cross-sectional survey in Bangladesh. Biodemography Soc Biol 2022; 67:3-15. [PMID: 34957870 DOI: 10.1080/19485565.2021.2016367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study provides evidence on the principal determinants of high-risk fertility - a level of fertility, which is measured through maternal age (less than 20 years and/or more than 34 years), a large number of children (more than 3), and short birth interval (less than 18 months) in Bangladesh. More specifically, this study explores the influences of women's autonomy in decision-making, physical mobility and economic matters on high-risk fertility. Also, the socioeconomic attributes of women are used to explain this relationship. To identify the amount of variations in high-risk fertility at different geographic units across the country, a multilevel approach is applied considering individual, community and district levels by using a large nationwide dataset (BDHS 2017-2018). The findings of the present study indicate women's autonomy in decision-making have strong significant effects on high-risk fertility; however, freedom of movement and economic autonomy do not have any significant effects. Furthermore, women's education, religion and place of residence are found to be strong determinants of high-risk fertility, which also partially mediate the relationship between high-risk fertility and decision-making autonomy. High-risk fertility also varies at district level across Bangladesh.
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Affiliation(s)
- Sumaiya Abedin
- Department of Population Science, University of Rajshahi, Rajshahi, Bangladesh
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Barnes KL, Cichowski S, Komesu YM, Jeppson PC, McGuire B, Ninivaggio CS, Dunivan GC. Home Biofeedback Versus Physical Therapy for Stress Urinary Incontinence: A Randomized Trial. Female Pelvic Med Reconstr Surg 2021; 27:587-94. [PMID: 33208658 DOI: 10.1097/SPV.0000000000000993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of the study was to assess whether home biofeedback is noninferior to supervised pelvic floor physical therapy (PFPT) for the treatment of stress urinary incontinence (SUI) in women. METHODS The study used a randomized controlled noninferiority trial to compare a home biofeedback device with PFPT. Women older than 18 years with SUI and no history of a prior incontinence surgery or PFPT were eligible. Forty-two participants were required to determine noninferiority for the primary outcome, improvement in quality of life as measured by the International Consultation on Incontinence Questionnaire Short Form. The noninferiority margin was 4 points. Secondary outcomes included sexual function, overactive bladder symptoms, and patient impression of improvement. RESULTS From June 2018 to October 2019, 54 women with SUI were recruited (27 biofeedback, 27 PFPT) and 43 (21 biofeedback, 22 PFPT) completed follow-up. The groups had comparable baseline characteristics. For the primary outcome of change in mean International Consultation on Incontinence Questionnaire-Short Form scores (where lower scores indicate less incontinence), home biofeedback was found to be noninferior to PFPT with a mean decrease from baseline of -3.95 (95% confidence interval [CI] = -2.21 to -5.70) in the home biofeedback group versus -4.73 (95% CI = -3.21 to -6.25) and -3.95 (95% CI = -2.21 to -5.70) in the PFPT group (P = 0.009). The PFPT group showed more improvement in overactive bladder symptoms, but not in incontinence severity without difference in sexual function. CONCLUSIONS Home biofeedback was noninferior to PFPT for the primary treatment of SUI in women at 3 months. These results support the use of personal biofeedback devices for the treatment of SUI.Clinical Trial Registration: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT03443687.
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Utama CS, Christiyanto M. The feasibility of fermented litter as a feed ingredient for ruminant livestock. J Adv Vet Anim Res 2021; 8:312-322. [PMID: 34395603 PMCID: PMC8280975 DOI: 10.5455/javar.2021.h517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/06/2021] [Accepted: 06/06/2021] [Indexed: 11/03/2022] Open
Abstract
Objective The feasibility of fermented litter as an alternative feed material for ruminant livestock is measured by organoleptic quality, fiber profile, heavy metal contamination, and the presence of worm eggs. This study aimed to examine the influence of broiler chicken litter fermentation with different fermentation lengths on organoleptic quality, and contents of cuprum (Cu), lead (Pb), worm eggs, fiber fractions including hemicellulose, cellulose, neutral detergent fiber (NDF), acid detergent fiber (ADF), lignin, and fermented litter fiber profile through analysis of scanning electron microscope-energy dispersive X-ray (SEM-EDX). Materials and Methods This study used a complete randomized design of a unidirectional pattern with four treatments and four repeats with long fermentation treatments of 0, 3, 6, and 9 weeks. Result The results showed a real influence (p ≤ 0.05) of fermentation length on organoleptic quality, NDF, ADF, lignin, hemicellulose, and fiber profile with SEM-EDX observations, with no presence of worm eggs and heavy metal content is still at a safe level for feed materials. Conclusion This study concluded that the processing of broiler chicken litter with 6 weeks of fermentation gave the best results on organoleptic observations, fiber profile, no presence of worm eggs, and heavy metal contamination that is safe for livestock.
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Affiliation(s)
- Cahya Setya Utama
- Faculty of Animal and Agricultural Sciences, Universitas Diponegoro, Semarang, Indonesia
| | - Marry Christiyanto
- Faculty of Animal and Agricultural Sciences, Universitas Diponegoro, Semarang, Indonesia
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Ribeiro GL, Firmiano MLV, Vasconcelos CTM, Saboia DM, de Moraes Lopes MHB, Vasconcelos Neto JA. Scale of pregnant women's assessment of knowledge, attitude and practice related to urinary incontinence. Int Urogynecol J 2021. [PMID: 34100974 DOI: 10.1007/s00192-021-04837-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is prevalent during pregnancy and negatively affects quality of life. Despite this, few women seek professional assistance during prenatal care. Assessing the knowledge, attitude and practice (KAP) of pregnant women related to UI can contribute to the development and improvement of the quality of interventions performed during this period. For this, it is essential to apply targeted and valid instruments for this population. Thus, the present study aimed to construct and validate the content of a scale to evaluate the KAP of pregnant women related to UI. METHODS Extensive literature review guided the operationalization of the instrument's initial items. Ten experts were selected for the theoretical analysis of the items, which was carried out using the Delphi technique, and the analysis of semantic adequacy proceeded from the application of the scale to 30 pregnant women. The data were analyzed using the content validity coefficient and kappa coefficient. RESULTS The proposed Scale of Pregnant Women's Assessment of Knowledge, Attitude and Practice related to UI was approved by consensus by the experts, with a mean Cohen's kappa of 0.84 (p < 0.01), comprising 23 items. CONCLUSIONS The results of the study confirm that the presented scale can be used as a valid tool to assess the KAP of pregnant women related to UI.
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Soundararajan K, Panikkar M, Annappa M. Urinary symptoms in pregnant women in their third trimester-a cross-sectional study. Int Urogynecol J 2021; 32:1867-1873. [PMID: 34028576 DOI: 10.1007/s00192-021-04838-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/02/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary symptoms are common in pregnancy. Our study aims to understand the extent of these symptoms in a cohort of pregnant women in the third trimester and their impact on quality of life (QOL) from the women's perspective. METHODS A single-centre cross-sectional study of self-reported urinary symptoms of pregnant women in the third trimester conducted from August 2018 at the Diana Princess of Wales Hospital, Northern Lincolnshire, and Goole NHS Foundation Trust, Grimsby, UK. We used an international validated questionnaire (ICIQ-FLUTS questionnaire) (Brookes et al. Am J Obstet Gynecol. 191(1):73-82, 2004). RESULTS A total of 302 women were included in this study. Nocturia was the most common symptom, reported by 97%, affecting QOL in 80%. Urgency of micturition was the second most common, present in 83%, adversely affecting QOL in 75%. Our study showed a startling finding of bladder pain in 47% (95% CI 41.1%, 52.3%) of these women. There was a high prevalence of nocturnal enuresis in 9.9% (95% CI 7.05%, 13.8%). Straining during micturition is not a well-known symptom in pregnancy, however reported by 18.2% (95% CI 14.2%, 23.0%). CONCLUSION The high prevalences of bladder pain, nocturnal enuresis and straining in the third trimester of pregnancy are novel findings. Our study also confirms that the prevalence of all voiding, filling and incontinence symptoms in pregnancy is significantly higher than in the non-pregnant population, having a negative impact on QOL, and yet is not discussed as part of routine antenatal care.
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Affiliation(s)
| | - Mohini Panikkar
- Foundation year 1, Royal Shrewsbury Hospital, Shrewsbury, UK
| | - Manjula Annappa
- Diana Princess of Wales Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Grimsby, UK
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Zhang RQ, Xia MC, Cui F, Chen JW, Bian XD, Xie HJ, Shuang WB. Epidemiological survey of adult female stress urinary incontinence. BMC Womens Health 2021; 21:172. [PMID: 33888113 PMCID: PMC8061196 DOI: 10.1186/s12905-021-01319-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
Background The prevalence of stress urinary incontinence (SUI) in adult female in Taiyuan and what are the related risk factors are not clear. The aim of this study was to provide a basis for exploring the prevention and treatment of SUI in adult female in Taiyuan. Methods A voluntary online questionnaire was used to investigate adult female in the community and surrounding townships of Taiyuan. Most of the questionnaires refer to the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms, and adapt to the specific circumstances of the region. Data were analyzed using SPSS software (version 22.0). Results A total of 4004 eligible questionnaires were obtained. The prevalence of SUI in adult female in Taiyuan was 33.5%. Univariate analysis and multivariate logistic regression analysis showed that place of residence, smoking, body mass index, diet, number of deliveries, mode of delivery, dystocia, menopause, oral contraceptives, urinary tract infection, making the bladder empty faster by pushing down and holding urine were risk factors for adult female stress urinary incontinence in Taiyuan. Conclusion The prevalence of SUI in adult female in Taiyuan was high, and based on risk factors identified in this survey, population-level intervention strategies should be developed for the prevention and treatment of adult female SUI in Taiyuan. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01319-z.
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Affiliation(s)
- Rui Qin Zhang
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Man Cheng Xia
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Fan Cui
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jia Wei Chen
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiao Dong Bian
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Hong Jie Xie
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Wei Bing Shuang
- Department of First Clinical Medical College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China. .,Department of Urology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
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Ikeda M, Mori A. Vaginal palpation versus transabdominal ultrasound in the comprehension of pelvic floor muscle contraction after vaginal delivery: a randomised controlled trial. BMC Womens Health 2021; 21:53. [PMID: 33549078 PMCID: PMC7866465 DOI: 10.1186/s12905-021-01203-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/01/2021] [Indexed: 11/13/2022]
Abstract
Background Pelvic floor muscles support the pelvic organs and control voiding. The first choice in the repair of pelvic floor function that is damaged during pregnancy and delivery is pelvic floor muscle training, which involves repeated muscle relaxation and contraction. However, as muscle contractions cannot be visualised, it is difficult to assess whether patients understand how to contract them. Therefore, we assessed patients’ comprehension of pelvic floor muscle contraction by comparing two teaching methods, vaginal palpation and transabdominal ultrasound, following vaginal delivery. We hypothesised that vaginal palpation is better than transabdominal ultrasound in this regard. Methods This randomised controlled trial conducted in facilities in Tokyo, Japan between July 2018 and January 2019 included women aged ≥ 20 years at 4–6 weeks after vaginal delivery. The randomisation involved website-based centralised allocation. The primary outcome was a change in bladder base displacement during pelvic floor muscle contraction before and after training, which was measured using transabdominal ultrasound. Participants performed three contractions for 3 s, and the mean value was used for statistical analysis. The secondary outcome was a change in understanding the contraction before and after training, which was measured using a five-point Likert scale questionnaire. Outcomes were analysed using Welch’s t-test. Results Sixty-five participants were randomly allocated to the vaginal palpation group (n = 32) and transabdominal ultrasound group (n = 33). Baseline characteristics were similar between the groups. Changes in bladder base displacement were not significantly different between the groups (p = 0.181). Within-group analyses showed that bladder base displacement was large in both groups after the respective intervention. There were no significant differences in any of the outcomes between the two groups before and after the intervention. Conclusions Vaginal palpation and transabdominal ultrasound might be useful for comprehending pelvic floor muscle contraction after vaginal delivery. Trial registration: UMIN 000032304. Registered 18 April 2018, https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000036820.
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Affiliation(s)
- Mayumi Ikeda
- Graduate Course of Midwifery, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
| | - Akiko Mori
- Department of Nursing, Shonan Kamakura University of Medical Sciences School of Nursing, 1195-3 Yamazaki, Kamakura-shi, Kanagawa, Japan
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Abstract
OBJECTIVES Although the impact of stigma is known for women with urinary incontinence, it has not been well studied among the full spectrum of pelvic floor disorders. This study quantifies the level of stigma among women presenting for urogynecologic care and tests the hypothesis that stigma related to pelvic floor disorders results in a delay in care seeking for these problems. METHODS Women presenting for new patient visits (N = 523) in university medical center-based urogynecology clinics completed 2 anonymous questionnaires (Stigma Scale for Chronic Illnesses 8-item version and Pelvic Floor Bother Questionnaire) before their visit. The Kruskal-Wallis test was used to compare the distributions of stigma scores. Logistic regression was used to model factors associated with a delay in seeking care. Spearman correlation was used to determine whether there was an association between stigma and bother scores. RESULTS Median stigma score was significantly higher for those presenting with complaints of urine leakage (P = 0.015), accidental bowel leakage (P < 0.001), and constipation (P < 0.001) compared with women without these symptoms. Women presenting with accidental bowel leakage had the highest median stigma score, and those presenting with pelvic organ prolapse had the lowest. Total stigma score had a moderately positive correlation (r = 0.5, P < 0.001) with bother score. In a logistic regression model, higher stigma score was associated with a decreased likelihood of waiting 1 year or more to seek care (odds ratio = 0.92, 95% confidence interval = 0.86-0.98). CONCLUSIONS Pelvic floor disorders carry varying levels of stigma. Women who feel more stigmatized by pelvic floor disorders seem to seek care earlier.
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Kizmaz M, Kumtepe Kurt B, Cetin Kargin N, Doner E. Frequency and Sociodemographic Characteristics of Urinary Incontinence in Patients Over 65 Years of Age in Rural of Turkey. Euras J Fam Med 2020. [DOI: 10.33880/ejfm.2020090403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of this study was to determine the prevalence of urinary incontinence in patients over 65 years of age and to investigate its relationship with sociodemographic characteristics.
Methods: This study is a cross-sectional descriptive study performed using a face to face survey and conducted between the dates of May 1st, 2019 and August 1st, 2019 in patients aged 65 and above and who applied to Gemerek State Hospital Family Medicine Outpatient Clinics. Following a literature search, the questionnaire developed by the investigators was applied.
Results: The prevalence of UI was 28.5%. Among those, 43.8% alone had not presented to any physician with this complaint. Among the patients with UI who refrained to tell this complaint to their physicians, 76% considered this condition as a natural consequence of ageing, 17.4% were shy to get examined and 6.6% told that they had no discomfort to have a UI. Among the patients, 72.9% (n=269) were never asked by a physician or a nurse whether they had experienced UI.
Conclusions: The symptoms of urinary incontinence are generally considered as a reflection of ageing or patients are shy to express this complaint. In addition, the rate of questioning about urinary incontinence by the physicians or nurses seems to be very low.
Keywords: geriatrics, urinary incontinence, aging
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Affiliation(s)
| | | | | | - Ezgi Doner
- Department of Quality Nursing, Gemerek State Hospital
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Zhai J, Jefford E, Tyer-viola L, Joseph H, Ebert L. Comparing Differences and Similarities Between Chinese and American Women's Experiences of Stress Urinary Incontinence and Health-Seeking Behaviors During Pregnancy. Int J Childbirth 2020; 10:198-205. [DOI: 10.1891/ijcbirth-d-20-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDStress urinary incontinence (SUI) is a globally pervasive health condition that is often first experienced during pregnancy and may well continue beyond pregnancy. Yet, definitive numbers of prevalence are uncertain due to multiple factors including embarrassment. This study compares differences and similarities between Chinese and American women's experiences of SUI and health-seeking behaviors during pregnancy.METHODOLOGYThis study used a cross-sectional design to explore health-seeking behaviors of primigravida women within the first 5 days following birth in China (n = 178) and the United States of America (n = 178) who experienced SUI using the Impact of Incontinence Questionnaire short form (IIQ-SF).RESULTSWhile more Chinese women experienced SUI (p =.049), American women who experienced SUI experienced it earlier in their pregnancy (p = .003) and more frequently (p < .0001) than the Chinese women. Therefore, it can be assumed that although less American women experienced SUI, the impact was greater on their daily living activities. Irrespective of ethnicity, only 14% (n = 18) of women who described having SUI sought medical aid.CONCLUSIONThe disconnect between high incidence and low rates of seeking treatment needs future exploration to develop interventions tailored to educate women about SUI and its role during pregnancy.
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Bertuit J, Barrau M, Huet S, Rejano-Campo M. Intérêt des applications mobiles et internet dans la prise en charge de l’incontinence urinaire d’effort chez la femme. Prog Urol 2020; 30:1022-1037. [DOI: 10.1016/j.purol.2020.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/04/2020] [Accepted: 09/04/2020] [Indexed: 11/28/2022]
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Yuan Y, Qiu L, Li ZY, Zhang L, Xu T, Lang JH, Li ZA, Gong J, Liu Q, Liu XC, Wang JT, Xia ZJ, Zhu L. An epidemiology study of fecal incontinence in adult Chinese women living in urban areas. Chin Med J (Engl) 2020; 133:262-8. [PMID: 31809317 DOI: 10.1097/CM9.0000000000000552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Fecal incontinence (FI) has been shown to be a common symptom in Western countries; however, there is few researches focusing on its epidemic condition in Chinese women. We conducted this national population-based epidemiology study to estimate the prevalence and risk factors of FI among adult Chinese women living in urban regions. Methods: This is a subgroup analysis of a national population-based epidemiology study of FI. Total 28,196 adult women from urban regions of six provinces and municipalities participated in this research from 2014 to 2015. They finished the questionnaire under the direction of trained interviewers. FI was defined as accidental leakage of flatus and/or liquid or solid stool at least once in the past. The FI prevalence trend and risk factors were identified by the Cochran-Armitage test, Chi-square test, and multivariable logistic regression. Results: The prevalence of FI in adult females in urban China was 0.43% (95% confidence interval: 0.35%–0.51%). Among women with FI, 42.96%, 82.96%, and 42.22% reported having leakage of solid, liquid stool, and gas, respectively. The overall FI prevalence and the incidence rate of solid stool/liquid stool/gas leakage increased with age. The mean Wexner score was 4.0% and 12.0% FI patients reported Wexner score ≥9. Body mass index ≥24 kg/m2, pelvic organ prolapses, chronic constipation, chronic cough, alcohol consumption, physical diseases including chronic bronchitis and cancer, gynecological diseases like gynecological inflammation are risk factors for FI. Vaginal delivery was the risk factor for FI in females with labor history. Conclusions: FI was not a common symptom in adult Chinese women living in urban areas and there were some potential modifiable risk factors. Trial Registration: Chinses Clinical Trial Registry: ChiCTR-OCS-14004675; http://www.chictr.org.cn/showproj.aspx?proj=4898
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Brooks KCL, Varette K, Harvey MA, Robert M, Brison RJ, Day A, Baker K, Della Zazzera V, Sauerbrei E, McLean L. A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence. Int Urogynecol J 2020; 32:719-728. [PMID: 33237355 PMCID: PMC7902568 DOI: 10.1007/s00192-020-04583-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/20/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study was to prospectively identify aspects of baseline demographic, clinical, and pelvic morphology of women with stress urinary incontinence (SUI) that are predictive of cure with physiotherapist-supervised pelvic floor muscle training (PFMT). METHODS Women ≥18 years old with SUI were recruited from urogynecology and pelvic health physiotherapy clinics. Participants completed a 3-day bladder diary, the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF), a standardized pad test, manual assessment of pelvic floor muscle (PFM) strength and tone, and transperineal ultrasound (TPUS) assessment of their urogenital structures at rest while in a supine position and standing, and during contraction, straining, and coughing. Participants attended six physiotherapy sessions over 12 weeks and performed a home PFMT program. The assessment was repeated after the intervention; cure was defined as a dry (≤2 g) pad test. RESULTS Seventy-seven women aged 50 (±10) years completed the protocol; 38 (49%) were deemed cured. Based on univariate testing, four predictors were entered into a binary logistic regression model: ICIQ-UI-SF, PFM tone, bladder neck (BN) height in a quiet standing position, and BN height during a cough in a standing position. The model was significant (p < 0.001), accurately classifying outcome in 74% of participants. The model, validated through bootstrapping, performed moderately, with the area under the receiver operating characteristic curve = 0.80 (95% CI: 0.69-0.90; p = 0.00), and with 70% sensitivity and 75% specificity. CONCLUSIONS Women with better bladder support in a standing position and less severe symptoms were most likely to be cured with PFMT. CLINICAL TRIAL REGISTRATION #NCT01602107.
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Affiliation(s)
- Kaylee C L Brooks
- School of Rehabilitation Sciences, University of Ottawa, Rm E260C, Building E, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Kevin Varette
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Marie-Andrée Harvey
- Department of Obstetrics and Gynaecology, Kingston General Hospital, Kingston, Canada
| | - Magali Robert
- Department of Obstetrics and Gynaecology, Foothills General Hospital, Calgary, Canada
| | - Robert J Brison
- Department of Emergency Medicine, Kingston General Hospital, Kingston, Canada
| | - Andrew Day
- Department of Population Health Sciences, Queen's University, Kingston, Canada
| | - Kevin Baker
- Department of Obstetrics and Gynaecology, The Ottawa Hospital, Ottawa, Canada
| | | | - Eric Sauerbrei
- Department of Radiology, Kingston General Hospital, Kingston, Canada
| | - Linda McLean
- School of Rehabilitation Sciences, University of Ottawa, Rm E260C, Building E, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada. .,School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
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Ofori AA, Osarfo J, Agbeno EK, Azanu WK, Opare-Addo HS. Prevalence and determinants of non-fistulous urinary incontinence among Ghanaian women seeking gynaecologic care at a teaching hospital. PLoS One 2020; 15:e0237518. [PMID: 32810136 DOI: 10.1371/journal.pone.0237518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
The study assessed the prevalence and determinants of non-fistulous urinary incontinence among gynaecologic care seekers as well as its interference with everyday life activities of affected women. A cross-sectional study involving 400 women was conducted in a tertiary facility in Ghana. Urinary incontinence was assessed using the International Consultation on Incontinence Questionnaire-short form (ICIQ-SF) which has not been validated locally. The questionnaire was administered mostly in the Asante Twi language with translation done at the time of the interview. The data was analysed for proportions and associations between selected variables. The prevalence of urinary incontinence was 12%, the common types being urgency (33.3%), stress (22.9%), and mixed (20.8%). Age ≥60 years compared to 18–39 years (OR 3.66 95%CI 1.48–9.00 P = 0.005), and a history of chronic cough (OR 3.80 95% CI 1.36–10.58 P = 0.01) were associated with urinary incontinence. Women with education beyond the basic level were 72% less likely to experience urinary incontinence (OR 0.28 95%CI 0.08–0.96 P = 0.04). Urinary incontinence interferes with everyday life activities of most affected women. Non-fistulous urinary incontinence is relatively common among gynaecologic care seekers yet very few women were referred with such a diagnosis. Advocacy measures aimed at urging affected women to report the condition and educating the general population on potential causes, prevention and treatment are needed.
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Stephen K, van Woerden H, MacRury S. Assessing prevalence of urinary incontinence in Scottish fitness instructors and experience of teaching pelvic floor muscle exercises: an online survey. J Public Health (Oxf) 2020; 41:e44-e50. [PMID: 29924346 PMCID: PMC6459359 DOI: 10.1093/pubmed/fdy102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study was to assess the prevalence of urinary incontinence in fitness instructors, experience of teaching pelvic floor muscle exercises (PFME), and attitudes to incorporating such exercises into classes. Method An online survey was undertaken of fitness instructors working in Scotland based on the Urinary Incontinence Short Form (ICIQ-UI). Results The survey was at least partially completed by 106, of whom 73.6% (53/72) were female and 52.8% (38/72) were in the 35–54 years age group. Prevalence of UI was 28.2% (24/85), and severity based on ICIQ-UI scores was ‘slight’ 65.2% (15/23), or ‘moderate’ in 26.1% (6/23). Leakage of urine was associated with physical activity in 36% (9/25), of whom 31.8% (7/22) had not taken actions to reduce the impact, and 86.4% (19/22) had not sought professional advice or treatment. There was widespread willingness to incorporate PFME into classes if given appropriate training 86.1% (62/72), and 67.1% (49/73) would be happy to recommend a PFME app. Conclusion A significant proportion of fitness instructors are in need of PFME and those who perform PFME do so at a level below that which is recommended. However, many have had some training on PFME or are willing to provide this.
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Affiliation(s)
- Kate Stephen
- University of the Highlands and Islands Ringgold Standard Institution, Rural Health Improvement, Inverness, United Kingdom of Great Britain and Northern Ireland
| | - Hugo van Woerden
- University of the Highlands and Islands Ringgold Standard Institution, Rural Health & Wellbeing, Inverness, United Kingdom of Great Britain and Northern Ireland
| | - Sandra MacRury
- University of the Highlands and Islands Ringgold Standard Institution, Rural Health & Wellbeing, Inverness, United Kingdom of Great Britain and Northern Ireland
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de Araujo CC, Juliato CRT, de Andrade Marques A, Reis A, Brito LGO. Validation and cultural translation for the Brazilian Portuguese version of the Questionnaire for Urinary Incontinence Diagnosis. Int Urogynecol J 2020; 32:3157-3162. [PMID: 32488321 DOI: 10.1007/s00192-020-04344-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Short questionnaires are important for validating the clinical diagnosis of urinary incontinence (UI). We sought to validate and culturally translate the Questionnaire for Urinary Incontinence Diagnosis (QUID) for the Brazilian Portuguese language. METHODS A cross-sectional study with 457 women (330 with urinary incontinence and 127 controls) was performed in a Southeastern Brazilian outpatient clinic. Patients answered a pilot-tested, notarized, six-item questionnaire (QUID) for internal consistency as well as a control questionnaire (ICIQ-SF and ICIQ-OAB) for construct validity. In both groups, floor and ceiling effects were calculated. Within UI women, test-retest (n = 41) and responsiveness to conservative treatment (n = 74) were also analyzed. RESULTS Internal consistency (Cronbach's alpha) from the QUID was adequate between the UI (0.845-0.850) and control (0.724-0.775) groups. Mean QUID scores were statistically different between UI and control groups (p < 0.05). No ceiling or floor effects were observed in incontinent patients. Test-retest reliability after 4 weeks (intraclass correlation coefficient [ICC]: 0.780-0.814) and responsiveness (0.867-0.889) were also adequate within UI women. Construct validity was adequate at all correlations between QUID and ICIQ-SF and ICIQ-OAB (r: 0.19-0.58; p <0.05). Responsiveness was demonstrated by a statistically significant difference in questions/subscale sores after physical therapy. CONCLUSION The QUID presented adequate cultural translation, reliability, and good responsiveness to treatment in the Brazilian Portuguese language.
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Affiliation(s)
- Camila Carvalho de Araujo
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil
| | - Cassia Raquel T Juliato
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil
| | - Andrea de Andrade Marques
- Section of Physical Therapy, Women´s Hospital, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Amanda Reis
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil
| | - Luiz Gustavo O Brito
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária, Campinas, SP, 13083-881, Brazil.
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Steibliene V, Aniuliene R, Aniulis P, Raskauskiene N, Adomaitiene V. Affective Symptoms and Health-Related Quality of Life Among Women with Stress Urinary Incontinence: Cross-Sectional Study. Neuropsychiatr Dis Treat 2020; 16:535-544. [PMID: 32158213 PMCID: PMC7047965 DOI: 10.2147/ndt.s236234] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/15/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To evaluate the relationship between affective symptoms, clinical variables of uro-gynaecological history and health-related quality of life (QoL) among women with stress urinary incontinence (SUI) in comparison to healthy controls. PATIENTS AND METHODS In a cross-sectional study, 80 women 30 to 80 years of age diagnosed with SUI and 97 controls without symptoms of SUI provided sociodemographic data and answered the King's Health Questionnaire (KHQ) for assessing the QoL among individuals with urinary incontinence. Symptoms of anxiety and depression were assessed by Hospital Anxiety and Depression (HAD) scale with a threshold ≥7. A multiple regression was performed to reveal the cross-sectional predictors of affective symptoms and QoL among women with SUI. RESULTS Women with SUI had a significantly higher prevalence of symptoms of anxiety and depression than the controls (50% vs 11% and 29% vs 3.1%, respectively; both p<0.001) and worse health-related QoL on all domains of the KHQ. In multiple logistic regression models adjusted for sociodemographic and clinical variables of uro-gynaecological history, perceived symptoms of mild-to-severe depression were associated with a higher amount of leakage (OR=3.59; 1.04-12.4), older age (≥55 years old vs <55 years old) (OR=5.82; 1.47-23.1) and higher BMI (OR=1.13; 1.01-1.27). In addition, when controlled for all domains of the KHQ, perceived depressive symptoms were associated with the "emotions" domain of the KHQ (OR=1.06; 1.02-1.09). Perceived anxiety symptoms (independent of age) were related to shorter duration of SUI, low parity, absence of comorbidities and to higher scores on the "personal relationships" and "emotions" domains of the KHQ. CONCLUSION Women with SUI have a significantly poorer QoL than their counterparts without SUI. It was determined that one-half of women with SUI had anxiety symptoms, while one-third of women with SUI had depressive symptoms. In addition, this study indicated that QoL was associated with anxiety symptoms in middle-aged women and with depressive symptoms in older women, especially those with a shorter duration of SUI.
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Affiliation(s)
- Vesta Steibliene
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rosita Aniuliene
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Povilas Aniulis
- Department of Urology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nijole Raskauskiene
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Novo R, Perez-Rios M, Santiago-Pérez MI, Butler H, Malvar A, Hervada X. Prevalence and associated risk factors of urinary incontinence and dyspareunia during pregnancy and after delivery. Eur J Obstet Gynecol Reprod Biol 2020; 245:45-50. [PMID: 31851895 DOI: 10.1016/j.ejogrb.2019.10.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective of this study is to estimate the prevalence of dyspareunia and stress urinary incontinence (SUI) during pregnancy and after delivery, in addition to evaluating possible associated risk factors. STUDY DESIGN A cross-sectional study was conducted in 2016 with the target population being women who had given birth within the previous 12 months (n = 6436) in Galicia (Spain). Information was collected regarding the mother's status 6 months before pregnancy, during pregnancy, at the time of delivery, and at the time of the survey. The prevalence of SUI and dyspareunia were estimated and regression models were performed to identify variables associated with both pathologies. RESULTS The prevalence of SUI and dyspareunia after delivery were 20.4 % (CI95 %: 19.2-22.0) and 23.4 % (22.3-24.8), respectively. The presence of dyspareunia during pregnancy (adjusted prevalence ratio PR 2.1), breastfeeding (PR 1.2), and having a history of episiotomy (PR 1.3) were all variables associated with the presence of dyspareunia after delivery. SUI after delivery was related to the mother's history of SUI before pregnancy (PR 2.4) and during pregnancy (PR 2.0), as well as having undergone vaginal delivery (PR 2.0). CONCLUSION Knowing which factors are associated with the manifestation of SUI and dyspareunia in women after delivery is useful for identifying susceptible or "at risk" patients. These variables should be included in the clinical history of every pregnant woman.
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Lima Ribeiro G, Teixeira Moreira Vasconcelos C, Silva Gomes ML, Veras Firmiano ML, Oliveira Batista Oriá M, Gomes Lopes L. Knowledge, attitude, and practice instruments for urinary incontinence: A psychometric review. Neurourol Urodyn 2019; 39:25-34. [DOI: 10.1002/nau.24202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/21/2019] [Indexed: 01/06/2023]
Affiliation(s)
| | | | | | - Mariana Luisa Veras Firmiano
- Hospital Complex of the Federal University of Ceará Empresa Brasileira de Serviços Hospitalares—EBSERH Fortaleza Brazil
| | | | - Lia Gomes Lopes
- Nursing Department Federal University of Ceará Fortaleza Brazil
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Pandey D, Maturi C, Dhakar BPS, Jain G, Kyalakond K. Interventions and Quality of Life in Stress Urinary Incontinence. Gynecol Minim Invasive Ther 2019; 8:106-112. [PMID: 31544020 PMCID: PMC6743231 DOI: 10.4103/gmit.gmit_72_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction: Stress urinary incontinence (SUI), though is more prevalent than many chronic diseases, has remained largely underreported and underdiagnosed condition. We aimed to find the improvement in the quality of life (QoL) of women with SUI after individual interventions, namely mid-urethral sling (MUS), pelvic floor muscle training (PFMT), and no treatment/control group, as primary treatment modalities. Materials and Methods: This was a prospective interventional case–control study conducted at a university teaching hospital, over a period of 2 years. Parous women with at least one vaginal delivery, attending the gynecology outpatient department, were encouraged to fill the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Those with SUI were divided into three arms (MUS, PFMT, and no treatment/control group), according to the informed decision for choice of management. Baseline QoL was documented for all with King's Health Questionnaire. QoL was again recorded after 3 months of the start of treatment and was compared with the baseline. Results: In our study cohort, the prevalence of SUI was 15.2%, with a consultation rate of only 30.7%. MUS surgery improves QoL significantly in women with SUI, followed by PFMT. We found 100% symptomatic relief, high rate of improvement in QoL with minimal easy to manage complications, in the surgical intervention arm. PFMT, though has a positive impact on QoL, requires continuous motivation, as 22% discontinued. Without treatment, QoL in SUI patients remained more or less the same. Conclusion: The help-seeking behavior (consultation rate) for SUI is poor. MUS (surgical arm) had 100% symptom relief in 3-month follow-up. MUS showed the best results in terms of QoL improvement, followed by PFMT in SUI in our study. It is important not only to educate women about the problem but also to encourage them to seek treatment and indicate that it is a treatable condition.
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Affiliation(s)
- Deeksha Pandey
- Department of Obstetrics and Gynecology, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | - Chaitanya Maturi
- Department of Obstetrics and Gynecology, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | | | - Gazal Jain
- Department of Obstetrics and Gynecology, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | - Keerti Kyalakond
- Department of Obstetrics and Gynecology, Kasturba Medical College, MAHE, Manipal, Karnataka, India
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Qi X, Shan J, Peng L, Zhang C, Xu F. The effect of a comprehensive care and rehabilitation program on enhancing pelvic floor muscle functions and preventing postpartum stress urinary incontinence. Medicine (Baltimore) 2019; 98:e16907. [PMID: 31464923 PMCID: PMC6736454 DOI: 10.1097/md.0000000000016907] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This study was to investigate the incidence and the risk factors of postpartum stress urinary incontinence (SUI), and the effect of comprehensive care and rehabilitation program (CCRP) on preventing postpartum SUI.In stage I, 479 puerperae were recruited within 1 week postpartum, then the postpartum SUI incidence at 8th week and its risk factors were investigated. In stage II, 240 vaginal delivery puerperae were enrolled within 1 week postpartum and randomly assigned to CCRP group or control group as 1:1 ratio. The postpartum SUI incidence and pelvic floor muscle function indexes were evaluated at 8th week.In stage I, the postpartum SUI incidence was 25.7%, and SUI puerperae presented with higher body mass index (BMI), vaginal delivery rate, newborn weight, and larger newborn head diameter compared with non-SUI puerperae. Besides, the vaginal delivery, the elevated age and BMI were independent risk factors for postpartum SUI. In stage II, the postpartum SUI incidence in CCRP group was decreased compared with control group, and the vaginal resting pressure, vaginal squeezing pressure, and vaginal contraction duration were increased in CCRP group compared to control group at 8th week postpartum.The incidence of postpartum SUI is 25.7%, and the vaginal delivery, increased age, and BMI are independent risk factors for postpartum SUI. More importantly, CCRP strengthens pelvic floor muscle functions and decreases postpartum SUI incidence in puerperae.
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Affiliation(s)
| | | | - Lei Peng
- Department of Emergency, Tongji Hospital, Tongji University School of Medicine
| | - Cuihong Zhang
- Department of Nursing, The Eighth people's Hospital of Shanghai
| | - Fanglei Xu
- Department of Nursing, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
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Chen CCG, Cox JT, Yuan C, Thomaier L, Dutta S. Knowledge of pelvic floor disorders in women seeking primary care: a cross-sectional study. BMC Fam Pract 2019; 20:70. [PMID: 31122187 PMCID: PMC6533649 DOI: 10.1186/s12875-019-0958-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/30/2019] [Indexed: 11/10/2022]
Abstract
Background Pelvic floor disorders including urinary incontinence (UI) and pelvic organ prolapse (POP) are common conditions; however, most women with these symptoms do not seek care. Failure to seek care may be related to misconceptions about these conditions. The aim of this study was to assess the baseline knowledge of UI and POP among adult women presenting to primary care clinics, as well as factors associated with knowledge levels. Methods A survey with questions from previously validated UI and POP knowledge questionnaires (PIKQ-UI and PIKQ-POP, respectively) was self-administered to a cross-sectional group of adult female patients presenting to three primary care clinics: geriatric, community-based, and hospital-based. Participants’ demographics and medical histories were compared using ANOVA or Kruskal-Wallis for continuous variables and Chi-square test or Fisher’s exact test for categorical variables. In order to compare various covariates with knowledge non-proficiency on PIKQ-UI and PIKQ-POP scales, unadjusted and adjusted ORs with 95% CIs were calculated using bivariate analysis and multivariate logistic regression, respectively. Results Of 346 participants, knowledge non-proficiency was similar and consistent across clinic sites and reached 72.0% for UI and 53.6% for POP. On multivariate analysis, lower educational attainment, being unaware of UI or POP as medical conditions, and having no history of care-seeking for these conditions were significantly associated with knowledge non-proficiency on UI, POP, or both. Conclusions Knowledge non-proficiency for UI and POP is common among women presenting for primary care. For UI, healthcare providers should assess patients’ actual understanding of the disease, especially among those with lower educational attainment, to eliminate any possible misconceptions. For POP, the focus should be on increasing awareness of this disease, as many women may have not previously heard of this condition. Simple strategies may increase knowledge in these areas and change care-seeking behaviors. Study registration None.
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Affiliation(s)
- Chi Chiung Grace Chen
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, 21224, USA.
| | - Jacob T Cox
- Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Chloe Yuan
- John A. Burns School of Medicine, Honolulu, HI, 96813, USA
| | - Lauren Thomaier
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, 21224, USA
| | - Sonia Dutta
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, 21224, USA
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Mohd Yusoff D, Awang S, Kueh YC. Urinary incontinence among pregnant women attending an antenatal clinic at a tertiary teaching hospital in North-East Malaysia. J Taibah Univ Med Sci 2019; 14:39-46. [PMID: 31435388 DOI: 10.1016/j.jtumed.2018.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/16/2022] Open
Abstract
Objectives Urinary incontinence (UI) is common among pregnant women. This growing health problem affects physical, emotional, and social well-being. This study determined the prevalence of UI and associated factors, and evaluated screening needs. Methods A total of 330 pregnant women visiting the antenatal clinic in Hospital Universiti Sains Malaysia (USM) were surveyed. Data were collected through a self-administered questionnaire and analysed with SPSS software version 22.0. Results Overall, 84.5% (n = 279) of the pregnant women had experienced UI. Multiple logistic regression identified body mass index (BMI), presence of other illness, and consumption of coffee as major risk factors for UI. The majority of pregnant women preferred early screening for UI. Conclusion A great majority of pregnant women in this study experienced UI. Higher BMI and the presence of other medical conditions are significant risk factors for UI and early screening is required. The need for universal education about UI and pelvic floor muscle exercise is warranted and can potentially prevent postnatal UI and UI later in life.
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Tan R, Pu D, Cao J, Ge H, Chang X, Ye G, Wu J. Prevalence of Stress Urinary Incontinence in Women with Premature Ovarian Insufficiency. J Womens Health (Larchmt) 2018; 27:1508-1512. [PMID: 30484729 DOI: 10.1089/jwh.2018.6935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: To determine the prevalence of stress urinary incontinence (SUI) and associated factors in women with premature ovarian insufficiency (POI). Materials and Methods: The study included 149 patients with POI and 303 control women without POI. Age, body mass index (BMI), gestational history, time since onset of POI, and status of hormone therapy (HT) for POI were recorded. Results: There was no statistical difference in the mean age, BMI, and parity between the two groups. The prevalence of SUI in the POI group tended to be higher than that in the control group (20.9%, 30/149 vs. 16.2%, 49/303), although not significantly (p = 0.297). About 41.6% (62/149) of patients with POI received HT. Patients with POI and SUI were older (p = 0.018) and had higher BMI (p = 0.007) than women with POI without SUI (p = 0.007). Compared to nulliparas, primiparas were more likely to have SUI (p = 0.046). However, SUI developed irrespective of time since onset of oligomenorrhea/amenorrhea or HT use. Furthermore, regression analysis showed that the prevalence of SUI was higher in women 30-39 years of age (odds ratio [OR] = 3.27, p = 0.002) and older than 40 years (OR = 7.78, p = 0.001). Primiparas (OR = 2.89, p = 0.001) and vaginal delivery (OR = 2.58, p = 0.023) were associated with SUI. Conclusions: The prevalence of SUI was fairly high among patients with POI, and age, parity, and vaginal delivery were the main risk factors. However, duration of POI and HT use had no effect on SUI. Increasing awareness of the importance of urinary system health in this population will improve the quality of life for these women.
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Affiliation(s)
- Rongrong Tan
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Danhua Pu
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Jinxiang Cao
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Huan Ge
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaoxia Chang
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Guihua Ye
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Jie Wu
- State Key Laboratory of Reproductive Medicine, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
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Bascur-Castillo C, Araneda-Gatica V, Castro-Arias H, Carrasco-Portiño M, Ruiz-Cantero MT. Determinants in the process of seeking help for urinary incontinence in the Chilean health system. Int J Gynaecol Obstet 2018; 144:103-111. [PMID: 30267534 DOI: 10.1002/ijgo.12685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/24/2018] [Accepted: 09/27/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To analyze via the Andersen model what leads women with urinary incontinence (UI) to seek help and remain in the healthcare system. METHODS An interpretative phenomenologic study enrolling women aged 18 years or older who were diagnosed with UI at a tertiary care hospital in Chile between January and March 2016. Data were collected by semi-structured interview. The categories explored experience with UI and reasons for seeking health care, and included the dimensions of the Andersen model. RESULTS Ten women were enrolled. Characteristics that eased or hindered healthcare seeking were identified to come from the women (frequency and quantity of symptoms, coping strategies, and beliefs about its causes) and from their environment (reaction of partner, family, or coworkers to her condition). Some were associated with primary care (human and/or technical resources) and some with secondary care (pelvic floor units). CONCLUSION The results reflect the complexities of asking for health care for women with UI, especially in a country such as Chile with different healthcare levels. Raising awareness of this complexity and developing an approach that includes all stakeholders (institution, community, and family) is crucial for professionals who want to offer both medical therapy and wellness-focused healthcare.
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Affiliation(s)
- Carolina Bascur-Castillo
- Department of Obstetrics and Puericulture, Faculty of Medicine, University of Concepción, Concepción, Chile.,Pelvic Floor Unit, Dr. Guillermo Grant Benavente Hospital, Concepción, Chile
| | | | - Henry Castro-Arias
- Pelvic Floor Unit, Dr. Guillermo Grant Benavente Hospital, Concepción, Chile.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Concepción, Concepción, Chile
| | - Mercedes Carrasco-Portiño
- Department of Obstetrics and Puericulture, Faculty of Medicine, University of Concepción, Concepción, Chile.,Research Group on Public Health, University of Alicante, Alicante, Spain
| | - María Teresa Ruiz-Cantero
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Concepción, Concepción, Chile.,CIBER de Epidemiología y Salud Púbica, Madrid, Spain
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Vasconcelos CTM, Firmiano MLV, Oriá MOB, Vasconcelos Neto JA, Saboia DM, Bezerra LRPS. Women's knowledge, attitude and practice related to urinary incontinence: systematic review. Int Urogynecol J 2019; 30:171-80. [PMID: 30182183 DOI: 10.1007/s00192-018-3759-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/21/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Knowledge, attitude and practice (KAP) investigations lead to an understanding of what a particular population group knows, thinks and does in relation to a certain subject. METHODS This systematic review was conducted to identify women's KAP related to urinary incontinence (UI) described in the literature and the measurement/evaluation instruments used. A literature search, up to July 2017, was conducted in PUBMED, SCOPUS and BVS (Virtual Health Library) for articles dealing with women's KAP related to UI that described the validation procedure of any data collection instrument. Articles that investigated exclusively male subjects, provider performance or academic teaching strategies were excluded. Relevant studies were analyzed and briefly summarized. RESULTS Initially, 799 articles were retrieved. After applying the inclusion and exclusion criteria, 19 remained for reading and summarizing. There has been interest in identifying and evaluating some of the KAP elements related to UI since 1994, with a wide variety of validated instruments used. Knowledge was evaluated in 15 articles and all concluded that there was misinformation about UI in the populations studied. Seven articles studied the intention to seek healthcare for UI, among which only one evidenced an adequate attitude in more than 70% of the participants. All the articles that investigated practice revealed low rates of seeking care. CONCLUSIONS The KAP elements are influenced by specific questions in each of the studied populations, leading to unique results, which indicates the importance of investigations using standardized data collection instruments that have psychometric validity tested in the target populations.
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Dokmeci F, Cetinkaya SE. An Overview of Surgical Treatment for Female Stress Urinary Incontinence. Curr Obstet Gynecol Rep 2018; 7:84-91. [DOI: 10.1007/s13669-018-0239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sousa M, Peate M, Lewis C, Jarvis S, Willis A, Hickey M, Friedlander M. Exploring knowledge, attitudes and experience of genitourinary symptoms in women with early breast cancer on adjuvant endocrine therapy. Eur J Cancer Care (Engl) 2018; 27:e12820. [PMID: 29337398 DOI: 10.1111/ecc.12820] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2017] [Indexed: 11/29/2022]
Abstract
Clinical trials of adjuvant endocrine therapy in women with early breast cancer have consistently reported that genitourinary symptoms are common. However, little is known about women's experiences of genitourinary symptoms, their views about the symptoms and how they impact on their lives. The aim of this study was to explore knowledge, attitudes and experiences of genitourinary symptoms among women receiving adjuvant endocrine therapy for early breast cancer. Thirty-two semi-structured interviews were conducted and subjected to a rigorous qualitative analysis. Genitourinary symptoms were commonly reported to negatively impact on personal, social and physical activities, were often attributed to anxiety and stress and were a source of embarrassment. Women also commented on the limited information available or provided regarding the potential genitourinary adverse effects of adjuvant endocrine therapy. There was a general lack of awareness that their symptoms could be associated with or exacerbated by adjuvant endocrine therapy. Women indicated a preference to receive information and advice about potential management options from either their general practitioner or specialist. These findings underscore the importance of improving communication and increasing awareness among both clinicians and patients about the potential impact of adjuvant endocrine therapy on genitourinary symptoms.
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Affiliation(s)
- M Sousa
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.,School of Nursing and Midwifery, Centre for Applied Nursing Research, South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Western Sydney University, Sydney, NSW, Australia
| | - M Peate
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,The Royal Women's Hospital, Parkville, VIC, Australia
| | - C Lewis
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.,Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
| | - S Jarvis
- Pelvic Floor Physiotherapy, Women's Health & Research Institute of Australia, Sydney, NSW, Australia
| | - A Willis
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.,Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,The Royal Women's Hospital, Parkville, VIC, Australia
| | - M Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.,Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
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Abstract
INTRODUCTION AND HYPOTHESIS The aims of this study were to determine the prevalence, symptom characteristics, risk factors and impact on quality of life (QoL) of urinary incontinence (UI) in female outpatients in Singapore, to describe the attitudes of these women towards UI, and to investigate the barriers to healthcare-seeking behaviour in symptomatic women. METHODS This was a cross-sectional study in a convenience sample and 249 women enrolled from outpatient clinics. A modified self-administered questionnaire which included two validated instruments (the International Consultation on Incontinence Questionnaire-Urinary Incontinence short form and the Incontinence Impact Questionnaire-7) was used. RESULTS Questionnaires from 230 women were included in the analysis. The overall prevalence of UI was 41.74% (95% CI 35.49-48.26%). Most of the symptomatic women suffered from mild UI and the most common subtype was stress UI. Age (OR 1.03, 95% CI 1.00-1.05), vaginal delivery (OR 2.67, 95% CI 1.43-4.97) and being sexually active (OR 2.41, 95% CI 1.31-4.43) were associated with UI. Among symptomatic women, only 41.25% (95% CI 30.82-52.53%) had sought medical attention before. The most common barrier to healthcare-seeking behaviour was embarrassment. The median QoL score was 33.33, indicating a mild impact of UI on QoL. QoL score was associated with UI severity (p < 0.001). CONCLUSIONS Despite the high prevalence of UI, only about 41% of UI sufferers had sought medical attention before. Common barriers included embarrassment, fear of surgery and misconceptions. This study emphasizes the need for policy development for UI prevention and management in Singapore.
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Affiliation(s)
- Rui Luo
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Wei Dai
- Saw Swee Hock School of Public health, National University of Singapore, Singapore, Singapore
| | - Lee Hua Tay
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Foo Cheong Ng
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Li-Tsa Koh
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
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Treister-Goltzman Y, Peleg R. Urinary incontinence among Muslim women in Israel: risk factors and help-seeking behavior. Int Urogynecol J 2018; 29:539-46. [PMID: 28779417 DOI: 10.1007/s00192-017-3438-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/17/2017] [Indexed: 12/17/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The prevalence of urinary incontinence (UI) varies among women in different cultures. Muslim women with UI have complex issues related to the need for cleaning (ablution) before prayer. The aim was to assess the prevalence of UI, factors associated with it, its effect on quality of life, and help-seeking behavior among Muslim women. METHODS This was a cross-sectional study. Self-administered questionnaires completed by women 18-75 years of age who visited the primary care clinic between 21 June 2015 and 9 October 2015 and additional data collected from their medical records. RESULTS A total of 492 women (mean age 31.8 ± 9.5 years) participated in the study. Of these, 43% suffered from UI and 19% from severe to very severe UI. The mean score for interference in daily life (0-10) was 6.3 ± 3.7. Sixty percent of women with UI had stress incontinence, 23% urge incontinence, and 9% mixed incontinence. Only 10% had consulted previously with their physician regarding UI. Increased BMI (OR = 1.048, 95% CI 1.009-1.089) and polygamy (OR = 1.943, 95% CI 1.007-3.749) were associated with severe to very severe UI. Age, parity, and more severe degrees of UI were associated with help-seeking behavior (OR = 1.065 95% CI 1.008-1.125, OR = 0.763 95% CI 0.624-0.934, OR = 4.073 95% CI 1.410-11.765 respectively). CONCLUSIONS Urinary incontinence is very common among Muslim women in primary care in southern Israel and significantly impairs their quality of life. Only a small percentage consults with their physician.
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Grzybowska ME, Wydra D. Predictors of sexual function in women with stress urinary incontinence. Neurourol Urodyn 2017; 37:861-868. [DOI: 10.1002/nau.23370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/24/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Magdalena E. Grzybowska
- Department of Gynecology; Gynecologic Oncology and Gynecologic Endocrinology; Medical University of Gdańsk; Gdańsk Poland
| | - Dariusz Wydra
- Department of Gynecology; Gynecologic Oncology and Gynecologic Endocrinology; Medical University of Gdańsk; Gdańsk Poland
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Norton JM, Dodson JL, Newman DK, Rogers RG, Fairman AD, Coons HL, Star RA, Bavendam TG. Nonbiologic factors that impact management in women with urinary incontinence: review of the literature and findings from a National Institute of Diabetes and Digestive and Kidney Diseases workshop. Int Urogynecol J 2017; 28:1295-307. [PMID: 28674734 DOI: 10.1007/s00192-017-3400-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/12/2017] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI)-defined as a complaint of involuntary loss of urine-is common in women, with major public health, financial, and quality of life (QoL) implications. Despite the high toll of UI and the availability of effective conservative treatments, many women with UI do not seek care. Those who do often continue to experience symptoms. Improving UI treatment may require a comprehensive approach to urology research, including a broad set of potentially influential factors beyond biologic. METHODS To explore the effects of nonbiologic factors (NBF) on UI management and treatment response, the National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop for clinical and psychosocial researchers. Participants proposed a UI treatment pathway: recognizing the problem, willingness to seek treatment, access to care, receiving quality treatment, engaging in self-management, and adhering to chosen treatments; discussed potential NBFs that may affect the pathway; and identified areas for future research. After the meeting, a rapid literature review was conducted to assess the current state of research on NBFs in women with UI. RESULTS Participants identified several patient-level NBFs that may influence the UI management pathway, including QoL and perceived bother; stigma, shame, and embarrassment; knowledge and perceptions; social determinants of health; cultural and language characteristics; personal characteristics and skills; and physical abilities. Additionally, participants acknowledged that provider- and system-level factors also play a role and likely interact with patient-level factors. CONCLUSIONS NBFs that potentially affect the UI management pathway are not well understood, and a comprehensive, interdisciplinary approach to research is needed to understand and appropriately support effective UI treatment.
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Fan Y, Huang Z, Zhang D, Chang J, Jia Y, He S, Wei B. Psychometric validation of the Chinese version of the Illness Perception Questionnaire–Revised for women with stress urinary incontinence. J Obstet Gynaecol Res 2017; 43:1305-1316. [PMID: 28586129 DOI: 10.1111/jog.13351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/19/2017] [Accepted: 03/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Yijun Fan
- Department of Gynaecology and Obstetrics Second Hospital of Anhui Medical University Hefei Anhui China
| | - Zhaohui Huang
- Anhui Provincial Family Planning Institute of Science and Technology Hefei Anhui China
| | - Dazhao Zhang
- Urological Surgical Department Second Hospital of Anhui Medical University Hefei Anhui China
| | - Jun Chang
- Department of Gynaecology and Obstetrics Second Hospital of Mengcheng County Bozhou Anhui China
| | - Yun Jia
- Department of Gynaecology and Obstetrics Taihe County People's Hospital Fuyang Anhui China
| | - Shuihong He
- Lianhua Community Health Service Centers of Hefei City Hefei Anhui China
| | - Bing Wei
- Department of Gynaecology and Obstetrics Second Hospital of Anhui Medical University Hefei Anhui China
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Silva JCPD, Soler ZASG, DominguesWysocki A. Associated factors to urinary incontinence in women undergoing urodynamic testing. Rev Esc Enferm USP 2017; 51:e03209. [PMID: 28380161 DOI: 10.1590/s1980-220x2016140903209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 12/13/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Analyzing factors associated with urinary incontinence (UI) among women submitted to urodynamic testing. METHOD A cross-sectional study of 150 women attended at a urological center. Data were analyzed using univariate and multivariate statistics. RESULTS White women (79.3%), overweight (45.3%), menopausal (53.3%), who drink coffee (82.7%), sedentary (65.3%), who had vaginal birth (51.4%), with episiotomy (80%), and who underwent the Kristeller maneuver (69%). 60.7% had Urethral Hypermobility (UH). A statistical association was found between: weight change and UH (p = 0.024); menopause, Intrinsic Sphincter Deficiency (ISD) and Detrusor Instability (DI) (p = 0.001); gynecological surgery, ISD and DI (p = 0.014); hysterectomy and all types of UI (p = 0.040); physical activity and mixed UI (p = 0.014). CONCLUSION Interventions and guidance on preventing UI and strengthening pelvic muscles should be directed at women who present weight changes, who are sedentary menopausal women, and those who have undergone hysterectomy or other gynecological surgery. Studies on pelvic strengthening methods are needed in order to take into account the profile of the needs presented by women. OBJETIVO Analisar os fatores associados à Incontinência Urinária (IU) entre mulheres submetidas a estudo urodinâmico. MÉTODO Estudo transversal realizado com 150 mulheres atendidas em um centro urológico. Os dados foram analisados por meio de estatística uni e multivariada. RESULTADOS Mulheres brancas (79,3%), com sobrepeso (45,3%), na menopausa (53,3%), que ingeriam café (82,7%), sedentárias (65,3%), que fizeram parto normal (51,4%), com episiotomia (80%), que sofreram Manobra de Kristeller (69%). 60,7% apresentavam HipermobilidadeUretral (HU).Houve associação estatística entre: mudança de peso e HU (p=0,024); menopausa,Deficiência Esfincteriana Intrínseca (DEI) e Instabilidade Detrusora (ID) (p=0,001); cirurgia ginecológica, DEI e ID (p=0,014); histerectomia etodos os tipos de IU (p=0,040); realização de atividade física eIU mista (p=0,014). CONCLUSÃO Intervenções e orientações quanto à prevenção da IU e ao fortalecimento da musculatura pélvica devem ser voltadas amulheres que apresentam mudança de peso, sedentárias, que se encontram na menopausa e àquelas que realizaram histerectomia ou outra cirurgia ginecológica. São necessários estudos sobre métodos de fortalecimento pélvico, de modo a contemplar o perfil dasnecessidades apresentadaspelas mulheres.
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Wan X, Wu C, Xu D, Huang L, Wang K. Toileting behaviours and lower urinary tract symptoms among female nurses: A cross-sectional questionnaire survey. Int J Nurs Stud 2017; 65:1-7. [PMID: 28027949 DOI: 10.1016/j.ijnurstu.2016.10.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/15/2016] [Accepted: 10/13/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Unhealthy toileting behaviours exist among women, and lower urinary tract symptoms have a high prevalence and significant effects on quality of life. However, the relationship between toileting behaviours and lower urinary tract symptoms is unclear. OBJECTIVES This study aimed to investigate the prevalence of lower urinary tract symptoms among female nurses, and the association between toileting behaviours and lower urinary tract symptoms. DESIGN A cross-sectional stratified cluster sampling study. PARTICIPANTS A total of 636 female clinical nurses from tertiary hospitals in Jinan (the capital city of Shandong Province, China). METHODS The Toileting Behaviour-Women's Elimination Behaviours and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms scales were used to assess the participants' toileting behaviours and lower urinary tract symptoms, respectively. Multiple linear regression analysis was used to evaluate the association between toileting behaviours and lower urinary tract symptoms. RESULTS Unhealthy toileting behaviours were common among the female nurses, with delayed voiding being the unhealthiest toileting behaviour, which was followed by place and position preference for voiding. Nearly 68% of the female nurses had at least one lower urinary tract symptom, nearly 50% had incontinence symptoms, 40% had filling symptoms, and 18% had voiding symptoms. Unhealthy toileting behaviours (premature voiding, delayed voiding, and straining to void) were positively associated with lower urinary tract symptoms. However, lower urinary tract symptoms were not significantly associated with voiding place or position preference. Among the control variables, being married or having a history of a urinary tract infection was associated with lower urinary tract symptoms. Having a higher income and regular menstrual period were negatively associated with lower urinary tract symptoms. Compared with vaginal delivery, caesarean delivery had a protective association with lower urinary tract symptoms. CONCLUSION Lower urinary tract symptoms among female nurses should not be overlooked, because their prevalence among female clinical nurses exceeded that among the general population of women. These findings highlight the importance of avoiding unhealthy toileting behaviours (especially premature voiding, delayed voiding, and straining to void), as these unhealthy toileting behaviours were significantly associated with susceptibility to lower urinary tract symptoms.
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Güvenç G, Kocaöz S, Kök G. Quality of life in climacteric Turkish women with urinary incontinence. Int J Nurs Pract 2016; 22:649-659. [DOI: 10.1111/ijn.12495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/25/2016] [Accepted: 09/10/2016] [Indexed: 01/17/2023]
Affiliation(s)
- Gülten Güvenç
- Department of Obstetrics and Gynecology Nursing, Gulhane School of Nursing; Health Sciences University; Ankara Turkey
| | - Semra Kocaöz
- Department of Obstetrics and Gynecology Nursing, Nursing Department; Nigde Zübeyde Hanim School of Health, Omer Halisdemir University; Nigde Turkey
| | - Gülşah Kök
- Department of Obstetrics and Gynecology Nursing, Gulhane School of Nursing; Health Sciences University; Ankara Turkey
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Zhang N, He Y, Wang J, Zhang Y, Ding J, Hua K. Effects of a new community-based reproductive health intervention on knowledge of and attitudes and behaviors toward stress urinary incontinence among young women in Shanghai: a cluster-randomized controlled trial. Int Urogynecol J 2016; 27:545-53. [DOI: 10.1007/s00192-015-2851-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022]
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