Dissertations / Theses: 'Stress urinary incontinence'

1

Spirka, Thomas A. "Finite Element Modeling of Stress Urinary Incontinence Mechanics." Cleveland State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=csu1291495865.

Full text

APA, Harvard, Vancouver, ISO, and other styles

2

Berglund, Anna-Lena. "A holistic view of urinary stress incontinence in women." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 1995. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96892.

Full text

Abstract:

The present study group consists of 45 women with genuine stress incontinence who were selected for surgical treatment and randomized either to retropubic urethrocystopexy (n=30) or pubococcygeal repair (n=15). The preoperative assessment included medical history, gynecological examination, urine analysis and culture, residual urine, pad test, frequency-continence charts, water urethrocystoscopy, continence test and cystometry with analysis of micturition. Moreover, five semistructured interviews were performed with the women and two with their partner. The following questionnaires were used measuring a) personality characteristics: Karolinska Scales of Personality (KSP), Eysenck Personality Inventory (EPI), b) depression: Beck Depression Inventory (BDI) and c) social support: Interview Schedule for Social Interaction (ISSI). The results have shown that there was no difference in the subjective cure rate between the two surgical methods (73% vs. 80 % respectively). The bladder volume had increased in both groups and the intravesical pressure of the bladder filled to maximum had increased in the pubococcygeal repair group. Other urodynamic variables were unchanged by the operation. Pad tests have demonstrated that 67 % of the women in the urethrocystopexy group and 47 % in the pubococcygeal repair group ceased to leak urine. Postoperatively, 63 % of the women in the urethrocystopexy group needed high doses of analgesics compared with only 33 % in the pubococcygeal repair group. Among the women experiencing severe to very severe pain dysphoric subjects were overrepresented. Postoperative residual urine was a minor nursing problem in both groups. Women with SUI of long duration scored significantly higher than controls on the KSP scales of somatic anxiety, psychic anxiety, psychasthenia, suspicion and on the EPI lie-scale. There was no significant difference in sexual activity before and after surgery. One or two sexual dysfunctions within the desire, excitement, orgasmic and resolution phase were reported by the majority of women both before and after surgical intervention. The cured women reported a higher level of overall activities before surgery than the improved (i.e. not cured) women, whereas post surgery both the cured and the improved women obtained about the same level of activities. Regarding social support, no differences between the cured or improved women occured as concerns attachment. The cured women showed a higher degree of adequacy of social integration compared with the improved women. In order to delineate predictive factors for the surgical outcome the following variables were investigated: age of patient, duration of urine leakage, parity, personality, psychological and social factors. The following predictors of the outcome of surgical treatment emerged: duration of stress incontinence, neuroticism and age of patient. The results of the present study indicate the ecessity of a multidisciplinary approach to the treatment and nursing of women with SUI.

Diss. (sammanfattning) Umeå : Umeå universitet, 1995

digitalisering@umu

APA, Harvard, Vancouver, ISO, and other styles

3

Pierson, Wanda Jane. "A study of the effect of stress incontinence and bladder retraining on older women's perceived self-esteem." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27730.

Full text

Abstract:

The purpose of this descriptive study was to determine the existence of a relationship between perceptions of global self-esteem and stress incontinence episodes in a group of older women participating in a bladder retraining protocol. A convenience sample of fifteen older women was obtained. The participants constituted a group of well older women who ranged in age from 63 years to 82 years. All participants were living in the community and experiencing urinary incontinence. The University of British Columbia Model for Nursing was the conceptual framework which guided the focus of the study. The model views the individual as a behavioural system composed of nine interrelated and interdependent subsystems. This study focused on the interrelationship of the excretory and ego-valuative subsystems. The theory of self-efficacy, as outlined by Bandura provided the method by which this study was operationalized. Self-efficacy is the product of personal efficacy—an individual's judgement of the effectiveness of an executed course of action in achieving a desired outcome. The enactive, persuasive, and emotive modes of influence were utilized to provide efficacy information. Data were collected on three occasions using four instruments. The first instrument involved collection of selected demographic variables and was completed during the initial interview. A continence assessment and the Rosenberg self-esteem scale were completed during the initial and final interviews. An interview guide was used during a telephone contact. The telephone contact occurred four days following the first interview; the final interview occurred fourteen days after the first. The data were summarized, compared and described using measures of central tendency and frequency distributions. Paired t-tests were performed on selected variables to determine if there was a difference between pre and post intervention interview score. These tests demonstrated no significant differences in scores. Study findings indicated that at the end of the two week trial 53% of the women were able to identify a change in their voiding habits. Four of the participants (26.7%) stated that they were completely continent at the completion of the two week trial and four other participants (26.7%) indicated that $ some type of positive change had occurred. Three women (20%) identified a negative change in their continence status. Global self-esteem scores, as measured by the Rosenberg self-esteem scale, remained relatively stable during the two week trial period. Scores appeared to be unaffected by a change in continence status. This may be due to the many successful normalizing strategies subjects had developed to hide the evidence of the symptom of urinary incontinence.
Applied Science, Faculty of
Nursing, School of
Graduate

APA, Harvard, Vancouver, ISO, and other styles

4

Hägglund, Doris. "Att leva med urinläckage : en longitudinell populationsstudie om livskvalitet hos kvinnor och hur de hanterar sitt urinläckage /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/uu/fulltext/nbn_se_uu_diva-2542.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Balog, Brian Michael. "Brain-Derived Neurotrophic Factor Mediates Recovery from Stress Urinary Incontinence." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1602113592326106.

Full text

APA, Harvard, Vancouver, ISO, and other styles

6

McNally, Donal Stewart. "Pressure measurement in the investigation and treatment of urinary stress incontinence." Thesis, University of Exeter, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.253561.

Full text

APA, Harvard, Vancouver, ISO, and other styles

7

Abdel-Fattah, Mohamed. "Evaluation of transobturator tension free vaginal tapes in management of female urodynamic stress incontinence." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=230504.

Full text

APA, Harvard, Vancouver, ISO, and other styles

8

Mostafa, Alyaa. "Evaluation of single incision mini-slings in surgical management of female stress urinary incontinence." Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=217882.

Full text

Abstract:

Objectives: To compare single incision mini-slings (SIMS) versus standard mid-urethral sling (SMUS) in the surgical management of female stress urinary incontinence (SUI) with regards; efficacy, safety and cost-effectiveness. Methods: A multicentre randomised controlled trial (RCT) comparing SIMS-Ajust® with SMUS-TVT-OTM (1-year follow-up) was performed. In addition, a systematic review and meta-analysis of RCTs comparing SIMS versus SMUS (1-3 years follow-up) was performed, incorporating the results of the RCT. Both studies assessed post-operative pain, time to return to normal activities and work, patient-reported and objective cure rates, peri-operative complications and impact on pre-operative urgency, women's quality of life (QoL), sexual function and cost effectiveness. Results: For the RCT, 137 women were randomised (SIMS-Ajust® [n=69] vs. TVT-OTM [n=68]). The SIMS Ajust® group had significantly lower post-operative pain-profile within the first four weeks (p <0.001). There were no significant differences in patient-reported success rate (p >0.999), objective success rate (p >0.999) or re-operation rates (p= 0.721) at 1-year follow-up. For the systematic review, 670 articles were identified, and 26 RCTs (n=3308 women) were included. After excluding RCTs evaluating TVT-SecurTM (recently withdrawn from clinical practice), there were no significant differences between SIMS and SMUS in patient-reported cure rates (RR 0.94, 95% CI 0.88, 1.00) and objective cure rates (RR 0.98, 95% CI 0.94, 1.01) at a mean follow-up of 18.6 months. SIMS had significantly lower post- 1 operative pain scores (WMD -2.94; 95% CI -4.16, -1.73), and earlier return to normal activities and work (WMD -5.08; 95% CI -9.59, -0.56; and WMD -7.20; 95% CI -12.43, -1.98, respectively). Conclusion: Adjustable anchored SIMS-Ajust® appears to have more favourable recovery, pain and cost effectiveness outcomes than SMUS-TVT-OTM, whilst having similar effectiveness outcomes, at 1-year follow-up. Generally, SIMS appear to have equivalent outcomes compared with SMUS at a mean follow-up of 18-months, in terms of patient-reported cure, objective cure and impact on women's QoL and sexual function. Consequently, SIMS represent a promising group of procedures in the treatment of women with SUI, and merits further research especially in terms of longer term outcomes.

APA, Harvard, Vancouver, ISO, and other styles

9

Dragomir, Anca Dana Schroeder Jane C. "Uterine location of leiomyomata risk factors and relation to stress urinary incontinence /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2007. http://dc.lib.unc.edu/u?/etd,1223.

Full text

Abstract:

Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2007.
Title from electronic title page (viewed Mar. 26, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology." Discipline: Epidemiology; Department/School: Public Health.

APA, Harvard, Vancouver, ISO, and other styles

10

Pagorek, Stacey. "PREVALENCE OF SPORTS-RELATED STRESS URINARY INCONTINENCE IN THE FEMALE COLLEGIATE ATHLETE." UKnowledge, 2019. https://uknowledge.uky.edu/rehabsci_etds/57.

Full text

Abstract:

Urinary incontinence is a health condition that is associated with involuntary leakage of urine. Stress urinary incontinence (SUI) describes involuntary leakage of urine on effort or exertion and can impact one’s ability to participate in activities and affect quality of life. Furthermore, clinical management of this health condition is challenging as individuals who experience urinary incontinence often do not report this concern to a health care provider. Stress urinary incontinence is not typically a health concern associated with young, healthy athletes. However, researchers have begun to examine the presence of this health condition amongst both a younger population and in athletes. Therefore, the purpose of this study is to assess the prevalence of stress urinary incontinence in collegiate female athletes. This study involved the development of an electronic survey tool to assess the prevalence of SUI in the female collegiate athlete. Female collegiate athletes from six different NCAA Division I schools were asked to complete the survey. The overall response rate for the survey was 32.6% (333/1020). Results indicate that SUI does in fact occur in NCAA Division I collegiate female athletes. Overall, 68.5% of female collegiate athletes surveyed reported ever experiencing SUI. During daily life activities (cough, sneeze, laugh), 54.2% of female collegiate athletes reported experiencing SUI. During participation in their sport, 40.0% of female collegiate athletes reported experiencing SUI, referred to as sports-related SUI. When reporting SUI experienced during either sport participation or during other exercise-based activities, 58.2% of female collegiate athletes reported SUI. The proportion of female athletes reporting sports-related SUI varied by sport. The highest prevalence of leakage in sport was reported by gymnasts (80%) and the lowest prevalence was reported by those who participated in rifle (0%). Over half (52.3%) of female athletes who reported sports-related SUI said their symptoms first began in high school. While majority of female collegiate athletes stated they did not avoid their sport because of SUI, one-fifth (20.5%) of athletes with sports-related SUI reported they alter how they move in their sport out of concern for leakage. The impact of sports-related SUI on other aspects of life (family, social, or school life) were reported to be minimal. Athletes who experience sports-related SUI are most likely to tell either a teammate (49%) or no one (36%). Very few female athletes have told someone in healthcare about this concern: doctor (3%), athletic trainer (4%); physical therapist (1%). Furthermore, only 3% of female collegiate athlete with sports-related SUI reported ever seeking treatment and only 25.8% reported they would find value in seeing a healthcare provider to discuss SUI. Most (76.7%) female collegiate athletes, whether they reported SUI or not, stated they had never been instructed on exercises to strengthen the pelvic floor muscles and 60.6% reported they would find educational programs involving exercises to decrease or prevent SUI beneficial. In conclusion, SUI does occur in the female collegiate athlete and is often not reported to healthcare providers. Based on this information, the general practice of screening athletes for relevant health conditions during pre-participation physicals may need to include additional questions for SUI. Further investigation needs to explore how to best engage and educate female collegiate athletes on the subject of SUI and how to successfully communicate with and address those with the condition.

APA, Harvard, Vancouver, ISO, and other styles

11

Tegerstedt, Gunilla. "Clinical and epidemiological aspects of pelvic floor dysfunction /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-065-6/.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Jackson, Simon. "Oestrogen supplementation in postmenopausal urinary stress incontinence : effect secondary to altered collagen pathophysiology?" Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390374.

Full text

APA, Harvard, Vancouver, ISO, and other styles

13

Murray, A. "A critical study of the application of the fluid bridge test before, during and after surgery for stress incontinence in women." Thesis, University of Liverpool, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384350.

Full text

APA, Harvard, Vancouver, ISO, and other styles

14

Sjöström, Malin. "Internet-based treatment of stress urinary incontinence : treatment outcome, patient satisfaction, and cost-effectiveness." Doctoral thesis, Umeå universitet, Allmänmedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-84405.

Full text

Abstract:

Background Stress urinary incontinence (SUI) is the leakage of urine when coughing, sneezing, or on exertion. It affects 10-35% of women, and can impair quality of life (QOL). First-line treatment is pelvic floor muscle training (PFMT). However, access barriers and embarrassment may prevent women from seeking care. There is a need for new, easily accessible ways to provide treatment. Aim To evaluate the treatment outcome, patient satisfaction, and cost-effectiveness of an Internet- based treatment programme for SUI. Methods We recruited 250 community-dwelling women aged 18-70 years, with SUI ≥1/week via our website. Participants were randomised to 3 months of PFMT with either an Internet-based programme (n=124), or a programme sent by post (n=126). We had no-face-to face contact with the participants, but the Internet group received individually tailored e-mail support from an urotherapist. Treatment outcome was evaluated after 4 months with intention-to-treat analysis. After treatment, we telephoned a strategic selection of participants (Internet n=13, postal n=8) to interview them about their experiences, and analysed the results according to grounded theory principles. We also performed a cost-utility analysis with a 1-year societal perspective, comparing the treatment programmes with each other and with a no-treatment alternative. To scrutinize our measure of QOL, we performed a reliability study of the ICIQ-LUTSqol questionnaire. Results Participants in both intervention groups achieved highly significant improvements (p<0.001) with large effect sizes (>0.8) in the primary outcomes symptom score (ICIQ-UI SF: mean change Internet 3.4 [SD 3.4], postal 2.9 [3.1]), and condition-specific QOL (ICIQ-LUTSqol: mean change Internet 4.8 [SD 6.1], postal 4.6 [SD 6.7]); however, the differences between the groups were not significant. Compared with the postal group, more participants in the Internet group perceived they were much or very much improved after treatment (40.9%, vs. 26.5%, p=0.01), reduced their use of incontinence aids (59.5% vs. 41.4%, p=0.02), and indicated satisfaction with the treatment programme (84.8% vs. 62.9%, p<0.001). Results from the interviews fell into three categories: about life with SUI and barriers to seeking care; about the treatments and the patient-provider relationship; about the sense of empowerment many women experienced. A core category emerged: “Acknowledged but not exposed.” The extra cost per quality-adjusted life year (QALY) gained through use of the Internet-based programme compared with the postal programme was €200. The extra cost per QALY for the Internet-based programme compared with no treatment was €30,935. The condition-specific questionnaire ICIQ-LUTSqol is reliable in women with SUI, with high degrees of agreement between overall scores (Intraclass correlation coefficient 0.95, p<0.001). Conclusion Internet-based treatment for SUI is a new, effective, and patient-appreciated treatment alternative, which can increase access to care in a sustainable way.

APA, Harvard, Vancouver, ISO, and other styles

15

Fozzatti, Maria Celina Martins. "Efeito da reeducação postural global (RPG) na incontinencia urinaria de esforço feminina." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311597.

Full text

Abstract:

Orientadores: Paulo Cesar Rodrigues Palma, Miriam Dambros
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-10T05:38:31Z (GMT). No. of bitstreams: 1 Fozzatti_MariaCelinaMartins_M.pdf: 2306333 bytes, checksum: 040314ce3a3460ed7af49497e661b9aa (MD5) Previous issue date: 2006
Resumo: A Incontinência urinária de esforço (IUE) feminina, condição com alta prevalência, é definida como um sinal e sintoma ligado a distúrbios funcionais da uretra (esfíncteres) e/ou bexiga e não caracteriza uma doença. Trata-se então de uma disfunção mecânica em que alterações na biomecânica da bacia pélvica podem estar associadas à modificação deste mecanismo. Atualmente tem-se valorizado e vem-se aplicando o tratamento fisioterapêutico nesta afecção, como o treinamento dos músculos do assoalho pélvico, obtendo-se bons resultados a curto e médio prazos. Além disso, técnicas baseadas na abordagem global da paciente, que consideram aspectos da estrutura postural, estão ainda em fase de investigação. O trabalho aqui descrito constou da aplicação do tratamento da Reeducação Postural Global (RPG), trabalhando-se a reestruturação postural por meio do reequilíbrio do Sistema músculo esquelético (SME), alongamento das cadeias musculares e reequilíbrio dos eixos ósseos, num enfoque global. Objetivo: Avaliar os efeitos da RPG nas queixas de IUE e qualidade de vida em um grupo de mulheres incontinentes. Casuística e Método: Para o estudo, foram selecionadas 26 mulheres portadoras de queixa clínica de IUE, que foram submetidas ao tratamento da RPG. O tratamento constou de sessões semanais de 50 minutos num período de três meses e posteriormente de sessões quinzenais por mais três meses. O grupo foi acompanhado por seis meses após final do tratamento, sendo reavaliado no término do tratamento, no terceiro e sexto meses. A avaliação foi feita usando Questionário de Qualidade de Vida, diário miccional de três dias, Pad Use e Avaliação funcional do assoalho pélvico (AFA). No término do tratamento e no seguimento de seis meses, as pacientes também foram avaliadas por meio de escala analógica de satisfação. Resultados: Das 26 pacientes que iniciaram o programa, 25 concluíram o tratamento. No final deste quatro pacientes (16%) estavam curadas, 18 (72%) apresentaram melhora significativa e três (12%) não apresentaram melhora. No seguimento de seis meses, seis (24%) pacientes estavam curadas, 16 (64%) apresentaram melhora e três (12%) não apresentaram melhora. Diferenças significativas foram notadas no número de perdas (p<0.001), Pad Use (p<0.001) e AFA (p<0.001). Além disso, foi percebida melhora em todos os domínios do Questionário de Qualidade de Vida, especialmente em Percepção geral da saúde (p<0.005) e Impacto da incontinência (p<0.001) em todos os seguimentos da avaliação. Conclusão: A RPG induziu à melhora significativa dos sintomas de IUE e qualidade de vida no grupo de mulheres incontinentes estudado
Abstract: Stress Urinary Incontinence (SUI), is defined as a signal and/or a symptom connected to functional disorders of the urethra (sphincter) and/or blader and do not characterize a disease. It is, indeed a dysfunction where alterations in the pelvis biomechanics can be associated to a modification of this mechanism. Lately, physiotherapeutic treatments, as the training of the pelvic floor muscles, have been used and good results have been obtained in short and medium terms. Besides, techniques based on a global approach of the patient, which consider also aspects of the postural structure, are still under investigation. The work hereby described consisted of the application of the Global Postural Reeducation (GPR) treatment, in which the postural restructuring is worked through the reestablishment of the balance of the skeletal muscle system, stretching of the muscle chains and rebalance of the bone axis, in a global approach. Objective: Evaluate the effects of the GPR on Stress Urinary Incontinence and Life Quality in a group of incontinent women. Material and Methods: For this study, 26 women with SUI were selected, who underwent a GPR treatment. All patients were treated for six months using GPR, 50 minutes weekly sessions during three months and three more months of sessions every other week. The patients were evaluated before and after the treatment, and also at three and six months follow-up. Outcome measures were made using King's Health Questionnaire, three days voiding diary, Pad Use and Functional Evaluation of Pelvic Floor (FEPF). In the end of the treatment and after six months, the patient satisfaction was evaluated trough a standardized analogical visual scale. Results: Twenty-five patients were available for follow-up. At the end of the treatment there were four (16%) patients completely dry, 18 (72%) pesented significant improvement and three (12%) did not presented improvement. At six months follow-up there were six (24%) patients completely dry, 16 (64%) improved and three (12%) failures. Significant differences were noted in the number of leak episodes (p<0.001), Pad Use (p<0.001) and FEPF (p<0.001). Regarding the King's Health Questionnaire, improvement in all domains were observed, especially in General Perception of Health (p<0.005), leakage impact (p<0.001) in all the moments of evaluation. Conclusion: GPR significantly improved the symptoms and Quality of Life in women with SUI
Mestrado
Pesquisa Experimental
Mestre em Cirurgia

APA, Harvard, Vancouver, ISO, and other styles

16

Silveira, Arlon Breno Figueiredo da. "Uso de sling sintetico pre-publico para tratamento da incontinencia urinaria de esforço : eficacia, segurança e qualidade de vida." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308657.

Full text

Abstract:

Orientadores: Cassio Luis Zanettini Riccetto, Paulo Cesar Rodrigues Palma
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias
Made available in DSpace on 2018-08-12T17:44:11Z (GMT). No. of bitstreams: 1 Silveira_ArlonBrenoFigueiredoda_M.pdf: 2621259 bytes, checksum: 4ce31188b66f0429c0dd69afbac24d21 (MD5) Previous issue date: 2008
Resumo: Objetivos: Com o objetivo de avaliar os resultados cirúrgicos e de modificação na qualidade de vida de mulheres submetidas ao tratamento de incontinência urinária de esforço com sling sintético de polipropileno com abordagem pré-púbica. Métodos: Foi desenvolvido estudo prospectivo, de intervenção, com seguimento por seis meses, envolvendo 20 pacientes, com idade mínima de 21 anos e com diagnóstico de incontinência urinária de esforço realizado no Serviço de Uroginecologia do Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, São Paulo, com base em dados clínicos, urodinâmicos e de Pad-test compatíveis, as quais expressaram a vontade de se submeter à implantação de sling para correção cirúrgica; não gestantes; sem doença ou qualquer condição que pudesse comprometer o resultado da cirurgia, tal como: distúrbio de coagulação sanguínea, obstrução do trato urinário superior, insuficiência renal, comprometimento do sistema imune, infecção urinária ou vaginal; não submetidas a procedimento de sling sintético prévio; que concordaram em participar do estudo, por meio da assinatura do Termo de Consentimento Livre Esclarecido e em responder os questionários King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) antes da cirurgia e decorridos seis meses do procedimento. Para o tratamento de incontinência urinária de esforço, empregou-se tela manufaturada em fibras de polipropileno, classe I, monofilamentar com 42 µm de diâmetro e macroporos maiores que 75 mm, por abordagem pré-púbica. As variáveis estudadas incluíram: idade, avaliação urodinâmica, Pad-test e resultados dos questionários King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) . Os dados foram organizados por meio do programa Epi-INfo versão 6.04d e analisados com o programa Statistical Package for Social Sciences (SPSS), versão 13.0. As variáveis nominais e ordinais foram expressas em distribuição de freqüências absolutas e relativas e as quantitativas, pelos parâmetros da Estatística Descritiva. Para comparação dos parâmetros objetivos uroginecológicos e de qualidade de vida aferida pelos questionários International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) e King's Health Questionnaire (KHQ), do período pré-operatório e decorridos seis meses do procedimento cirúrgico, empregou-se teste de diferença de médias, em nível de significância de 0,05, determinando-se o intervalo de confiança em nível de confiança de 95%. Resultados: Comparando a avaliação pré-operatória àquela decorridos seis meses do procedimento cirúrgico, verificou-se redução significante da perda de urina mensurada através do Pad-test (p<0,001). A pressão de perda sob esforço foi negativa em 90% das pacientes decorridos seis meses da cirurgia. Os demais parâmetros urodinâmicos da cistometria não foram alterados significativamente comparando antes e depois da cirurgia. O fluxo máximo miccional despida de significância estatística (p = 0,034). Houve melhora de todos os parâmetros subjetivos avaliados pelo International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), com significância estatística da freqüência de perda de urina (0,009) e menor interferência na vida da pacientes (p= 0,001), assim como de todos os domínios do King's Health Questionnaire (KHQ). Houve 6 (30%) casos de complicações, que consistiram em extrusão vaginal do sling, instituindo-se tratamento cirúrgico por retirada do segmento da tela exposta e síntese da mucosa vaginal. Conclusão: Embora tenha havido a necessidade de interromper este estudo devido ao alto índice de complicações, confirmou-se o fato de ser a incontinência urinária um evento que compromete a qualidade de vida das pacientes exercendo tal impacto que, mesmo diante do insucesso do procedimento terapêutico, a avaliação subjetiva foi favorável, decorridos seis meses da cirurgia
Abstract: Objectives: A prospective study of intervention was developed aiming to evaluate the surgical results and impact in the quality of life of women submitted to stress urinary incontinence treatment with polypropylene synthetic sling with prepubic approach. Methods: Twenty patients were included in this study. Diagnosis of stress urinary incontinence were based on clinical data, urodynamics and Pad-test. Inclusion criteria included: minimum age of 21 years; non pregnant; without illness or any condition that could compromise surgery's result (sanguineous coagulation disorders, superior urinary tract obstruction, renal insufficiency, immune system disorder, urinary or vaginal infection); abcense of previous synthetic sling procedure; agreement to participate of the study, by means of Free Consent Term signature and to answer to the questionnaires King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) before the surgery and after six months of the procedure. Its was used a sling made of staple fibres of polypropylene, type I, monofilamentar (42 µm diameter) and macropores. All the procedures were performed under spinal anesthesia. The sling was placed and adjusted in midurethral area with minimal periurethral dissection. The proper tension and fixation was achieved by passing the sling arms through the prepubic subcutaneous fat tissue. The variables studied included: age; urodynamic evaluation; Pad-test; King's Health Questionnaire; and International Consultation on Incontinence Questionnaire. Data were recorded using Epi-INfo version 6.04d software and analyzed with Statistical Package for Social Sciences (SPSS), version 13.0. The nominal and ordinal variables were express in absolute and relative frequency distribution and the quantitative ones by parameters of descriptive statistics. Difference of means test was used (significance level of 0,05, 95% confidence interval) for comparison of the urogynecologic objective parameters and quality of life surveyed by ICIQ and KHQ questionnaires, of pre-operative and six months post-operative evaluation. Results: Comparing pre-surgical evaluations with those after six months of the surgical procedure, there were significant reduction of urine loss assessed by the pad-test (p<0,001). Comparing urodynamics evaluations before and after surgical procedure 90% patients no there were of urine loss. Other urodynamics parameters no there were significant alterations. The max flow there was significant reduction (p=0,034). There was an improvement of all subjective parameters evaluated by ICIQ-SF, with significance for frequency of urine loss (0,009) and minor interference in life (p= 0.001), as well as of all KHQ domains. Six patients (20%) presented complications which consisted of vaginal exposition of the sling. All of them were corrected surgically by excision of the mesh and suture of the vaginal wall. The study was interrupted after six months of follow up due to the high frequency of adverse effects. Conclusion: Although the decision of interrupting the study due to the high index of complication, it allowed to confirm that stress urinary incontinence compromises the quality of life of the patients significantly, and the treatmet could promote an improvement in the quality of life, even when objective results were unfavourable
Mestrado
Cirurgia
Mestre em Cirurgia

APA, Harvard, Vancouver, ISO, and other styles

17

Thiel, Marcelo. "Analise quantitativa da fibrose e semiquantitativa da reação inflamatoria de quatro diferentes slings sinteticos." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308661.

Full text

Abstract:

Orientadores: Cassio Luis Zanettini Riccetto, Paulo Cesar Rodrigues Palma
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-06T21:41:51Z (GMT). No. of bitstreams: 1 Thiel_Marcelo_D.pdf: 2563508 bytes, checksum: cb0427728a1aecf6795c3443f2f0cea9 (MD5) Previous issue date: 2006
Resumo: OBJETIVOS: Analisar quantitativamente, com método estereológico, a densidade de fibras colágenas formadas após implante de quatro diferentes tipos de sling;verificar por análise histopatológica a reação inflamatória. MATERIAS E MÉTODOS: Realizou-se o estudo em 70 ratas da raça Wistar, divididas em 3 grupos (A,B,C): No grupo A (30 ratas) implantou-se uma faixa de silicone e outra de submucosa intestinal suína, de 8x 4 mm, no tecido subcutâneo da parede abdominal. No grupo B (30 ratas), implantou-se, da mesma maneira, uma faixa de copolímeros de poligalactina com ácido poliglicólico e outra de polipropileno monofilamentar, de 8x 4 mm. Sutura com fio de nylon 5/0, fixou as faixas e, no grupo C (10 ratas), denominado controle, realizou-se dissecção do subcutâneo e aplicação do mesmo fio, sem implante de material. A coloração de Picro-Sirius, empregada apenas no 90° dia de pós-operatório, permitiu análise das fibras colágenas e a de Hematoxilia-eosina, o estudo histopatológico da reação inflamatória. Nos dias 7, 30 e 90 de pós-operatório, sacrificaram-se 10 ratas de cada grupo. RESULTADOS: No 7° dia, todos os materiais induziram moderada reação inflamatória, sem diferença com o controle. No 30° dia, os copolímeros de poligalactina com ácido poliglicólico apresentaram a menor reação inflamatória, sem diferença com o controle. Neste período, polipropileno monofilamentar e silicone produziram inflamação moderada, enquanto que na submucosa intestinal suína, a intensidade foi severa. No 90° dia, a reação inflamatória, nos copolímeros de poligalactina com ácido poliglicólico, foi maior que antes, porém menor do que a do polipropileno monofilamentar e silicone, que permaneceram semelhantes entre si. Novamente, o grau de inflamação na submucosa intestinal suína continuou o maior de todos. Na análise estereológica, a densidade. de fibras colágenas dos copolímeros de poligalactina com ácido poliglicólico e polipropileno monofilamentar foi significativamente menor (61 % e 65% respectivamente) do que o silicone (85%) e submucosa intestinal suína (86%). CONCLUSÕES: Polipropileno monofilamentar foi o melhor material inabsorvível, pois induziu menos reação inflamatória que os outros materiais testados. Como a submucosa intestinal suína foi completamente removida, a intensa reação fibrótica que produz, toma-se útil, e responsável pelo suporte suburetral após a cirurgia
Abstract: OBJECTIVES: To analyse quantitatively, using stereological methods, the density of the collagen fibres induced by four types of sling materials, and verify by a histopathological analysis the corresponding inflammatory reaction, as fibrosis secondary to sling implantation is considered responsible for restoring urethral support and re-establishing continence in women with stress urinary incontinence, and new synthetic materials that promote adequate fibrosis with the least intensity and duration have been proposed to substitute the aponeurotic sling. MATERIALS AND METHODS: The study comprised 70 isogenic white Wistar rats divided into three groups: group A (30 rats) had 8 x 4 mm strips of silicone and porcine small intestine submucosa (SIS) implanted in the abdominal subcutaneous tissues; group B (30 rats) had 8 x 4 mm strips of polycaprolactone and polylactic acid copolymers and monofilament polypropylene (PLP) implanted the abdominal subcutaneous layer; while a control group of 10 rats had dissection and suturing with 5/0 Nylon in the abdominal subcutaneous layer, as used to fix the strips in the other rats. Picro-Sirius staining was used to assess collagen fibres, and haematoxylin-eosin for the histopathological study. At 7, 30 and 90 days after surgery, 10 rats from each group were killed and assessed. RESULTS: Afier 7 days all the materials induced a moderate inflammatory reaction that did not differ from that in the control group. At 30 days there was no difference between the control and polycaprolactone and polylactic acid copolymers, having the least inflammatory reaction. PLP and silicone produced a moderate inflammatory reaction, while the porcine SIS induced a more intense reaction. At 90 days there was a more intense inflammatory reaction in polycaprolactone and polylactic acid copolymers than before but it was less than with PLP and silicone, which again were no different. During this period the inflammatory reaction induced by SIS was greater. The stereological analysis indicated that collagen fibres induced by polycaprolactone and polylactic acid copolymers and PLP were less dense (61% and 65%, respectively), and significant1y less than with silicone (85%) and SIS (86%). CONCLUSION: PLP was the best nonabsorbable material as it induced a less intense inflammatory reaction than the other tested materials. As porcine SIS was completely absorbed the intense fibrosis induced is useful, as it is exclusively responsible for the urethral support later after surgery
Doutorado
Cirurgia
Mestre em Cirurgia

APA, Harvard, Vancouver, ISO, and other styles

18

Brooks, Kaylee. "Characteristics Predictive of Successful Pelvic Floor Muscle Training Outcomes Among Women with Stress Urinary Incontinence." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36667.

Full text

Abstract:

Physiotherapist-supervised pelvic floor muscle (PFM) training is the recommended first-line treatment for women with stress urinary incontinence (SUI); however, only up to 50% of women are cured with this treatment. The primary objective of this study was to develop a predictive model of successful physiotherapy intervention outcomes among women with SUI using predictors that are accessible to clinicians. The secondary objective of this study was to run a preliminary investigation of morphologic differences between women with SUI who were cured with a physiotherapy intervention and those who were not cured, using a subset of ultrasound imaging data. Seventy-nine women with SUI were assessed at baseline on measures of demographic data (i.e. age, body mass index, etc.), 3-day bladder diary, 30-minute standardized pad test, clinical assessments of PFM strength and tone, and transperineal ultrasound assessments of PFM morphology. Women then attended a 12-week physiotherapy intervention and returned for a follow-up assessment. The multivariate logistic regression model was significant (p < .001) with two predictors: baseline ICIQ-FLUTS UI subscale (SUI severity; p = .01) and parity (p = .06). A significant ROC curve for the ICIQ-FLUTS UI subscale (p ˂ .01) predicts physiotherapy intervention outcomes with 55.6% sensitivity and 80.8% specificity at a cut-off score of 7.50. Women most likely to be cured with a physiotherapy intervention were those with lower scores on the ICIQ-FLUTS UI subscale and those who have given birth to fewer children. Significant differences were found in a subset of data between women with SUI who are cured with the physiotherapy intervention and women who are not cured on morphologic measures in standing of bladder neck height at peak cough (p = .03), descent of the bladder neck during maximal Valsalva maneuver (MVM; p = .04), levator hiatus circumference at rest (p = .03) and at maximal voluntary contraction in both standing and supine (MVC; p = .01; p = .03). Variables that were trending towards significance included bladder neck height in standing at rest, levator plate length (LPL) at maximal excursion during a cough and MVM in standing, and mid-urethral wall cross-sectional area. These significant differences indicate potential value in using ultrasound imaging outcomes as predictors of a cure with physiotherapy intervention in future models, and a combination of demographic, clinical, and morphologic variables may build a more robust predictive model.

APA, Harvard, Vancouver, ISO, and other styles

19

Yip, Clare. "The contribution of pelvic muscle and ligament weaknesses to the development of stress urinary incontinence." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/37905.

Full text

Abstract:

The symptoms of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) are incited by strenuous activities, such as a valsalva maneuver, cough or lifting heavy objects. SUI is characterized by weakened bladder neck support and urine leakage. POP is characterized by the displacement of pelvic organs into the vaginal space. In women, the symptoms of SUI and POP often coexist, yet their relationship remains ambiguous. The POP-related defects that are relevant to SUI are unknown and are yet to be examined. Damages in pelvic floor muscles and cardinal and uterosacral ligaments are potential defects leading to SUI, since they are commonly found in SUI patients with POP symptoms. These defects can be objectively evaluated using Pelvic Muscle Strength test and Pelvic Organ Prolapse Quantification (POPQ) test. This study aims to explore the contribution of pelvic muscle and ligament weaknesses to the development of SUI by developing a biomechanical model of a female pelvic support system. The model simulates the behavior of a pelvic system during a valsalva maneuver, and it incorporates muscle strength score and POPQ points. Patient data were collected and implemented into the model to estimate the material parameters that describe the stiffness properties of the vaginal and ligament tissues for clinical patients. Using the model with parameters, the effect of varied degree of muscular and ligament weaknesses on the changes in the bladder neck and apical vaginal supports were assessed for the patients. The estimated vaginal and ligament parameters were shown to vary, illustrating the diverse material properties of pelvic tissues in individuals. In modeling, simulated conditions of defective muscles and ligaments were demonstrated to contribute to bladder neck and vaginal apex prolapse, consistent with the clinical conditions of POP; alternatively, simulated conditions of restored muscular and ligament supports were shown to help re-establish both bladder neck and vaginal apex supports. The results exhibit the impact of compromise of pelvic muscles and ligaments on the development of SUI and vaginal apex prolapse and suggest a mechanism of how pelvic muscles and vaginal apex rehabilitation impact SUI and vaginal apex supports in patients with coexisting POP symptoms.

APA, Harvard, Vancouver, ISO, and other styles

20

Gill, Bradley Cameron. "Neurotrophin Therapy Improves Recovery from Postpartum Stress Urinary Incontinence Following Simulated Childbirth Injury in Rats." Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1336054611.

Full text

APA, Harvard, Vancouver, ISO, and other styles

21

Fozzatti, Maria Celina Martins. "Tratamento da incontinência urinária de esforço feminina pela Reeducação Postural Global (RPG) : estudo comparativo longitudinal." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312270.

Full text

Abstract:

Orientadores: Viviane Herrmann, Paulo César Rodrigues Palma
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-17T02:53:51Z (GMT). No. of bitstreams: 1 Fozzatti_MariaCelinaMartins_D.pdf: 4656341 bytes, checksum: eb6677485cb09dbe79185403e87167c4 (MD5) Previous issue date: 2010
Resumo: A incontinência urinária de esforço é uma das queixas clínicas mais comuns de mulheres em consultório médico e o desequilíbrio postural tem sido considerado como possível causa deste sintoma. Estudos demonstram que disfunções posturais como a hiperlordose, a anteversão da bacia pélvica, dores lombares e fraqueza dos músculos abdominais estão associados às disfunções dos músculos do assoalho pélvico. Objetivo: Comparar o efeito da Reeducação Postural Global com o treinamento dos músculos do assoalho pélvico no tratamento da incontinência urinária de esforço feminina a curto e a longo prazo. Metodologia: Cinquenta e duas mulheres com queixa clínica de incontinência urinária de esforço foram divididas em dois grupos: o Grupo 1 (G1) recebeu tratamento pela Reeducação Postural Global em 1 sessão semanal de 50 minutos por três meses e o Grupo 2 (G2) recebeu treinamento dos músculos do assoalho pélvico quatro vezes por semana, uma vez supervisionada em sessão individual de 50 minutos e três não supervisionadas, por três meses. Ao final do tratamento, após 6 meses, e em dois anos, foi realizada avaliação subjetiva (cura, melhora, inalterada e piora), diário miccional, avaliação funcional do assoalho pélvico (AFA) e questionário de qualidade de vida. Resultados: Concluíram o tratamento 25 pacientes do G1 e 17 do G2. A avaliação subjetiva do G1 ao final do tratamento apresentou 16% cura e após seis meses, 24%. No G2, no final do tratamento, nenhuma paciente considerava-se curada, 69% referiram melhora e 31% encontravam-se inalteradas. Após seis meses, 19% referiram cura, 37,5% melhoram, 31% inalteradas e 12,5% que haviam referido melhora ao final do tratamento, apresentaram piora dos sintomas. O número de episódios de perda e o número de troca de absorventes diminuiram significativamente nos dois grupos (p<0,001), sendo significativamente menor no G1. A Avaliação Funcional do Assoalho Pélvico (AFA) melhorou significativamente nos dois grupos (p<0,001), sem diferença entre eles. A avaliação da Qualidade de Vida demonstrou melhora significativa nos dois grupos, em todos os domínios. Após dois anos foram reavaliadas 21 pacientes no G1 e 12 no G2. O G1 apresentou 47,6% de cura e o G2, 16,7%, sendo que neste grupo, 33,3% das pacientes referiram piora com relação ao final do tratamento. O número de perdas e o número de absorventes diminuíram significativamente nos dois grupos (p=0,0001), sem diferença significativa entre eles (p=0,0787 e p=0,0579, respectivamente). A AFA melhorou significativamente no G1, porém no G2, apresentou melhora significativa ao final do tratamento e mante-se inalterada no seguimento de dois anos (p=0,045). Conclusão: A RPG mostrou-se uma alternativa eficaz no tratamento da Incontinência Urinária de Esforço Feminina, com resultados comparáveis ao treinamento dos músculos do assoalho pélvico, a curto e a longo prazo
Abstract: Stress urinary incontinence (SUI) is one of the most common complains of women and postural unbalances have been considered as a possible cause. Studies have shown that postural disequilibrium such as hiperlordose, pelvis anteversion, lumbar pain and weakness of the abdominal muscles are associated to pelvic floor muscles dysfunctions. Objective: To compare the effect of Global Postural Re-education (GPR) and Pelvic Floor Muscle Training (PFMP) for the treatment of female stress urinary incontinence at short and long term. Methodology: Fifty-two women with SUI complain were distributed into two groups: Group 1 (G1) was submitted to 50 minutes weekly sessions of GPR for three months and Group 2 (G2) performed PFMT four times a week for three months, being one time in individual session under professional supervision and the other three times at home, for three months. Patients were evaluated at the end of the treatment and after six months and two years on subjective evaluation (cure, improvement, no change and recurrence), voiding diary, functional evaluation of pelvic floor (FEPF) and through a questionnaire of quality of life. Results: The number of patients completing the treatments was 25 in G1 and 17 in G2. The subjective evaluation of G1 showed cure in 16% women at the end of the treatment and 24% after six months. In G2 no women reported cure at the end of the treatment, 69% indicated improvement and 31% reported no change. After six months, the reports of cure, improvement and no change in G2 were, respectively, 19%, 37.5% and 31%. Additionally, 12.5% of the women in this group, who had referred to improvement at the end of the treatment, reported symptom recurrence after six months. The urine leakage episodes reduced significantly in both groups (p<0.001), being significantly lower in G1. PAD use reduced significantly in both groups (p<0.001) and was significantly lower in G1. FEPF improved significantly in both groups (p<0.001), with no difference between them. The evaluation of Quality of Life had shown significantly improvement in both groups, in all domains. Two years after the end of the treatment, 21 patients of G1and 12 of G2 were reevaluated. The amount of women reporting cure in G1 and G2 were, respectively, 47.6% and 16.7%. In G2, 33.3% of the patients referred to symptoms recurrence in comparison with the end of the treatment. Episodes of urine leakage and PAD use reduced significantly in both groups (p=0.0001), without significant difference between groups (p=0.0787 and p=0.0579, respectively). FEPF had shown improvement in G1 in the evaluation at six months and two years; however, in G2 it had shown improvement at the end of the treatment but it did not change in the evaluation at two years. This shows that the behavior of the groups was different throughout the time (p=0.045). Conclusion: GPR has proven to be an efficient alternative to treat SUI in women when compared to PFMT, either on short term or long term follow-up
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências

APA, Harvard, Vancouver, ISO, and other styles

22

Lord, Helen Elizabeth. "A randomised controlled equivalence trial comparing tension-free vaginal tape (TVT) with suprapubic urethral support sling (SPARC)." University of Western Australia. Faculty of Medicine and Dentistry and Health Sciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0086.

Full text

Abstract:

[Truncated abstract] Approximately 35% of women worldwide have stress incontinence, which is defined as involuntary leakage of urine on effort, exertion, or on sneezing and coughing. There are various surgical techniques for stress incontinence; however, minimally invasive operations are increasingly being chosen by surgeons and their patients. Of these procedures, tension-free vaginal tape (TVT) has a cure rate of approximately 90% and is now perceived as the standard technique for stress incontinence. Reported complications of TVT include arterial laceration, bladder perforation, bowel perforation, de novo urgency, dyspareunia, excessive blood loss, haematoma, nerve injuries, urethral erosion, urge incontinence, urinary tract infection, vascular injury, vaginal mesh erosion, voiding dysfunction and death. Suprapubic urethral support sling (SPARC) is a very similar minimally invasive operation and early indications suggested that the success rate for treating stress incontinence was expected to be identical or better than those obtained with the earlier TVT approach, with possibly fewer adverse perioperative events. Our trial sought to establish equivalence between TVT and SPARC in relation to short-term complications and efficacy. OBJECTIVES The primary outcome was bladder perforation. Secondary outcomes were blood loss, voiding difficulty, urgency, and cure of stress incontinence symptoms. METHOD A randomised controlled one-sided equivalence trial (RCT) was conducted in Perth, Western Australia during 2003 and 2004 by researchers in the School of Population Health, University of Western Australia (UWA) and King Edward Memorial Hospital (KEMH). Patients were recruited from the public Urology/Urogynaecology Clinic at the primary women's hospital and the consultant surgeons' private practices. ... However, acute urinary retention requiring a return to theatre to loosen the tape (TVT 0%, SPARC 6.5%; OR: [infinity], 95% CL: 2.2, [infinity]; p=0.002) and subjective short-term cure (TVT 87.1%, SPARC 76.5%; OR: 2.07, 95% CL: 1.13, 3.81; p=0.03) were statistically significantly different. CONCLUSIONS The results are consistent with clinical equivalence between TVT and SPARC in relation to the incidence of bladder perforation. No statistically significant difference was found between TVT and SPARC in blood loss, urgency or short-term objective cure of stress incontinence at the six week post-discharge visit to the surgeon. However, the tapes were more difficult to adjust correctly in SPARC procedures and a statistically significant number of patients required a return to theatre for loosening of the tape (TVT 0/147, 0% and SPARC 10/154, 6.5%, p=0.002). Compared with SPARC, TVT was statistically significantly higher for subjective short-term cure. In ii relation to vaginal mesh erosion, TVT was lower than SPARC, though not statistically significantly. Overall, voiding difficulty (loosening of the tape), urgency and vaginal mesh erosion were the most important clinical problems. This randomised controlled trial demonstrates the importance of testing new devices which appear to be similar, but which may have clinically relevant differences. A follow up study to assess the long-term efficacy of tension-free vaginal tape and suprapubic urethral support sling and associated complications is planned.

APA, Harvard, Vancouver, ISO, and other styles

23

Pires, Telma Filipa Rodrigues Pereira. "Effects of pelvic floor muscles training on prevention and treatment of stress urinary incontinence in pregnant." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/16541.

Full text

Abstract:

Mestrado em Fisioterapia
Introduction: Stress urinary incontinence (SUI) is the most common type of urinary incontinence (UI) in pregnant women and is known to have detrimental effects on the quality of life (QoL). Pelvic floor muscle training (PFMT) is considered the first-line treatment and prevention of SUI in pregnant women. Since there are few randomized controlled trial studies (RCT) in this population, it is important to check the effectiveness of another randomized protocol of the PFMT. Objectives: This study aimed to verify the effects of PFMT between the Intervention Group (IG) and the Control Group (CG) and exploring the effects with and without PFMT, in pregnant women. Methods: Participated in this RCT, pregnant women (aged 21-44 years), having been applied two questionnaires: King's Health Questionnaire (KHQ's) and Broome Pelvic Muscle self-efficacy Scale. The amount of urine was assessed using the modified pad test (20 minutes) and the muscular strength of the Pelvic Floor Muscles (PFM) was measured with Oxford Grading Scale. There were two moments of assessment, T1: 1st time of evaluation (pre- delivery) and T2: 2nd time of evaluation (6 weeks after delivery). The IG was added an exercise plan with duration of six weeks, applicable in Preparation for childbirth classes and at home exercise plan for 9 weeks. Results:The loss of urine, quantified by the Pad test significantly reduced, 0.86±0.83at T1 to 0.50±0.67at T2 in IG (p= 0.021). The degree of muscle contraction, measured by the Oxford Grading Scale, increased significantly in IG (p<0.001) from 3.59±0.85 to 4.82 ± 0:39 and did not change significantly in the CG (p=0.609). The total KHQ and severity of symptoms were observed significant improvements in both groups (p <0.05). As for the scale of Broome - Total scale women's IG improved significantly (p = 0.001 and p = 0.031, respectively) while in CG women no significant change (p> 0.05). Conclusion: PFMT can prevent and treat SUI, and recommend strength training of the PFM during pregnancy, two times per week for at least 6-9 weeks, making it extremely relevant for clinical practice.
Enquadramento: A Incontinência Urinária de Esforço (SUI) é o tipo mais comum em mulheres grávidas, tendo implicações prejudiciais para a qualidade de vida. O treino dos músculos do pavimento pélvico (PFMT) é considerado um tratamento de primeira linha para a SUI. Uma vez existirem poucos estudos randomizados controlados (RCT) nesta população, é importante verificar a eficácia de mais um protocolo randomizado de PFMT. Objetivos: Este estudo teve como objetivos verificar os efeitos do treino dos músculos do pavimento pélvico entre o grupo de intervenção (IG) e o grupo controle (CG) e explorar os efeitos com e sem treino dos músculos do pavimento pélvico, em mulheres grávidas. Métodos: Participaram neste RCT, mulheres grávidas (com idades compreendidas entre os 21-44 anos), tendo sido aplicados dois questionários: King´s Health Questionnaire (KHQ’s) e Broome Pelvic Muscle Self-Efficacy Scale. A quantidade de urina foi avaliada através do pad-test modificado (20minutos) e a força muscular dos músculos do pavimento pélvico (PFM) foi medida com o Oxford Grading Scale. Houve dois momentos de avaliação, a 1ª avaliação (T1), no período pré-parto e a 2ª avaliação (T2), 6 semanas após o parto. Ao IG foi acrescentado um plano de exercícios com duração de 6 semanas, aplicável nas aulas de preparação para o parto, com supervisão e um plano de exercícios ao domicílio, durante 9 semanas, sem supervisão. Resultados: A perda de urina, quantificada pelo pad test, reduziu significativamente, de 0.86±0,83 em T1 para 0.50±0.67 em T2 no IG (p = 0.021). O grau de contração muscular, avaliado pelo Oxford Grading Scale, aumentou significativamente no IG (p <0.001) de 3.59±0,85 para 4.82±0.39 e não sofreu alterações significativas no GC (p=0.609). No KHQ total e severidade dos sintomas observaram-se melhorias significativas em ambos os grupos (p <0,05). Quanto à escala de Broome – Total, as mulheres do IG melhoraram significativamente (p=0.001 e p=0.031, respetivamente) e nas mulheres do CG não se verificaram nenhumas alterações significativas (p> 0,05). Conclusão: O PFMT pode prevenir e tratar a SUI, e recomenda-se o treino da força do PFM durante a gravidez, 2 vezes por semana durante pelo menos 6-9 semanas, tornando-se de extrema relevância para a prática clínica.

APA, Harvard, Vancouver, ISO, and other styles

24

Weber, Lebrun Emily Elise. "Factors Associated with Subjective Improvement Following Midurethral Sling Procedures for Stress Urinary Incontinence: A Masters Thesis." eScholarship@UMMS, 2010. https://escholarship.umassmed.edu/gsbs_diss/466.

Full text

Abstract:

Background Female stress urinary incontinence (SUI) greatly affects quality of life. The midurethal sling (MUS) procedure has been widely accepted as the standard of care treatment for SUI, although there is little information regarding patients' subjective reports of symptom improvement. Objectives The objective of this study was to identify clinical and demographic characteristics that predict subjective symptom improvement following MUS procedures in women with SUI. Materials and Methods The study design was retrospective cohort. Subjects included women who underwent MUS between 2006 and 2008, returned mailed surveys and met our predefined inclusion criteria. Pre-operative data included demographics, prior surgery, co-morbid diseases, urodynamics and concomitant reconstructive surgery. Subjective improvement was measured by score improvement on the UIQ-7, UDI-6, the UDI stress subscale and Question 3 of the UDI, "Do you experience urine leakage related to physical activity, coughing, or sneezing?" Results The mean age of the study sample was 57 years, parity was 2.5 and BMI was 28. Subjects with lower MUCP demonstrated more improvement on the UIQ-7. ΔUDI-6 stress subscale scores were more sensitive to symptom change than either the ΔUDI-6 or ΔUIQ-7. Older, menopausal subjects with urethral hypermobility and concomitant vaginal suspension showed less improvement than subjects without these characteristics. After controlling for urethral straining angle, PVR, menopause and time out from surgery, older age and concomitant vaginal suspension were associated with persistent post-op symptoms on the UDI-6 Question 3 and age remained the only variable associated with persistent symptoms on the UDI-6 stress subscale. Conclusion Concurrent vaginal suspension and advancing age were risk factors for persistent symptoms following MUS procedures in patients with SUI. Symptoms may recur after 24 post-operative months. Clinicians are encouraged to provide additional preoperative counseling to those women who are at greatest risk for persistent symptoms.

APA, Harvard, Vancouver, ISO, and other styles

25

Irazabal, Flores Alessandra Milagros, and cante Giancarlo Yaya. "Association between physical activity and stress urinary incontinence in sportswomen from a private university in Lima - Peru." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/655774.

Full text

Abstract:

Introduction Urinary incontinence in young sportswomen is a common disorder that interferes with sports practice. Objective: To determine if there is an association between physical activity and stress urinary incontinence in sportswomen from a private university. Methodology: Analytical cross-sectional study, developed in sportswomen from the Peruvian University of Applied Sciences. The International Physical Activity Questionnaire - short version (IPAQ –SF) was used to determine the level of physical activity and the Abbreviated Form of the International Incontinence Consultation Questionnaire (ICIQ - SF) to determine stress urinary incontinence. Results: Of the 92 athletes analyzed in the study, 75% performed high physical activity, 47.8% presented urinary incontinence, of which 63.3% belonged to stress urinary incontinence. In the bivariate analysis between physical activity and stress urinary incontinence, 46% of the athletes who performed high physical activity presented stress urinary incontinence compared to 10% who performed moderate or low physical activity, being significant (p < 0.05). In the multivariate analysis, it was evidenced that women who perform high physical activity have 7.92 times more prevalence of stress urinary incontinence than women who perform moderate or low physical activity, being significant (p = 0.04) and adjusted to the age variables, kind of sport and sport time. Conclusion: An association was found between high-intensity Physical Activity and Stress Urinary Incontinence in female university athletes.
Introducción: La incontinencia urinaria en mujeres jóvenes deportistas es un trastorno frecuente y que interfiere con la práctica deportiva. Objetivo: Determinar si existe asociación entre la actividad física y la incontinencia urinaria por esfuerzo en mujeres deportistas de una universidad privada. Metodología: Estudio transversal analítico, desarrollado en las mujeres deportistas de la Universidad Peruana de Ciencias Aplicadas. Se utilizó el Cuestionario Internacional de Actividad Física – versión corta (IPAQ –SF) para determinar el nivel de actividad física y el Formulario abreviado del cuestionario de Cuestionario Internacional de Incontinencia de formato corto (ICIQ – SF) para determinar la incontinencia urinaria por esfuerzo. Resultados: De las 92 deportistas analizadas en el estudio, el 75% realizaba actividad física alta, el 47, 8% presentaron incontinencia urinaria, de las cuales el 63.3% pertenecían a incontinencia urinaria por esfuerzo. En el análisis bivariado entre la actividad física y la incontinencia urinaria por esfuerzo, el 46% de las deportistas que realizaba actividad física alta presentaban incontinencia urinaria por esfuerzo en comparación con el 10 % que realizaba actividad física moderada o baja, siendo significativo (p<0.05). En el análisis multivariado, se evidenció que las mujeres que realizan actividad física alta tienen 7.92 veces más prevalencia de Incontinencia Urinaria por Esfuerzo que las mujeres que realizan actividad física moderada o baja, siendo significativo (p=0.04) y ajustado a las variables edad, tipo de deporte y tiempo de deporte. Conclusión: Se encontró asociación entre la Actividad Física de alta intensidad con la Incontinencia Urinaria por Esfuerzo en deportistas mujeres universitarias.
Tesis

APA, Harvard, Vancouver, ISO, and other styles

26

Rahmanou, Philip. "Assessment of lower urinary tract function in women with urodynamic stress incontinence with and without detrusor overactivity." Thesis, Imperial College London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.589995.

Full text

Abstract:

There are many diagnostic tests available to help evaluate urethral sphincter and bladder dysfunction in patients with urinary incontinence. The most commonly used tests are multichannel cystometry, urethral pressure profilometry, leak point pressure, bladder diaries, pad tests and quality of life questionnaires. More recently, measurements of opening detrusor pressure obtained during pressure f1ow urodynamic studies have claimed to offer a suitable alternative to tests predicting urethral sphincter insufficiency. There have been very few studies evaluating the validity and reliability of these investigations in assessing lower urinary tract in women. The initial part of this thesis provides a review of the normal and abnormal bladder and urethral function. It also presents an overview of the investigation and management of women with lower urinary tract dysfunction. The remainder of this thesis aims to determine the reliability of the various tests currently available. This is done by assessing their reproducibility using test re-test analysis, on the same subject, in two different visits. The different tests are compared in a larger number of subjects, to establish any correlation that may be evident between them. Furthermore, I have compared different subgroups of patients with urodynamic stress incontinence, with or without detrusor overactivity, and assessed the effect they have on the reproducibility of urodynamic studies, urethral function tests and other commonly used bladder investigations. In the last section, the relevance of the study findings are discussed, final conclusions are made and suggestions for future research considered.

APA, Harvard, Vancouver, ISO, and other styles

27

Khaida, Lina Sarah. "Prevalência e fatores de risco da incontinência urinária em atletas de diferentes modalidades desportivas: revisão bibliográfica." Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/6723.

Full text

Abstract:

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: a prática desportiva leva a muitos benefícios físicos e psicológicos, mas, paradoxalmente, a sua exigência poderá causar disfunções, nomeadamente génito-urinárias. Objetivo: avaliar a prevalência e os fatores de risco da incontinência urinária (IU) em atletas de diferentes modalidades desportivas. Metodologia: a pesquisa foi realizada nas bases de dados Scielo e PubMed, fundamentada em artigos compreendidos entre os anos de 2007 e 2017, avaliados segundo a escala Critical Appraisal Skills Programme (CASP). Resultados: nesta revisão foram incluídos 11 estudos, com um total de 3666 participantes do sexo feminino, atletas e sedentárias, com uma média de idades de 24,49±6,75 anos. As atletas, independentemente da modalidade ou do nível desportivo, são mais suscetíveis de desenvolver incontinência urinária do que as mulheres sedentárias. Conclusão: as atletas de distintas modalidades apresentam uma grande variabilidade quanto à prevalência da incontinência urinária. Nos desportos gravitacionais, os que incluem saltos, foi observada uma maior prevalência de IU. A competição, o impacto e o volume de atividade física realizada poderão ser fatores potenciadores ou fatores de risco para o aparecimento de IU.
Background: sports practice draws away many physical and psychological benefits but, paradoxically, its requirement can cause dysfunctions, notably genito-urinary. Objectives: assess the prevalence and the risk factors of urinary incontinence among athletes of different sports modality. Methodology: the survey was conducted in Scielo and PubMed databases, based on articles dated between 2007 and 2017, evaluated according to the Critical Appraisal Skills Program (CASP) scale. Results: 11 studies were included in this revision, with a total of 3666 participants, women athletes and sedentary women, with a medium age of 24,49±6,75 years old. Women athlete, regardless of the sport modality or sports level, are more likely to develop an urinary incontinence than sedentary women. Conclusion: athletes of different modalities present a large variability in the prevalence of urinary incontinence. In gravitational sports, which include jumps, a higher prevalence of UI has been noticed. Competition, impact and volume of physical activity can be potential factors or risk factors of appearance of UI.
N/A

APA, Harvard, Vancouver, ISO, and other styles

28

Clark, Linnette. "Effect of transverse abdominus muscle activation on a pelvic muscle exercise program in women with stress urinary incontinence." Thesis, NSUWorks, 2008. https://nsuworks.nova.edu/hpd_pt_stuetd/12.

Full text

Abstract:

Purpose: The literature indicates that normal healthy women can increase the strength of the pelvic floor muscles (PFMs) by simultaneously contracting the transverse abdominus (TrA) muscle. This study investigated the relationship of the PFMs and the TrA in women with stress urinary incontinence (SUI). Subjects: 15 women with SUI, verified by scores on the Questionnaire of Urinary Incontinence Diagnosis (QUID), were randomly assigned, blocked by age, into 2 exercise groups. The 6 women in the PFM only group had a mean age of 63 years and the 9 women in the PFM+TrA group had a mean age of 49 years. Method: For 2 weeks, all women were trained by rehabilitative ultrasound imaging (RUSI) to correctly contract the TrA or relax the TrA during a PFM contraction depending upon the group assignment. Each woman was examined using the PERFECT scheme and prescribed a patient-specific PFM exercise program. The exercise protocols required 6 weeks of supervised patient specific exercises. Data collection occurred at 3 time periods (before intervention, after intervention, and follow-up) and included: measurement of TrA thickness changes and PFM lift by RUSI, PFM strength and endurance with pressure perineometry, number of incontinence episodes and pad use from bladder diaries, and quality of life (QOL) measurements using the Incontinence Impact Questionnaire (IIQ) and the Patient Specific Functional Scale (PSFS). Results: MANOVA identified no significant difference after interventions between groups. All women significantly improved in PFM strength (PConclusion: PFM exercises done in isolation or with recruitment of the TrA increased PFM strength, endurance, lift and decreased incontinence in women with SUI. Recommendations: Women with SUI can benefit from physical therapists prescribing PFM exercises in isolation or in combination with TrA contractions.

APA, Harvard, Vancouver, ISO, and other styles

29

Pinho, Maria Teresa Silva Castanheira. "A intervenção fisioterapêutica e sua eficácia na incontinência urinária de stress: uma revisão bibliográfica." Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/7022.

Full text

Abstract:

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: A incontinência urinária (IU) afeta milhões de pessoas em todo em todo mundo, sendo que maioritariamente são mulheres de todas as idades. A incontinência urinária de stress (IUS) é a forma mais comum e afeta a qualidade de vida, a função sexual, a socialização e o estado emocional. A abordagem conservadora inclui Fisioterapia, considerada a primeira linha de tratamento. Objetivo: Identificar os vários procedimentos fisioterapêuticos no tratamento da incontinência urinária de stress e consequentemente analisar a eficácia destes procedimentos. Metodologia: Foi realizada uma pesquisa nas bases de dados/motores de busca: Pubmed, PEDro e Web of Science. Após a seleção dos estudos, segundo os critérios de inclusão e exclusão, foi avaliada a qualidade metodológica através da Critical Appraisal Skills Programme (CASP). Resultados: Foram selecionados 9 artigos, que englobam 1517 mulheres diagnosticadas com IUS. Apesar da diversidade de intervenções e protocolos utilizados, todas tiveram melhorias significativas no tratamento da IUS. Conclusão: A Fisioterapia parece ser eficaz no tratamento da IUS, uma vez que todas as intervenções estudadas apresentaram resultados positivos.
Background: Urinary incontinence (UI) affects millions of people worldwide, most of whom are women of all ages. Stress urinary incontinence (SUI) is the most common form and affects quality of life, sexual function, socialization and emotional state. Physical therapy is included in the conservative approach, which is considered the first line of treatment. Objectives: Identify several physiotherapeutic procedures in the treatment of stress urinary incontinence and analyze the effectiveness of these procedures. Methodology: A search was performed in the Pubmed, PEDro and Web of Science databases. After selecting the studies according to the inclusion and exclusion criteria, the methodological quality was evaluated through the Critical Appraisal Skills Program (CASP). Results: A total of 9 articles were selected, comprising 1517 women diagnosed with SUI. Despite the diversity of interventions and protocols used, all interventions had significant improvements in SUI treatment. Conclusion: Physical therapy seems to be effective in the treatment of SUI as all interventions have been successful.
N/A

APA, Harvard, Vancouver, ISO, and other styles

30

Valpas, A. (Antti). "Evaluation of laparoscopic colposuspension and the tension-free vaginal tape procedure in the surgical treatment of female stress urinary incontinence." Doctoral thesis, University of Oulu, 2005. http://urn.fi/urn:isbn:9514278275.

Full text

Abstract:

Abstract Though not a life threatening condition, involuntary loss of urine is a miserable situation. It has a multidimensional effect on the afflicted individuals, both men and women – and for the society. The purpose of this study was to evaluate two modern, minimally invasive surgical techniques for the treatment of female stress urinary incontinence (SUI). The techniques evaluated were laparoscopic colposuspension with mesh and staples (LCM) and the tension-free vaginal tape procedure (TVT). The study consisted of four parts. The first part (Study I) was an observational retrospective follow-up study. Data on the first forty patients operated on with LCM at Oulu University Hospital were collected. Patients had SUI or mixed urinary incontinence (MUI) with predominantly stress incontinence. The Studies II–IV were parts of a randomized, multicenter clinical trial, where LCM was compared with TVT. According to the predefined inclusion criteria 128 SUI women were randomly allocated into two treatment groups: 70 patients received TVT treatment as allocated and 51 LCM. There were seven drop-outs after randomization. After one year of follow-up the cure and improvement rate of the patients operated with LCM were ~ 90%. Also a significant improvement was found in Urinary Incontinence Severity Scores (UISS). At base line the score was 12.1 and after one year follow-up 2.7 (p < 0.001). The bladder perforation rate was 15%. In Study II immediate cure rates and complications of LCM and TVT were studied. After six weeks of follow-up there was no difference in cure rates (~ 90%) between the procedures. There was no difference in complication rates. A significant difference was found in the use of anti-inflammatory / opioid drugs in the immediate post-operative period to relief the pain in favour for TVT. Hospital care was also significantly shorter after TVT than LCM. After one year of follow-up (Study III) TVT was found to give better result both objectively and subjectively. Negative stress test result was recorded in 85.7% in the TVT group and 56.9% in the LCM group. A significant difference was also found, when Visual Analoque Scale (VAS), King's College Health Questionnaire (KHQ) and UISS were used as outcome measures, in the favour of TVT. When 48-hour pad test was used as outcome measure there was no statistically significant difference between the groups. The cost-effectiveness (Study IV) of TVT was found to be better than that of LCM after one year of follow-up. In conclusion, the results of this study suggest, that TVT procedure is on the whole a cost-effective alternative for LCM in the treatment of female SUI.

APA, Harvard, Vancouver, ISO, and other styles

31

Majid, Oneeb. "Population pharmacokinetic-pharmacodynamic modelling and optimal experimental design of Ro115-1240 in healthy subjects and stress urinary incontinence patients." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493915.

Full text

Abstract:

Stress urinary incontinence (SUI) is a distressing condition characterised by urine leakage upon physical effort, coughing or sneezing and may affect up to half of adult women. Despite this there are no globally approved pharmacotherapies. A common approach is the targeting of lower urinary tract (LUT) α₁-adrenoceptors, which however can lead to unwanted increases in blood pressure and reflex bradycardia.

APA, Harvard, Vancouver, ISO, and other styles

32

Janse, van Rensburg Karina. "Pre-operative urodynamic studies : is there value in predicting post-operative stress urinary incontinence in women undergoing prolapse surgery." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85662.

Full text

Abstract:

Thesis (MMed)-- Stellenbosch University, 2013.
ENGLISH ABSTRACT: Aims of the study Urodynamic studies (UDS) have been suggested to be performed as part of the pre-operative work-up of patients undergoing prolapse surgery. Some women with POP have occult stress urinary incontinence (OSUI) and even if subjectively continent, have a higher incidence of developing de novo stress urinary incontinence (SUI). The aim of this study was to describe the outcome of a group of patients who had pre-operative UDS and manual prolapse reduction. Methods This was a retrospective descriptive study including all women who had prolapse surgery during the period January 2006 to December 2011. Patients received routine pre-operative UDS and manual reduction of prolapse, performed at maximum bladder capacity determined by UDS. Patients demonstrating urodynamic SUI or OSUI were offered a concomitant anti-incontinence procedure. Post-operative follow-up data included symptoms of SUI and clinical evidence of SUI. Results The final group consisted of 131 women. The mean age of the patients was 57 years (range 33 to 79) and parity 3.6 (range 0 to 7). The mean body mass index was 32 (range 19 to 53). Twenty-four (18.3%) women had demonstrable SUI on clinical examination at initial presentation in the clinic. At the time of urodynamic studies, forty patients (30.5%) had evidence of SUI determined by either UDS and/ or cough test in the standing position at maximum bladder capacity. Ninety-one women (69.5%) had no evidence of UI on UDS, of which 20(15.3%) demonstrated OSUI (SUI on manual reduction of prolapse at maximal bladder capacity determined by UDS). Of the 40 women with UI on UDS, 36 had 1-step surgery (combination of anti-incontinence procedure and prolapse repair) and 4 had prolapse surgery alone. Of the 20 women with OSUI on UDS, 16 had 1-step (combined) surgery and 4 prolapse surgeries only. Of the 4 who had prolapse surgery alone, 3 complained of post-operative SUI. In the group with no SUI on UDS and manual reduction of POP, 69 of the 71 women had follow-up data. Only 1 had demonstrable SUI on examination. The manual reduction test had a sensitivity of 42.9% and a specificity of 98.5% (95% CI, 92.0-99.9%). The positive predictive value was 75.0% (95% CI, 19.4-99.3%), with a high negative predictive value of 94.4% (95% CI, 86.2-98.8%). Conclusion The numbers in our study are too small to determine sensitivity and positive predictive value of UDS and manual prolapse reduction for the detection of OSUI. However, our data shows promise in identifying POP patients without OSUI, which is a complement of the hypothesis. We recommend that UDS can be performed pre-operatively in women undergoing prolapse surgery, to identify patients with urodynamic stress incontinence. Manual reduction of the prolapse at maximum bladder capacity can then be done to identify a subgroup of patients without OSUI. Future research is needed on the true predictive value of reduction stress testing with larger numbers.
AFRIKAANSE OPSOMMING: Doel van die studie Urodinamiese studies (UDS) word voorgestel as deel van die pre-operatiewe ondersoeke voor prolaps chirurgie gedoen word. Sommige vroue met genitale prolaps het verborge druklek, en selfs as hulle subjektief kontinent is, het hulle ‘n groter insidensie van de novo druklek. Die doel van die studie was om die uitkoms van ‘n groep pasiënte wat pre-operatiewe UDS en manuele prolaps reduksie gehad het, te beskryf. Metodes Die studie was ‘n retrospektiewe beskrywende studie. Al die pasiënte wat prolapse chirurgie in die tydperk Januarie 2006 tot Desember 2011 gehad het, is ingesluit. UDS en manuele prolaps reduksie tydens maksimale blaaskapasiteit, bepaal deur UDS, was deel van die roetine pre-operatiewe ondersoeke. In die gevalle waar urodinamiese druklek of verborge druklek demonstreer is, is die opsie van ‘n meegaande prosedure vir kontinensie tydens prolaps chirurgie aangebied. Post-operatiewe opvolg inligting het simptome van druklek en kliniese bewys van druklek ingesluit. Resultate Die finale groep was 131 vroue reikwydte. Die gemiddelde ouderdom van die pasiënte was 57 jaar (reikwydte 33 - 79) en pariteit 3.6 (reikwydte 0 - 7). Die gemiddelde liggaamsmassa indeks was 32 (reikwydte 19 - 53). Vier-en-twintig (18.3%) vroue het aantoonbare druklek gehad met kliniese ondersoek tydens die eerste kliniek afspraak. Tydens UDS het 40(30.5%) pasiënte druklek getoon tydens UDS en/ of hoestoets in die staande posisie teen maksimale blaaskapasiteit. Een-en-negentig (69.5%) het geen tekens van urinêre inkontinensie tydens UDS demonstreer nie, waarvan 20(15.3%) verborge druklek demonstreer het (druklek met reduksie van prolapse tydens maksimale blaaskapasiteit, bepaal deur UDS). Veertig pasiënte het urodinamiese druklek gehad, waarvan 36 een-stap chirurgie (‘n kombinasie van prolaps herstel en meegaande kontinensie prosedure) en 4 prolaps chirurgie alleenlik gehad het. Uit die 20 vroue met verborge druklek tydens UDS, het 16 een-stap (kombinasie) chirurgie en 4 prolaps chirurgie alleen gehad. Uit die 4 wat prolaps chirurgie alleen gehad het, het 3 post-operatiewe klagtes van druklek gehad. In die groep wat geen inkontinensie tydens UDS en manuele prolaps reduksie gehad het nie, het 69 van die 71 vroue opvolg data gehad. Druklek kon net by een pasiënt met ondersoek demonstreer word. Die manuele reduksie toets het ‘n sensitiwiteit van 42.9% en ‘n spesifisiteit van 98.5% (95% CI, 92.0-99.9%) gehad. Die positiewe voorspellingswaarde was 75.0% (95% CI, 19.4-99.3%), en die negatiewe voorspellingswaarde was 94.4% (95% CI, 86.2-98.8%). Gevolgtrekking Die getalle in ons studie was te min om te bepaal wat die sensitiwiteit en positiewe voorspellingswaarde van UDS and manuele prolaps reduksie is om verborge druklek te demonstreer. Die belowende data om pasiënte te identifiseer met genitale prolaps sonder verborge druklek (‘n kompliment van die hipotese). UDS kan pre-operatief gedoen word in pasiënte wat prolapse herstel chirurgie benodig, om pasiënte met urodinamiese druklek te identifiseer. Manuele reduksie van die prolaps tydens maksimum blaas kapasiteit kan dan volg, om ‘n subgroep van pasiente sonder verborge druklek, uit te ken. Verdere navorsing, met groter getalle word benodig om die werklike voorspellende waarde van die reduksie toets te ondersoek.

APA, Harvard, Vancouver, ISO, and other styles

33

Wahlström, Gunilla, and Kerstin Jonsson. "Yngre kvinnors upplevelse av hur urinläckage påverkar livssituationen." Thesis, Mid Sweden University, Mid Sweden University, Mid Sweden University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-9770.

Full text

Abstract:

Background: Among young women vary the presence of urinary leakage between 28-80% depending on the study and the sport practiced. Poor support in the upper part of the urethra and urinary bladder base is considered the common cause of stress urinary incontinence. Supports are given by the pelvic floor muscles and the key muscles to prevent incontinence. Urinary leakage occurs more frequent in women who engaged in sports that provide a high abdominal pressure. Pelvic floor training is considered to be an effective and safe method to treat stress urinary incontinence and is recommended in the literature as the first treatment action. Aim: To examine young active women's experience of urinary incontinence affects their lives. Method: A qualitative design with tape-recorded interviews and semi-structured open questions were used as data collection method. A strategic selection was made. Six young active elite sportswomen interviewed. A qualitative content analysis was conducted. Results: Four categories were identified: manageable, social limitations, emotional and communication. Main findings shows that young women do not talk about urinary leakage as a problem, they have different ways to cope. Women experience a fear of urinary leakage shall be affected without prior notice and to lose control. The risk of urinary leakage gives concentration difficulties in training. The study shows a great lack of information. Weighted understanding: Among young women, there may be a risk that they are more affected by urinary leakage than middle-aged and older women, in terms of their experience of urinary leakage and leak impact on their lives. This in view of the ideals which today makes high demands and is difficult to live up to. Women get often their first information on the basin floor exercise to prevent urinary leakage at childbirth. This information should take place earlier.

Bakgrund: Hos unga elitidrottare varierar förekomsten av urinläckage mellan 28-80 % beroende på studie och vilken sport som utövas. Dåligt stöd i övre delen av urinröret och urinblåsans botten anses vara den valigaste orsaken till ansträngningsinkontinens. Stödet ges av bäckenbottenmuskulaturen och dess viktiga muskler för att förhindra inkontinens. Urinläckage förekommer oftare hos kvinnor som utövar sporter som ger ett högt buktryck. Bäckenbottenträning anses vara en effektiv och säker metod för att behandla ansträngningsinkontinens och rekommenderas i litteraturen som första behandlingsåtgärd. Syfte: Att undersöka yngre aktiva idrottande kvinnors upplevelse av om urininkontinens påverkar deras livssituation. Metod: En kvalitativ metod med bandade intervjuer och halvstrukturerade öppna frågor användes som datainsamlingsmetod. Ett strategiskt urval gjordes. Sex yngre kvinnliga aktiva elitidrottare intervjuades. En kvalitativ innehålls analys utfördes. Resultat: Fyra kategorier identifierades: Hanterbarhet, sociala begränsningar, Emotionellt och kommunikation. Huvudesultatet visar att yngre kvinnor inte pratar om urinläckage som ett problem, de hade olika sätt att hantera situationen. Kvinnorna upplevde en rädsla för att urinläckage skulle ske utan förvarning och för att tappa kontrollen. Risk för urinläckage gav koncentrationssvårigheter vid träning. Studien visar en stor informationsbrist. Sammanvägd förståelse: Hos yngre kvinnor kan det finnas en risk för att de påverkas mer av urinläckage än medelålders och äldre kvinnor, när det gäller upplevelsen av urinläckage och läckagets påverkan på livssituationen. Detta med tanke på de ideal som idag ställer stora krav och är svåra att leva upp till. Kvinnor får oftast sin första information om bäcken botten träning för att förebygga urinläckage vid barnafödande. Denna information bör ske tidigare.

APA, Harvard, Vancouver, ISO, and other styles

34

Czyrnyj, Catriona. "UROKIN: A Novel Software for Kinematic Analysis of Urogenital Motion Using Transperineal Ultrasound Imaging." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36147.

Full text

Abstract:

Dynamic transperineal ultrasound (TPUS) video allows for kinematic analysis of urogenital morphology and mobility, however, measures are often limited to peak displacements of anatomical landmarks and are vulnerable to error incurred by probe rotation during imaging. This thesis aimed to (1) develop an algorithm to calculate kinematic curves of urogenital landmark motion from TPUS video and to (2) investigate the error incurred in these kinematic measures due to in-plane ultrasound probe rotation. UROKIN, a semi-automated software, was developed and, as a proof of concept, was used to identify differences in urogenital kinematics during pelvic floor muscle maximum voluntary contractions between women with and without stress urinary incontinence. A mathematical model revealed that the error incurred by TPUS probe rotation in the x- (anterior-posterior) and y- (cranial-caudal) directions, was a factor of: r, the radius of rotation; Ɵ, the in-plane angular probe rotation; and α, the angular deviation between the anatomical planes and the coordinate system in which error was calculated. As an absolute measure, the error incurred by in-plane probe rotation is reduced to a factor of only r and Ɵ. Moving forward, UROKIN must be adapted to include findings from (1), and must be tested for validity and reliability.

APA, Harvard, Vancouver, ISO, and other styles

35

Moonat, Shweta. "Investigation of neural correlates of bladder control using functional magnetic resonance imaging (fMRI) in patients with overactive bladder (OAB)." Master's thesis, Temple University Libraries, 2008. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/217452.

Full text

Abstract:

Electrical Engineering;
M.S.E.E.;
Overactive bladder (OAB) is considered to be a disorder of the urinary bladder and is defined by the International Continence Society Terminology Committee as "urgency, with or without urge incontinence, usually with frequency and nocturia". There is some preliminary evidence using functional magnetic resonance imaging (fMRI) that the brain response to bladder filling in OAB patients is abnormal. The purpose of this research is to determine whether there are Central Nervous System (CNS) differences in modulating bladder function that contribute to, or are themselves the cause of the symptoms in OAB patients. We further investigated the pharmacological fMRI changes
Temple University--Theses

APA, Harvard, Vancouver, ISO, and other styles

36

Oremus, Mark. "Surgery versus collagen to treat female stress urinary incontinence, physician beliefs and requirements for treatment & a modeled cost-effectiveness analysis." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0034/MQ64424.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

37

Oremus, Mark 1968. "Surgery versus collagen to treat female stress urinary incontinence : physician beliefs and requirements for treatment & a modeled cost-effectiveness analysis." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30719.

Full text

Abstract:

The Surgery Collagen Incontinence Trial (SCIT) is a randomized controlled trial evaluating the comparative efficacy of surgery versus collagen injection to treat female stress urinary incontinence (SUI). This thesis investigated two issues from SCIT: (1) the trial investigators' use of a consensus estimate that assumed collagen would be preferred as a first line treatment if it was at most 20% less efficacious than surgery; and (2) the cost-effectiveness of surgery and collagen.
A physician survey was conducted to help verify the SCIT investigators' consensus estimate. Respondents on average believed surgery was more efficacious than collagen, and they generally had stronger beliefs in the ability of surgery to meet their requirements for remaining the first line treatment for SUI. However, on average, respondents indicated a willingness to use collagen if it was at most approximately 23% less efficacious than surgery. The survey also provided baseline data for future research into how SCIT's results may or may not play a role in changing the views of clinicians.
The cost-effectiveness analysis was based on a risk-benefit model (decision-tree) that delineated the success rates, side-effects and complication rates of both surgery and collagen. Probabilities from the physician survey and the published literature were used in the model. Collagen was found to be less costly than surgery, but also less efficacious. Until more is known about collagen's long-term durability, the injection material will probably not gain coverage under Canada's provincial health insurance plans.

APA, Harvard, Vancouver, ISO, and other styles

38

Mangera, Altaf. "Development of an autologous fibroblast impregnated tissue for use in urological procedures for stress urinary incontinence and pelvic organ prolapse repair." Thesis, University of Sheffield, 2011. http://etheses.whiterose.ac.uk/2567/.

Full text

Abstract:

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) lead to significant interference in the quality of life of the millions of women affected by them. The treatment options for these women include surgical prostheses which are currently fraught with high failure and complication rates. Our aim was to explore tissue engineering as a solution to the problems of prosthetic failure. The objective was to identify suitable scaffolds that may be used to produce tissue engineered prostheses, with autologous fibroblasts, for use in women with SUI/ POP. Seven candidate scaffolds; Alloderm, cadaveric dermis, polypropylene, porcine dermis, sheep forestomach, porcine small intestinal submucosa and thermoannealed poly(l)lactic acid were investigated. We seeded 800 000 oral fibroblasts to 2cm2 of each scaffold. We assessed the metabolic activity and proliferation of attached cells using AlamarBlue and DAPI staining, contraction using serial photographs, biomechanical properties using a uniaxial tensiometer, collagen production using Sirius red and immunofluorescence staining, and extracellular matrix production using scanning electron microscopy. In addition, the effect of mechanical restraint, simple variable stress and ascorbate-2-phosphate on the above parameters of the tissue engineered prostheses were also investigated. Two scaffolds; porcine small intestinal submucosa and thermoannealed poly(l) lactic acid have been identified as suitable matrices for supporting fibroblast attachment and new extracellular matrix production. Both scaffolds showed cells proliferated and increased their metabolic activity over 14 days of culture. Immunostaining also revealed new collagen I, III and elastin. The mechanical properties of the two scaffolds when cellularised were also close to those of native tissue. We have also shown that mechanical and chemical modulation of the culture environment may be beneficial in producing tissue engineered prostheses with improved properties. Further work will now take these findings in to in vivo models.

APA, Harvard, Vancouver, ISO, and other styles

39

Araújo, Eva Aires. "Efeito da fisioterapia na incontinência urinária de esforço - revisão bibliográfica." Bachelor's thesis, [s.n.], 2020. http://hdl.handle.net/10284/9586.

Full text

Abstract:

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: Define-se Incontinência Urinaria como, uma queixa de qualquer perda involuntária de urina. Representa um problema de saúde pública, não só pela sua prevalência, como também pelo elevado impacto desencadeia a nível psicológico, emocional, físico social económico na vida da mulher. Objetivo: Identificar os vários procedimentos da fisioterapia no tratamento da incontinência urinária de stress e analisar a eficácia destes procedimentos. Metodologia: Foi realizada uma pesquisa nas bases de dados: Pubmed,e PEDro. Após a seleção dos estudos, segundo os critérios de inclusão e exclusão, foi avaliada a qualidade metodológica através da Escala de PEDro. Resultados: Foram selecionados 6 artigos, que englobam Estudos Randomizados Controlados, com diferentes abordagens fisioterapêuticas. Apesar da diversidade de intervenções e protocolos utilizados, todas tiveram melhorias significativas no tratamento da IUS. Conclusão: A Fisioterapia parece ser eficaz para o tratamento de mulheres com IUE , já que que todas as intervenções estudadas apresentaram melhorias.
Introduction : Urinary Incontinence is defined as a complaint of any involuntary loss of urine. It represents a public health problem, not only because of its prevalence, but also because of the high impact it triggers at a psychological, emotional, physical and economic level in women's lives. Objective : To identify the various physiotherapy procedures in the treatment of stress urinary incontinence and to analyze the effectiveness of these procedures. Methodology: A search was carried out in the databases: Pubmed, and PEDro. After selecting the studies, according to the inclusion and exclusion criteria, the methodological quality was assessed using the PEDro Scale. Results: Six articles were selected, which include Randomized Controlled Studies, with different physiotherapeutic approaches. Despite the diversity of interventions and protocols used, all had significant improvements in the treatment of IUS. Conclusion: Physiotherapy seems to be effective in the treatment of IUS, since all the studied interventions showed positive results.
N/A

APA, Harvard, Vancouver, ISO, and other styles

40

Modiri, Ali-Reza. "Functional Models in the Search for Pharmacological Treatment of Urinary Incontinence : The Role of Adrenergic, Cholinergic, and Serotonergic Receptors." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5278-7/.

Full text

APA, Harvard, Vancouver, ISO, and other styles

41

Souza, Ricardo Santos 1982. "Estudo biomecânico comparativo entre dispositivos de fixação de mini slings em modelo murino ex-vivo = Biomechanical study comparing fixation devices of mini slings in murine model ex vivo." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312988.

Full text

Abstract:

Orientadores: Paulo César Rodrigues Palma, Cássio Luís Zanettini Riccetto
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-26T04:00:44Z (GMT). No. of bitstreams: 1 Souza_RicardoSantos_M.pdf: 13317413 bytes, checksum: 0a96e1d0f200ad24527de159c56d6023 (MD5) Previous issue date: 2014
Resumo: Introdução e hipótese: O implante de slings corresponde ao padrão atual de tratamento da incontinência urinária de esforço. Para sua eficácia, exigem um mecanismo de ancoragem adequado. O objetivo deste estudo foi comparar as características biomecânicas de sistemas de fixação de dois modelos de mini slings atualmente disponíveis no mercado (Ophira® e Mini Arc®) por meio de teste de tração uniaxial em modelo murino ex vivo. Materiais e Métodos: Os dispositivos de ancoragem dos mini sling foram implantados cirurgicamente na parede abdominal de 15 ratos divididos em três grupos de cinco animais. Estes grupos foram sacrificados de acordo com a data pós implante em 7, 14 e 30 dias. Na sequência, extraia-se em bloco a parede abdominal de cada animal contendo os dispositivos de fixação. Este material era submetido a teste de tração até o despreendimento do sistema de ancoragem a partir do tecido leito de implante. Foram determinadas a medida da carga máxima (N) e deformação total (mm) até a avulsão. Os resultados foram comparados por meio do teste t de Student e o valor de p 5% foi considerado significativo. Resultados: O sistema de fixação do mini sling Ophira® em comparação ao Mini Arc® exigiu maior carga máxima para avulsão do tecido abdominal nos 3 períodos avaliados com significância estatística: 7º dia, 5,14 ± 0,69 N versus 4,11 ± 0,81 N (p 0,037), 14º dia 10,64 ± 0,81 N contra 9,02 ± 0,54 N (p 0,001) e no 30º dia 18,76 ± 1,48 N versus 14,85 ± 1,28 N (p < 0,001), respectivamente. Quanto ao deslocamento ocorrido durante a tração, o Ophira® desenvolveu maior deflexão significante em todos os momentos avaliados: no dia 7, 11,14 ± 0,53 mm enquanto o Mini Arc® 7,89 ± 1,01 mm (p 0,001), no dia 14 15,80 ± 0,95 mm versus 12,49 ± 1,43 mm (p < 0,001) e no trigésimo dia os valores foram 23,95 ± 1,38 mm contra 18,24 ± 0,50 mm (p < 0,001), respectivamente. Conclusão: O dispositivo de ancoragem do mini sling Ophira® proporcionou melhor fixação à parede abdominal murina em relação ao do Mini Arc®. Este resultado foi mantido mesmo no período pós-operatório tardio
Abstract: Introduction and hypothesis: Slings are currently the standard treatment for stress urinary incontinence. To be effective, they require an adequate anchoring system. The aim of this study is compare the biomechanical features of fixation systems of two mini slings models currently available on the market (Ophira¿ and Mini Arc¿). Materials and Methods: Anchoring devices of each sling were surgically implanted in the abdominal wall of 15 rats divided into three groups of five animals. These groups are formed according to the date of post implant euthanasia on 7, 14 and 30 days. Each abdominal wall was extracted in block containing the mini sling fixation device and was submitted to a tensile strength test for measure the maximum load and total deflection until device avulsion from the tissue. The results were compared using Student test t and a 5% cut off was considered significant. Results: The Ophira¿ mini sling fixation system demanded a greater maximum load compared to the Mini Arc¿ for avulsion of abdominal tissue in 3 evaluation periods with statistical significance: 7th day, 5.14 ± 0.69 versus 4.11 ± N 0,81 N (p 0.037), on day 14 10.64 ± 0.81 N versus 9.02 ± 0.54 N (p 0.001) and on day 30 18.76 ± 1.48 N versus 14.85 ± 1.28 N (p <0.001), respectively. Regarding the displacement occurred during traction, the Ophira¿ has developed significant higher deflection at all times evaluated: on day 7, 11.14 ± 0.53 mm while the Mini Arc¿ 7.89 ± 1.01 mm (p 0.001), on day 14 15.80 ± 0.95 versus 12.49 mm ± 1.43 mm (p <0.001) and on day 30 the values were 23.95 ± 1.38 mm vs. 18.24 ± 0.50 mm (p <0.001), respectively. Conclusion: The Ophira¿ mini sling anchoring device provided better fixation to the host tissue site compared to the Mini Arc¿ device in rats. This outcome were maintained even in the late post operative period
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências

APA, Harvard, Vancouver, ISO, and other styles

42

Chapin, Katherine Joan. "In vivo Biocompatibilty and Time-Dependent Changes in Mechanical Properties of Woven Collagen Meshes: Comparison to Xenograft and Synthetic Mid-Urethral Sling Materials." Case Western Reserve University School of Graduate Studies / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=case1462899086.

Full text

APA, Harvard, Vancouver, ISO, and other styles

43

PATRIZI, LODOVICO. "La chirurgia mininvasiva dell’incontinenza urinaria da sforzo femminile sintomatica: studio randomizzato TVT (transvaginal tape) vs. TOT (transobturator tape)." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2008. http://hdl.handle.net/2108/450.

Full text

Abstract:

Obiettivo: L’obiettivo dello studio è stato quello di comparare le tecniche chirurgiche TVT (tension free vaginal tape) vs. TOT (trans obturator tape) con un trial doppio cieco randomizzato per valutare il tasso di guarigione, le complicanze, la percentuale complessiva di soddisfazione e infine considerare le indicazioni in base alla severità della sintomatologia. Metodologia: Abbiamo reclutato tutte pazienti affette da incontinenza urinaria da stress sintomatica di grado 1 e 2 con Q-tip test > 1. I criteri di esclusione sono stati: pazienti con SUI di grado 3, Q-tip test =1, incontinenza urinaria da urgenza, prolasso associato, alterazioni neurovegetative, pregressa chirurgia o terapie medicali o riabilitative per SUI. La severità e il grado dell’incontinenza veniva presunta dai dati clinici. Le pazienti sono state randomizzate per ricevere un trattamento chirurgico con TVT o TOT e i risultati sono stati valutati ad un mese e ad un anno. Risultati: Abbiamo arruolato 104 donne. Differenze significative sono state trovate sui due gruppi per quanto riguarda, i tempi operatori, il numero di giorni di cateterizzazione e il dolore postoperatorio (maggiore per la TVT; p<0.05). Sebbene le complicanze nel postoperatorio, le percentuali di recidive e reinterventi sono risultati simili nei due gruppi, il grado di soddisfazione delle pazienti ad un mese e ad un anno dall’intervento è risultato significativamente differente se analizzato in accordo alla severità dell’incontinenza: le paziente con SUI 1 hanno apprezzato maggiormente la tecnica chirurgica della TOT e le pazienti con SUI 2 maggiormente la TVT (p<0.001). Conclusioni: La scelta tra TOT e TVT non è completamente simile. In accordo al grado di soddisfazione, il TOT sembra più indicato nella SUI di tipo 1 e la TVT nella SUI di grado 2. Sebbene la percentuale di ostruzione urinaria e di recidiva di malattia nelle due tecniche non siano risultati differenti queste hanno influenzato significativamente il grado di soddisfazione delle pazienti in base al grado di severità della SUI.
Objective: The aim of our study was to compare tension-free vaginal (TVT) vs. trans-obturator tape (TOT) technique on a double blind randomised trial to evaluate cure rates, complications, overall satisfaction rates and after stratification according to symptoms severity. Methods: We recruited all patients affected by symptomatic SUI grade 1 and 2 and Q tip test > I. Exclusion criteria consisted in patients with SUI grade 3, Q tip test =1, urge incontinence, associated prolapses, neurovegetative disorders, previous surgery for SUI or under rehabilitative or medical therapies. SUI grade of severity was recorded as well as clinical data. Patients were randomized to receive TOT or TVT and results assessed at one month and one year. Results: We analysed 104 women. Significant differences were found between TOT and TVT groups regarding the operating times, number of catheterization days, postoperative pain (all greater for TVT; p<0.05). Although postoperative complications, recurrences and reoperations were similar among techniques, patients’ satisfaction rates at one month and one year were significant different when analysed according to the severity of SUI: SUI 1 patients appreciated more the TOT operation and SUI 2 patients more the TVT (p<0.001). Conclusions: The choice of TOT vs. TVT is not completely similar. According to satisfaction rates, TOT could be more indicated in SUI 1 and TVT in SUI 2. Although recurrences or bladder obstructions rates are not different among techniques, they can influence patients’ satisfaction and could be avoided with accurate and proper indications according to the SUI severity.

APA, Harvard, Vancouver, ISO, and other styles

44

Costa, Cruz Danilo Souza Lima 1970. "Parâmetros da ultrassonografia perineal bidimensional para avaliação da incontinência urinária pós prostatectomia radical." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312524.

Full text

Abstract:

Orientador: Carlos Arturo Levi D'Ancona
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-25T19:04:46Z (GMT). No. of bitstreams: 1 CostaCruz_DaniloSouzaLima_M.pdf: 2430901 bytes, checksum: 4c23db321d8199b8fdab28de5ce06ed9 (MD5) Previous issue date: 2014
Resumo: Objetivos: Comparar parâmetros ultrassonográficos através de ultrassonografia perineal em homens sem cirurgia prostática, com homens no pós-operatório de prostatectomia radical, continentes e incontinentes. Métodos: Trata-se de um estudo transversal, multicêntrico (2 centros), envolvendo 92 colaboradores, dos quais 70% foram submetidos à prostatectomia radical retropúbica há mais de um ano. Estes pacientes foram provenientes do ambulatório do Serviço de Urologia do Hospital Universitário Pedro Ernesto e do ambulatório do Serviço de Urologia do Hospital de Clínicas - UNICAMP, com indicação adequada para o exame. Estes pacientes foram escolhidos aleatoriamente, de acordo com os critérios de inclusão e exclusão, e foram divididos em três diferentes grupos: 27 pacientes sem cirurgia prostática, 34 pacientes em pós-operatório de prostatectomia radical continentes e 31 pacientes em pós-operatório de prostatectomia radical incontinentes. Todos apresentaram urocultura negativa. O grupo incontinente realizou, ainda, pad test de 24h e avaliação urodinâmica. O exame foi realizado com o paciente em posição supina, com as pernas levemente abduzidas, semelhante à litotomia. O transdutor foi posicionado na região perineal (entre o escroto e o ânus), em orientação sagital, para obter imagens da sínfise púbica, bexiga, colo vesical e uretra. No exame foram avaliadas a hipermobilidade da uretra proximal, ângulo uretral, funelização do colo vesical e contração voluntária do assoalho pélvico, sendo estes avaliados durante manobra de Valsalva, contração perineal e repouso. Após coleta de dados, foram comparados padrões ultrassonográficos em homens sem cirurgia prostática e em homens no pós-operatório de prostatectomia radical, continentes e incontinentes. Resultados: Neste trabalho, observamos que o grupo continente apresentou o ângulo uretral em repouso significativamente menor que o grupo sem cirurgia (p = 0,0002). Observamos ainda que o grupo incontinente apresentou deslocamento da porção anterior da junção uretrovesical durante a contração significativamente menor que o grupo continente. (p = 0,008) Esta condição foi mais evidente quando comparamos o grupo com incontinência grave ao grupo continente.(p = 0,022). Conclusão: Observamos diferença significativa entre o grupo continente e o grupo sem cirurgia prostática em relação ao ângulo uretral. Observamos ainda diferença significativa no deslocamento da porção anterior da junção uretrovesical durante a contração quando comparamos os grupos continente e incontinente
Abstract: Purpose: To compare sonographic patterns through perineal ultrasonography in men without prostate surgery, with continent and incontinent men after radical prostatectomy. Methods: This cross-sectional clinical study investigated the differences of a dynamic evaluation of the urethra and pelvic floor contraction using perineal ultrasound in men without prostate surgery and in men submitted to radical prostatectomy with and without stress urinary incontinence. Ninety two male patients were included, which 70% of them underwent radical prostatectomy (RP) for more than one year. Thirty one men with clinically post prostatectomy incontinence were compared by two-dimensional (2D) perineal ultrasound to 34 patients without post prostatectomy incontinence and to 27 men without surgery in two centers in Brazil. All patients had negative urine culture. The incontinent group also presented 24h pad test and urodynamic evaluation. The examination was performed with the patient in supine position, with legs slightly abducted, similar to lithotomy. The transducer was placed in the perineal area (between the scrotum and anus), with sagittal orientation, to obtain images of the pubic symphysis, bladder, bladder neck and urethra. During examination, hypermobility of the proximal urethra, urethral angle, bladder neck funnelling and voluntary contraction of the pelvic floor were assessed. These parameters were evaluated during Valsalva maneuver, perineal contraction and rest. Results: Our results showed that the continent group presented the urethral angle at rest significantly lower than the prostate group (p = 0.0002). We also observed that the incontinent group showed the displacement of the anterior bladder neck during contraction significantly lower than the continent group (p = 0.008). This condition was more evident when compared the severe incontinent group with the continent group. (p=0,022) Conclusion: We observed a significant difference between the continent group and the group without prostate surgery when urethral angle was compared. We also observed a significant difference in anterior displacement of the bladder neck during contraction when comparing continent and incontinent groups
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências

APA, Harvard, Vancouver, ISO, and other styles

45

Schmidt, Adriana Prato. "Tratamento conservador da incontinência urinária de esforço feminina : estudo comparativo entre reeducação vesical e treinamento da musculatura do assoalho pélvico com biofeedback." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/174826.

Full text

Abstract:

Base teórica A incontinência urinária (IU) é um sintoma comum, afetando mulheres em todas as idades, com prevalência estimada em 30%. A incontinência urinária aos esforços (IUE) pode representar cerca de metade dos casos. O treinamento da musculatura do assoalho pélvico (TMAP), associado a medidas comportamentais e reeducação vesical constitui a primeira linha de tratamento. Apesar dos bons resultados em curto e médio prazo, pode haver perda de motivação e adesão ao tratamento em longo prazo. Técnicas complementares como o biofeedback (BIO) podem auxiliar no treinamento inicial e contribuir para melhores resultados, mas permanece indefinido o perfil de casos que pode realmente se beneficiar desta abordagem. Novos estudos e a implementação de dispositivos facilitadores do tratamento são necessários, pois a adesão é etapa fundamental para manutenção dos resultados. Objetivo Determinar o efeito do TMAP associado ao BIO comparados ao treinamento vesical (TV), considerando resultados com questionários de sintomas, qualidade de vida (QV) e função sexual (FS). Investigação adicional a partir de dados do diário miccional (DM), avaliação da funcionalidade dos músculos do assoalho pélvico por meio de palpação manual e perineométrica do assoalho, gerando informações adicionais sobre o efeito de ambos os tratamentos. Métodos Ensaio clínico randomizado, paralelo, aberto, incluindo mulheres acima de 18 anos com IUE na ausência de prolapso genital. Recrutamento de casos de forma consecutiva em ambulatório de uroginecologia, com alocação aleatória para TV ou BIO, sendo comparadas a resposta aos sintomas, força muscular, escores de QV e FS ao final de 3 meses de tratamento supervisionado com fisioterapeuta. Para o cálculo amostral foi considerada a detecção de uma diferença de 42 pontos percentuais entre os grupos e estimadas 26 pacientes em cada grupo para um α=0,05 e β-80%. Resultados Ao final do estudo, das 53 pacientes inicialmente recrutadas, 28 pacientes foram analisadas, 14 em cada grupo. Ambos os grupos apresentaram melhores resultados em número de perdas diárias (P<0.001), micções noturnas (P<0.002) e no questionário de sintomas (p<0.001). Na FS, não houve diferença individual e entre os grupos. Alguns domínios do questionário de qualidade de vida foram significativamente melhores nas pacientes que fizeram o treinamento vesical (TV), mas a percepção geral de saúde não se modificou de forma significativa ao longo do tempo e entre os grupos TV (P=0.157) e BIO (P=0.795). Apesar de ter havido melhora subjetiva da contração perineal, esse achado não se correlacionou com aumento de força muscular (rs=0.428 P=0.144). Conclusão No presente estudo, os resultados em ambos os grupos foram equivalentes em termos de melhora clínica, nas ferramentas de medida utilizadas, não sendo possível demonstrar um efeito significativo do biofeedback. O desenvolvimento de tecnologias para melhorar a adesão e motivação dos pacientes para o tratamento conservador segue sendo um desafio atual.
Objective: To compare the effect of pelvic exercises combined with biofeedback, against bladder training, using questionnaires on symptoms, quality of life, and sexual function. Methods: Randomized clinical trial. Women over the age of 18 with stress urinary incontinence, but without genital prolapse, were recruited at a urogynecology clinic and assigned to bladder training or pelvic floor restoration at home with biofeedback. Results for muscle strength and symptoms, quality of life, and sexual function questionnaires were compared after 3 months of physiotherapist-supervised treatment. Results: Fourteen patients in each group were analyzed at the end of the study. Both groups exhibited improved results for number of daily leakages (P<0.001), nighttime micturitions (P<0.002) and symptoms (P<0.001). For sexual function, there were no individual or intragroup differences. Some quality of life domains were significantly better in the bladder training patients, but perceived general health did not change significantly and did not differ between the BT (P=0.157) and BIO (P=0.795) groups. Improvements in perineal contraction were not correlated with increased muscle strength (rs=0.428 P=0.144). Conclusion: The two methods had equivalent results, but larger patient samples could change certain findings. It remains a challenge to develop technologies to improve patients’ motivation and adherence to conservative treatment. Registration: Plataforma ReBec (Brazilian Clinical Trials Register - http://www.ensaiosclinicos.gov.br/). Reference code REQ:7854.

APA, Harvard, Vancouver, ISO, and other styles

46

Hoşcan, Burak Perk Hakkı. "Stres üriner inkontinans tedavisi tedavisinde ekstrakorporeal manyetik innervasyon /." Isparta : SDÜ Tıp Fakültesi, 2004. http://tez.sdu.edu.tr/Tezler/TT00199.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

Locali, Priscila Katsumi Matsuoka. "Avaliação do impacto do tratamento da incontinência urinária oculta na correção de prolapso genital estádio 3 e 4: revisão sistemática e metanálise." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-20092016-161128/.

Full text

Abstract:

Mulheres com prolapso genital estádio 3 e 4 são consideradas de risco para desenvolver incontinência urinária de esforço após a correção cirúrgica do prolapso. A provável explicação para estas pacientes manterem-se, subjetivamente, continentes seria porque o prolapso poderia gerar um acotovelamento na uretra ou compressão da mesma. O objetivo do estudo foi avaliar o impacto de procedimentos anti-incontinência durante a correção cirúrgica de prolapso genital estádio 3 e 4 em mulheres sem sintomas de incontinência urinária de esforço. Método: Realizou-se revisão sistemática com ensaios clínicos. A casuística incluiu mulheres com prolapso genital estádio 3 e 4 sem sintomas clínicos de incontinência urinária de esforço. O desfecho primário foi a presença de incontinência urinária ou necessidade de tratamento para incontinência urinária. Os resultados serão apresentados com o risco relativo, com 95% de intervalo de confiança. Resultados: Inicialmente, 5618 estudos foram identificados com a estratégia de busca, mas apenas oito preencheram os critérios de inclusão. Realizou-se metanálise com as variáveis em comum dos estudos que tivessem mesma escala de quantificação. Observou-se que realizar qualquer procedimento anti-incontinência no mesmo momento do tratamento cirúrgico do prolapso não reduziu a incidência de incontinência urinária no pós-operatório (RR 0.61; 95%CI 0.34-1.10]). Todavia, quando os procedimentos são analisados separadamente, encontraram-se resultados distintos. O subgrupo de pacientes submetidas ao sling retropúbico foi o único que diminuiu a incidência de IUE (RR 0.09; 95%CI 0.02-0.36). Conclusão: O tratamento profilático em mulheres com prolapso genital estádio 3 e 4 com sling retropúbico reduziu a incidência de IUE
Women with high-grade pelvic organ prolapse (POP) are considered at risk of developing postoperative stress urinary incontinence (SUI) once the prolapse has been repaired The probable explanation for the patients to remain subjectively continent, is that POP can affect the urethra by urethral kinking or compression. Our objective was to evaluate the impact of anti-incontinence procedures during surgical POP correction stage 3 and 4 in women with no symptoms for stress urinary incontinence. Methods: A systematic review of randomized trials was performed. The subjects were women with severe POP and no symptoms of SUI. The primary outcomes were UI or treatment for this condition after the surgical procedure. The results were presented as relative risk (RR), with 95% confidence interval (95%CI). Results: Initially, 5618 studies were identified by the search strategy, but only eight trials met the inclusion criteria. We performed a meta-analysis with common variables of studies and with the same scale of quantification. We found that performing an anti-incontinence procedure at the same time of prolapse repair did not reduce the incidence of (SUI) post-operatively (RR 0.61; 95%CI 0.34-1.10]). However, when the types of anti-incontinence procedure were analyzed separately, we found different results. The subgroup of patients who underwent a retropubic sling surgery was the only one that benefited from the antiincontinence procedure, with a decrease in the incidence of SUI (RR 0.09; 95%CI 0.02- 0.36). Conclusions: A prophylactic treatment of women with severe POP using retropubic sling reduced the risk of SUI

APA, Harvard, Vancouver, ISO, and other styles

48

Schytt, Erica. "Women's health after childbirth /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-896-7/.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Rêgo, Aljerry Dias do. "Incontinência urinária de esforço: estudo comparativo entre população urbana e ribeirinha da região Amazônica." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-01082018-134645/.

Full text

Abstract:

Incontinência Urinária de Esforço (IUE) é a queixa de perda involuntária de urina durante esforços ou exercício físico ou espirro ou tosse. A prevalência mundial varia de 8,5 a 68,8%. Tem como principais fatores de risco a paridade, menopausa, obesidade, cirurgias vaginais e Diabetes Mellitus, e causa impacto negativo na qualidade de vida das mulheres podendo levar a depressão, problemas sexuais e pessoais. Existem poucos trabalhos epidemiológicos no Brasil e não existem informações sobre a prevalência de IUE em mulheres ribeirinhas (origem indígena) da Amazônia ou sobre avaliação de fatores de risco e influência do parto domiciliar nesta população. O Objetivo deste estudo foi avaliar prevalência e fatores de risco para IUE em mulheres ribeirinhas da Amazônia e comparar com mulheres que moram em um centro urbano da mesma região. Após cálculo amostral foram entrevistadas 120 mulheres ribeirinhas e 260 mulheres da região urbana, sendo pesquisados a prevalência e os fatores de risco para IUE e, realizado exame físico para avaliar prolapso genital e avaliação funcional do assoalho pélvico em cada população. No grupo de mulheres com queixa de IUE, foi aplicado questionário de qualidade de vida (Kings Health Questionnaire) e realizado estudo urodinâmico. No grupo de mulheres ribeirinhas a prevalência de IUE foi de 25.8% e no grupo urbano de 20% (p > 0.05). Na avaliação dos fatores de risco, paridade, número de partos normais e partos domiciliares foram estatisticamente maiores no grupo ribeirinha. Em relação a qualidade de vida, foi encontrada diferença significativa em alguns domínios (impacto da incontinência, limitação de atividades diárias e físicas, relações pessoais e emoção) sendo pior na população urbana
Stress Urinary Incontinency (SUI) is the complaint of an involuntary loss of urine during efforts or physical exercises, sneezing or coughing. The worldwide prevalence ranges from 8,5 to 68,8%. The main risk factors are: parity, menopause, obesity, vaginal surgeries and Diabetes Mellitus and it causes a negative impact in women\'s quality of life that may lead to depression, sexual and personal problems. There are few epidemiological works in Brazil and there is no information about the prevalence of SUI in riverside community women (indigenous origin) from the Amazon or about the evaluation of the risk factors and influence of home births in this population. The aim of this study was to evaluate the prevalence and the risk factors for SUI in riverside women from the Amazon and to compare them to women that live in urban areas at the same region. After sample calculation, 120 riverside women were interviewed, as well as 260 women from urban areas, when the prevalence and the risk factors were studied. In addition, physical examination was carried out in order to verify genital prolapse and functional evaluation of the pelvic floor in each population. In the group of women with complaints of SUI a questionnaire on quality of life was applied (Kings Health Questionnaire) and also the conduction of an urodynamic study. In the group of riverside women the prevalence of SUI corresponded to 25,8% and in the urban group it was 20.0% (p > 0.05). In the evaluation of risk factors, parity, number of normal deliveries and home births were statistically higher in the riverside women group. In relation to the quality of life, significant difference in some domains was found (incontinency impact, limitation of the daily and physical activities, personal relations and emotion) and it was worse in the urban population

APA, Harvard, Vancouver, ISO, and other styles

50

Muia, Catherine Mwikali. "Women's perceptions and experiences of post-operative physiotherapy management at an Obstetric Fistula Center in Eldoret, Kenya." University of the Western Cape, 2017. http://hdl.handle.net/11394/6301.

Full text

Abstract:

Masters of Science - Msc (Physiotherapy)
Post-operative physiotherapy plays a vital role in the management of patients with incontinence in order to optimise the outcome of obstetric fistula surgery. Women who suffer residual urinary incontinence continue to experience shame, social isolation and institutional rejection. Incontinence continues to impair them leading to lower levels of role participation and restriction in most activities. Gynocare Fistula Center, Eldoret, receives a number of referrals for women with obstetric fistula requiring surgical and physiotherapy care. Many studies have focused on the determinants of surgical outcomes and social reintegration but none have focused on woman's perceptions and experiences with postoperative physiotherapy. While continence is not always achieved immediately after surgery, this study was designed to explore women's perceptions and experience of postoperative physiotherapy management at an obstetric fistula center in Eldoret,Kenya. Participants were then asked about their experiences and related perceptions and perceived challenges regarding the physiotherapy service following discharge from the Center. An explorative qualitative method was used to explore the women's perceptions and experiences of the post-operative physiotherapy management, as well as their perceived challenges regarding access to physiotherapy post discharge.

APA, Harvard, Vancouver, ISO, and other styles

Dissertations / Theses on the topic 'Stress urinary incontinence'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles