Search

Pelvic floor dysfunctions (PFD) are prevalent conditions that affect millions of women worldwide, encompassing a range of issues severely affecting women's quality of life. Pelvic floor muscle strength and function are fundamental to the management and prevention of PFD, and pelvic rehabilitation is a non-invasive approach that effectively improves symptoms, restores function, and prevents complications. This study aimed to evaluate the impact of pelvic floor muscle training program using weighted vaginal cones, on pelvic floor muscle function and quality of life in women with pelvic floor dysfunction (PFD). Fifty-four women aged 26-62 years, with different type of urinary incontinence, cystocele, and prolapse participated in this pre-post intervention comparative analysis. Pelvic floor muscle function was assessed using the PC test, which measures strength, endurance and fatigability, while the impact on patients' quality of life was assessed with the Pelvic Floor Impact Questionnaire - Short Form 7 (PFIQ-7). A three-month vaginal cone training regimen was implemented, with as-sessments conducted before the intervention (T0), one month later (T1), and three months later (T2). Data analysis showed a change with significant differences between the PC test score values at the level of each parameter and at each assessment (p<0.05, ES=0.254-511). The scores for bladder and urinary problems Urinary Impact Questionnaire (UIQ-7) significantly de-creased from 38.901 ± 1.268 at T0 to 29.366 ± 2.493 at T2 (W = 1082.000, p < 0.001, ES=0.570). In contrast, the scores for vaginal or pelvic problems (POPIQ-7) showed a slight, insignificant decrease from 12.699 ± 1.128 at T0 to 10.499 ± 2.362 at T2 (W = 278.000, p = 0.800, ES=0.053). fVaginal cone training significantly improves pelvic floor mus-cle function and reduces urynary symptoms in women with PFD [ABSTRACT FROM AUTHOR]

Objectives: To investigate the incidence of urinary incontinence (UI) during pregnancy and after delivery, perceptions of UI, effectiveness of pelvic floor muscle exercise (PFME) on UI, and risk factors for UI among pregnant women. Methods: Chinese women aged =18 years at 35 to 37 weeks of gestation were invited to participate. Perceptions of UI were assessed using a questionnaire that comprises seven statements. Urinary symptoms were assessed using the self-report six-item Urogenital Distress Inventory (UDI-6). Women were considered to have UI when they had positive scores on any of the incontinence items. Women who reported to have UI symptoms were assessed by a physiotherapist in the postnatal ward and were taught PFME. UI impact on quality of life was assessed using the self-report seven-item Incontinence Impact Questionnaire. Participants with UI during pregnancy who delivered in our hospital were followed up at 6 weeks postnatally through telephone. Their adherence to PFME was assessed in terms of the mean number of contractions performed per day. Results: Of 1134 participants, the incidence of UI was 73.0% during pregnancy and 21.9% after delivery. Predictors for UI during pregnancy were a history of UI before pregnancy (odds ratio [OR]=14.40, p<0.001), higher pre-pregnancy body mass index (OR=1.04, p=0.034), and previous vaginal delivery (OR=2.06, p=0.001), whereas predictors for UI after delivery were vaginal delivery in the index pregnancy (OR=3.86, p<0.001), older age (OR=1.12, p<0.001), a history of UI before pregnancy (OR=1.86, p=0.028), and total score of items 2 to 4 on the UDI-6 during pregnancy (OR=1.20, p=0.015). 86.4% of participants reported poor or no adherence to PFME. Adherence to postnatal PFME was not associated with UI after delivery (p=0.477). Women with higher education levels adhered more to PFME (p=0.008). Perceptions of UI were not associated with adherence to postnatal PFME. Conclusion: A history of pre-pregnancy UI is the main predictor for UI during pregnancy, whereas vaginal delivery is the main predictor for UI after delivery. The effect of postpartum PFME on UI after delivery is not significant, probably owing to the low rate of adherence to PFME. [ABSTRACT FROM AUTHOR]

Female urinary incontinence (UI) is highly prevalent in the US (>60%). Pelvic floor muscle training (PFMT) represents first-line care for UI; however, access and adherence challenges urge new care delivery models. This prospective cohort study investigates the feasibility and safety of a remote digital care program (DCP) combining education and PFMT with real-time biofeedback with an average duration of 10 weeks. The primary outcome was the change in the Urinary Impact Questionnaire—short form (UIQ-7) from baseline to program-end, calculated through latent growth curve analysis (LGCA). Secondary outcomes included the impact of pelvic conditions (PFIQ-7), depression (PHQ-9), anxiety (GAD-7), productivity impairment (WPAI), intention to seek additional healthcare, engagement, and satisfaction. Of the 326 participants who started the program, 264 (81.0%) completed the intervention. Significant improvement on UIQ-7 (8.8, 95%CI 4.7; 12.9, p < 0.001) was observed, corresponding to a response rate of 57.3%, together with improvements in all other outcomes and high satisfaction (8.9/10, SD 1.8). This study shows the feasibility and safety of a completely remote DCP with biofeedback managed asynchronously by a physical therapist to reduce UI-related symptoms in a real-world setting. Together, these findings may advocate for the exploration of this care delivery option to escalate access to proper and timely UI care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ege University Nursing Faculty (JEUNF) is the property of Journal of Ege University Nursing Faculty (JEUNF) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Urinary incontinence affects approximately 200 million people worldwide. The objective of this study was to investigate the effect of pelvic floor muscle (PFM) training with biofeedback (BF) in women with urinary incontinence in comparison to PFM training alone. The primary outcome was PFM strength with secondary outcomes being the severity of incontinence, other PFM parameters, quality of life (QoL), social life, satisfaction and adherence to treatment. Randomized controlled trials (RCTs) published from 2005 to 2023 in PubMed, MEDLINE, Scopus and Google Scholar were searched and evaluated with the PEDro scale. Nine moderate and two high methodological quality RCTs were selected. There was a statistically significant improvement in all parameters. In five studies, muscle strength and the severity of incontinence were statistically better in the BF group compared to the non-BF group. In most studies, no differences were found for QoL and social life between the groups. For adherence to treatment, the results were ambiguous. Τhe remaining variables (endurance, precontraction, function, adherence and satisfaction) had few studies to support the results. There was moderate level evidence that the group utilizing PFM exercises with BF showed significant improvements in the management of urinary incontinence. Concerning muscle strength and the severity of incontinence, findings were inconclusive, as only in some studies the results were statistically better in the BF group compared to the non-BF group. [ABSTRACT FROM AUTHOR]

Background: Childbirth is one of the biggest risk factors for incontinence. Urinary and anal incontinence can cause pain and social limitations that affect social life, cohabitation, and work. There is currently no up-to-date literature study on the effect of pelvic floor muscle training with feedback from a physiotherapist, which involves verbal instructions based on vaginal and anal digital palpation, compared to treatment without feedback (e.g., recommendations for pelvic floor muscle training). Aim: The objective of this systematic review was to examine the scientific evidence regarding the impact of pelvic floor muscle training (PFMT) with feedback from a physiotherapist and/or biofeedback on urinary and anal incontinence in women during the first six months following vaginal delivery, compared to treatment without feedback. Methods: The literature search was conducted in the databases PubMed, Cochrane, and CINAHL. In addition, a manual search was conducted. The search terms consisted of MeSH terms and synonyms in the respective search block including population, intervention, and study design, as well as the terms pelvic floor and postpartum. An evaluation of each included study was conducted for methodological quality, evidence value, and clinical relevance. Results: Eight studies were included, three of which showed a significant difference between groups, in favor of the intervention group that received pelvic floor muscle training with feedback from a physiotherapist and/or biofeedback. Due to the varying results and insufficient quality for the majority of the studies, the scientific basis was considered insufficient. Conclusion: The scientific evidence for pelvic floor muscle training with feedback from a physiotherapist or biofeedback on postpartum urinary and anal incontinence compared to treatment without feedback is considered insufficient. Further research on the subject is needed. The study is registered in PROSPERO CRD42022361296. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Urinary incontinence (UI) is a condition that is more common in women than men and has an increasing prevalence with age. It provides a range of psychological and physical burdens that negatively affect the patient's quality of life (QoL). However, the economic burden for the healthcare system is being augmented due to the increasing life expectancy of the population. This article aims to identify the effectiveness of pelvic floor muscle training (PFMT) on the QoL in women with UI. Materials and Methods: A systematic review and meta-analysis were conducted in the PubMed, EMBASE, ProQuest medicine, Cochrane Library, and Google Scholar databases. The terms selected according to components of PICOS were women with urinary incontinence, pelvic floor muscle training, watchful or other types of therapies, quality of life, randomized controlled trials, and interventional or observational studies. The articles included were those published between November 2018 and November 2022. Ten articles were found for the systematic review and eight for the meta-analysis. Results: The QoL moderately increased when PFMT was used on women with UI, the results indicating an overall small effect on the QoL across the controlled studies and a moderate effect on the QoL across the one-group pre-post-studies. Conclusions: Specific QoL domains, such as social activities and general health, also demonstrated benefits from PFMT interventions. This study confirmed the effectiveness of PFMT on the QoL in women with UI, mainly for patients with stress urinary incontinence. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The objective was to investigate and compare the efficacy of supervised Kegel exercises with bio-feedback on stress urinary incontinence (SUI) and pelvic floor muscle strength (PFMS) compared with unsupervised Kegel exercises. Method: Matched-group quasi-experimental study of 29 female participants divided into two groups (supervised and non-supervised) was conducted over 12 weeks. Baseline measurements of PFMS were undertaken by a women's health physiotherapist and a Kegel exercise regime bespoke designed for each participant. The supervised group visited the physiotherapist monthly for bio-feedback training (BT); the unsupervised group continued at home with their individualised Kegel exercises. Data were collected via a perineometer (Peritron™) and self-reporting responses to questionnaires. All participants received a final PFMS measurement on completion of the study. Results: Overall Incontinence Severity index (ISI) score was significantly lower in the supervised group post-intervention. Wilcoxon signed-rank tests indicated that supervised Kegel exercises significantly reduced frequency (p= 0.002) and severity (p= 0.020) of overall ISI. Analysis of PFMS were not significantly different, despite an increase in maximum voluntary contraction or pelvic floor muscle strength (PFMS) (p= 0.032) in the supervised group. Of the questionnaires, results of Wilcoxon signed-rank tests indicated that "total bother" was significantly reduced (p= 0.005) in the supervised group. The correlation analysis between PFMS and ISI did not reveal any significant results. Conclusions: The study confirmed that supervised BT is more effective in reducing SUI than unsupervised Kegel exercises, and that this reduction in ISI score did not correlate with the improvement in PFMS. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of supervised remote rehabilitation programs comprising novel methods of pelvic floor muscle (PFM) training for women with urinary incontinence (UI). Design: A systematic review and meta‐analysis including randomized controlled trials (RCTs), involving novel supervised PFM rehabilitation programs as intervention groups (e.g., mobile applications programs, web‐based programs, vaginal devices) versus more traditional PFM exercise groups (acting as control); both sets of groups being offered remotely. Methods: Data have been searched and retrieved from the electronic databases of Medline, PUBMED, and PEDro using relevant key words and MeSH terms. All included study data were handled as reported in the Cochrane Handbook for Systematic Reviews of Interventions and the evaluation of their quality was undertaken utilizing the Cochrane risk‐of‐bias tool 2 (RoB2) for RCTs. The included RCTs, involved adult women with stress UI (SUI) or mixed urinary incontinence, where SUI were the most predominant symptoms. Exclusion criteria involved pregnant women or up to 6‐month postpartum, systemic diseases and malignancies, major gynecological surgeries or gynecological problems, neurological dysfunction or mental impairments. The searched outcomes included subjective and objective improvements of SUI and exercise adherence in PFM exercises. Meta‐analysis was conducted and included studies pulled by the same outcome measure. Results: The systematic review included 8 RCTs with 977 participants. Novel rehabilitation programs included mobile applications (1 study), web‐based programs (1 study) and vaginal devices (6 studies) versus more traditional remote PFM training, involving home‐based PFM exercise programs (8 studies). Estimated quality with Cochrane's RoB2, presented the 80% of the included studies as "some concerns" and the 20% as "high risk." Meta‐analysis included 3 studies with no heterogeneity (I2 = 0) across them. Weak‐evidenced results presented home PFM training equally effective with novel PFM training methods (mean difference: 0.13, 95% confidence interval: −0.47, 0.73), with small total effect size (0.43). Conclusions: Novel PFM rehabilitation programs presented as effective (but not superior) to traditional ones in women with SUI, both offered remotely. However, individual parameters of novel remote rehabilitation including supervision by the health professional, remains in question and larger RCTs are required. Connection between devices and applications in combination with real‐time synchronous communication between patient and clinician during treatment is challenged for further research across novel rehabilitation programs. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor disorders are common, especially in pregnancy and after delivery, in the postmenopausal period, and old age, and they can significantly impact on the patient's quality of life. Methods: This narrative review is based on publications retrieved by a selective search of the literature, with special consideration to original articles and AWMF guidelines. Results: Pelvic floor physiotherapy (evidence level [EL] 1), the use of pessaries (EL2), and local estrogen therapy can help alleviate stress/urge urinary incontinence and other symptoms of urogenital prolapse. Physiotherapy can reduce urinary incontinence by 62% during pregnancy and by 29% 3-6 months post partum. Anticholinergic and β-sympathomimetic drugs are indicated for the treatment of an overactive bladder with or without urinary urge incontinence (EL1). For patients with stress urinary incontinence, selective serotonin-noradrenaline reuptake inhibitors can be prescribed (EL1). The tension-free tape is the current standard of surgical treatment (EL1); in an observational follow-up study, 87.2% of patients were satisfied with the outcome 17 years after surgery. Fascial reconstruction techniques are indicated for the treatment of primary pelvic organ prolapse, and mesh-based surgical procedures for recurrences and severe prolapse (EL1). Conclusion: Urogynecological symptoms should be specifically asked about by physicians of all relevant specialties; if present, they should be treated conservatively at first. Structured surgical techniques with and without mesh are available for the treatment of urinary incontinence and pelvic organ prolapse. Preventive measures against pelvic floor dysfunction should be offered during pregnancy and post partum. [ABSTRACT FROM AUTHOR]

Women frequently suffer from urinary incontinence due to atrophic changes in the urogenital tract. Recommended conservative treatment includes evaluation of pelvic-floor strength and the functional use of pelvic-floor-muscle (PFM) training. Following the PRISMA 2020 guidelines, a search was conducted in the electronic databases PubMed, Web of Science, and Scopus for articles with at least one group performing PFM exercises in post-menopausal women with urinary incontinence. Eight articles were included, and each study had at least one group of PFM exercise-based intervention alone or combined. The volume or duration, frequency, and number of sessions were heterogeneous. All the studies reported significant differences in favor of PFM exercise in strength, quality of life, and/or severity of urinary incontinence. PFM exercise is a highly recommended intervention to treat urinary incontinence in postmenopausal women. However, more research is needed to establish specific factors such as dose–response relationships and to standardize methods for measuring effects. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A common condition with a large global prevalence and a persistent medical taboo for many people is urinary incontinence. Around one in three women globally are impacted by it. The most frequently suggested physical therapy treatment for women with stress incontinence or urge incontinence is Kegel exercise (also called pelvic floor muscle training). This study aims to assess the effects of a Kegel exercise training program among women with urinary incontinence. The study was conducted at three government hospitals in Egypt's Port Said city's outpatient gynecological clinic. The intervention design was quasi-experimental. In total, 292 women with urine incontinence who visited the research sites made up the subjects. The necessary data were gathered using an interview questionnaire. Improvements in urinary incontinence and quality of life were positively correlated with daily Kegel exercise practice. Urinary incontinence has statistically significant positive correlations with age (p = 0.026), respiratory rate (p = 0.007), and body mass index (p = 0.026) as women grow older. Urinary incontinence, being single, and increasing pulse, however, had adversely significant negative correlations (p = 0.031 and 0.020, respectively). Urinary incontinence affects women's overall wellbeing, particularly in the emotional and social spheres, as well as their quality of life and their ability to participate in normal everyday activities. Following the adoption of the Kegel exercise training program, there was a substantial improvement in both urine incontinence and quality of life. [ABSTRACT FROM AUTHOR]

Aims: The objective of this analysis was to describe longitudinal adherence with recommended urinary incontinence (UI) evaluation and treatment guidelines over a 2‐year period in patients newly diagnosed with stress (SUI) or mixed UI (MUI), and average 2‐year cost associated with initial treatment. Methods: A retrospective claims analysis using the IBM MarketScan database was conducted. Women diagnosed with SUI/MUI between July 1, 2014 and June 30, 2016 were identified using the International Classification of Diseases (ICD) 9 and 10 codes for SUI or MUI. Newly diagnosed SUI/MUI patients who did not have a UI‐related diagnosis for at least 1 year before their index date were assessed. Results: 103 813 patients with newly diagnosed SUI or MUI were identified. Of those, 96.15% (99 821/103 813) received an initial evaluation in accordance with professional guidelines (e.g., patient history, physical examination, urinalysis). Only 6.8% (5086/74 925) and 7.7% (2229/28 888) of patients with SUI and MUI, respectively, received a first‐line behavioral treatment (e.g., pelvic floor muscle exercises, bladder training), according to guidelines. The 2‐year average UI‐related medical costs associated with guideline adherence for SUI were $5770.93 ± $9454.81 and for MUI, $4416.16 ± $7401.53. Nonadherence was observed in 59.2% (44 382/74 925) of SUI and 64.1% (18 530/28 888) of MUI patients. Two‐year average UI‐related medical costs for the nonadherent group were $8568.00 ± $11 275.52 for SUI and $6986.66 ± $10 765.55 for MUI, significantly more than the adherent group (p < 0.0001). Conclusion: The majority of SUI or MUI patients do not receive a documented behavioral intervention as their first‐line treatment, which is a recommendation by professional society guidelines. This was found to affect the cost burden for payers; those that were nonadherent had significantly higher costs 2‐year postindex. [ABSTRACT FROM AUTHOR]

Objective: This meta‐analysis aims to compare biofeedback‐assisted pelvic muscle floor training (PFMT) and pelvic electrical stimulation (ES) as an intervention group, with PFMT or bladder training (BT) as the control group, in women with an overactive bladder (OAB). Method: PubMed, Cochrane, CINAHL, EMBASE, and Scopus were systematically searched for randomized controlled trials (RCTs) published up to November 2021. The RCTs were screened for our eligibility criteria and quality was evaluated using the Cochrane Risk Index of Bias tools. The outcomes were changes in quality of life (QoL), episodes of incontinence, and the number of participants cured/improved. Results: Eight studies involving 562 patients (comprising 204 patients with biofeedback‐assisted PFMT, 108 patients with pelvic ES, and 250 patients who received PFMT alone or BT and lifestyle recommendations only, as the control group) were included. The ES group showed significant differences in terms of changes to QoL (mean difference [MD]: 7.41, 95% confidence interval [CI]: 7.90−12.92, p = 0.008), episodes of incontinence (MD: −1.33, 95% CI: −2.50 to −0.17, p = 0.02), and the number of participants cured or improved (risk ratio [RR]: 1.46, 95% CI: 1.14−1.87, p = 0.003), while the biofeedback group resulted in nonsignificant changes in QoL (MD: 0.13, 95% CI: 7.87−8.12, p = 0.98), episodes of incontinence (MD: 0.01, 95% CI: −0.89 to 0.90, p = 0.99), and the number of participants cured or improved (RR: 1.15, 95% CI: 0.99−1.33, p = 0.08), both compared to the control group respectively. Conclusion: This meta‐analysis shows that low‐frequency pelvic ES appears to be sufficient and effective as an additional intervention for women with OAB in clinical practice according to improvements in the subjects' QoL and reduction of symptoms. Meanwhile, biofeedback‐assisted PFMT does not appear to be a significant adjuvant for conservative OAB therapy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rehabilitation / Rehabilitacija is the property of University Rehabilitation Institute, Republic of Slovenia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aimed to evaluate the pre- and postoperative effects of pelvic floor muscle training (PFMT) and the biofeedback method on the management of urinary incontinence (UI) in patients who underwent radical prostatectomy (RP). Material and Methods: Fifty-seven patients were enrolled in this study from September 2019 to July 2020. They were randomly divided into three groups each of 19 patients: two case groups (biofeedback before and after RP) and a control group. All patients underwent RP, followed by PFMT and 24-hour pad use instructions after the postoperative removal of the Foley catheter. Then, the rate of patient-reported pads/day usage was recorded and compared among the three groups at the end of the 1st, 3rd, and 6th months of catheter removal. Results: Compared with the control group (only 15%), 63 and 52% of the patients who used pre- or postoperative treatment interventions, respectively, regained urinary continence during the first postoperative period, showing significant downward rates of pads/day use (P = .01 and .001, respectively). However, the results were not significant between the two case groups. Conclusion: Our study revealed that applying the biofeedback method for pelvic floor muscles could be an efficient interventional approach in patients with UI, leading to the earlier regaining of continence following RP. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor muscles support the pelvic organs and control voiding. The first choice in the repair of pelvic floor function that is damaged during pregnancy and delivery is pelvic floor muscle training, which involves repeated muscle relaxation and contraction. However, as muscle contractions cannot be visualised, it is difficult to assess whether patients understand how to contract them. Therefore, we assessed patients' comprehension of pelvic floor muscle contraction by comparing two teaching methods, vaginal palpation and transabdominal ultrasound, following vaginal delivery. We hypothesised that vaginal palpation is better than transabdominal ultrasound in this regard.Methods: This randomised controlled trial conducted in facilities in Tokyo, Japan between July 2018 and January 2019 included women aged ≥ 20 years at 4-6 weeks after vaginal delivery. The randomisation involved website-based centralised allocation. The primary outcome was a change in bladder base displacement during pelvic floor muscle contraction before and after training, which was measured using transabdominal ultrasound. Participants performed three contractions for 3 s, and the mean value was used for statistical analysis. The secondary outcome was a change in understanding the contraction before and after training, which was measured using a five-point Likert scale questionnaire. Outcomes were analysed using Welch's t-test.Results: Sixty-five participants were randomly allocated to the vaginal palpation group (n = 32) and transabdominal ultrasound group (n = 33). Baseline characteristics were similar between the groups. Changes in bladder base displacement were not significantly different between the groups (p = 0.181). Within-group analyses showed that bladder base displacement was large in both groups after the respective intervention. There were no significant differences in any of the outcomes between the two groups before and after the intervention.Conclusions: Vaginal palpation and transabdominal ultrasound might be useful for comprehending pelvic floor muscle contraction after vaginal delivery.Trial Registration: UMIN 000032304. Registered 18 April 2018, https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000036820 . [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of single and combined use of biofeedback (BF) and electrical stimulation (ES) added to bladder training (BT) on incontinence‐related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Material and Methods: Seventy women were randomized into four groups as follows: Group 1 received BT alone (n = 18), Group 2 received BT + BF (n = 17), Group 3 received BT + ES (n = 18), and Group 4 received BT + BF + ES (n = 17). BF and ES were performed 3 days a week, 20 min a day, a total of 24 sessions for 8 weeks. All women were evaluated in terms of incontinence severity (pad test), pelvic floor muscles strength (perineometer), 3‐day voiding diary (frequency of voiding, nocturia, incontinence episodes, and number of pads), QoL (incontinence impact questionnaire), treatment success (positive response rate), cure/improvement rate, treatment satisfaction (Likert scale), and discomfort level (visual analog scale). Results: At the end of the treatment, severity of incontinence, frequency of voiding, incontinence episodes, and treatment satisfaction significantly improved in Group 3 and Group 4 compared with the other two groups. In Group 3 and Group 4, high statistically significant values were found in cure/improvement and positive response rates as opposed to Group 1 and Group 2. In Group 2 and Group 3, statistically significant improvements were seen in nocturia and QoL compared with Group 1. Moreover, statistically significant improvements in nocturia and QoL were found in Group 4 compared with the other three groups. There was no difference in the discomfort level of application between the groups. Conclusion: We conclude that in the first‐line conservative treatment of women with idiopathic OAB: (i) adding BF and/or ES to BT increases treatment effectiveness, (ii) clinical efficiency is greater when the combination includes ES, (iii) BT + BF + ES (triple combination) is the most effective treatment option in reducing nocturia and improving QoL. [ABSTRACT FROM AUTHOR]

Introduction: The aims of the present study were to report longitudinal data on the prevalence of urinary incontinence (UI) in a fitness club setting and to investigate whether gym members are educated about and exercise their pelvic floor muscles. Methods: New members (125 women) from 25 fitness clubs in Oslo, Norway, filled in a 25-min online questionnaire (SurveyXact) at four time points (onset, 3, 6 and 12 months of fitness club membership). The questionnaire covered background/health information, membership dropout and exercise habits, including pelvic floor muscle training (PFMT). A modified Subjective Health Complaints Inventory (SHC Inventory) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were used to gather repeated measures of UI. Results: At onset, 3, 6 and 12 months of fitness club membership, 16.8%, 13.8%, 19.6% and 18.7% reported UI, respectively (p = 0.11). Of these, 57.1% to 76.2% reported leakage during exercise and perceived the UI to be slight. Less than 8% had received information about PFMT by the fitness club staff. Adherence to regular exercise and PFMT throughout the follow-up period (minimum two sessions/week) did not show any association with absent or present UI at 12 months (p = 0.48 and p = 0.63) and was reported by 30% and 22.2% of the participants, respectively. Conclusions: About 17% reported UI at onset of fitness club membership, with no changes in proportions throughout the first year. Adherence to regular exercise and PFMT did not show any association with absent or present UI at 12 months. Few had been taught PFMT. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Pelvic floor muscle training (PFMT) is internationally recommended for prevention and treatment of urinary incontinence (UI) and pelvic organ prolapse (POP). However, there is lack of knowledge about PFMT among pregnant Nepalese women. The objectives of this study were to develop a PFMT programme and to assess the feasibility of the programme. Methods: A feasibility study was conducted to address aspects of the PFMT programme provided to pregnant women attending antenatal check-ups at Kathmandu University Dhulikhel Hospital. The women were recruited consecutively from June 2017 to April 2018. The PFMT programme consisted of attending a minimum of four supervised PFMT follow-up visits after inclusion to the programme and performing PFMT daily at home. Feasibility was assessed in terms of the recruitment capability, sample characteristics, data collection procedures, outcome measures, and acceptability (attendance to PFMT visits, PFMT adherence, participant experiences) of the programme. Data were collected using self-reported questionnaires. Educational material (video, leaflet, and exercise diary) was developed in Nepali. Results: Among 253 women included, 144 (57%) attended four or more supervised PFMT visits. No significant differences were found in the symptoms of UI (0.89) and POP (0.44) between those attending and those not attending four PFMT visits. Half of the women adhered to 50–100% of PFMT daily at home. The supervised PFMT and the educational material motivated the women to daily PFMT. Conclusion: The PFMT programme was acceptable, at least to those living in the district of the study site. The results and experiences from the current study may guide implementation and future studies on the effectiveness of PFMT in Nepal. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The objective was to appraise the current use of mobile technologies for the conservative self-management of urinary incontinence (UI). Moreover, we aimed to explore whether they integrate recommended features for the use of mobile technologies in healthcare and recognized parameters for optimal conservative UI treatment. Methods: We conducted a literature search on Medline, Embase, CINAHL, REHABDATA, Cochrane Library and PEDro databases. Eligible articles included people with UI of any type and use of a mobile technology for the conservative self-management of UI. Two reviewers independently screened, reviewed, and extracted data on study design, type of mobile technologies, valuable features, and outcomes related to UI. Results: Twelve articles (level of evidence II to V) were retained. Technologies used were a mobile app alone (n = 2), a Pelvic Floor Muscle Training (PFMT) device and app (n = 2), a PFMT device and telerehabilitation (n = 1), a smartphone messaging system (n = 1), and an internet-based program (n = 1). PFMT programs prescribed a daily frequency for at least 8 weeks. Between 1 and 4 valuable features were reported out of 6 identified. After intervention, at least 1 outcome on UI severity was reported improved in 6/7 studies, satisfaction was high in 3/3 studies and adherence was high (daily usage) in 4/5 studies. Conclusion: There is level 2 evidence that there are benefits of using mobile technologies in terms of improvements in UI, satisfaction, adherence, and costs. Mobile technologies reviewed seem to follow optimal PFMT parameters, but users could benefit further from more built-in features that may optimize rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Aims: To assess the effects of individual pelvic floor muscle (PFM) training vs individual training (IT) progressing to group training (GT) vs group‐only training in women with stress urinary incontinence (SUI). Methods: Randomized controlled and pragmatic clinical trials with 90 women with SUI. Participants were randomly allocated to one of three groups: IT, GT, or four individual sessions progressing to group training (IPGT). The intervention included 12 sessions, once a week, with direct supervision by a physical therapist. Primary outcome: severity according to the King's Health Questionnaire. Secondary outcomes: PFM function by palpation and manometer, bladder and exercise diaries, PFM training adherence, and self‐efficacy. Reassessments were conducted at the end of the intervention, 3 and 6 months after the intervention. Intra‐ and intergroup analysis for all outcomes was performed using a multivariate analysis of variance. In the mixed‐effects model used, the evaluation groups and times and their interactions were considered. A significance level of 5% was adopted. Results: After the intervention, the severity measure improved in all three groups (P <.001), without difference between them (P =.56). The benefits of the intervention were maintained 3 and 6 months after the end of the supervised training (P <.001). The IPGT group had a significant improvement in PFM function when compared to the other groups posttreatment (P <.001). Conclusion: PFM training improved the severity of urinary incontinence in all groups after 12 sessions of training supervised by a physical therapist. IT progressing to GT improved the function of upper PFM when compared to the other groups. [ABSTRACT FROM AUTHOR]

Keywords: urinary incontinence; overactive bladder; diagnosis; stress urinary incontinence; urgency urinary incontinence EN urinary incontinence overactive bladder diagnosis stress urinary incontinence urgency urinary incontinence 638 655 18 05/02/20 20200501 NES 200501 Abbreviations ACOG American College of Obstetrics and Gynecology/American Urogynecologic Society AFS autologous fascial sling AGREE Appraisal of Guidelines for Research and Evaluation AUGS American Urogynecologic Society AUS artificial urinary sphincter BTX botulinum toxin CUA Canadian Urological Association DO detrusor overactivity EAU European Association of Urology ER extended release (formulations) FDA USA Food and Drug Administration ICI International Consultation on Incontinence ICIQ ICI Questionnaire IR immediate release MEDLINE Medical Literature Analysis and Retrieval System Online (R)(T)MUS (retropubic) (transobturator) mid-urethral sling NICE National Institute for Health and Care Excellence OAB overactive bladder PFMT pelvic floor muscle therapy POP pelvic organ prolapse PTNS posterior tibial nerve simulation PVS pubovaginal sling QoL quality of life RCT randomised controlled trial SUFU Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction UA urine analysis UDS urodynamic studies (M)(S)(U)UI (mixed)(stress)(urge) urinary incontinence ValUE Value of Urodynamic Evaluation (trial) Key Points Guidelines are not exhaustive, but practical evidence-based reviews of "index patients". Guidelines suggest a stepwise approach to treat both urgency UI and stress UI, starting with conservative therapy, advancing to more invasive procedures as needed Urodynamics should be used when it will change management and if there is recurrent UI after failure of invasive treatments. [Extracted from the article]

Introduction and hypothesis: Lower urinary tract symptoms (LUTS) affect up to 80% of patients with multiple sclerosis (MS). The present randomized, open-label, clinical trial examines the effectiveness, as a conservative treatment for LUTS, of a physiotherapist-guided pelvic floor muscle training (PFMT) program adapted for patients with relapsing-remitting multiple sclerosis (RRMS) and urinary incontinence (UI). Methods: Forty-eight patients with RRMS were randomly assigned to a 12-week PFMT program with or without physiotherapist guidance. The primary endpoint was the reduction in urinary leakages after 12 weeks of following the program. The secondary variables assessed were quality of life (QoL), UI severity, LUTS, and treatment adherence. Results: Forty patients completed the program. No significant differences in baseline characteristics were seen between the two treatment groups. At 12 weeks, both groups reported a significantly reduced number of leakages compared with baseline (P < 0.001), with no significant differences seen between groups (P = 0.210). In the physiotherapist-guided group, significant differences were found in QoL, UI severity, and LUTS between baseline and 12 weeks, for both male and female subjects. No significant differences in adherence were seen between the two treatment groups. Conclusions: No difference in leakage reduction was seen between physiotherapist-guided and unguided PFMT. However, the physiotherapist-guided program was associated with improvements in UI severity, QoL, and LUTS in women and men. The guided PFMT group also showed a trend towards better adherence to treatment. Clinical trial registration: No. NCT03000647; Title: "Guided Versus Non-Guided Pelvic Floor Exercises for Urinary Incontinence in Relapsing-Remitting Multiple Sclerosis." [ABSTRACT FROM AUTHOR]

Aims: Efficacy of pelvic floor muscle training (PFMT) for postprostatectomy incontinence (PPI) differs between randomized clinical trials (RCT). This might be explained by variation in content/delivery of PFMT (eg, biofeedback, muscles targeted, and time of commencement of training). This review investigated whether outcome of meta‐analysis differs based on presence or not of specific RCT features. Methods: PubMed, CINAHL, EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane were searched for RCTs that investigated efficacy of PFMT on PPI. PFMT details and outcomes were extracted. Methodological quality and comprehensiveness of PFMT reporting was assessed using the PEDro scale and Consensus on Reporting Template, respectively. Effect size and 95% confidence intervals were calculated for incontinence rate at 3 months. To identify features that influenced efficacy, separate meta‐analyses were performed for studies with and without specific features. Results: Twenty‐two trials were included, and 15 were used for meta‐analysis of 3‐month outcomes. Overall, meta‐analysis showed reduced incontinence with PFMT (risk ratio [RR] = 0.85; I2= 55%; P =.005). Meta‐analyses showed better outcomes for PFMT than control groups when the study included preoperative PFMT (RR = 0.76; I2= 30%; P =.006), biofeedback (RR = 0.73; I2= 58%; P =.006), instruction to contract around the urethra (RR = 0.9; I2= 43%; P =.009), a control group without PFMT instruction (RR = 0.85; I2= 69%; P =.05), inclusion of all men irrespective of continence status (RR = 0.84; I2= 30%; P =.003) and continence defined as no leakage (RR = 0.85; I2= 48%; P =.05). Conclusions: Preoperative PFMT, biofeedback, urethral instructions, no PFMT instruction for controls, inclusion of all men, and continence defined as no leakage are features associated with successful patient outcomes. Future studies should consider these features in design of interventions and pooling data for meta‐analysis. [ABSTRACT FROM AUTHOR]

A quick, well-timed pelvic-floor muscle contraction during physical effort is recommended for active women to prevent urine leakage.Purpose: We address two research questions: how well do future female exercise professionals contract the pelvic-floor muscles, and whether the biofeedback session is necessary to train them to contract pelvic-floor muscles?Method: Participants were 84 nulliparous future exercise professionals (age 23 ± 3 years, mean ± SD), randomly allocated into biofeedback (n = 27), usual-advice (n = 26), and control (no advice, n = 21) groups. Contraction of pelvic-floor muscles on a 4-point scale (1 = incorrect through 4 = correct) was assessed in all groups by surface electromyography (sEMG) with a vaginal probe before and after 6 weeks of intervention.Results: In pretest, almost one in five participants (17%) could not activate the pelvic floor and less than half of them (45%) presented correct technique. The technique score for the three groups was 3.1 ± 1.1 (mean ± SD). After training, both intervention groups presented better technique score by 0.6 (90% confidence limits ± 0.5) relative to the control group, and two-thirds (65%) of the intervention groups presented the correct technique.Conclusions: Future exercise professionals displayed poor skills in contracting pelvic-floor muscles. Both training interventions (with and without biofeedback) were effective for this study group. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effect of pelvic floor muscle training with surface electromyographic (sEMG) biofeedback (BF group) and Pilates exercises (P group) on the bioelectrical activity of pelvic floor muscles in women with stress urinary incontinence. The other aim aim was to compare changes in voiding diaries and scores on quality of life questionnaire against baseline values and between the groups. Women in the BF group (n = 18) participated in pelvic floor muscle training with sEMG biofeedback; the P group (n = 13) participated in basic level Pilates workouts. Both protocols were continued for eight weeks. Voiding diary, quality of life and electromyographic characteristics of the pelvic floor muscles were assessed at the three-time points: at baseline, after eight weeks' training, and at month six post-training. The sEMG activity of the pelvic floor muscles was tested during five trials in two positions. There was no marked improvement in bioelectrical activity of the pelvic floor muscles during contraction following training with sEMG biofeedback or Pilates exercises. Following eight weeks of sEMG biofeedback training, a decrease was noted in resting bioelectrical activity of pelvic floor muscles and during relaxation after sustained contraction but only in supine-lying. No such effect was observed in the Pilates group. In the BF group, the number of incontinence episodes after end of treatment (timpepoints: 1vs. 2) and at six month follow-up (timpepoints: 1vs. 3) decreased by 68.5% and 89.3%, respectively. The respective values in the P group were 78.6%, and 86.4%. The intergroup differences did not reach the level of statistical significance. As regards the quality of life, the questionnaire demonstrated that Pilates exercises had significantly better effects compared to biofeedback training both at the end of the eight-week exercise program and (p = 0.003) and at six month follow-up (p = 0.0009). The International Consultation on Incontinence Questionnaire—Short Form (ICIQ- SF) showed comparable efficacy of Pilates exercises and training with sEMG biofeedback. Intragroup improvements in micturition frequency, incontinence (leakage) episodes, and nocturia frequency were comparable. Alleviation of urinary incontinence symptoms was comparable in both groups, whereas the improvement in the quality of life was more notable in the Pilates group. The obtained results failed to demonstrate the superiority of any of the two methods regarding the bioelectrical activity of pelvic floor muscles in patients with stress urinary incontinence. [ABSTRACT FROM AUTHOR]

Background: Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). UI has a devastating effect on women's quality of life in the physical, social, sexual and psychological spheres. Women restrict or diminish their activity and social participation, with serious implications. In SUI, there is an association between physical exertion and urinary loss. Increased intra-abdominal pressure triggered by physical exertion leads to increased intra-vesical pressure and, if it exceeds intraurethral pressure, in the absence of contraction of the detrusor muscle, the resulting urinary leakage is referred to as SUI. Aim of the study: To identify the protocol and/or most effective training parameters in the treatment of female SUI. Materials and methods: 100 patients with stress urinary incontinence attending the out-patient department were thoroughly evaluated and randomized into 2 groups of 50 patients each, both groups were taught Kegels exercises and instructions to perform them at home. The experimental group (A) received additional strategies to enhance the efficacy of PFME in the form of reminder bindis to be placed in areas of the home frequented by the patient like the kitchen and its appliances. Patients in the control group (B) did not receive any additional reminders. Both groups were asked to maintain an exercise diary and allowed to continue their routine medications for comorbidities if any. They were reviewed on Day 15, Day 30 and physiotherapy sessions are given. Later on Day 90 the patients of both groups were reviewed and evaluated with a questionnaire for improvement in symptoms and adherence to PFME. Results: Among the total 100 patients who were trained to do PFME, 23 (14 from group A and 9 from group B) were completely dry by 90 days, 51 (29 from group A and 22 from group B) patients had reduction in the leak and 26 (7 from group A and 19 from group B) patients showed no improvement. Assessment from the exercise diary showed good adherence and symptom relief in most patients in the trial group. Conclusions: Adherence to PFME was better in the trial group in whom indigenous reminders were used which in turn translated into clinical improvement. In this time and era as PFMT is the first management modality in patients with stress and mixed incontinence implementation of such strategies to improve adherence to treatment is suggested especially in tertiary care setups. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: We evaluated whether vaginal tampon training (VTT) combined with pelvic floor muscle training (PFMT) results in better outcomes than PFMT alone for treating stress urinary incontinence (SUI).Methods: This was a randomized, controlled study. Patients were allocated to either the combined program, consisting of PFMT and VTT over 12 weeks [PFMT and VTT group (n = 24)] or to PFMT alone [PFMT group (n = 24)]. The primary outcome measure was self-reported improvement, while secondary outcome measures were severity of incontinence, quality of life (QoL), urinary parameters, and pelvic floor muscle strength (PFMS) and endurance (PFME). Values were analyzed with Friedman, Mann-Whitney U, Wilcoxon, and chi-square tests.Results: Between-group analysis showed no statistically significant differences in self-reported improvement, severity of incontinence, symptom distress score, PFMS, PFME, urinary parameters, and all domains of QoL scores, except social limitations, at weeks 4, 8, and 12 (p > 0.05). However, the increase in PFMS and PFME between baseline and week 12 and earlier improvement was significantly greater in the PFMT and VTT than in the PFMT group (both p < 0.05) Conclusion: Short-term results demonstrated that PFMT with and without VT exercises had similar effectiveness on the symptoms of SUI and QoL. [ABSTRACT FROM AUTHOR]

Stress urinary incontinence (SUI) is a little-discussed but perhaps surprisingly common condition in elite athletes involved in high-impact sports. This article discusses the possible causes of SUI (which is more complex than simply weak pelvic floor muscles), methods of SUI assessment and the various options for therapy. This will enable you to tailor a training regimen to suit your patient and create the best chances of a successful outcome, allowing your client to continue their sport with confidence and dignity. [ABSTRACT FROM AUTHOR]

Introduction: New methods of conservative treatment of female stress urinary incontinence are needed. We investigated whether superimposed vibration mechanosignals during Kegel exercises could reduce the amount of urinary leakage after 4 and 6 weeks of training.Material and Methods: Sixty women with stress urinary incontinence were included in this prospective cohort study. Vibration mechanosignals were superimposed during Kegel exercises using an intravaginal device. Each training session consisted of 15 maximal contractions of pelvic floor muscles for 5 s. The women performed training (5 min/day) at home for 4 (n = 60) and 6 (n = 36) weeks. Urine leakage (g) during stress test with standardized bladder volume, and contraction force without and with superimposed mechanical stimulations were measured at inclusion (T0 ), and after 4 (T2 ) and 6 (T3 ) weeks of training using an intravaginal device. Incontinence Questionnaire-Short Form was recorded at T0 , and in a sub-cohort of women (n = 36) at 2 years follow up.Results: Mean urine leakage reduced significantly from 20.5 (± 12.2) g at T0 to 4.8 (± 6.7) g at T2 and 1.5 (± 6.7) g at T3 . After 4 and 6 weeks of training, urinary leakage was ≤ 4 g on stress test in 44 and 49 of the 60 women, respectively. At T0 , the mean Incontinence Questionnaire-Short Form score was 13 (± 2.4), and at 2 years follow up, the score was 6.3 (± 3.75).Conclusions: Superimposed mechanical stimulation with Kegel exercises significantly reduced urinary leakage in women with stress urinary incontinence. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: We investigated the long-term effects of using a mobile app to treat stress urinary incontinence with a focus on pelvic floor muscle training.Material and Methods: A previous randomized controlled trial of 123 women aged 27-72 years found that three months of self-managing stress urinary incontinence with support from the Tät® app was effective. We followed up the women in the app group (n = 62) two years after the initial trial with the same primary outcomes for symptom severity (International Consultation on Incontinence Questionnaire Short Form) and condition-specific quality of life (ICIQ-Lower Urinary Tract Symptom Quality of Life) and compared the scores with those at baseline.Results: Of the 62 women, 61 and 46 (75.4%), respectively, participated in three-month and two-year follow-ups. Baseline data did not differ between responders and non-responders at follow-up. The mean decreases in International Consultation on Incontinence Questionnaire Short Form and ICIQ-Lower Urinary Tract Symptom Quality of Life scores after two years were 3.1 (95% confidence interval 2.0-4.2) and 4.0 (95% confidence interval 2.1-5.9), respectively. Of the 46 women, four (8.7%) rated themselves as very much better, nine (19.6%) as much better, and 16 (34.8%) as a little better. The use of incontinence protection products decreased significantly (p = 0.04), and the proportion of women who felt they could contract their pelvic muscles correctly increased from 14/46 (30.4%) at baseline to 31/46 (67.4%) at follow-up (p < 0.001).Conclusions: Self-management of stress urinary incontinence with support from the Tät® app had significant and clinically relevant long-term effects and may serve as first-line treatment. [ABSTRACT FROM AUTHOR]

AimThis study aimed to explore, describe and enhance understanding of women’s experiences, beliefs and knowledge of urinary symptoms in the postpartum period and also sought to understand the perceptions of health professionals of these issues.BackgroundWomen often take no action with regard to urinary symptoms particularly in the postnatal period, which can lead to the adoption of coping mechanisms or normalisation of symptoms. The true prevalence is difficult to assess due to differing age groups and time spans in studies. There is only a small body of work available to try to understand the lack of action on the part of the women, and even less around the attitudes of health professionals.MethodsGrounded theory was selected for a qualitative inductive approach, to attempt to understand the social processes involved and generate new knowledge by examining the different interactions. Recruitment was by theoretical sampling. In total, 15 women were interviewed and two focus groups of health professionals were undertaken. In addition, an antenatal clinic and a postnatal mothers group were observed. All information was analysed manually using constant comparison.FindingsThe findings revealed that at times poor communication, lack of clear education and the power of relative’s stories of the past were barriers to help seeking, and were disempowering women, creating a climate for normalisation. Women were willing to talk but preferred the health professional to initiate discussion. In addition, health professionals were concerned about a lack of time and knowledge and were uncertain of the effect of pelvic floor muscle exercises due to some research indicating improvement may not be maintained over time. The core category was; ‘overcoming barriers to facilitate empowerment’, indicating that improving communication and education could reduce barriers and enable them to seek help. [ABSTRACT FROM PUBLISHER]

Aim: Prostatitis is an inflammation of the prostate tissue, its swelling. This term defines the inflammation of the prostate gland. Prostatitis can develop only in men. According to statistics, over the past 20 years the incidence of prostatitis increased about twice, and now, it suffers from almost half the world's population of men aged 20 to 50 year. The purpose of the present study was to design of booklet about all information of Kegel exercises by Arabic language as ahealthawarenessprogram from prostatitis. Methods: Ten Urologists (a doctor who specializes in diseases of the urinary tract and the male reproductive system) from faculty of medicine and ten personal trainers (Clinical experience years23.8 +/- 3.9 years) participated in this studyas an experts. The suggested booklet contain primary information's about nature of the disease, causes, symptoms, and Kegel exercises. All experts suggested and put their opinion into the booklet. Results: The data revealed that booklet is good, and all experts constant about the important of the Kegel exercises and contents of the booklet. Conclusions: The findings indicated that almost all studies, the positive effects of physical therapy on urge urinary incontinence (UUI). These results have to be taken into account by health ministry in order to better understand and implicated of these concepts in health awareness. [ABSTRACT FROM AUTHOR]

The RELAX trial studied the efficacy of intra‐detrusor onabotulinum toxin A (onaBoNTA) for the treatment of detrusor overactivity (DO) in women. Our objectives in this study were to explore patients' experience and understanding of taking part in a randomised controlled trial (RCT) and their experience of the treatment itself. In addition we explored how patients felt about their bladder problem prior to treatment, conservative management strategies they had been offered, and anti‐muscarinic treatment. Purposive sampling was used to interview patients who had successful and unsuccessful outcomes. Interviewers were blinded to this sampling. Semi‐structured telephone interviews were conducted with all recruited women. Analysis was using a grounded theory approach. Transcripts were analysed thematically based on a constant comparative method until the point of data saturation, that is no new themes were identified. Fifteen women in total were interviewed. There were eight global themes identified. These were: quality of life, conservative management, study awareness, reasons for participation, role of the media, the extension study, intervention and experience of a RCT. The impact of overactive bladder (OAB) symptoms was a strong theme leading to feelings of anxiety. All of the women interviewed perceived pelvic floor exercises as a short term plan. Compliance was sporadic and most discontinued because of lack of efficacy. All women had been counselled about the risk of voiding dysfunction after onaBoNTA treatment and women found the actual process of being taught clean intermittent self‐catheterisation by another woman difficult, Patients stated they felt embarrassed and traumatised by the experience. OnaBoNTA is an effective treatment for patients with DO whose disease burden is considerable. This work highlights the value of incorporating qualitative research methods into the design of RCTs particularly when dealing with surgical procedures. [ABSTRACT FROM AUTHOR]

Purpose: Supervised pelvic floor muscle training in patients of stress and mixed urinary incontinence has been recommended. Our aim was to assess the utilisation and effectiveness of our supervised pelvic floor muscle training service and assess the impact of incontinence scores before physiotherapy on the subsequent results of physiotherapy.Methods: All 271 patients referred to physiotherapy for symptoms of incontinence filled out the International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms before starting treatment. Depending on pelvic floor muscle assessment, plans for exercises and follow up were made. If the strength of pelvic floor muscles was poor, electrical stimulation was offered. If awareness of the pelvic floor muscle contraction was poor, bio feedback was offered. Group sessions and vaginal cones were also used. Depending on the response to the treatment; patients were either discharged, referred to Urogynaecology clinic or continued physiotherapy. All patients who were discharged or referred for surgery were given a post treatment questionnaire to fill out.Results: 79 (56 %) of 132 women with stress, 49 (51 %) of 98 with mixed and 27 (66 %) of 41 with urge incontinence reported successful control of symptoms (overall success 54 %). However, 65 % of women with incontinence scores of 0-5 before physiotherapy, 64 % with 6-10, 42 % with 11-15 and mere 28 % with 16-20 achieved success with physiotherapy. 27 (10 %) were lost to follow up.Conclusion: 1 in 2 women referred to physiotherapy for incontinence, achieved successful control of symptoms without the need for invasive investigations or surgery. However, poor incontinence scores before the start of physiotherapy is a poor prognostic indicator for success. 90 % women utilised the service. [ABSTRACT FROM AUTHOR]

Objective: Evaluate effect of pelvic floor muscle training (PFMT) on vaginal symptoms and sexual matters, dyspareunia and coital incontinence in primiparous women stratified by major or no defects of the levator ani muscle.Design: Randomised controlled trial (RCT).Setting: Akershus University Hospital, Norway.Sample: About 175 primiparous women with a singleton vaginal delivery.Methods: Two-armed assessor blinded parallel group RCT from 6 weeks to 6 months postpartum comparing effect of PFMT versus control.Main Outcome Measures: International Consultation on Incontinence Modular Questionnaire-vaginal symptoms questionnaire (ICIQ-VS) and ICIQ sexual matters module (ICIQ-FLUTSsex).Results: Overall, analysis (n = 175) showed no difference between training and control groups in women having vaginal symptoms or symptoms related to sexual dysfunction 6 months postpartum. The majority of women (88%) had intercourse and there was no difference between groups. Unadjusted subgroup analysis of women with a major defect of the levator ani muscle (n = 55) showed that women in the training group had 45% less risk of having the symptom 'vagina feels loose or lax' compared with the control group (relative risk 0.55, 95% confidence interval 0.31, 0.95; P = 0.03).Conclusions: Unadjusted analysis showed that in women with major defect of the levator ani muscle, significantly fewer in the training group had the symptom 'vagina feels loose or lax' compared with the control group. No difference was found between groups for symptoms related to sexual dysfunction. More studies are needed to explore effect of PFMT on vaginal symptoms and sexual dysfunction.Tweetable Abstract: Unadjusted analysis shows that PFMT might prevent symptoms of 'vagina feels loose or lax'. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives To determine the feasibility and acceptability of traditional Chinese medicine (TCM) acupuncture and pelvic floor muscle training (PFMT) in reducing symptoms and bothersomeness in women with mixed urinary incontinence (MUI); and to estimate the sample size for a full scale trial. Methods Thirty-four women with MUI were randomly assigned to either 12 sessions of TCM acupuncture, 12 sessions of PFMT, or to a waiting list control group. Outcome measures included an assessment of interest to participate in the trial, identification of successful recruitment strategies, the appropriateness of eligibility criteria, and compliance with treatment. Clinical outcomes were assessed at baseline and 12 weeks, and included the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI SF), expectations of treatment effect, and adverse events. Results Recruitment was feasible and randomisation worked adequately by means of SurveyMonkey. SurveyMonkey does not permit stratification by ICIQ-UI SF baseline score. Fourteen of 22 women found the treatment options acceptable. The dropout rate was high, especially in the control group (6/12). Outcome forms were completed by 20 of 34 women. The median (IQR) changes of the ICIQ-UI SF scores in the acupuncture, physiotherapy, and waiting list group were 5.5 (2.3 to 6.8), 1.0 (-3.0 to 4.5), and 1.5 (-1.5 to 3.0), respectively, suggesting the need for a full scale trial. Conclusions Women with MUI were willing to participate in this study. There is a need for adjusting eligibility criteria. A sample size of 129 women, 43 in three arms, is required. No major adverse events occurred. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the long-term effects of two non-face-to-face treatment programmes for stress urinary incontinence ( SUI) based on pelvic floor muscle training ( PFMT). Subjects and Methods The present study was a randomized controlled trial with online recruitment of 250 community-dwelling women aged 18-70 years with SUI ≥ one time/week. Diagnosis was based on validated self-assessed questionnaires, 2-day bladder diary and telephone interview with a urotherapist. Consecutive computer-generated block randomization was carried out with allocation by an independent administrator to 3 months of treatment with either an internet-based treatment programme ( n = 124) or a programme sent by post ( n = 126). Both interventions focused mainly on PFMT. The internet group received continuous e-mail support from a urotherapist, whereas the postal group trained on their own. Follow-up was performed after 1 and 2 years via self-assessed postal questionnaires. The primary outcomes were symptom severity ( International Consultation on Incontinence Questionnaire Short Form [ ICIQ- UI SF]) and condition-specific quality of life ( ICIQ- Lower Urinary Tract Symptoms Quality of Life [ ICIQ- LUTSqol]). Secondary outcomes were the Patient Global Impression of Improvement, health-specific quality of life ( EQ-visual analogue scale [ EQ- VAS]), use of incontinence aids, and satisfaction with treatment. There was no face-to-face contact with the participants at any time. Analysis was based on intention-to-treat. Results We lost 32.4% (81/250) of participants to follow-up after 1 year and 38.0% (95/250) after 2 years. With both interventions, we observed highly significant ( P < 0.001) improvements with large effect sizes (>0.8) for symptoms and condition-specific quality of life ( Qo L) after 1 and 2 years, respectively. No significant differences were found between the groups. The mean ( sd) changes in symptom score were 3.7 (3.3) for the internet group and 3.2 (3.4) for the postal group ( P = 0.47) after 1 year, and 3.6 (3.5) for the internet group and 3.4 (3.3) for the postal group ( P = 0.79) after 2 years. The mean changes ( sd) in condition-specific Qo L were 5.5 (6.5) for the internet group and 4.7 the for postal group (6.5) ( P = 0.55) after 1 year, and 6.4 (6.0) for the internet group and 4.8 (7.6) for the postal group ( P = 0.28) after 2 years. The proportions of participants perceiving they were much or very much improved were similar in both intervention groups after 1 year (internet, 31.9% [28/88]; postal, 33.8% [27/80], P = 0.82), but after 2 years significantly more participants in the internet group reported this degree of improvement (39.2% [29/74] vs 23.8% [19/80], P = 0.03). Health-specific Qo L improved significantly in the internet group after 2 years (mean change in EQ- VAS, 3.8 [11.4], P = 0.005). We found no other significant improvements in this measure. At 1 year after treatment, 69.8% (60/86) of participants in the internet group and 60.5% (46/76) of participants in the postal group reported that they were still satisfied with the treatment result. After 2 years, the proportions were 64.9% (48/74) and 58.2% (46/79), respectively. Conclusion Non-face-to-face treatment of SUI with PFMT provides significant and clinically relevant improvements in symptoms and condition-specific Qo L at 1 and 2 years after treatment. [ABSTRACT FROM AUTHOR]

Aim: Urinary incontinence is a major health problem among middle‐aged women. Pelvic muscle exercise is one of the primary interventions, but difficulty performing this exercise has led researchers to seek alternative or conjunctive exercise. This study aimed to examine the effect of a combined pelvic muscle exercise and yoga intervention program on urinary incontinence. Methods: A single group pre‐/post‐test design was used. Subjects were recruited from a community health center in Seoul, Korea, and a questionnaire survey was conducted. Fifty‐five women participated in the first day of the program, 34 of whom completed the 8 week, twice weekly intervention program. Urinary incontinence was measured by five domains of urinary tract symptoms: filling factor, voiding factor, incontinence factor, sexual function, and quality of life. Also measured were attitude toward pelvic muscle exercise and pelvic muscle strength. Results: Significant improvements were found in attitude toward pelvic muscle exercise, pelvic muscle strength, and incontinence factor. Daily performance of pelvic muscle exercise was positively correlated with improved incontinence factor and with quality of life related to urinary tract symptoms. Conclusion: A combined pelvic muscle exercise and yoga program was effective for improving overall urinary incontinence in community health center attendees in Korea. Further study is needed with a control group, different populations, and a longer intervention period. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the effectiveness of pelvic floor muscle training in reducing the symptoms of urinary incontinence. The study used randomized controlled clinical trial to assess urinary incontinence symptoms and pelvic floor muscle strength. The study revealed that urinary incontinence symptoms of all participants has been reduced after undergoing a home based pelvic floor muscle training for 12 weeks.