Urinary leakage during exercise: problematic activities,adaptive behaviors,and interest in treatment for physically active Canadian women

Introduction and hypothesis

Urine loss during recreational exercise is problematic. We aimed to characterize which activities are most frequently reported as causing leakage for women, adaptive management mechanisms, and awareness and interest in treatment in a cohort of physically active women.

Methods

We administered an anonymous questionnaire to 59 physically active women in Canada. Surveys were completed electronically or on paper. Demographic information was obtained. Questions about which specific activities caused leakage, adaptive behaviors to deal with urinary loss, and degree of bother were addressed, and knowledge and interest in therapies for leakage were queried.

Results

Activities most likely to cause leakage were skipping, trampoline, jumping jacks, and running/jogging. To decrease leakage, 93.2% voided immediately before exercise, 62.7% reported voiding breaks, and some reported fluid restriction (37.3%). Leakage impacted activity level for 50% of women. Most often, activity intensity was decreased (90.3%) or specific activities avoided (80.7%). Pad use during exercise was common (49.2%). Interest in receiving treatment for urinary incontinence (UI) was high (88.1%) despite a large proportion (35.6%) not knowing of available treatments. Interest was highest for pelvic floor physiotherapy (84.6%), although interest in both pessary and surgical management (63.5% each) was significant.

Conclusions

Women experiencing UI during exercise report high-impact activities as most frequently causing loss. Adaptive behaviors are common. Physically active women are interested in treatment, and the high interest in pelvic physiotherapy presents a unique opportunity to link pelvic exercise with recreational exercise to meet both cardiovascular and continence needs in the physically active patient population.

     

A systematic review of outcome and outcome-measure reporting in randomised trials evaluating surgical interventions for anterior-compartment vaginal prolapse: a call to action to develop a core outcome set

Introduction

We assessed outcome and outcome-measure reporting in randomised controlled trials evaluating surgical interventions for anterior-compartment vaginal prolapse and explored the relationships between outcome reporting quality with journal impact factor, year of publication, and methodological quality.

Methods

We searched the bibliographical databases from inception to October 2017. Two researchers independently selected studies and assessed study characteristics, methodological quality (Jadad criteria; range 1–5), and outcome reporting quality Management of Otitis Media with Effusion in Cleft Palate (MOMENT) criteria; range 1–6], and extracted relevant data. We used a multivariate linear regression to assess associations between outcome reporting quality and other variables.

Results

Eighty publications reporting data from 10,924 participants were included. Seventeen different surgical interventions were evaluated. One hundred different outcomes and 112 outcome measures were reported. Outcomes were inconsistently reported across trials; for example, 43 trials reported anatomical treatment success rates (12 outcome measures), 25 trials reported quality of life (15 outcome measures) and eight trials reported postoperative pain (seven outcome measures). Multivariate linear regression demonstrated a relationship between outcome reporting quality with methodological quality (β?=?0.412; P?=?0.018). No relationship was demonstrated between outcome reporting quality with impact factor (β?=?0.078; P?=?0.306), year of publication (β?=?0.149; P?=?0.295), study size (β?=?0.008; P?=?0.961) and commercial funding (β?=??0.013; P?=?0.918).

Conclusions

Anterior-compartment vaginal prolapse trials report many different outcomes and outcome measures and often neglect to report important safety outcomes. Developing, disseminating and implementing a core outcome set will help address these issues.

     

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a non-profit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.     

氙光低周波加封闭治疗腰腿痛的临床观察

我们对门诊就诊５２例腰腿痛病人，男３０人，女２２人，随机分为三组进行了对比观察。患者分组１（超短波组）、组２（Ｘｅｎｏｎ氙光低周波治疗组）和组３（氙光低周波加椎旁或硬膜外腔封闭组）。对于上述各组以ＶｉｓｕａｌＡｎａｌｏｇＳｃａｌｅ（ＶＡＳ）测痛法以疼痛为主要指标、快适度以舒适轻松程度为主要指标，就治疗前后自觉症状的改变进行了评价及统计学处理。结果表明：组３优于组２，组２优于组１，都具有显著性差异。本组结果提示日本医广公司生产的５５０／型氙光低周波治疗仪加激素类药物行椎旁或硬膜外腔封闭具有良好的协同作用，治疗效果显著。使ＶＡＳ痛苦度明显降低，同时治疗后还具有良好的舒适感，是治疗腰腿痛的好方法。