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71.
Takako Masue Keiko Wada Chisato Nagata Takashi Deguchi Makoto Hayashi Noriyuki Takeda Keigo Yasuda 《Maturitas》2010
Objectives
Studies focusing on lifestyle and health factors and stress urinary incontinence (SUI) are scarce in Japan. The aim of this study is to examine the association of lifestyle and health factors in SUI.Methods
Study subjects were retrieved from Japanese women participating in a health checkup program provided by a general hospital between October 2003 and March 2006. The presence of SUI was confirmed by responses to a self-administered questionnaire assessing lower urinary tract symptoms. The questionnaire included other questions on lifestyle and health factors. Each subject underwent weight and height measurements.Results
A total of 823 women completed the questionnaire and were included in the analyses (the response rate was 62.6%). Of them, 70 (8.5%) women had SUI. BMI and parity were significantly positively associated with SUI (OR = 3.47 and 7.17, 95% CI 1.65–7.33 and 1.71–30.04, respectively). Multiple logistic regression analysis controlling for age, parity, and BMI showed that first delivery at age >27 (OR = 1.82, 95% CI 0.97–3.41), past estrogen use (OR = 2.50, 95% CI 1.14–5.47), and unilateral ovariectomy (OR = 3.07, 95% CI 1.16–8.13) were also significantly associated with SUI.Conclusions
The data suggested that lifestyle and health factors such as parity, BMI, age at first delivery, past estrogen use, and unilateral ovariectomy were associated with SUI in Japanese women. 相似文献72.
73.
目的:观察基于经筋理论的透刺法结合滞针术治疗女性轻、中度压力性尿失禁(stress urinary incontinence,SUI)的临床疗效。方法:77例轻、中度SUI女性患者随机分为观察组38例,对照组39例。观察组使用透刺法,并施以滞针术;对照组使用普通针刺法;两组均配合盆底肌训练(pelvic floor muscle training,PFMT)。于治疗前后记录24 h漏尿事件发生次数,于治疗前及治疗期间的第4周、第8周、第12周进行尿失禁影响问卷简版(incontinence impact questionnaire short form,IIQ-7)、国际尿失禁咨询委员会尿失禁问卷简表(international consultation committee on incontinence questionnaire short form,ICI-Q-SF)调查。结果:治疗12周后,观察组及对照组的漏尿事件发生次数均显著低于治疗前(P<0.01),且观察组漏尿事件发生次数均显著低于对照组(P<0.05)。观察组和对照组的IIQ-7评分、ICI-Q-SF评分在治疗4周、8周、12周逐渐降低,且与各组治疗前比较,差异均有统计学意义(P<0.01);在治疗第8周和第12周时,观察组和对照组比较,差异有统计学意义(P<0.01)。观察组有效率为94.74%,对照组有效率为74.36%,两组比较,差异有统计学意义(P<0.05)。结论:基于经筋理论的透刺法结合滞针术治疗轻、中度女性压力性尿失禁临床疗效显著,可显著降低漏尿事件发生次数,降低IIQ-7评分、ICI-Q-SF评分。 相似文献
74.
A.M. Abdelbary 《The African Journal of Urology》2012,18(4):175-179
ObjectiveTo determine the efficacy, safety and urodynamic effects of the Martius flap and the anterior vaginal wall sling in treating post-birth trauma in the form of urethra-vaginal fistula (UVF) associated with stress urinary incontinence (SUI).Patients and methodsBetween July 2006 and August 2011, 19 patients underwent repair of UVF by interposition of a Martius flap and correction of associated SUI by a modified anterior vaginal wall sling. The procedure was carried out 3–17 (mean 7) months after post-birth trauma. Pre-operative evaluation consisted of history, voiding diary, physical examination, routine laboratory work-up, abdominopelvic ultrasonography, intravenous urography (IVU), and cystourethrography. The patients were followed up for a mean of 34 months. Follow-up included history, physical examination, urine analysis and pelvic ultrasonography for the assessment of residual urine. Urodynamic evaluation was performed at 3 months post-operatively.ResultsNone of the patients developed recurrence of UVF. SUI was corrected in 16 patients (84%). In the post-operative period, 3 patients (16%) complained of an overactive bladder (OAB) with urodynamic detrusor overactivity (DO) and an obstructed flow. These problems were managed successfully using anticholinergics and urethral dilation. Three patients (16%) complained of mild SUI, but refused further management. Within 3 years following the intervention, 3 patients complained of a recurrence of SUI which was managed successfully by a rectus sheath sling.ConclusionsPatients with a post-birth trauma in the form of UVF should be examined intra-operatively for the presence of associated SUI following correction of UVF. The use of the Martius flap and anterior vaginal wall sling in treating such patients is safe, efficient and reproducible. An anterior vaginal wall sling should be avoided in distal UVF to avoid recurrence of SUI. 相似文献
75.
Serati M Ghezzi F Cattoni E Braga A Siesto G Torella M Cromi A Vitobello D Salvatore S 《European urology》2012,61(5):939-946
Background
One of the most effective and popular current procedures for the surgical treatment of stress urinary incontinence (SUI) is tension-free midurethral slings.Objective
To evaluate the outcomes of women with retropubic tension-free vaginal tape (TVT) for urodynamic stress incontinence (USI) after 10-yr follow-up.Design, setting, and participants
This was a prospective observational study. Consecutive women with proven USI were treated with TVT. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded.Intervention
Standard retropubic TVT.Measurements
Patients underwent preoperative clinical and urodynamic evaluations. During follow-up examinations, women were assessed for subjective satisfaction and objective cure rates. Multivariable analyses were performed to investigate outcomes.Results and limitations
A total of 63 women were included. After 10 yr, 5 patients (8%) were lost or no longer evaluable. The 10-yr subjective, objective, and urodynamic cure rates were 89.7%, 93.1%, and 91.4%, respectively. These rates were stable across the whole study period (p > 0.99). De novo overactive bladder was reported by 30.1% and 18.9% of patients at 3-mo and 10-yr follow-up, respectively (p for trend = 0.19). A total of 84.2% of women with detrusor overactivity received antimuscarinic drugs, but 43.8% were nonresponders 12 wk later. At multivariable analysis, maximum detrusor pressure during the filling phase >9 cm H2O (hazard ratio [HR]: 16.2; p = 0.01) and maximum detrusor pressure during the voiding phase ≤29 cm H2O (HR: 8.0; p = 0.01) were independent predictors for the recurrence of SUI, as well as obesity was for the recurrence of objective SUI (HR: 17.1; p = 0.01) and of USI (HR: 8.9; p = 0.02), respectively. Intraoperatively, bladder perforation occurred in two cases; no severe bleeding or other complications occurred.Conclusions
The 10-yr results of this study seem to demonstrate that TVT is a highly effective option for the treatment of female SUI, recording a very high cure rate with low complications after a 10-yr follow-up. 相似文献76.
Steven E. Schraffordt Koops Tanya M. Bisseling H. Jorien van Brummen A. Peter M. Heintz Harry A. M. Vervest 《International urogynecology journal》2007,18(4):437-442
This study assessed the long-term outcome of tension-free vaginal tape (TVT) in women with concomitant pelvic surgery. A prospective
cohort study of 746 patients in 41 hospitals was undertaken. The Incontinence Impact Questionnaire (IIQ-7) and Urogenital
Distress Inventory (UDI-6) were used to measure the results of the TVT. Fifty-nine patients with concomitant prolapse surgery
were compared with 687 women with TVT only. The decrease in IIQ/UDI mean scores were statistically significant in both groups
after the TVT. The success rates of “no leakage at all” is comparable for both groups. This study, with 54 gynecologists and
urologists participating, showed the long-term (2 years) success rates of TVT with concomitant prolapse surgery. It shows
that the procedure in conjunction with prolapse surgery can be safely performed with good results. 相似文献
77.
Baoyan Liu Yan Liu Zongshi Qin Kehua Zhou Huangfang Xu Liyun He Ning Li Tongsheng Su Jianhua Sun Zenghui Yue Zhiwei Zang Wei Zhang Jiping Zhao Zhongyu Zhou Lian Liu Dongning Wu Jiani Wu Jing Zhou Zhishun Liu 《Mayo Clinic proceedings. Mayo Clinic》2019,94(1):54-65
Objective
To evaluate the efficacy and safety of electroacupuncture vs pelvic floor muscle training (PFMT) plus solifenacin for women with mixed urinary incontinence (MUI).Patients and Methods
This randomized controlled noninferiority trial was conducted at 10 hospitals in China between March 1, 2014, and October 10, 2016. Participants were randomized 1:1 to receive electroacupuncture (36 sessions) over 12 weeks with 24 weeks of follow-up or PFMT-solifenacin (5 mg/d) over 36 weeks. The primary outcome was percentage change from baseline to week 12 in mean 72-hour incontinence episode frequency (IEF) measured by the 72-hour bladder diary. It was analyzed in the per-protocol set with a prespecified noninferiority margin of 15%.Results
Of 500 women with MUI who were randomized, 467 (239 in the electroacupuncture group and 228 in the PFMT-solifenacin group) completed treatment per protocol and were included in the primary outcome analysis. At weeks 1 through 12, the percentage of reduction from baseline in mean 72-hour IEF was 37.83% in the electroacupuncture group and 36.49% in the PFMT-solifenacin group (between-group difference, ?1.34% [95% CI, ?9.78% to 7.10%]; P<.001 for noninferiority), which demonstrates noninferiority; the treatment effect persisted throughout follow-up. Statistically significant improvements were found for secondary outcomes in both groups, with no meaningful difference between treatments.Conclusion
In women with moderate to severe MUI, electroacupuncture was not inferior to PFMT-solifenacin in decreasing the 72-hour IEF and shows promise as an effective alternative for the treatment of MUI.Trial Registration
clinicaltrials.gov Identifier: NCT02047032. 相似文献78.
目的分析自制蝶型网片吊带治疗老年压力性尿失禁(SUI)患者的近期疗效。方法 38例老年SUI女性患者,采用自制蝶型网片吊带,改进固定方法和部位。结果全部38例SUI患者尿失禁均得到控制或减轻,经随访无患者出现尿失禁复发和加重现象。结论采用自行设计蝶型网片治疗老年女性SUI患者,费用低、安全性高、创伤小、操作简便,近期疗效满意。 相似文献
79.
J. B. Sharma Karishma Thariani Rajesh Kumari Tanudeep Kaur Bharti Uppal Kavita Pandey Venus Dalal 《Journal of obstetrics and gynaecology of India》2021,71(3):285
BackgroundStress urinary incontinence (SUI) is involuntary leakage of urine on raised intra- abdominal pressure which adversely affects quality of life usually requiring surgical treatment.MethodsThis is a prospective study of efficacy, cure rates and complications of tension free transobturator tape (TOT) surgery on 85 women with SUI. Pre-operatively and 6 months post-operatively International consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) scores were calculated for all patients to know the severity of incontinence and efficacy of tape.ResultsMean age, parity, body mass index and mean duration of symptoms were 45.78 years, 2.68, 26.38 kg/m2 and 3.85 years, respectively. SUI was demonstrated in all cases on cough stress test and Bonney’s test. Mean operative time, blood loss, post-operative analgesic injections, post- operative stay and post- operative catheterisation were 23.28 min, 45.50 ml, 1.2 injections, 1.2 days and 1.2 days. Various complications noted were excessive bleeding (3.52%), urinary retention (7.05%), urinary urgency (8.23%), urinary tract infection (2.35%), surgical site infection (1.17%), groin pain (28.23%) and mesh exposure (3.52%). At 6 months follow-up, the complete cure rate was 83.52% , partial cure rate was 11.76% and failure rate was found to be 4.70% whereas it was 79.16%, 12.0% and 8.33% respectively at 3 years follow up. 2 patients (2.35%) required burch colposuspension and 12 patients (14.11%) required pelvic floor exercises and duloxetine therapy for their symptoms. Mean pre- operative ICIQ-SF score reduced post- operatively (17.8 ± 4.67 to 2.71 ± 1.42) (p value = 0.001).ConclusionStudy demonstrates short and long-term efficacy and safety of TOT for surgical management of SUI. 相似文献
80.
目的探索孕期体重管理在预防产后压力性尿失禁(SUI)中的作用。方法选取在南宁市妇幼保健院保健门诊建卡的单胎头位初产妇400例,以就诊时间将产妇随机分入干预组和对照组,每纽各200例,干预组接受体重干预教育,对照组接受常规产科检查和教育。分别对分娩前体重和身体质量指数(BMI)的变化、SUI发生率及程度、妊娠并发症及妊娠结局进行研究。结果和对照组相比,干预组产妇分娩前体重:(10.16±3.07)vs(11.42±2.86),u=4.2469,P〈0.01;BMI:(3.38±0.55)vs(5.71±0.43),u=47.1985,P〈0.01;SUI发生率:5%vs10.5%,χ2=4.2311,P〈0.01;SUI发生程度:(8.35±1.28)VS(10.63±1.72),u=15.0391,P〈0.01;妊娠期糖尿病:2.5%vs7%,χ2=4.4758,P〈0.01、;妊娠期高血压疾病:7.5%vs15.5%,χ2=6.2884.P=0.0121;高危新生儿:4.5%vs9.5%,χ2=3.8402,P〈0.01,其发生率均显著下降。结论对产妇体重进行系统管理,不但可预防产后SUI的发生,而且尚可降低妊娠并发症和不良妊娠结局的发生。 相似文献