Most of cases of urination incontinence should be treated. The symptoms and causes were complicated. It should educative their children and establish advice services of mental health for children to early diagnose and care, concurrently train the physicians for mental health.
Urination ; Urinary Incontinence ; child ; stress

PURPOSE: Extracorporeal magnetic innervation (ExMI) therapy has been known to be safe and immediately effective in stress urinary incontinence (SUI). However, no long term follow-up results have been reported. Therefore; herein, are reported our results from a two year follow-up study on ExMI therapy, with pelvic floor muscle exercises, for SUI. MATERIALS AND METHODS: The study group was comprised of 94 patients with SUI. ExMI therapy was performed for 20 minutes (10Hz and 50Hz for each 10 minutes), twice a week, for 6 weeks. Thereafter, 44 of the 94 patients underwent pelvic floor muscle exercises. Objective measures (quality-of-life surveys, pad changes, and leak episodes per day) were evaluated before, immediately after and 24 months after the ExMI therapy. RESULTS: After 6-week of ExMI therapy, the quality-of-life score improved from 5.1+/-0.9 to 1.8+/-1.1. The mean frequency of pad changes was reduced from 2.1+/-1.6 to 1.1+/-1.0. The mean frequency of leak episodes was also reduced from 2.8+/-1.8 to 1.7+/-1.5 times. After 24 months, the 44 patients having also undergone pelvic floor muscle exercise had persistent improvements in their leak episodes per day compared to the 50 patients that had not. CONCLUSIONS: When ExMI therapy was followed by pelvic floor muscle exercises, the favorable effect in leak episodes per day after ExMI therapy may persist for at least 24 months.
Exercise ; Humans ; Muscles ; Pelvic Floor* ; Urinary Incontinence* ; Urinary Incontinence, Stress

PURPOSE: The 1-hour pad-weighing test was compared with the cystourethrogram as a method for the preoperative diagnostic assessment of female stress urinary incontinence. MATERIALS AND METHODS: The records of 80 women, with stress urinary incontinence that had undergone anti-incontinence surgery, were reviewed. The 1-hour pad weighing test, proposed by the International Continence Society in 1988, was performed for the objective assessment of the degree of incontinence in all patients. History taking, physical examinations and cystourethrograms were also performed and the correlation between the 1-hour pad-weighing test and the results from the above procedures evaluated. RESULTS: The urinary leakage was examined in all patients during the 1-hour pad-weighing test, with an average urine loss of 50g (5-150). In 13 patients, no urinary leakage was demonstrated during straining on the cystourethrogram. Thus, compared with the 1-hour pad-weighing test, the cystourethrography was less sensitive in the diagnosis of incontinence, with a 16% false negative rate. The bladder neck position and degree of descent were measured on the cystourethrogram during resting and straining. The position of the bladder neck averaged 2.2 (0.5-6.0) and 4.2cm (1.0-8.0) from the upper margin of the symphysis pubis at rest, and during straining, respectively. The difference between these two parameters averaged 2.0cm (0.2-4.0). The number of type III stress urinary incontinence patients, based on the Blaivas classification, was 9. There were statistically significant correlations between the 1-hour pad-weighing test and the bladder neck positions during resting (r=0.296, p=0.008) and straining (r=0.356, p=0.001) on the cystourethrograms. There was a statistically significant difference between the 1-hour pad-weighing test and bladder neck opening during resting (p=0.001). CONCLUSIONS: It seems that the 1-hour pad-weighing test is an easy, inexpensive and non-invasive method for the preoperative diagnostic assessment of female stress urinary incontinence.
Classification ; Diagnosis ; Female* ; Humans ; Incontinence Pads ; Neck ; Physical Examination ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress

We report a case of stress incontinence in 51 year old female treated by Marshall Marchetti operation with the review of literatures.
Female ; Humans ; Middle Aged ; Urinary Incontinence, Stress*

PURPOSE: After correction of stress incontinence, some patients experience the improvement of overactive bladder symptoms. During urodynamic study of some patients, the leak point pressure has a tendency to decrease at increasing vesical volumes. We evaluated the possibility of a correlation between stress incontinence parameters and bladder capacity or compliance. MATERIALS AND METHODS: 113 stress incontinence patients who received urodynamic study from February 2000 to August 2005, were reviewed retrospectively for this study. In these patients, urodynamic stress incontinence parameters(abdominal leak point pressure: ALPP, maximum urethral closure pressure: MUCP), Q-tip angle and Stamey symptom grade and age were analyzed for a correlation with urodynamic cystometric capacity or compliance. We also compared the cystometric capacity of each symptom grade group to assess the difference among the groups. RESULTS: The mean age of the patients was 49.5+/-10.4 years(29~75), symptom grade was I(37), II(27), III(19), Q-tip angle was 33.6+/-14.0 degrees(10~60), cystometric capacity was 390.2+/-109.7 ml(121~641), compliance was 51.6+/-30.4 ml/cmH2O(9.2~142.5), ALPP was 83.2+/-31.0 cmH2O(24~200), MUCP was 55.4+/-29.3 cmH2O(7~142). In the correlation analysis, cystometric capacity had a correlation of -0.207 with age (p=0.029) and -0.215 with symptom grade(p=0.031). However, bladder compliance had no significant correlation with any of the parameters studied. In each symptom grade, cystometric capacity was 407.0+/-103.1 cc(I), 395.8+/-103.0 cc(II), 324.5+/-124.0 cc(III)(p=0.04) and the age for each symptom grade was 48.5+/-9.7(I), 48.1+/-10.1 (II), 57.3+/-10.1(III)(p=0.005). CONCLUSION: As cystometric capacity decreased, symptom grade of stress incontinence increased and age also increased. However, there were no other correlations between cystometric capacity or compliance and stress incontinence parameters.
Compliance* ; Humans ; Retrospective Studies ; Urinary Bladder* ; Urinary Bladder, Overactive ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

PURPOSE: The aim of this study was to determine whether or not the 1-hour pad test demonstrates the objective severity of female stress urinary incontinence. MATERIALS AND METHODS: One hundred eighteen female patients with stress urinary incontinence symptom were prospectively evaluated with a 1-hour pad test as recommended by the International Continent Society and they also underwent videourodynamics to determine the ALPP. The patients were divided into 2 groups by the ALPP: group A (n=94) was the low leak point pressure group (ALPP< or=100cmH2O), and group B (n=24) was the high leak point pressure group (ALPP>100cmH2O or no leakage). A pad gain < or=2g was considered a negative pad test. Student's t-test was done to evaluate the difference of urine leakage between the two groups. RESULTS: The mean amount of urine leakage measured by the 1-hour pad test for groups A and B were 53.4+/-47.2 and 50.9+/-53.9g, respectively, and there was no statistically significant differences between two groups (p=0.839). Eighteen (15.2%) women did not leak during the ALPP measurement and 6 (5.1%) women had a negative pad test. Among the 18 women with no leakage on the ALPP, 15 had a positive pad test and 3 had a negative pad test. Among the 6 women with a negative pad test, 3 had leakage and 3 had no leakage during the ALPP measurement. One hundred fifteen patients received an operation for stress urinary incontinence. The three patients who had no leak on the ALPP and who also had a negative pad test did not receive the operation. CONCLUSIONS: These data suggest that the 1-hour pad test did not demonstrate the objective severity of stress urinary incontinence. However, the 1-hour pad test was more sensitive to demonstrate leakage than the ALPP; therefore, in the case of no leakage during the ALPP measurement, the 1-hour pad test is needed to check the leakage.
Female ; Humans ; Incontinence Pads ; Prospective Studies ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

PURPOSE: Lateral cystourethrography is a radiological method used in the diagnosis and prediction of the degree of stress urinary incontinence. The aim of this study was to evaluate the efficiency of lateral cystourethrography in women with stress urinary incontinence. MATERIALS AND METHODS: In this retrospective study, a total of 76 women who underwent both cystourethrography and urodynamic study were included. The proximal urethral support was evaluated by lateral cystourethrography at rest and during voiding, with the images anatomically superimposed to measure the degree of bladder base descent and the posterior urethro-vesical angle (PUV angle). The urethral diameter was measured at 1cm below the bladder neck. Urodynamic assessments, included valsalva leak point pressure (VLPP), maximal urethral closing pressure (MUCP) and functional urethral length, were compared with the parameters of the cystourethrography. RESULTS: There was a significant correlation between the VLPP and the urethral diameter (p<0.05) only. Other parameters from the two methods showed no significant correlations. When the patients were divided into three subgroups, according to their VLPP (<60, 60-90, >90cmH2O), and into two subgroups, according to their MUCP (< or =25, >25cmH2O), the mean values of bladder base descent and PUV angle among the subgroups showed no significant correlation. CONCLUSIONS: In the current study, the lateral cystourethrography is suggested to not be appropriate for the diagnosis and prediction of stress urinary incontinence.
Diagnosis ; Female ; Humans ; Neck ; Retrospective Studies ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics* ; Urography

PURPOSE: The factors affecting the success and quality of life following a tension-free vaginal tape(TVT) procedure were investigated in patients with stress urinary incontinence. MATERIALS AND METHODS: We included 79 women with stress urinary incontinence that underwent the TVT procedure and were followed for at least 3 years. Preoperatively, the patients were evaluated by history, physical examination, a 1-hour pad test, and videourodynamics to determine the abdominal leak point pressure(ALPP). In addition, pre- and postoperative quality of life was evaluated by the incontinence quality of life questionnaire(I-QoL). We analyzed factors including patient characteristics, history, 1-hour pad test and ALPP with respect to the success and quality of life after the TVT. A success after the TVT was defined as the absence of any subjective complaint of leakage. RESULTS: The overall 3-year success rate of the TVT was 90%. There was a statistically significant increase in the I-QoL scores postoperatively. There were no significant preoperative factors affecting the success rate and the postoperative I-QoL scores. However, when the postoperative I-QoL scores were compared with the preoperative scores, the increase in the I-QoL scores was significantly higher in the patients with urge incontinence, low ALPP and high-grade incontinence. CONCLUSIONS: The results of this study suggest that the TVT procedure is effective for treating female stress incontinence and improving the quality of life without any independent risk factors. However, for improving the quality of life, the TVT was more effective in women with stress urinary incontinence with urge incontinence, low ALPP and high-grade symptoms.
Female ; Humans ; Physical Examination ; Quality of Life* ; Risk Factors ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge

PURPOSE: The aims of this study were to analyze the types of voiding dysfunction following a tension free vaginal tape (TVT) procedure, and to report our experience of diagnosing and treating post-TVT voiding dysfunction. MATERIALS AND METHODS: A TVT procedure was performed on 201 patients, of which, 51 (25.4%) developed a voiding dysfunction. The TVT was incised or released to increase the uroflow and decrease the residual urine volume for those whose symptoms were not controlled by anticholinergics (tolterodine, propiverine) and/or alpha-blockers (alfuzocin, terazocin) or clean intermittent catheterization (CIC). The success rate and degree of satisfaction were investigated for the correction of stress incontinence. RESULTS: In 36 patients, the voiding symptoms improved after medication administration, with a mean interval of 16.5 days. Another 15 patients required a TVT incision or release at means of 27 and 8 days, respectively. After the incision or release of the TVT sling, the mean maximal flow rate (MFR) increased from 9.3+/-4.3 to 21.7+/-6.7ml/sec, and mean residual urine volume (RU) decreased from 277.9+/-156.2 to 24.6+/-16.0ml. The success rate and satisfaction of the TVT procedure were 98.0 and 90.4%, respectively. Lastly, 88.3% of the subjects reported they would recommend the TVT procedure to people they know with symptoms of stress urinary incontinence. CONCLUSIONS: This study suggests that voiding dysfunction, with normal uroflow and RU, may be effectively controlled with conservative treatment. However, when the voiding dysfunction is accompanied by a decreased MFR and an increased RU, an additional procedure, such as the TVT incision or release, is recommended.
Cholinergic Antagonists ; Humans ; Intermittent Urethral Catheterization ; Suburethral Slings* ; Urinary Incontinence* ; Urinary Incontinence, Stress

PURPOSE: Recently, intrinsic sphincter deficiency (ISD) has been identified as one important factor in the outcome of stress urinary incontinence (SUI) related surgery. Clinical factors that can predict ISD are uncommon. The aim of this study was to determine predictive clinical factors for ISD in female patients with SUI. METHODS: The patients were classified into 3 groups according to the value of Valsalva leak point pressure (VLPP)>90 cm H₂O (anatomical incontinence, AI), between 61 and 90 cm H₂O (equivocal, EV), and <60 cm H₂O (ISD). All groups underwent a full examination, history evaluation, physical examination, uroflowmetry, and complete urodynamic study. Univariate analysis was performed by chi-square or t-test for categorical variables, respectively. A multivariate study was performed by Pearson correlation analysis in order to get clinical predictors of VLPP<60 cm H₂O. Statistical significance was set at P<0.05. RESULTS: There were 3 groups with a total of 189 patients: 56 patients (AI, 29.7%), 64 patients (EV, 33.8%), and 69 patients (ISD, 36.5%). The univariate analysis revealed a significant difference associated with maximal urethral closing pressure (P=0.03) and Stamey classification (P=0.006) between ISD and AI. The more severe the urinary symptom grade, the higher the frequency of ISD. However, the multivariate analysis showed the independent predictor of ISD is only present in grades II and III symptoms in the Stamey classification (P=0.001). CONCLUSIONS: It was found that the more severe the symptoms of urinary incontinence, the higher the possibility of ISD. In other words, the degree of urinary incontinence was found to be one relevant clinical factor in predicting ISD. This finding may help in evaluating and identifying the appropriate surgical technique for EV. Currently, absolute cutoff value to diagnose ISD has not yet been determined. More research is needed to identify clinical factors that can predict ISD.
Classification ; Female ; Humans ; Multivariate Analysis ; Physical Examination ; Urethra ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics