We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

PURPOSE: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. METHODS: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. RESULTS: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. CONCLUSION: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.
Clinical Trials as Topic ; Databases, Factual ; *Exercise Therapy ; Fecal Incontinence/*prevention & control ; Female ; Humans ; Muscle Contraction/physiology ; Postpartum Period ; Pregnancy ; Urinary Incontinence/*prevention & control

OBJECTIVETo evaluate the safety and effectiveness of a modified method of holmium laser enucleation of the prostate (HoLEP)--6-o'clock tunnel HoLEP for the treatment of benign prostate hyperplasia (BPH).

METHODSWe included 112 cases of BPH in this study, 57 treated by 6-o'clock tunnel HoLEP (experimental group) and the other 55 by conventional HoLEP (control group). We compared the operation time, volume of the resected prostatic tissue, intraoperative blood transfusion, volume of bladder irrigation solution, postoperative hemoglobin change, and incidence of urinary incontinence between the two groups.

RESULTSStatistically significant differences were observed between the experimental and control groups in the operation time ([56.01 ± 8.62] min vs [68.65 ± 9.08] min), cases of intraoperative blood transfusion (0 vs 2), volume of bladder irrigation solution ([27.51 ± 3.67] L vs [36.89 ± 6.47] L), postoperative hemoglobin decrease ([10.70 ± 2.50] g/L vs [12.60 ± 3.30] g/L), and cases of postoperative stress-induced urinary incontinence (2 vs 7) (all P <0.05). One-month follow-up revealed smooth urination in both groups of patients but no true urinary incontinence or secondary bleeding in either.

CONCLUSIONModified 6-o'clock tunnel HoLEP can significantly reduce the operation time, bladder irrigation, and intraoperative bleeding, and therefore can be used as a safe and effective option for the treatment of BPH.

Case-Control Studies ; Hemorrhage ; prevention & control ; Holmium ; Humans ; Laser Therapy ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Operative Time ; Postoperative Period ; Prostatic Hyperplasia ; surgery ; Therapeutic Irrigation ; statistics & numerical data ; Urinary Bladder ; Urinary Incontinence ; epidemiology ; etiology ; Urinary Incontinence, Stress ; etiology

OBJECTIVETo assess the effect of bladder neck preservation (BNP) on postoperative continence during laparoscopic radical prostatectomy.

METHODSOne hundred and forty-five patients with localized prostate cancer (Tlb-T2c) underwent laparoscopic radical prostatectomy in our center from July 2006 to May 2010, including 59 cases treated with bladder neck preservation (BNP group) and 86 cases with bladder neck resection (non-BNP group). All cases were diagnosed as prostate cancer by transrectal ultrasonography-guided prostate biopsy preoperatively, in which localized tumors were confirmed by CT or MRI and distant metastases were ruled out by ECT bone scan. All patients had no history of incontinence and no radiation therapy preoperatively. All the 145 operations were performed by the same surgeon. The bladder neck preservation was defined as a procedure of direct suturing of the bladder neck on the urethra without repair and reconstruction of the bladder neck. Both procedures of neurovascular bundle preservation and external striated urethral sphincter preservation were carried out on all cases. Urinary continence was evaluated using the International Continence Society questionnaire at 1, 3 and 6 months postoperatively. Positive surgical margins rates were compared between the two groups. Postoperative continence was defined as the absence of need for pads or the use of one pad daily.

RESULTSAt 1, 3 and 6 months, the urinary continence rates were 42.4%, 74.6% and 86.4% in BNP group, respectively, while 25.6%, 58.1% and 80.2% in non-BNP group, respectively. There were statistically significant differences in continence at 1 and 3 months between two groups (P <0.05), while no significant differences were observed at 6 months postoperatively (P=0.331). There were no significant differences in overall rate of positive surgical margins between two groups (10.1% Compared with 10.4% P=0.954) and both groups had one case with positive surgical margins at bladder neck.

CONCLUSIONBladder neck preservation during laparoscopic radical prostatectomy is helpful for postoperative continence without increase of positive surgical margins rate.

Adult ; Aged ; Aged, 80 and over ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery ; Retrospective Studies ; Urinary Bladder ; surgery ; Urinary Incontinence ; prevention & control

OBJECTIVETo discuss the effect of urine control after radical retropubic prostatectomy by preserve the membranous part of sphincter urethrae and the neurovascular bundle, or to rebuild the bladder neck.

METHODSThe radical retropubic prostatectomy was performed on a total of 32 cases of prostate cancer. We preserve the membranous part of sphincter urethrae and the neurovascular bundle lateral to the prostate. We evaginate the posterior wall of the bladder adequately and make an additional folding stitch to rebuild the bladder neck.

RESULTSThe follow up is of 6-72 months. All patients could void without difficulty, no tumor recurrence and only 2 cases occurred slight incontinence. Other 30 cases regained the ability of controlling their urinations within 6 months.

CONCLUSIONSThe incontinence after radical retropubic prostatectomy could be reduced by the method of preserving the membranous part of sphincter urethrae and preserving the neurovascular bundle lateral to the prostate in operation. It could also be avoided by evaginate the posterior wall of the bladder adequately and make an additional folding stitch to the bladder neck.

Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Prostatectomy ; adverse effects ; methods ; Prostatic Neoplasms ; surgery ; Retrospective Studies ; Urinary Incontinence ; etiology ; prevention & control

PURPOSE: This study compared the catheter-associated urinary tract infection (CAUTI) rates resulting from the use of four perineal care agents (soap-and-water, skin cleansing foam, 10% povidone-iodine, and normal saline) among patients in intensive care units (ICUs). METHODS: This four-group experimental study was done with 97 adult patients who had urinary catheters over 2 days in three ICUs between April and July 2008. The patients received one of the four types of perineal care. Data collected included the incidence of CAUTI at baseline (prior to perineal care) and 1 week, 2 weeks, and 4 weeks after beginning perineal care. Patients were divided into UTI and non-UTI groups based on the Centers for Disease Control and Prevention/National Healthcare Safety Network UTI definition to calculate incidence rates. The hazard ratio (HR) and 95% confidence intervals were calculated by Cox's proportional hazard analysis. RESULTS: The cumulative incidence of CAUTIs per 100 urinary catheter days were 3.18 episodes during 1 week with urinary catheter, 3.31 during 2 weeks, and 3.04 during 4 weeks. No statistically significant difference in hazard ratios of CAUTIs for each perineal care agent was evident with reference to soap-and-water at 1 week, 2 weeks, and 4 weeks after beginning perineal care after controlling for age, use of antibiotics, fecal incontinence, consciousness level, fever, and diabetes. CONCLUSIONS: The type of perineal care does not influence the incidence of CAUTIs. Further confirmatory studies with a larger patient population should be conducted, as well as determining perineal agent preference.
Adult ; Anti-Bacterial Agents ; Centers for Disease Control and Prevention (U.S.) ; Consciousness ; Delivery of Health Care ; Detergents ; Fecal Incontinence ; Fever ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Perineum ; Povidone-Iodine ; Skin ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections

OBJECTIVETo assess the penile erectile function, urinary continence and voiding, and cancer recurrence in 18 bladder cancer patients after sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruction.

METHODSEighteen male patients with bladder cancer underwent sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruction, and were followed up for cancer recurrence and such clinical outcomes as erectile function and urinary continence and voiding.

RESULTSThe patients were followed up for an average of 41 months, of whom, all achieved day- and night-time urinary continence, but 2 with positive lymph nodes died of extensive metastasis at 10 and 15 months, respectively, after surgery. Among the total number, potency was maintained in 11 patients (61.1%), impaired in 2 and lost in 5, and the post-operative IIEF-5 score was (10.83 +/- 8.25) as compared with (13.72 +/- 6.39) before the operation, with a statistically significant difference (P < 0.05).

CONCLUSIONErectile function and urinary continence are fairly good in bladder cancer patients after sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruction, and the oncological results are fairly acceptable, but still need to be confirmed by longer follow-ups and larger trials.

Aged ; Aged, 80 and over ; Colon, Sigmoid ; surgery ; Cystectomy ; Erectile Dysfunction ; prevention & control ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Penile Erection ; Urinary Bladder Neoplasms ; surgery ; Urinary Incontinence ; prevention & control

This study's purpose was to compare the treatment efficacy and the effects on the patients' quality of life of the pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback method. Ninety female incontinence patients were randomly selected and evenly divided into three groups: control, intensive PFM exercise, and FES-biofeedback groups. They were treated for 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of Jackson's Bristol female urinary symptom questionnaire. Objective changes of pelvic muscle contraction force were measured by perineometer. Pre and post-treatment maximal pelvic floor muscle contractile pressure (PMC pressure) among the three groups showed statistically significant differences (p < 0.001). Especially the FES-biofeedback group showed significantly increased maximal PMC pressure compared with other groups (p < 0.001). From the questionnaire, pre and post-treatment changes in the severity of urinary incontinence and discomfort due to incontinence showed significant differences among the three groups (p < 0.001). The level of discomfort in daily life, social activity, physical activity, personal relations and discomfort due to urinary symptoms had largely changed and the FES-biofeedback group, in particular, showed a significant decrease after treatment. In conclusion, when PFM exercise and FES-biofeedback were compared in terms of their effects on the patients' quality of life, FES-biofeedback proved to be more effective than verbal explanation or simple PFM exercise.
Adolescence ; Adult ; Aged ; Electric Stimulation ; Exercise* ; Female ; Human ; Middle Age ; Pelvis/physiology* ; Prospective Studies ; Quality of Life* ; Urinary Incontinence, Stress/prevention & control*

OBJECTIVETo investigate the prevalence of urinary tract atrophy and related factors to urinary incontinence in postmenopausal women in the urban area of Beijing.

METHODSSubjects were selected from 4 central districts in Beijing with a multiple-stage randomly sampling procedure. A total of 1,257 postmenopausal women aged 60 years or over received interviews on lower urinary tract symptoms and physical examinations. The prevalences of different urinary tract symptoms were calculated. Logistic regression analysis was used to find the related factors of urinary incontinence.

RESULTSThe prevalence of urinary incontinence of postmenopausal women was 61.0%. Stress urinary incontinence had the highest prevalence (64.5%). While the prevalence of nocturia was 66.8%. Logistic regression analysis indicated that stress urinary incontinence in postmenopausal women was associated with the following factors: obesity, long education years, long-time standing, and low ability of bending or squatting. High grip strength might reduce the risk of urinary stress incontinence. Urge incontinence was associated with obesity, while higher education and high grip strength might reduce the risk of urge incontinence.

CONCLUSIONSIncontinence is very common in postmenopausal women. The prevalence in this study is even higher than that in other reports. Obesity and muscle strength are related to the prevalence of urinary incontinence in subjects over 60 in Beijing.

Aged ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Middle Aged ; Postmenopause ; Prevalence ; Risk Factors ; Sampling Studies ; Surveys and Questionnaires ; Urban Health ; Urinary Incontinence ; epidemiology ; etiology ; prevention & control