OBJECTIVE: To explore the improvement effect of rehabilitation nursing based on information-knowledge-belief-behavior (IKAP) theory on urinary incontinence patients after radical prostatectomy. METHODS Sixty-six patients with urinary incontinence who received robot-assisted laparoscopic radical prostatectomy in General Hospital of Eastern Theater Command from January 2021 to January 2023 were selected and divided into control group (n=33) and observation group (n=33) according to random number table method. The patients in the control group were treated with rehabilitation nursing. The patients in the observation group were treated with rehabilitation nursing guided by IKAP theory. The recovery of urinary incontinence, duration of urinary incontinence, subjective well-being, quality of life, psychological and emotional indexes of patients in the two groups were compared. Results： The total effective rate of urinary incontinence recovery in the observation group was significantly higher than that in the control group (90.91% vs 60.61%，P<0.05). The duration of urinary incontinence in the observation group was significantly shorter than that in the control group (［3.36±1.54］d vs ［4.15±1.36］d，P<0.05). And the subjective well-being score in observation group was significantly higher than that in the control group (［19.36±2.69］points vs ［11.65±2.65］points， P<0.05). There was no significant difference in preoperative physical function, social function，and mental health scores between the two groups (P>0.05). And all scores in the observation group were significantly higher than those in the control group after surgery (P<0.05). There was no significant difference in the preoperative SAS and SDS scores between the two groups of patients (P>0.05). And the scores of SAS and SDS in observation group were lower than those of the control group after the operation (P<0.05). Conclusion： Rehabilitation nursing based on IKAP theory can significantly improve urinary incontinence in patients with prostate cancer after surgery, which promotes the recovery of urinary incontinence, shortens the time of urinary incontinence, and improves the subjective well-being and quality of life, as well as reduces the negative impact of negative emotions. Therefore, it can be widely promoted and implemented in clinical practice.
Humans ; Prostatectomy/adverse effects* ; Urinary Incontinence/etiology* ; Male ; Quality of Life ; Rehabilitation Nursing ; Middle Aged ; Aged

Multimodal precision nursing intervention enhances cognitive function and quality of life through multisensory collaborative stimulation by integrating multidimensional data of patients. As one of the most common complications after radical prostatectomy, urinary incontinence seriously affects the quality of life of prostate cancer patients after surgery which has a negative impact on multidimensional health in the "physiological-psychological-social" aspects. This paper summarizes the clinical manifestations, influencing factors, and nursing interventions of urinary incontinence after radical prostatectomy, and focuses on the key points of nursing based on multimodal theory, in order to provide nursing strategies for improving urinary incontinence after prostate cancer surgery.
Humans ; Urinary Incontinence/etiology* ; Prostatectomy/rehabilitation* ; Male ; Prostatic Neoplasms/surgery* ; Quality of Life ; Postoperative Complications/nursing*

OBJECTIVE: The study aimed to evaluate the contributions of levator ani muscle (LAM) injury, vesical neck movement, urethral length and mobility, and urethral sphincter dysfunction observed on magnetic resonance imaging (MRI) towards stress urinary incontinence (SUI) after vaginal delivery. MATERIALS AND METHODS: Fifty primiparous women after 6 months of delivery (15 with SUI and 35 without) and 35 nulliparous as continent controls underwent MRI at rest and Valsalva maneuver. A published levator ani scoring system was used to characterize morphological changes of LAM. The severity of the injury was divided into three categories as none, minor, and major. A series of common parameters including levator plate angle, iliococcygeal angle, and levator hiatus were used to describe the functional conditions of LAM. Urethral mobility was defined based on the rotation of the urethra between Valsalva and rest status. Vesical neck movement was evaluated by its distance to the pubococcygeal line. Urethral sphincter dysfunction was defined as the widening of the proximal urethra and/or funneling at the urethrovesical junction during Valsalva. RESULTS: Primiparous incontinent (PI) women had additional major levator ani defects (33.3% vs. 17.1%) while less minor defects (0.7% vs. 31.4%) than primiparous continent (PC) women. Vesical neck downward movement in PI women was more obvious than PC women (28.5 mm vs. 24.2 mm, p = 0.006). Urethral mobility was more active in primiparous women than in nulliparous continent controls (57.4 vs. 52.4), whereas no difference was observed on urethral mobility in the primiparous group (p = 0.25). Urethral sphincter dysfunction and funneling were present in 80% of PI women versus 22.9% in PC women (p < 0.001). CONCLUSION: The MRI findings revealed that de novo SUI was associated with major LAM injury, vesical neck downward movement as well as urethral sphincter dysfunction. Vesical neck funneling on sagittal images can be treated as a valuable predictor for SUI. The intervention for the PI should focus on the elevation of vesical neck, rehabilitation of LAM as well as recovery of the urethral sphincter muscle.
Female ; Humans ; Magnetic Resonance Imaging* ; Neck ; Pelvic Floor Disorders ; Pelvic Floor* ; Rehabilitation ; Urethra ; Urinary Incontinence* ; Valsalva Maneuver

As the average life expectancy is longer and the prevalence of chronic disease increases in the elderly, the number of people who needs the care and treatment in the sanatorium is also growing. Voiding dysfunction is common disease in elderly people admitted in the sanatorium and it causes various problems such as fall and fracture. Urinary incontinence is the most frequent condition that decreases physical and mental ability and therefore, it is an important risk factor to reduce the quality of life in the elderly. Thus, investigation of the prevalence and actual practise about the care of urinary incontinence is necessary to reduce not only urinary incontinence but also combined problems in the sanatorium. About 48.1 - 65.3% of the elderly experienced urinary incontinence and the most common management for urinary incontinence was pad usage. However, pad usage without considering the each patient's condition induces poor hygiene, skin problem, and pressure ulcer. Therefore, care according to the each patient's type of urinary incontinence and condition is needed.
Aged ; Chronic Disease ; Hospitals, Convalescent* ; Humans ; Hygiene ; Life Expectancy ; Pressure Ulcer ; Prevalence ; Primary Health Care* ; Quality of Life ; Rehabilitation* ; Risk Factors ; Skin ; Urinary Incontinence

PURPOSE: Climacturia is involuntary loss of urine during orgasm. The mechanism of climacturia in men who undergo radical prostatectomy (RP) is not fully understood, while deficiency in bladder neck coaptation during orgasm may be the cause. We evaluated the prevalence and risk factors of climacturia after RP. MATERIALS AND METHODS: We retrospectively reviewed the medical records of prostate cancer patients who underwent RP from 2002 to 2013 and was able to have a vaginal intercourse postoperatively. RP was conducted using open or robot-assisted approach. We analysed the symptoms of climacturia, relationship between climacturia and several clinical factors. Also, we tried to find factors to predict the presence of climacturia. RESULTS: Total of 123 patients were analyzed in this study. The median age of the men was 65 year and postoperative follow-up period for the interview was 37 months. Of the total 123 patients, 29 (23.6%) complained of the climacturia. In climacturia group, robot-assisted RP (p=0.018), nerve-sparing (p=0.046) and penile rehabilitation (p=0.012) were significantly less frequent, and more pad were comsumed (p=0.001) compared to non-climacturia group. On multivariable analysis, post-prostatectomy incontinence (PPI) (OR 6.49, p=0.004) and penile rehabilitation (OR 0.22, p=0.036) were significant factors to predict the presence of climacturia. CONCLUSIONS: Climacturia occurs in more than 20% patients who were potent enough after RP in our study. PPI and penile rehabilitation were positive and negative factor to predict an occurrence of climacturia, respectively. Therefore, in addition to PPI and erectile dysfunction, patients must be informed of this complication before undergoing RP.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Neck ; Orgasm ; Prevalence ; Prostatectomy* ; Prostatic Neoplasms ; Rehabilitation ; Retrospective Studies ; Risk Factors ; Urinary Bladder ; Urinary Incontinence

Since Dr. Kegel first reported good outcomes for pelvic floor muscle training in women with urinary incontinence this therapy has become used for women with various pelvic floor disorders. The incidence of pelvic floor disorders such as urinary incontinence and pelvic organ prolapse has been steadily increasing. Although surgery or medications are commonly used, behavioral modification and pelvic floor rehabilitation are gaining in popularity both as primary treatment and as alternatives to surgery. The goal of this article is to review the pelvic floor rehabilitation with emphasis on biofeedback and electrical stimulation and examine the evidence of effectiveness and application of pelvic floor rehabilitation.
Biofeedback, Psychology ; Electric Stimulation ; Female ; Humans ; Incidence ; Pelvic Floor Disorders ; Pelvic Floor* ; Pelvic Organ Prolapse ; Rehabilitation* ; Urinary Incontinence

PURPOSE: The purposes of this study were to examine the effectiveness of a behavioral intervention program combining pelvic floor muscle exercise with bladder training for urinary incontinence and also to conduct follow-up assessment after self-training. METHODS: This study was conducted using a non-equivalent control group, pretest-posttest design. The subjects were 60 middle-aged women (control group, n=30; intervention group, n=30) who experienced an episode of urinary incontinence at least once a week. The program was run over a 4 week period (once a week) and composed of urinary incontinence education, pelvic floor muscle exercise, and bladder training. RESULTS: Overall, there was a significant difference in urinary incontinence symptoms and psycho-social wellbeing related to urinary incontinence between the treatment and control group. Of the variables, weekly leakage frequencies, leakage amounts on each occasion, leakage index, frequencies of nocturia, and quality of life were significantly different between the groups. Follow-up assessment (9th week) indicated that overall incontinence symptoms and psycho-social well-being were significantly different between the posttest and follow-up assessments. Most variables of incontinence symptoms and psycho-social well-being were significantly improved at follow-up assessment versus posttest. CONCLUSIONS: The program was overall effective in terms of relieving symptoms and improving psycho-social well-being related to urinary incontinence, and this effect continued after a 4-weeks self-training period. In the respect that this is a community-based application study, the results can be meaningful and applicable.
Urinary Incontinence/*rehabilitation ; *Pelvic Floor ; Multivariate Analysis ; Middle Aged ; Humans ; Female ; Exercise Therapy/*methods ; Behavior Therapy/*methods ; Adult

PURPOSE: The elderly with UI experienced urine leakage for a long time. The prevalence of UI has increased and it makes costly. Particularly, the elderly were reluctant to visit a hospital or a clinic for the reasons of modesty and poverty. To solve this problem, incontinence intervention programs should be provided at the elderly welfare center. The purpose of this research was to develop Incontinence Intervention Program for the Elderly Women (IIPE) and evaluate in its effect. METHODS: The study design was quasi-experimental with pre and post-test. The study was performed for ten weeks at one elderly welfare center, Seoul, Korea. The subjects were gathered through an official announcement and informed consent was obtained. IIPE, in this study, was consisted of diagnosis, education, exercise and evaluation. The study variables were PFM exercise adherence, pelvic muscle strength, Continence selfefficacy, geriatric depression and incontinence stress. The effects of the IIPE on PFM exercise adherence, pelvic muscle strength, Continence self-efficacy, geriatric depression and incontinence stress were also evaluated. RESULTS: The mean age of the subjects was 75.2 years. The average attendance was 6.2 times. The IIPE improved PFM exercise adherence, intra-vaginal contraction power and CSE significantly. But it was not significant in incontinence stress and geriatric depression. Other important results were that the two-finger test and urine stream interruption were more useful for elderly women with rigid vaginas in teaching and evaluating. CONCLUSION: The Findings suggest that IIPE is effective to the community-residing elderly. Further investigation is needed on a long-term basis with control group.
Aged ; Exercise Therapy/*organization & administration ; Female ; Geriatric Assessment ; Geriatric Nursing/*organization & administration ; Humans ; Korea/epidemiology ; Nursing Assessment ; Nursing Evaluation Research ; *Nursing Homes ; Parity ; Patient Acceptance of Health Care ; Patient Education as Topic/*organization & administration ; Pelvic Floor ; Prevalence ; Program Development ; Program Evaluation ; Questionnaires ; Risk Factors ; Self Efficacy ; Treatment Outcome ; Urinary Incontinence/diagnosis/epidemiology/psychology/*rehabilitation ; Urodynamics

PURPOSE: This study was designed to provide the basic data for the development of the urinary incontinence nursing management program by identifying voiding patterns and pressure ulcer prevalence of residents in long term care facilities. MATERIALS AND METHODS: The study was performed from January to February, 2003. The subjects consisted of 92 residents in long term care facilities around S city. Researcher visited the facilities and assessed their voiding patterns, voiding management, and skin. To investigate the voiding patterns of the residents, care givers in the facilities were educated how to fill up voiding diaries and the diaries were made for two days. The data were analyzed by t-test and x2-test with using SAS program. RESULTS: The mean score for the activities of daily living of the subjects was 17.7+/-10.3 indicating medium. Mean score for mental status was 2.5+/-3.5 indicating very low. Among the subjects, self-voiding group was 40.8%, the group with self-voiding at daytime and diapers at night 10.9%, the group managed with diapers all the time 41.1%. In UI status of self-voiding group, urge urinary incontinence 22.8%, mixed urinary incontinence 13.6%, stress urinary incontinence 6.8%, and 56.8% had no urinary incontinence. About 9.8% of the subjects suffered from pressure ulcers and 15% of the group managed with diapers all the time had skin problems at perineal area. Between the group with pressure ulcer and the group without pressure ulcer, there were significant differences by length of residence, activities of daily living, mental status, and Braden scale. CONCLUSION: The above findings indicated that the care programs for the group managed with diaper change and the group with skin problems were required to improve, and the voiding management focusing on rehabilitation rather than simple diaper change should be encouraged.
Activities of Daily Living ; Caregivers ; Humans ; Long-Term Care* ; Nursing ; Pressure Ulcer* ; Prevalence ; Rehabilitation ; Skin ; Urinary Incontinence

INTRODUCTION: Several different methods of enhancing pelvic floor functions have been developed and modified. The aim of this investigation was to compare the usage of a new vaginal cone (double cone) with conventional FES-Biofeedback therapy for female urinary incontinence cases with respect to the effects on pelvic floor rehabilitation. MATERIALS AND METHODS: It was performed on a multi-center based study. One hundred patients, who desired a non-surgical treatment for their urinary incontinence, were divided into two groups randomly. They were: (1) the FES-Biofeedback group (or BFB group); and (2) the new vaginal cone group (or cone group). For a period of six weeks, two sessions each week were carried out for the BFB group. The new 150-gram dumbbell- shaped vaginal cone, made up of fine ceramics material, was developed domestically. A therapist instructed these patients in the cone group for using the new cone for pelvic floor exercises and directed them to repeat the exercises at home daily, as these patients had follow-up visits every week. RESULTS: Objective improvements were obvious in both of these groups. 88% of the cone group and 92% of the BFB group showed an improvement after treatment. There was no significant difference in the improvement of dissatisfaction scores between the two groups. CONCLUSION: The new vaginal cone is relatively easy to use at home and aids in pelvic floor muscle exercises. Consequently, the new vaginal cone could be another treatment modality in non-surgical approaches to female stress urinary incontinence.
Ceramics ; Exercise ; Female ; Follow-Up Studies ; Humans ; Pelvic Floor ; Prospective Studies* ; Rehabilitation ; Urinary Incontinence*