PURPOSE: The purpose of this study is to evaluate the efficacy of biofeedback 1 treatment and functional electrical stimulation in stress incontinence patients as a physiotherapy and to know which factors affect on the outcome. MATERIALS AND METHOD: A group of 65 patients with stress incontinence were treated with combined alternating biofeedback and intravaginal electrical stimulation during 12 sessions, each 21 minutes in length, during 6 weeks. All patients had type l or ll stress incontinence. RESULTS: At immediate post treatment, subjective cure(complete dryness) rate was 15% and improvement(recovery to avoid other forms of treatment) rate was 60% and failure rate was 25%. Thus, the overall success rate for this treatment was 75%. In 49 patients who had all scheduled sessions and good compliance, subjective cure rate was 14% and improvement rate was 71%, but in 16 patients not to have good compliance, cure rate was 19%, improvement rate was 25%. In compliant patients, the result of 3 months after treatment showed cure rate was 11%, improvement rate was 54%. Compliance with reatment was the most significant parameter predictive of a good outcome(p<0.01) and the degree of stress incontinence was also significant in compliant patients(p<0.05). No clinical correlation with outcome was found in age, type, severity of cystocele, pelvic muscle strength, initial degree of vaginal contraction. Intravaginal pressure increased by an average of 10cmH20. Increased vaginal pressure was found in 93% of the patients and at least 50%improvement was 61%. Urge incontinence and urgency were present in 10(15%) and 19(29%) of the patients and improvement including cure was found 90% in urge incontinence and 89% in urgency. CONCLUSIONS: Biofeedback treatment and functional electrical stimulation is more effective for the patients who have good compliance, low degree stress incontinence and combined bladder irritation symptoms. In order to attain and maintain good results, a well structured biofeedback and functional electrical stimulation program that teaches specific muscle exercise should be used and the patients should be followed by a maintenance program and reinforcement.
Biofeedback, Psychology* ; Compliance ; Cystocele ; Electric Stimulation* ; Humans ; Muscle Strength ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

PURPOSE: The effectiveness of intravaginal electrical stimulation and biofeedback combined with pelvic muscle exercise was evaluated in stress, urge and mixed incontinence, and the success rates of each urinary incontinence were compared. MATERIALS AND METHODS: Eighty-nine women between 26 and 75 years of age (mean age 49 years) were studied. Based upon history and the results of clinical investigation, the patients were divided into three groups: pure stress incontinence (39 patients), pure urge incontinence (24 patients), mixed incontinence (26 patients). Also, patients presented with urge incontinence was divided two groups: motor urge incontinence (27 patients) and sensory urge incontinence (23 patients). All patient were treated with combination of biofeedback and intravaginal electrical stimulation, and then the success rate of this combination therapy for urinary incontinence was evaluated RESULTS: The overall success rate was 76.4% (68/89). We found a 69.2% (27/39) success rate in patients with pure stress incontinence, 75% (18/24) in pure urge incontinence, and 88.5% (23/26) in mixed incontinence. There were no significant differences of success rate among three incontinence. Also, there were statistically significant differences in success rates between motor urge incontinence and sensory urge incontinence (70.4% vs. 95.7%)(p<0.05). CONCLUSIONS: We conclude that biofeedback and intravaginal electrical stimulation areeffective treatment for urinary incontinence if we select appropriate patients, and considered as a treatment option in sensory urge incontinence as well as motor urge incontinence.
Biofeedback, Psychology* ; Electric Stimulation* ; Female* ; Humans ; Urinary Incontinence* ; Urinary Incontinence, Urge

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation* ; Pelvic Floor* ; Urinary Incontinence*

No abstract available in English.
Biofeedback, Psychology* ; Compliance* ; Female ; Humans ; Pelvic Floor* ; Urinary Incontinence*

BACKGROUND: To evaluate the efficacy of EMG biofeedback and pelvic floor electrical stimulation in the stress urinary incontinence patients by Kontinence HMT2000. MATERIALS AND METHODS: A group of 14 patients with stress urinary incontinence were treated with combined biofeedback and intravaginal electrical stimulation during 12 sessions from 2 weeks to 6 weeks. RESULTS: At immediate post treatment, subjective cure rate was 28% and improvement rate was 57% and failure rate was 15%. Thus the overall success rate for this treatment was 85%. The result of 3 months after treatment showed cure rate 14% and improvement rate was 43%. Intravaginal pressure increased by an average of 11.9 cmH2O. Increased vaginal pressure was found in 93% of the patients and more than 50% increment of intravaginal pressure was 71%. CONCLUSIONS: Combined biofeedback and pelvic floor electrical stimulation by use of Kontinence HMT2000 is effective for the patients who have good compliance, relative low degree stress urinary incontinence. In order to attain good results, a well structured program that teaches specific muscle exercise and the patients should be followed by regular interval reinforcement treatment.
Biofeedback, Psychology* ; Compliance ; Electric Stimulation* ; Humans ; Pelvic Floor ; Urinary Incontinence*

Neurofibromatosis is a rare systemic disease, and genitourinary tract involvement is especially uncommon. Bladder is the most frequently involved organ in the genitourinary tract. Bladder neurofibromatosis may present as a diffuse infiltrative process or an isolated neurofibroma. The symptoms vary, ranging from urinary incontinence to retention. Treatment is usually conservative. The patient should be worked up to rule out other manifestation of tumor enlargement and followed to evaluate the development of new lesion. We report a case of the development of invasion of bladder in a patient with neurofibromatosis.
Humans ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Retention (Psychology) ; Urinary Bladder ; Urinary Incontinence ; Urinary Retention

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

Defective or inadequate pelvic floor function is important etiologic factor for urinary stress incontinence and uterine prolapse. Pelvic floor muscle exercise is the mainstream of the nonoperative treatment for female stress urinary incontinence. Especially Vaginal cones have been known as a simple and practical means of improving both pelvic floor muscle strength and genuine stress incontinence using biofeedback mechanism. Forty adult women suffering from mild and moderate stress incontincnce were instructed to exercise their pelvic muscles using vaginal cones. They retained cones of increasing weight in the vagina by contracting pelvic floor muscles for 15 minutes twice a day for 4 weeks. The comparison of pelvic floor muscle function before and after the exercise were assessed by the frequency of incontinence, vaginal digital palpation, vaginal pressure measurement and speculm lift test. The results were as follows; 1. The frequency of incontinence was significantly reduced after the exercise using vaginal cone (P<0.001). 2. Vaginal digital palpation score (strength of vaginal levator muscle) was significantly increased after the exercise using vaginal cone (P<0.001). 3. The vaginal pressure by perineometer was significantly increased after the exercise using vaginal cones (P<0.001). 4. The vaginal lumen during contraction was significantly narrower after the exercise using vaginal cones (P<0.001). 5. The maximal cone weight which patients could hold over 1 minute was significantly increased after the exercise using vaginal cones (P<0.001).
Adult ; Biofeedback, Psychology ; Female ; Humans ; Korea* ; Muscle Strength ; Muscles ; Palpation ; Pelvic Floor* ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Uterine Prolapse ; Vagina

Overactive bladder (OAB) is a medical condition characterized by urgency, with or without urge urinary incontinence, frequency, and nocturia in the absence of genitourinary pathologies or metabolic factors that can explain these symptoms. The current management of OAB is complex, and a wide range of options for conservative treatment have been offered, including bladder training, biofeedback, behavioral changes, oral or intravesical anticholinergic agents, S3 sacral neuromodulation, and peripheral electrical stimulation. The clinical efficacies of these treatments remains an open issue, and several experimental and clinical studies have been carried out during the last years. However, a minor group of OAB patients prove to be refractory to these conservative managements and need further evaluation involving sophisticated urodynamic testing and cystoscopy to carefully define the nature of the lower urinary tract dysfunction and to rule out other causes underlying the symptoms. Thus, the management of refractory OAB, which accounts for 10% of the whole spectrum of OAB, is extremely difficult. The aforementioned therapeutic tools have not always been completely satisfactory in these refractory OAB. Here, the author reviews the mechanism of micturition reflex and the current therapies, particularly highlighting the potential benefit of neuromodulation for refractory OAB.
Biofeedback, Psychology ; Cholinergic Antagonists ; Cystoscopy ; Electric Stimulation ; Humans ; Nocturia ; Reflex ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urination ; Urodynamics