OBJECTIVES: Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes. METHODS: In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (n=36) or a control group (n=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment. RESULTS: Both groups showed statistically significant improvements in all parameters after treatment (all P<0.05). However, there were no statistically significant differences between groups in most measures (all P>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: P=0.026; right leg: P=0.006), with a significant increase from baseline (P<0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (P=0.037). CONCLUSIONS Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Middle Aged ; Biofeedback, Psychology ; Adult ; Exercise Therapy/methods* ; Proprioception ; Electroacupuncture/methods* ; Quality of Life ; Electric Stimulation Therapy/methods* ; Treatment Outcome ; Combined Modality Therapy

PURPOSE: This study aimed to examine the effectiveness of the workshop on the nurses' knowledge about urinary incontinence (UI) self-management, attitudes toward UI, and self-efficacy to plan and implement a UI self-help group program for their clients. METHODS: A one-group pretest and posttest design was used to examine changes in knowledge, attitudes, and self-efficacy following a one-day training workshop. Twenty-seven community health nurses completed a questionnaire before and after the workshop. Before participating in the workshop, the participants were required to take a UI online continuing education program developed by the researchers. During the workshop, the participants took four sessions which consisted of an introduction of a self-help group program, demonstration of a 5-week UI self-management program contents, pelvic floor muscle training and biofeedback practice, and group discussions to plan the implementation in their workplaces. RESULTS: A significant improvement in knowledge of and attitudes toward UI were found (t=3.53, p=.002; t=2.83, p=.009, respectively) after the workshop. Participants also demonstrated improvement in their self-efficacy to plan and operate a UI self-help group program (Z=-2.64, p=.008). CONCLUSION: The one-day workshop for community health nurses is a feasible strategy to increase their abilities and confidence in operating a UI self-help group program.
Biofeedback, Psychology ; Education* ; Education, Continuing ; Nurses, Community Health* ; Pelvic Floor ; Program Evaluation ; Self Care* ; Self-Help Groups ; Urinary Incontinence*

OBJECTIVETo observe the effect on female stress urinary incontinence (SUI) treated with the pudendal nerve stimulation of electroacupuncture therapy at different frequencies.

METHODSSixty patients were divided into a group treated three times every week (group A) and a group treated twice every week (group B), 30 cases in each one. The pudendal nerve stimulation of electroacupuncture therapy was adopted at Disixue (four acupoints on sacral region), 60 min in each time in the two groups, treated three times a week or twice a week respectively. SUI severity and the score of life quality were observed before and after 12 treatments separately. The efficacy was evaluated in the two groups.

RESULTSAt the end of treatment, SUI severity was relieved and the score of life quality was improved in the two groups (all P<0.01). The results in group A were superior to group B [0 (0-4.3) vs 4 (0-5), P<0.01]. At the end of treatment, the total effective rate in group A was 90.0% (27/30) and was 76.7% (23/30) in group B; the efficacy in group A was better than that in group B (P<0.05).

CONCLUSIONThe pudendal nerve stimulation of electroacupuncture therapy achieves the definite efficacy on female SUI and the results in the treatment of three times a week are superior to those in the treatment of twice a week.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Middle Aged ; Quality of Life ; Treatment Outcome ; Urinary Incontinence, Stress ; psychology ; therapy

No abstract available.
Aging ; *Attitude of Health Personnel ; Health Knowledge, Attitudes, Practice ; Humans ; *Physician's Practice Patterns ; Physicians ; Prostatectomy ; Risk Factors ; Urinary Bladder/physiology ; Urinary Incontinence/*epidemiology/*psychology ; Urination/physiology

PURPOSE: This study was done to compare clinical nurses' knowledge and visual differentiation diagnostic ability for the pressure ulcer classification system (PUCS) and incontinence-associated dermatitis (IAD). METHODS: A convenience sample of 602 nurses took the pressure ulcer classification system and incontinence-associated dermatitis knowledge test (PUCS & IAD KT) and completed the visual differentiation tool (VDT), consisting of 21 photographs with clinical information. RESULTS: The overall mean score for correct answers was 14.5 (+/-3.2) in PUCS & IAD KT and 11.15 (+/-4.9) in PUCS & IAD VDT. Incorrect responses were most common for statements related to stage III, IAD for PUCS & IAD KT, and suspected deep tissue injury (SDTI), unstageable, and stage III for PUCS & IAD VDT. Significant correlations were found between PUCS & IAD KT and VDT (r=.48, p<.001). Factors affecting scores for PUCS & IAD VDT were PUCS & IAD KT, frequency of pressure ulcer, IAD management and participation in wound care education programs. CONCLUSION: Results indicate that nurses have an overall understanding of PUCS & IAD, but low visual differentiation ability regarding stage III, SDTI, and unstageable ulcers. Continuing education is needed to further improve knowledge and visual differentiation ability for PUCS & IAD.
Adult ; Dermatitis/*classification/complications/pathology ; Education, Continuing ; Educational Measurement ; Fecal Incontinence/complications ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Nurses/*psychology ; Pressure Ulcer/*classification/pathology ; Questionnaires ; Urinary Incontinence/complications

Since their introduction in 1996, tension-free midurethral slings (MUS) have been proven to have long-term efficacy and safety. They are considered the gold standard treatment of female stress urinary incontinence, especially in cases that are associated with urethral hypermobility. However, they are not free of complications and, although rare, some of these complications can be challenging for both patients and physicians. Some complications occur intraoperatively, whereas others appear in the early or late postoperative period. There is less controversy in the diagnosis and treatment of complications such as vaginal extrusion or urinary system erosion, whereas de novo voiding problems are at best not completely understood. Voiding dysfunction after MUS placement may vary in a wide range from urinary frequency or urgency to retention and is usually attributed to the obstructive or irritative effect of the sling. However, present urodynamic criteria for the diagnosis of female infravesical obstruction are not satisfactory, and the best management policy for de novo voiding dysfunction remains controversial. In the majority of cases, the diagnosis of obstruction leading to a urethral release surgery depends on a combination of several clinical findings. The timing of urethral release surgery varies depending on the preferences of the surgeon, and the outcome of this surgery is not always predictable. The purpose of this review was to assess the diagnosis and management of the immediate, short-term, and long-term complications of MUS in light of the current literature in an attempt to determine the best management policy.
Animals ; Female ; Humans ; Light ; Mice ; Postoperative Period ; Retention (Psychology) ; Suburethral Slings ; Urinary Incontinence ; Urodynamics

PURPOSE: The purpose of this study was to investigate homebound status and significant related factors for community-dwelling female elders according to age. METHODS: The participants were female elders over 65 years of age registered in public health centers. Data were collected by interviewing the elders, who voluntarily completed the entire survey. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 18.0. RESULTS: There were statistically significant differences in homeboundness and related factors between the young-old (65 to 74 years of age) and the old-old (75 years of age or older). The level of homeboundness of the old-old was higher than that of the young-old. Multiple logistic regression showed, timed "up and go", depression, and fear of falling as significantly associated with homebound status of the young-old, while hand grip strength (right), timed "up and go", static balance ability, severity of urinary incontinence, and fear of falling as significant for the old-old. CONCLUSION: The findings of this study indicate that homebound status and related factors for elders are different according to age, and therefore, interventions to prevent and help homebound elders get over being homebound should be developed according to age.
Accidental Falls ; Activities of Daily Living ; Age Factors ; Aged ; Aged, 80 and over ; Depression ; Fear ; Female ; Hand Strength ; Health Status ; Homebound Persons/*psychology ; Humans ; Interviews as Topic ; Logistic Models ; Residence Characteristics ; 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

One of the annoying complications of radical prostatectomy is urinary incontinence. Post-prostatectomy incontinence (PPI) causes a significant impact on the patient's health-related quality of life. Although PPI is stress urinary incontinence caused by intrinsic sphincter deficiency in most cases, bladder dysfunction and vesicourethral anastomotic stenosis can induce urine leakage also. Exact clinical assessments, such as a voiding diary, incontinence questionnaire, pad test, urodynamic study, and urethrocystoscopy, are necessary to determine adequate treatment. The initial management of PPI is conservative treatment including lifestyle interventions, pelvic floor muscle training with or without biofeedback, and bladder training. An early start of conservative treatment is recommended during the first year. If the conservative treatment fails, surgical treatment is recommended. Surgical treatment of stress urinary incontinence after radical prostatectomy can be divided into minimally invasive and invasive treatments. Minimally invasive treatment includes injection of urethral bulking agents, male suburethral sling, and adjustable continence balloons. Invasive treatment includes artificial urinary sphincter implantation, which is still the gold standard and the most effective treatment of PPI. However, the demand for minimally invasive treatment is increasing, and many urologists consider male suburethral slings to be an acceptable treatment for PPI. The male sling is usually recommended for patients with persistent mild or moderate incontinence. It is necessary to improve our understanding of the pathophysiologic mechanisms of PPI and to compare different procedures for the development of new and potentially better treatment options.
Biofeedback, Psychology ; Constriction, Pathologic ; Humans ; Life Style ; Male ; Muscles ; Pelvic Floor ; Postoperative Complications ; Prostatectomy ; Prostatic Neoplasms ; Quality of Life ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence ; Urinary Sphincter, Artificial ; Urodynamics

OBJECTIVES: To describe the surgical technique according to personal experience, the effectiveness and safety of HoLEP. MATERIALS & METHODS: From May 2010 to April 2011, 120 consecutive patients treated with HoLEP were enrolled in this study. All patients was evaluated by digital rectal examination (DRE), transrectal ultrasonography (TRUS), serum PSA preoperatively. International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and postvoid residual urine (PVR) were documented preoperatively and 3 months postoperatively. The perioperative data and complications were analyzed. All procedures of HoLEP was done by single surgeon. RESULTS: The mean patient age was 68.0 (50-82), and the average operation time was 71.6 minutes (range, 30-150). Mean prostate volume was 54.1 ml (range, 20-120) and mean resected tissue weight was 7.9 g (range, 2-30). Postoperatively, IPSS and PVR decreased and Qmax increased significantly. Postoperative complications were transient incontinence, urinary retention, hematuria, urinary tract infection, urethral stricture and bladder neck contracture, and intraoperative complication was minor capsular perforation. HoLEP is a method that may completely remove prostatic adenoma tissues. In particular, its clinical effectiveness is excellent regardless of prostatic size, and it is effective even in cases with prostate volume of 100 ml or more. However, about 50 cases are needed to reach the experienced level. CONCLUSIONS: HoLEP was found to be effective and safe regardless of prostatic size. The author believe HoLEP is a size independent gold standard for BPH surgery.
Contracture ; Digital Rectal Examination ; Hematuria ; Holmium ; Humans ; Intraoperative Complications ; Lasers, Solid-State ; Neck ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Retention (Psychology) ; Urethral Stricture ; Urinary Bladder ; Urinary Incontinence ; Urinary Tract Infections