Urinary incontinence has become a societal problem that affects millions of people worldwide. Although numerous therapeutic modalities are available, none has been shown to be entirely satisfactory. Consequently, cell-based approaches using regenerative medicine technology have emerged as a potential solution that would provide a means of correcting anatomical deficiencies and restoring normal function. As such, numerous cell-based investigations have been performed to develop systems that are focused on addressing clinical needs. While most of these attempts remain in the experimental stages, several clinical trials are being designed or are in progress. This article provides an overview of the cell-based approaches that utilize various cell sources to develop effective treatment modalities for urinary incontinence.
Regenerative Medicine ; Tissue Therapy ; Urinary Incontinence

The relevant documents of apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years have been collated and analyzed in aspect of current situation of acupuncture-moxibustion treatment, acupoint selection, manipulation and problems. The result indicates that the main therapy for this disease is acupuncture-moxibustion combined with electroacupuncture or other methods, and the acupuncture-moxibustion therapy is superior to the medicine. The clinical research has made considerable progress and the great importance has been attached to the research method. The main problems are low credibility of total quality, inconsistent curative course, incomplete case of illness, missing of quality control, disordered standards of clinical diagnosis and curative effect evaluation, varied observation index and phatic discussion of mechanism. It is suggested to carry on scientific research, enhance research lever, expand mind, innovate ideas, and establish uniformed standards of diagnosis and curative effect evaluation and observation index.
Acupuncture Therapy ; Humans ; Moxibustion ; Stroke ; complications ; Urinary Incontinence ; etiology ; therapy

Humans ; Tissue Engineering ; methods ; Urinary Incontinence, Stress ; pathology ; therapy

The overactive bladder, according to the original definition by International Continence Society refers to the storage phase of the bladder and is diagnosed by urodynamics. The overactive bladder is a medical condition referring to the symptoms of frequency and urgency, with or without urge incontinence, in the absence of local pathology or metabolic factors that would account for these symptoms. The definition of overactive bladder needs clarification, which would help to overcome the current confusion. Possible neurological, muscular, and metabolic causes have been proposed but in many cases the exact causes remain unclear. The diagnosis depends greatly on a detailed history, clinical examination, and urinalysis. Urodynamic evaluation is indicated when neuropathy is suspected, and the treatment may be unsuccessful without exact knowledge of patients' state. It can be treated conservatively by bladder training, physiotherapy, and drugs alone or with combination. For refractory cases neuromodulation, denervation techniques, and bladder augmentation or substitution can be used with good results.
Behavior Therapy ; Denervation ; Diagnosis ; Pathology ; Urinalysis ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge ; Urodynamics

Functional urinary incontinence, the absence of any neurologic or structural abnormality as a cause of urinary incontinence in children, is one of the most common clinical problems encountered in pediatric and urologic departments, and it can be socially and emotionally distressing for the affected children. The prevalence rates of functional urinary incontinence in school-aged children are not very high and differ between boys and girls. The underlying mechanisms of functional urinary incontinence are heterogenous and can be associated with the following dysfunctions of both the storage and voiding patterns of the bladder: overactive bladder, dysfunctional voiding, lazy bladder syndrome, HinmanAllen syndrome, giggle incontinence, and vaginal voiding. Treatment methods for urinary incontinence in children should be chosen according to these clinical conditions. Treatment modalities generally consist of the treatment of comorbid conditions such as urinary infection and constipation, behavior therapy to modify learned voiding patterns, and pharmacotherapy primarily with anticholinergics and alpha -adrenergic blockers. This review discusses the optimal treatment modalities, including treatment of the underlying voiding disorders, and diagnostic approaches related to functional urinary incontinence in children.
Behavior Therapy ; Child ; Cholinergic Antagonists ; Constipation ; Humans ; Prevalence ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence

PURPOSE: To evaluate the efficacy of acute maximal functional electrical stimulation(AMFES) for the treatment of overactive bladder(OAB). MATERIALS AND METHODS: Twenty-eight patients(male 3, female 25) with OAB symptoms were treated with AMFES(10Hz biphasic alternating pulse, 20 min per session, 10 sessions) via intravaginal or anal electrode. They were divided into OAB symptoms with and without detrusor overactivity(DO) based on urodynamic study (n=15 vs. 13, respectively). DO-present group was subdivided into idiopathic DO subgroup (IDO, n=9) and neurogenic DO subgroup(NDO, n=6). The outcomes were assessed by 3-day frequency-volume chart and the Bristol Female Lower Urinary Tract Symptoms Questionnaire Changes in OAB symptoms at 1 and 3 months after discontinuing the stimulation were evaluated. RESULTS: Cure rates for urgency and urge incontinence at 1-month after stimulation were determined as 62.5% and 50% in IDO group, 66.7% and 66.7% in NDO group, respectively, which were higher compared to DO-absent group. At 3-month after treatment most patients in IDO and DO-absent group who achieved a cure at 1 month, maintained improvement, however three(75%) of 4 patients in NDO group recurred. There were no significant changes in urodynamic parameters. The detrusor overactivity was no longer observed in 5(55.6%) patients in IDO group and none in NDO group. CONCLUSION: AMFES has a beneficial effect on women with OAB. Our data suggest electrical stimulation may have a significant carry-over effect in well-selected OAB patients although further studies with large population are needed to establish long-term results.
Electric Stimulation Therapy ; Electric Stimulation* ; Electrodes ; Female ; Humans ; Lower Urinary Tract Symptoms ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

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 purpose of this study was to determine the effect of pelvic floor magnetic stimulation with BIOCON for the treatment of patients with stress urinary incontinence. MATERIALS AND METHODS: Forty-nine patients with urinary incontinence were randomly assigned to two treatment groups (20 patients in the NEOCONTROL group and 29 in the BIOCON group). The patients were treated for 20 minutes, twice or three times a week for 12 weeks; each patient was fully clothed and seated on a special chair, a NEOCONTROL or BIOCON chair with a magnetic field therapy head in the seat. Objective measures included the symptom score, vaginal pressure and quality of life survey. RESULTS: Both NEOCONTROL and BIOCON ExMI offered an effective modal for frequency, urgency and urinary incontinence. No statistical difference was seen between the two groups when comparing their vaginal pressures. In the NEOCONTROL group, the score for the quality of life improved 2.4 to 6.05 and 2.21 to 6.03 for the BIOCON group. CONCLUSIONS: ExMI is painless. There is no need for a probe, nor for the need to undress for treatments. BIOCON ExMI therapy is as effective in stress and urge incontinence as the NEOCONTROL type. A longer follow-up is required to determine the benefits of treatment.
Female* ; Follow-Up Studies ; Head ; Humans ; Magnetic Field Therapy ; Pelvic Floor* ; Quality of Life ; Urinary Incontinence* ; Urinary Incontinence, Urge

The pelvic floor disorder disease (PFDD) typically originates from supportive tissue defects or injuries in the pelvic floor with a wide spectrum of symptoms such as urinary incontinence, pelvic organ prolapse, sexual dysfunction, fecal incontinence and chronic pelvic pain. But its etiology is complex, involving multiple systems and organs. So the best management of PFDD requires the implementation of multidisciplinary team (MDT). Pelvic floor centers have been developed abroad to provide pelvic floor services. In the setting of PFDD, the concept of MDT starts lately and develops slowly in China. The MDT approach was demonstrated to improve general rehabilitation, psychological state and quality of life. However, there is no unified standardization for MDT diagnosis and treatment of PFDD at home and abroad. Meanwhile, the personnel composition, responsibilities, training, and operation mode of the MDT need to be further developed. Perfecting the management mode of MDT team members, establishing standardized training programs and assessment criteria play crucial role in the future development of MDT in PFDD.
China ; Fecal Incontinence ; Humans ; Pelvic Floor ; Pelvic Floor Disorders/therapy* ; Pelvic Organ Prolapse/therapy* ; Quality of Life ; Urinary Incontinence