A significant association exists between lower urinary tract symptoms and anxiety. Despite the efficacy of cognitive behavior therapies in treating a variety of phobic disorders, there are few published reports about ...A significant association exists between lower urinary tract symptoms and anxiety. Despite the efficacy of cognitive behavior therapies in treating a variety of phobic disorders, there are few published reports about the use of such treatments for urinary problems. We report a case of the phobia of urinary incontinence treated with cognitive behavioral techniques, which involved cognitive restructuring, distraction, relaxation training, and exposure to feared situations.展开更多
The new conservative treatment methods of female stress urinary incontinence mainly include laser therapy, magnetic stimulation therapy and stem cell therapy. Laser therapy and magnetic stimulation therapy can improve...The new conservative treatment methods of female stress urinary incontinence mainly include laser therapy, magnetic stimulation therapy and stem cell therapy. Laser therapy and magnetic stimulation therapy can improve the urodynamic parameters, clinical symptoms, quality of life and sexual life of female stress urinary incontinence patients, with higher compliance and less side effects. Stem cell therapy can improve histological changes, urodynamic parameters of stress urinary incontinence rats, and clinical symptoms and quality of life of patients with stress urinary incontinence, but it has not been widely used in clinical practice, and the successful experience is mainly accumulated in the animal experiment stage. In order to make it easier for medical workers to understand and promote these three new conservative treatment methods, this article reviews the treatment principles and treatment effects of these new conservative treatment methods.展开更多
We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of pat...We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.展开更多
Pelvic floor disorders(PFDs)represent a group of common and frequentlyoccurring diseases that seriously affect the life quality of women,generally including stress urinary incontinence and pelvic organ prolapse.Surger...Pelvic floor disorders(PFDs)represent a group of common and frequentlyoccurring diseases that seriously affect the life quality of women,generally including stress urinary incontinence and pelvic organ prolapse.Surgery has been used as a treatment for PFD,but almost 30%of patients require subsequent surgery due to a high incidence of postoperative complications and high recurrence rates.Therefore,investigations of new therapeutic strategies are urgently needed.Stem cells possess strong multi-differentiation,self-renewal,immunomodulation,and angiogenesis abilities and they are able to differentiate into various cell types of pelvic floor tissues and thus provide a potential therapeutic approach for PFD.Recently,various studies using different autologous stem cells have achieved promising results by improving the pelvic ligament and muscle regeneration and conferring the tissue elasticity and strength to the damaged tissue in PFD,as well as reduced inflammatory reactions,collagen deposition,and foreign body reaction.However,with relatively high rates of complications such as bladder stone formation and wound infections,further studies are necessary to investigate the role of stem cells as maintainers of tissue homeostasis and modulators in early interventions including therapies using new stem cell sources,exosomes,and tissueengineering combined with stem cell-based implants,among others.This review describes the types of stem cells and the possible interaction mechanisms in PFD treatment,with the hope of providing more promising stem cell treatment strategies for PFD in the future.展开更多
Objective:To observe the clinical efficacy of deep electroacupuncture(EA)at Baliao points in treating stress urinary incontinence(SUI).Methods:A total of 60 female patients with SUI were divided into two groups accord...Objective:To observe the clinical efficacy of deep electroacupuncture(EA)at Baliao points in treating stress urinary incontinence(SUI).Methods:A total of 60 female patients with SUI were divided into two groups according to the order of consultation,with 30 cases in each group.The control group was treated with pelvic floor muscle training.The treatment group was treated with deep EA at Baliao points[Shangliao(BL 31),Ciliao(BL 32),Zhongliao(BL 33)and Xialiao(BL 34)].Results:The total effective rate was 93.3%in the treatment group,versus 33.3%in the control group,and the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the scores of international consultation on incontinence questionnaire-short form(ICIQ-SF)and the volume of urinary leakage in both groups were lower than those before treatment(all P<0.05),and the ICIQ-SF score and the volume of urinary leakage in the treatment group were lower than those in the control group(both P<0.05).Conclusion:Deep EA at Baliao points with long needles can improve the clinical symptoms in female patients with SUI,and it has a better curative effect than pelvic floor muscle training.展开更多
Objective： To observe the effect of different treatment frequency of electric pudendal nerve stimulation （EPNS） on stress urinary incontinence （SUl）. Methods： A total of 60 female SUl cases were randomly alloca...Objective： To observe the effect of different treatment frequency of electric pudendal nerve stimulation （EPNS） on stress urinary incontinence （SUl）. Methods： A total of 60 female SUl cases were randomly allocated into group A and group B, 30 in each group. Cases in both groups were treated with EPNS, 3 times a week for group A, versus twice a week for group B. Then clinical symptoms, stress urinary incontinence and quality of life （QOL） were assessed respectively before treatment and after 12 times of treatment by using questionnaire. In addition, for 99 cases whose clinical symptom scores were reduced by more than 50% after EPNS treatment, a telephone interview follow-up was conducted. Results： The cases in the treatment group were better than those in the control group in the enhancement of clinical effects, the decline of VAS scores and the improvement of clinical symptoms and sign integrals, with statistical significance （P〈0.01 or P〈0.05）. Conclusion： EPNS has positive effect for female SUl; different treatment frequencies have certain impact on clinical effect： the effect achieved by 3 times a week was better than that by twice a week; and this therapy has stable long-term effect.展开更多
文摘A significant association exists between lower urinary tract symptoms and anxiety. Despite the efficacy of cognitive behavior therapies in treating a variety of phobic disorders, there are few published reports about the use of such treatments for urinary problems. We report a case of the phobia of urinary incontinence treated with cognitive behavioral techniques, which involved cognitive restructuring, distraction, relaxation training, and exposure to feared situations.
基金Shanxi Provincial Key Research and Development Program(No.201803D31103).
文摘The new conservative treatment methods of female stress urinary incontinence mainly include laser therapy, magnetic stimulation therapy and stem cell therapy. Laser therapy and magnetic stimulation therapy can improve the urodynamic parameters, clinical symptoms, quality of life and sexual life of female stress urinary incontinence patients, with higher compliance and less side effects. Stem cell therapy can improve histological changes, urodynamic parameters of stress urinary incontinence rats, and clinical symptoms and quality of life of patients with stress urinary incontinence, but it has not been widely used in clinical practice, and the successful experience is mainly accumulated in the animal experiment stage. In order to make it easier for medical workers to understand and promote these three new conservative treatment methods, this article reviews the treatment principles and treatment effects of these new conservative treatment methods.
文摘We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.
基金Foundation of Sichuan Provincial Science and Technology Program,No.2019YFH0147 and No.2019YFH0158Chengdu Technological Innovation Research and Development Project,No.2018-YF05-00195-SN+1 种基金West China Second University Hospital Xinya Fund,No.kx1111.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC18016.
文摘Pelvic floor disorders(PFDs)represent a group of common and frequentlyoccurring diseases that seriously affect the life quality of women,generally including stress urinary incontinence and pelvic organ prolapse.Surgery has been used as a treatment for PFD,but almost 30%of patients require subsequent surgery due to a high incidence of postoperative complications and high recurrence rates.Therefore,investigations of new therapeutic strategies are urgently needed.Stem cells possess strong multi-differentiation,self-renewal,immunomodulation,and angiogenesis abilities and they are able to differentiate into various cell types of pelvic floor tissues and thus provide a potential therapeutic approach for PFD.Recently,various studies using different autologous stem cells have achieved promising results by improving the pelvic ligament and muscle regeneration and conferring the tissue elasticity and strength to the damaged tissue in PFD,as well as reduced inflammatory reactions,collagen deposition,and foreign body reaction.However,with relatively high rates of complications such as bladder stone formation and wound infections,further studies are necessary to investigate the role of stem cells as maintainers of tissue homeostasis and modulators in early interventions including therapies using new stem cell sources,exosomes,and tissueengineering combined with stem cell-based implants,among others.This review describes the types of stem cells and the possible interaction mechanisms in PFD treatment,with the hope of providing more promising stem cell treatment strategies for PFD in the future.
文摘Objective:To observe the clinical efficacy of deep electroacupuncture(EA)at Baliao points in treating stress urinary incontinence(SUI).Methods:A total of 60 female patients with SUI were divided into two groups according to the order of consultation,with 30 cases in each group.The control group was treated with pelvic floor muscle training.The treatment group was treated with deep EA at Baliao points[Shangliao(BL 31),Ciliao(BL 32),Zhongliao(BL 33)and Xialiao(BL 34)].Results:The total effective rate was 93.3%in the treatment group,versus 33.3%in the control group,and the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the scores of international consultation on incontinence questionnaire-short form(ICIQ-SF)and the volume of urinary leakage in both groups were lower than those before treatment(all P<0.05),and the ICIQ-SF score and the volume of urinary leakage in the treatment group were lower than those in the control group(both P<0.05).Conclusion:Deep EA at Baliao points with long needles can improve the clinical symptoms in female patients with SUI,and it has a better curative effect than pelvic floor muscle training.
基金supported by Special Project for Chinese Medicine Modernization, Shanghai Municipal Science and Technology Commission (09dZ1974900)3-Year Action Plan for Shanghai Municipal Chinese Medicine Development (Major Research) Project(ZYSNXD-CC-ZDYJ010)
文摘Objective： To observe the effect of different treatment frequency of electric pudendal nerve stimulation （EPNS） on stress urinary incontinence （SUl）. Methods： A total of 60 female SUl cases were randomly allocated into group A and group B, 30 in each group. Cases in both groups were treated with EPNS, 3 times a week for group A, versus twice a week for group B. Then clinical symptoms, stress urinary incontinence and quality of life （QOL） were assessed respectively before treatment and after 12 times of treatment by using questionnaire. In addition, for 99 cases whose clinical symptom scores were reduced by more than 50% after EPNS treatment, a telephone interview follow-up was conducted. Results： The cases in the treatment group were better than those in the control group in the enhancement of clinical effects, the decline of VAS scores and the improvement of clinical symptoms and sign integrals, with statistical significance （P〈0.01 or P〈0.05）. Conclusion： EPNS has positive effect for female SUl; different treatment frequencies have certain impact on clinical effect： the effect achieved by 3 times a week was better than that by twice a week; and this therapy has stable long-term effect.
