Menopause is one of the natural stages of life of women that is associated with instability of vasomotor, flushing, sweating, anxiety and depression, urogenital atrophy and urinary problems. The age range of physiolog...Menopause is one of the natural stages of life of women that is associated with instability of vasomotor, flushing, sweating, anxiety and depression, urogenital atrophy and urinary problems. The age range of physiological event is between 48 - 55 years old. With regard to the role of genetics, nutrition and geographical conditions of the age of menopause in Iranian women is lower than and among 46 - 53 years. With the increase in life expectancy in recent decades, duration of menopause is increased and almost involved a third of the life of women so special issues of this era have had more attention. Since menopause is not the end of the life of a woman and keep her physical and mental health and problems resulting from the process of menopause such as urinary problems and incontinence will lead to improve the quality of life in this period. Many studies have tried to find a therapy for postmenopausal women with stress urinary incontinence using hormone. So this article seeks to examine the effect of conjugated estrogen in stress urinary incontinence of menopausal women with using the library method. The survey showed that by starting menopause, decreasing estrogen causes atrophy of mucosa of urogenital and the lining of the urethra and bladder, estrogen causes to maintain muscle tonicity. Also sacral nerves are also rich in estrogen receptors and by estrogen deficiency, elasticity of the urinary system decreases. Estrogen deficiency causes excitability of nerves and frequency of urine. So estrogen can increase the resistance of the urethra, bladder sensory threshold and sensitivity in Adorno in smooth muscles of the urethra and the rest of detrusor.展开更多
Objective: To study the correlation of pelvic floor ultrasound parameter with extracellular matrix remodeling and apoptosis in patients with stress urinary incontinence. Methods:Patients with stress urinary incontinen...Objective: To study the correlation of pelvic floor ultrasound parameter with extracellular matrix remodeling and apoptosis in patients with stress urinary incontinence. Methods:Patients with stress urinary incontinence who underwent surgical treatment in Tianmen First People's Hospital in Hubei Province between March 2015 and August 2017 were selected as the SUI group of the research and patients who underwent total hysterectomy due to benign uterine lesions in Tianmen First People's Hospital in Hubei Province over the same period were selected as the control group of the research. Pelvic floor ultrasonography was done before surgery to measure the bladder neck descent (BND), and pelvic floor tissue was collected after surgery to determine the contents of Col-I, Col-III, TGF-β1, MMP1, MMP9, TIMP1, E-cadherin, Bax, Bcl-2, Bcl-xL, Caspase-3 and HIF-1 . Results: The pelvic floor ultrasound parameter BND of SUI group was significantly higher than that of control group;Col-I, Col-III, TIMP1, E-cadherin, Bcl-2 and Bcl-xL contents in the pelvic floor tissue of SUI group were significantly lower than those of control group whereas TGF-β1, MMP1, MMP9, Bax, Caspase-3 and HIF-1 contents were significantly higher than those of control group;Col-I, Col-III, TIMP1, E-cadherin, Bcl-2 and Bcl-xL contents in the pelvic floor tissue of SUI group of patients with high BND were significantly lower than those of patients with low BND whereas TGF-β1, MMP1, MMP9, Bax, Caspase-3 and HIF-1 contents were significantly higher than those of patients with low BND. Conclusion: The change of pelvic floor ultrasound parameter BND in patients with stress urinary incontinence is closely related to the extracellular matrix remodeling and apoptosis in pelvic floor tissue.展开更多
The aim of this study was to determine the types of urinary incontinence prevalent among Kuwaiti women with Type two Diabetes Mellitus attending the outpatient clinic at the Urology center and suggest appropriate nurs...The aim of this study was to determine the types of urinary incontinence prevalent among Kuwaiti women with Type two Diabetes Mellitus attending the outpatient clinic at the Urology center and suggest appropriate nursing interventions. Urinary incontinence is not a life threatening condition but it can be emotionally devastating and therefore affects the sufferer’s quality of life. This cross-sectional descriptive survey consisted of 250 Kuwaiti women with type two diabetes mellitus receiving treatment at the outpatient department at Sabah Al-Ahmad Urology Center, Kuwait. The questionnaire comprised of a total of 33 questions, twelve of which explored participants’ socio demographic characteristics, risk factors and symptoms of their urinary incontinence. The remaining 21 items were adapted from King’s Health Questionnaire (KHQ) formulated in 1997 at King’s college, London, for the assessment of quality of life in women with urinary incontinence. Data collection was from February to May 2014. The result revealed that mixed urinary incontinence was the most prevalent type of urinary incontinence affecting Kuwaiti women with type two diabetes mellitus. Symptoms of both stress incontinence and urge incontinence (Over active bladder) were not mutually exclusive as they were present in 247 (98.8%) and 240 (96%) of the participants respectively. Key risk factors for developing incontinence were over three years duration of diabetes mellitus in 115 (56%) and delivery of one or more children reported by 206 (82%) of the participants. Analysis and result of King Health Questionnaire on quality of life will be reported in separate paper on the psychosocial impact of urinary incontinence on diabetic Kuwaiti women. In conclusion, urinary incontinence had a devastating effect on the lives of sufferers and therefore should be prevented at all cost by nurses providing anticipatory guidance to all pregnant and diabetic women and routinely teaching pelvic floor exercises to all postnatal women. However, in the event that there are symptoms of urinary incontinence then thorough investigation and early treatment is advocated.展开更多
BACKGROUND Stress urinary incontinence(SUI)is a common disease in women.The emergence of the needle-free sling has led to a new clinical treatment for SUI in women.AIM To explore the clinical value of the needleless s...BACKGROUND Stress urinary incontinence(SUI)is a common disease in women.The emergence of the needle-free sling has led to a new clinical treatment for SUI in women.AIM To explore the clinical value of the needleless sling without acupuncture in the treatment of SUI in women.METHODS From February 2017 to November 2018,according to the order of admission,44 patients(mid-suspension group)were treated by tension-free transobturator urethral suspension,and 44 patients(non-acupuncture group)were treated with a needleless non-acupuncture band.The clinical effects of the two treatments were evaluated.RESULTS There was no significant difference between the two groups in the total clinical effectiveness rate(P=0.374),but intraoperative blood loss and visual analogue scale score at postoperative day 1 were significantly lower in the non-acupuncture suspension group than in the middle urethral suspension group(P=0.396).The incidence of complications in the needle-free sling group was significantly lower than that in the middle urethral suspension group(P=0.025).CONCLUSION The clinical effectiveness of acupuncture-free suspension in treating SUI in female patients is better than that of traditional tension-free transobturator mid-urethral suspension.展开更多
This study was conducted to determine the psycho-social impact of urinary incontinence (UI) on the quality of life of 250 Kuwaiti women with type 2 diabetic mellitus (DM). A survey method, using a 33-item 5-point Like...This study was conducted to determine the psycho-social impact of urinary incontinence (UI) on the quality of life of 250 Kuwaiti women with type 2 diabetic mellitus (DM). A survey method, using a 33-item 5-point Likert scale Arabic questionnaire adapted from the King’s Health Questionnaire (KHQ), was employed for data collection from February to May, 2014 while all the participants were receiving treatment for UI at a specialized urology center in Kuwait. Participants with UI and a co-morbidity of type 2 DM and obesity were 20 to 65 years old. Results showed the following variables were statistically significant for frequency of urine leak: Age was (<em>χ</em><sup>2</sup> = 36.877, df = 3, P ≤ 0.000). Parity showed nulliparous women reported less urine leak compared to parous women: Chi-square was (<em>χ</em><sup>2</sup> = 24.83, df = 12, P ≤ 0.016). Type 2 DM for more than 3 years duration had the highest incidence of several leaks per day. BMI of above 25 kg/m2 caused daily urine leak: Chi-square (<em>χ</em><sup>2</sup> = 17.912, df = 9, P ≤ 0.036). Participants’ self reports of good general health were those who leaked urine either 2 - 3 times weekly or occasionally. Finally, the impact of incontinence on their lifestyle was reported as extreme by 128 (51.2%), and 6 (2.4%) reported little or no impact on their quality of life: Chi-square was (<em>χ</em><sup>2</sup> = 52.392, df = 18, P ≤ 0.000). In conclusion, this study showed a clear correlation between UI and reduced quality of life. Midwives are well positioned to correct the myth that UI is an inevitable byproduct of childbearing. Midwives should explain to all pregnant women how childbirth can be a risk factor and provide anticipatory guidance by teaching preventive measures like pelvic floor exercises before and after delivery. Family members should assist sufferers in coping with their challenges by dispelling any form of stigmatization, joining them in practicing pelvic floor exercises, and encouraging, empathizing and supporting them emotionally.展开更多
目的 分析老年子宫脱垂患者术后新发压力性尿失禁(de novo SUI)情况及其影响因素。方法 回顾性分析泗县人民医院2020年10月~2023年5月期间因子宫脱垂行手术治疗的60例患者,调查患者术后de novo SUI发生情况,将患者分为无de novo SUI组及...目的 分析老年子宫脱垂患者术后新发压力性尿失禁(de novo SUI)情况及其影响因素。方法 回顾性分析泗县人民医院2020年10月~2023年5月期间因子宫脱垂行手术治疗的60例患者,调查患者术后de novo SUI发生情况,将患者分为无de novo SUI组及de novo SUI组,通过单因素及多因素logistic回归分析影响患者术后de novo SUI发生的相关因素。结果 60例行手术治疗的子宫脱垂患者,18例患者术后发生de novo SUI,发病率为30.00%。单因素分析结果显示,体质量指数(BMI)、高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史、雌激素治疗史是影响老年子宫脱垂患者术后de novo SUI的相关因素(χ^(2)=5.701、4.775、6.782、4.113、3.951、5.644、9.966,P<0.05)。多因素logistic分析结果显示,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素(P<0.05)。结论 老年子宫脱垂患者术后存在一定的de novo SUI发生风险,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素。展开更多
文摘Menopause is one of the natural stages of life of women that is associated with instability of vasomotor, flushing, sweating, anxiety and depression, urogenital atrophy and urinary problems. The age range of physiological event is between 48 - 55 years old. With regard to the role of genetics, nutrition and geographical conditions of the age of menopause in Iranian women is lower than and among 46 - 53 years. With the increase in life expectancy in recent decades, duration of menopause is increased and almost involved a third of the life of women so special issues of this era have had more attention. Since menopause is not the end of the life of a woman and keep her physical and mental health and problems resulting from the process of menopause such as urinary problems and incontinence will lead to improve the quality of life in this period. Many studies have tried to find a therapy for postmenopausal women with stress urinary incontinence using hormone. So this article seeks to examine the effect of conjugated estrogen in stress urinary incontinence of menopausal women with using the library method. The survey showed that by starting menopause, decreasing estrogen causes atrophy of mucosa of urogenital and the lining of the urethra and bladder, estrogen causes to maintain muscle tonicity. Also sacral nerves are also rich in estrogen receptors and by estrogen deficiency, elasticity of the urinary system decreases. Estrogen deficiency causes excitability of nerves and frequency of urine. So estrogen can increase the resistance of the urethra, bladder sensory threshold and sensitivity in Adorno in smooth muscles of the urethra and the rest of detrusor.
文摘Objective: To study the correlation of pelvic floor ultrasound parameter with extracellular matrix remodeling and apoptosis in patients with stress urinary incontinence. Methods:Patients with stress urinary incontinence who underwent surgical treatment in Tianmen First People's Hospital in Hubei Province between March 2015 and August 2017 were selected as the SUI group of the research and patients who underwent total hysterectomy due to benign uterine lesions in Tianmen First People's Hospital in Hubei Province over the same period were selected as the control group of the research. Pelvic floor ultrasonography was done before surgery to measure the bladder neck descent (BND), and pelvic floor tissue was collected after surgery to determine the contents of Col-I, Col-III, TGF-β1, MMP1, MMP9, TIMP1, E-cadherin, Bax, Bcl-2, Bcl-xL, Caspase-3 and HIF-1 . Results: The pelvic floor ultrasound parameter BND of SUI group was significantly higher than that of control group;Col-I, Col-III, TIMP1, E-cadherin, Bcl-2 and Bcl-xL contents in the pelvic floor tissue of SUI group were significantly lower than those of control group whereas TGF-β1, MMP1, MMP9, Bax, Caspase-3 and HIF-1 contents were significantly higher than those of control group;Col-I, Col-III, TIMP1, E-cadherin, Bcl-2 and Bcl-xL contents in the pelvic floor tissue of SUI group of patients with high BND were significantly lower than those of patients with low BND whereas TGF-β1, MMP1, MMP9, Bax, Caspase-3 and HIF-1 contents were significantly higher than those of patients with low BND. Conclusion: The change of pelvic floor ultrasound parameter BND in patients with stress urinary incontinence is closely related to the extracellular matrix remodeling and apoptosis in pelvic floor tissue.
文摘The aim of this study was to determine the types of urinary incontinence prevalent among Kuwaiti women with Type two Diabetes Mellitus attending the outpatient clinic at the Urology center and suggest appropriate nursing interventions. Urinary incontinence is not a life threatening condition but it can be emotionally devastating and therefore affects the sufferer’s quality of life. This cross-sectional descriptive survey consisted of 250 Kuwaiti women with type two diabetes mellitus receiving treatment at the outpatient department at Sabah Al-Ahmad Urology Center, Kuwait. The questionnaire comprised of a total of 33 questions, twelve of which explored participants’ socio demographic characteristics, risk factors and symptoms of their urinary incontinence. The remaining 21 items were adapted from King’s Health Questionnaire (KHQ) formulated in 1997 at King’s college, London, for the assessment of quality of life in women with urinary incontinence. Data collection was from February to May 2014. The result revealed that mixed urinary incontinence was the most prevalent type of urinary incontinence affecting Kuwaiti women with type two diabetes mellitus. Symptoms of both stress incontinence and urge incontinence (Over active bladder) were not mutually exclusive as they were present in 247 (98.8%) and 240 (96%) of the participants respectively. Key risk factors for developing incontinence were over three years duration of diabetes mellitus in 115 (56%) and delivery of one or more children reported by 206 (82%) of the participants. Analysis and result of King Health Questionnaire on quality of life will be reported in separate paper on the psychosocial impact of urinary incontinence on diabetic Kuwaiti women. In conclusion, urinary incontinence had a devastating effect on the lives of sufferers and therefore should be prevented at all cost by nurses providing anticipatory guidance to all pregnant and diabetic women and routinely teaching pelvic floor exercises to all postnatal women. However, in the event that there are symptoms of urinary incontinence then thorough investigation and early treatment is advocated.
文摘BACKGROUND Stress urinary incontinence(SUI)is a common disease in women.The emergence of the needle-free sling has led to a new clinical treatment for SUI in women.AIM To explore the clinical value of the needleless sling without acupuncture in the treatment of SUI in women.METHODS From February 2017 to November 2018,according to the order of admission,44 patients(mid-suspension group)were treated by tension-free transobturator urethral suspension,and 44 patients(non-acupuncture group)were treated with a needleless non-acupuncture band.The clinical effects of the two treatments were evaluated.RESULTS There was no significant difference between the two groups in the total clinical effectiveness rate(P=0.374),but intraoperative blood loss and visual analogue scale score at postoperative day 1 were significantly lower in the non-acupuncture suspension group than in the middle urethral suspension group(P=0.396).The incidence of complications in the needle-free sling group was significantly lower than that in the middle urethral suspension group(P=0.025).CONCLUSION The clinical effectiveness of acupuncture-free suspension in treating SUI in female patients is better than that of traditional tension-free transobturator mid-urethral suspension.
文摘This study was conducted to determine the psycho-social impact of urinary incontinence (UI) on the quality of life of 250 Kuwaiti women with type 2 diabetic mellitus (DM). A survey method, using a 33-item 5-point Likert scale Arabic questionnaire adapted from the King’s Health Questionnaire (KHQ), was employed for data collection from February to May, 2014 while all the participants were receiving treatment for UI at a specialized urology center in Kuwait. Participants with UI and a co-morbidity of type 2 DM and obesity were 20 to 65 years old. Results showed the following variables were statistically significant for frequency of urine leak: Age was (<em>χ</em><sup>2</sup> = 36.877, df = 3, P ≤ 0.000). Parity showed nulliparous women reported less urine leak compared to parous women: Chi-square was (<em>χ</em><sup>2</sup> = 24.83, df = 12, P ≤ 0.016). Type 2 DM for more than 3 years duration had the highest incidence of several leaks per day. BMI of above 25 kg/m2 caused daily urine leak: Chi-square (<em>χ</em><sup>2</sup> = 17.912, df = 9, P ≤ 0.036). Participants’ self reports of good general health were those who leaked urine either 2 - 3 times weekly or occasionally. Finally, the impact of incontinence on their lifestyle was reported as extreme by 128 (51.2%), and 6 (2.4%) reported little or no impact on their quality of life: Chi-square was (<em>χ</em><sup>2</sup> = 52.392, df = 18, P ≤ 0.000). In conclusion, this study showed a clear correlation between UI and reduced quality of life. Midwives are well positioned to correct the myth that UI is an inevitable byproduct of childbearing. Midwives should explain to all pregnant women how childbirth can be a risk factor and provide anticipatory guidance by teaching preventive measures like pelvic floor exercises before and after delivery. Family members should assist sufferers in coping with their challenges by dispelling any form of stigmatization, joining them in practicing pelvic floor exercises, and encouraging, empathizing and supporting them emotionally.
文摘目的 分析老年子宫脱垂患者术后新发压力性尿失禁(de novo SUI)情况及其影响因素。方法 回顾性分析泗县人民医院2020年10月~2023年5月期间因子宫脱垂行手术治疗的60例患者,调查患者术后de novo SUI发生情况,将患者分为无de novo SUI组及de novo SUI组,通过单因素及多因素logistic回归分析影响患者术后de novo SUI发生的相关因素。结果 60例行手术治疗的子宫脱垂患者,18例患者术后发生de novo SUI,发病率为30.00%。单因素分析结果显示,体质量指数(BMI)、高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史、雌激素治疗史是影响老年子宫脱垂患者术后de novo SUI的相关因素(χ^(2)=5.701、4.775、6.782、4.113、3.951、5.644、9.966,P<0.05)。多因素logistic分析结果显示,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素(P<0.05)。结论 老年子宫脱垂患者术后存在一定的de novo SUI发生风险,高血压史、巨大儿分娩史、糖尿病史、便秘史、盆腔手术史为老年子宫脱垂患者术后de novo SUI的独立危险因素。
