Small Extracellular Vesicles Secreted by Peri-urethral Tissues Regulate Fibroblast Function and Contribute to the Pathogenesis of Female Stress Urinary Incontinence

Objective:This study aimed to explore the existence of small extracellular vesicles(sEVs)in peri-urethral tissues and the role of abnormal expression of sEVs in the pathogenesis of female stress urinary incontinence(SUI).Methods:sEVs were extracted from peri-urethral vaginal wall tissues using differential centrifugation and were observed by transmission electron microscopy(TEM).The number of sEVs and their protein contents were compared between SUI and control groups using nanoparticle tracking analysis(NTA)and bicinchoninic acid(BCA)protein assay.Fibroblasts were cultured separately with SUI(SsEVs group)and normal tissue sEVs(NsEVs group).Proliferation and migration of fibroblasts were compared between groups using CCK-8 and wound healing assays,respectively.Expression levels of collagenⅠandⅢwere compared among blank control(BC),NsEVs,and SsEVs groups using real-time PCR.Protein mass spectrometry was used to test the differentially expressed proteins contained in sEVs between groups.Results:sEVs were extracted and found under the electron microscope.There were significantly more sEVs extracted from the SUI group compared to the normal group.Fibroblasts showed increased proliferative and decreased migratory abilities,and expressed more collagen in the SsEVs group compared to the NsEVs and BC groups.Protein spectrum analysis demonstrated several differentially expressed targets,including components of microfibrils,elastin polymer,and anti-inflammatory factors.Conclusion:sEVs were detected in the peri-urethral tissues.SUI tissues expressed more sEVs than control.The abnormal expression of sEVs and their protein contents may contribute to the pathogenesis and progression of SUI.

The prevalence,associated factors,and impact of urinary incontinence in pregnant and postpartum women in Nanjing,China:A cross-sectional study

Objective:Urinary incontinence(UI)is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84%to 38.65%.This study was to assess the prevalence of UI,the associated factors,and the impact of UI on daily life in pregnant and postpartum women in Nanjing,China.Methods:The prevalence of UI and the impact of UI on life were assessed by the validated Chinese version of International Consultation on Incontinence Questionnaire-urinary incontinence-short form and the validated Chinese version of urinary incontinence quality of life.The associated factors were estimated by using logistic regression analysis.Results:UI affected 37.80%of pregnant women and 16.41%of postpartum women of the study population.Among the pregnant participants,the prevalence rates of stress UI,urge UI,and mixed UI were 25.77%,4.47%,and 7.10%,respectively.Among the postpartum women,the prevalence rates of stress UI,urge UI,and mixed UI were 11.15%,1.92%,and 2.69%,respectively.In both pregnant women and postpartum women,vaginal delivery had significantly increased the odds of reporting UI(p=0.007,p=0.003,respectively).The impact of UI on daily life was significantly greater in postpartum women compared to pregnant women especially in social embarrassment(p=0.000).Conclusion:The prevalence rates of UI were high in pregnant women in Nanjing,China.Vaginal delivery significantly increased odds of reporting UI.UI has a great impact on pregnant and postpartum women’s life,especially in social embarrassment.

Non-Ablative Transvaginal Radiofrequency in the Treatment of Stress Urinary Incontinence: Review of the Literature

Background: Urinary incontinence is defined as the involuntary loss of urine, which can affect up to 45% of women after menopause. Radiofrequency is a non-invasive procedure that involves the application of an electromagnetic wave that through heat generation promotes neocollagenesis and neoeslatinogenesis in the vaginal epithelium. This energy-based technology has been studied as a potential alternative for the treatment of genitourinary syndrome of menopause and urinary incontinence. Objective: To review the recent literature (from 2020 to June 2022) on the use of transvaginal radiofrequency in the treatment of stress urinary incontinence, by searching articles at databases of Capes, PubMed Cochrane and Scielo. Methods: The descriptor terms “Urinary Incontinence/therapy” [Majr] AND “Urinary Incontinence, Stress/therapy” [Majr] AND RADIOFREQUENCY-Search Results-PubMed, [“woman” OR “women”] AND [“urinary incontinence” OR “stress urinary incontinence”] AND Radiofrequency were used, with a filter for the period 2020 to 2022. Conclusion: The studies evaluated in this review demonstrated significant results of radiofrequency in the resolution or reduction of complaints of women with urinary incontinence, especially stress urinary incontinence, but most of these studies presented a low methodological quality. There is, therefore, a lack of studies with longer follow-ups, evaluation of cost-effectiveness, randomized clinical trials with objective outcomes and the use of validated questionnaires with international acceptance.

Effect of Comprehensive Nursing Intervention in Patients with Urinary Incontinence After Radical Prostatectomy

Objective:To explore and analyze the clinical effect of comprehensive nursing intervention in patients with urinary incontinence after radical prostatectomy.Methods:84 patients with urinary incontinence after radical prostatectomy admitted to the Urology Department between May 2021 and May 2023 were included in this study.The patients were divided into a comprehensive group and a control group,with 42 cases in each group through a double-blind mechanism.The comprehensive group received comprehensive nursing care,and the control group received primary nursing care.The duration of indwelling urinary catheters and urinary incontinence;psychological performance and living conditions were compared between the two groups.Results:The duration of the indwelling urinary catheter and urinary incontinence of the patients in the comprehensive group were significantly shorter than that in the control group(P<0.05).Before nursing,there was no statistically significant difference in the anxiety,depression,and other psychological manifestations between the two groups(P>0.05);after nursing,the comprehensive group’s anxiety,depression,and other psychological manifestations of the comprehensive group were significantly lower than those of the control group(P<0.05).Before nursing,there was no statistically significant difference in the physical function,mental state,emotional state,and physical recovery of the patients between both groups(P>0.05);after nursing,the physical function,mental state,emotional state,physical recovery of the patients in the comprehensive group were significantly better than those of the control group.Besides,the living conditions of the patients in the comprehensive group were also significantly better than the control group’s(P<0.05).Conclusion:Comprehensive nursing intervention can effectively improve symptoms of urinary incontinence after radical prostatectomy,reduce inner pressure,and improve living standards.

Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

AIM: To define the magnetic resonance imaging(MRI) parameters differentiating urethral hypermobility(UH) and intrinsic sphincter deficiency(ISD) in women with stress urinary incontinence(SUI).METHODS: The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic(UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and thevolunteer groups:(1) urethral angle;(2) bladder neck descent;(3) status of the periurethral ligaments,(4) vaginal shape;(5) urethral sphincter integrity, length and muscle thickness at mid urethra;(6) bladder neck funneling;(7) status of the puborectalis muscle;(8) pubo-vaginal distance. UDs parameters were assessed in the patient study group as follows:(1) urethral mobility angle on Q-tip test;(2) Valsalva leak point pressure(VLPP) measured at 250 cc bladder volume; and(3) maximum urethral closure pressure(MUCP). The UH type of SUI was defined with the Q-tip test angle over 30 degrees, and VLPP pressure over 60 cm H2 O. The ISD incontinence was defined with MUCP pressure below 20 cm H2 O, and VLPP pressure less or equal to 60 cm H2 O. We considered the associations between the MRI and clinical data and UDs using a variety of statistical tools to include linear regression, multivariate logistic regression and receiver operating characteristic(ROC) analysis. All statistical analyses were performed using STATA version 9.0(Stata Corp LP, College Station, TX).RESULTS: In the incontinent group, 52% have history of vaginal delivery trauma as compared to none in control group(P < 0.001). There was no difference between the continent volunteers and incontinent patients in body habitus as assessed by the body mass index. Pubovaginal distance and periurethral ligament disruption are significantly associated with incontinence; periurethral ligament symmetricity reduces the odds of incontinence by 87%. Bladder neck funneling and length of the suprapubic urethral sphincter are significantly associated with the type of incontinence on UDs; funneling reduced the odds of pure UH by almost 95%; increasing suprapubic urethral sphincter length at rest is highly associated with UH. Both MRI variables result in a predictive model for UDs diagnosis(area under the ROC = 0.944). CONCLUSION: MRI may play an important role in assessing the contribution of hypermobility and sphincteric dysfunction to the SUI in women when considering treatment options.

Contemporary diagnostics and treatment options for female stress urinary incontinence

Stress urinary incontinence is not a deadly disease,but for the large population of women suffering from it,it is a very important issue.Especially in the continuously aging population all over the world,there is more and more need for treatment of this serious medical condition.Treatment of female stress urinary incontinence exists already for ages.In the 20th century invasive treatments like Burch colposuspension and pubovaginal slings were the mainstay of surgical treatments.The introduction of the midurethral sling made the procedure less invasive and accessible for more caregivers.Luckily there are many options available and the field is developing quickly.In recent years many new medical devices have been developed,that increase the number of treatment options available and make it possible to find a suitable solution for the individual patient based on subjective and objective results and the chances of complications.This manuscript provides an introduction to the therapeutical options that are available nowadays for female stress urinary incontinence.

Prevalence and Risk Factors of Stress Urinary Incontinence Among Perimenopausal Women and Its Influence on Daily Life in Women with Sexual Desire Problem

The prevalence of,and related factors to,stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated.In this study,1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area,and two impoverished,mountainous communities in Hubei province,and followed from April to October 2014.Detailed information about demographic characteristics,menstruation,pregnancy,sexual life and chronic diseases was collected.A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis.Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4,95% CI:1.92-6.04),vaginal delivery (OR=0.623,95% CI:0.45-0.87),low income (OR=0.063,95% CI:0.40-0.92),atrophic vaginitis (OR=1.4,95% CI:1.03-1.80),pelvic organ prolapse (OR=2.81,95% CI:1.36-5.80),chronic pelvic pain (OR=2.17,95% CI:1.90-4.03),constipation (OR=1.44,95% CI:1.07-1.93) and incontinence of feces (OR=3.32,95% CI:2.03-5.43).Moreover,the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1 %) or the ratio of mixed urinary incontinence (17.4%),and SUI had a greater impact on daily life among women with decreased sexual desire.In conclusion,SUI is a common disorder affecting over one third of the women surveyed,and has a severe impact on the daily life of perimenopausal women with declined sexual desire.Age,mode of delivery,and monthly income are major risk factors involved in the development of SUI.

Regenerative medicine based applications to combat stress urinary incontinence

Stress urinary incontinence(SUI), as an isolated symptom, is not a life threatening condition. However, the fear of unexpected urine leakage contributes to a significant decline in quality of life parameters for afflicted patients. Compared to other forms of incontinence, SUI cannot be easily treated with pharmacotherapy since it is inherently an anatomic problem. Treatment options include the use of bio-injectable materials to enhance closing pressures, and the placement of slings to bolster fascial support to the urethra. However, histologic findings of degeneration in the incontinent urethral sphincter invite the use of tissues engineering strategies to regenerate structures that aid in promoting continence. In this review, we will assess the role of stem cells in restoring multiple anatomic and physiological aspects of the sphincter. In particular, mesenchymal stem cells and CD34+cells have shown great promise to differentiate into muscular and vascular components,respectively. Evidence supporting the use of cytokines and growth factors such as hypoxia-inducible factor1-alpha, vascular endothelial growth factor, basic fi-broblast growth factor, hepatocyte growth factor and insulin-like growth factor further enhance the viability and direction of differentiation. Bridging the benefits of stem cells and growth factors involves the use of synthetic scaffolds like poly(1,8-octanediol-co-citrate)(POC) thin films. POC scaffolds are synthetic, elastomeric polymers that serve as substrates for cell growth,and upon degradation, release growth factors to the microenvironment in a controlled, predictable fashion.The combination of cellular, cytokine and scaffold elements aims to address the pathologic deficits to urinary incontinence, with a goal to improve patient symptoms and overall quality of life.

Exploratory and Confirmatory Factor Analyses for Testing Validity and Reliability of the Malay Language Questionnaire for Urinary Incontinence Diagnosis (QUID)

This study examines the construct validity and reliability of the Malay language questionnaire for urinary incontinence diagnosis (QUID) in women. Study Design: Random sampling design was used in this cross-sectional survey. Materials and Methods: The Americanized English language questionnaire was translated to the Malay language and distributed to community-dwelling Malaysian women living in various locations in Selangor. The construct validity was tested using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA). The reliability was determined using Cronbach’s α. Results: A total of 111 women completed the Malay language QUID in this pilot study. The Keiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.675 and Bartlett’s test of sphericity (χ2 = 284.633, df = 15, p = 0.001) indicated that the EFA was possible. The total variance and the scree plot identified two factors above the initial eigenvalue of 1 while a third factor was just below it (0.758). The CFA output showed a recursive model with the solution being not admissible because two unobserved and exogenous variables had negative variance estimates. The following values of absolute fit indices showed an acceptable level of fit: 1) Chi-square test with χ2 = 4.997, df = 5, p = 0.416, indicated a smaller difference between the expected and observed covariance matrices;2) GFI = 0.986, AGFI = 0.939, RMR = 0.021 and CMIN/DF = 1.0 indicated acceptable level of fit;3) The baseline comparison values of NFI = 0.983 and CFI = 1.0 also indicated a good fit to the data;4) RMSEA = 0.000 was considered a perfect fit indicating that the hypothesized model was a good fit to the observed data. Under the hypothesis of “close fit”, the probability of getting a sample RMSEA as large as 0.000 was 0.567. The Cronbach’s α coefficient of 0.823 indicated good reliability. Conclusion: The Malay language QUID is a valid and reliable instrument for diagnosing female urinary incontinence in the Malaysian population.

Long Term Follow up of the Solyx Single Incision Sling in the Treatment of Female Stress Urinary Incontinence (SUI)

Objectives: The Solyx System was developed to be easier and safer to use than other slings. It was the objective of this study to retrospectively assess the long-term safety and efficacy of the SolyxTM SIS Sling System. Methods: After IRB approval and informed consent, chart reviews with follow up phone questionnaires of 69 subjects implanted with the Solyx Sling were collected at 2 sites. All of the patients had SUI and had urethral hypermobility with a q-tip test of >30 degrees. All subjects underwent surgery from 12/2008 to 01/2010 with a mean follow up of 43 months (range 39 -49). Subjects included in this data collection had a mean age of 67 years (range 30 -87). The dominant type of incontinence within the study patients was SUI while 17/69 (25%) of the subjects also had a component of urge incontinence. 38/69 (55%) of study patients had concomitant procedures. Results: Long-term Solyx results showed 64/69 (93%) of patients were subjectively dry by questionnaire and were satisfied with their outcome. 63/69 (91%) would have the procedure again. There were 4 cases of denovo urge incontinence and 2 reports of transient retention. There were no serious adverse events including no bladder, bowel, vessel or nerve perforations and no erosions or extrusions. No pain was reported that was attributed to the implant. Conclusions: Chart review with follow phone questionnaires indicated that the Solyx Sling was a safe, efficacious and less-invasive option for patients requiring SUI surgery and that these results were sustainable for an average of 43 months.

Combination therapy for male erectile dysfunction and urinary incontinence

Urinary incontinence （UI） and erectile dysfunction （ED） are both very prevalent conditions. Insertion of an artificial urinary sphincter （AUS） and penile prosthesis （PP） is an effective and proven method of treatment for both conditions. With advancing age, as well as with increasing populations of patients radically treated for prostate cancer, the occurrence of both conditions found in the same patient is increasing. The purpose of this article was to analyze the available evidence for simultaneous surgical management of male ED and UI using prosthetic devices. The existing literature pertaining to dual implantation of AUS and PP was reviewed. The concomitant insertion of the PP with the male perineal sling was also considered. Concurrent ED and UI are increasingly seen in the post radical prostatectomy population, who are often younger and less willing to suffer with these conditions. Insertion of an AUS and PP, either simultaneously or as a two-stage procedure, appears to be a safe, efficacious and long-lasting method of treatment. The improvements in design of both the AUS and PP as well as the development of the single transverse scrotal incision have made simultaneous insertion of these prostheses possible. Dual implantation of the PP and male sling looks promising in a selected population. In conclusion, the insertion of the AUS and PP for the treatment of concurrent UI and ED is safe and effective. Simultaneous insertion of these prostheses in the same patient offers potential advantages in operative and recovery time and is associated with high patient satisfaction. Combination therapy should therefore be included in the arsenal of treatment of these conditions.

Effect of Conjugated Estrogen in Stress Urinary Incontinence in Women with Menopause

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.

The effect of a urinary incontinence selfmanagement program for older women in South Korea:A pilot study

Background:Although self-management approaches have shown strong evidence of positive outcomes for urinary incontinence prevention and management,few programs have been developed for Korean rural communities.Objectives:This pilot study aimed to develop,implement,and evaluate a urinary incontinence self-management program for community-dwelling women aged 55 and older with urinary incontinence in rural South Korea.Methods:This study used a one-group pre-post-test design to measure the effects of the intervention using standardized urinary incontinence symptom,knowledge,and attitude measures.Seventeen community-dwelling older women completed weekly 90-min group sessions for 5 weeks.Descriptive statistics and paired t-tests and were used to analyze data.Results:The mean of the overall interference on daily life from urine leakage(pre-test:M=5.76±2.68,post-test:M=2.29±1.93,t=4.609,p<0.001)and the sum of International Consultation on Incontinence Questionnaire scores(pre-test:M=11.59±3.00,post-test:M=5.29±3.02,t=-5.881,p<0.001)indicated significant improvement after the intervention.Improvement was also noted on the mean knowledge(pre-test:M=19.07±3.34,post-test:M=23.15±2.60,t=7.550,p<0.001)and attitude scores(pre-test:M=2.64±0.19,post-test:M=3.08±0.41,t=5.150,p<0.001).Weekly assignments were completed 82.4%of the time.Participants showed a high satisfaction level(M=26.82±1.74,range 22e28)with the group program.Conclusions:Implementation of a urinary incontinence self-management program was accompanied by improved outcomes for Korean older women living in rural communities who have scarce resources for urinary incontinence management and treatment.Urinary incontinence self-management education approaches have potential for widespread implementation in nursing practice.

The bothersomeness of female urinary incontinence and its influencing factors: Study from a Chinese city

Purpose:To investigate the bothersomeness of female urinary incontinence(UI)and analyse its influencing factors.Methods:A purposive sample of 506 women with UI from three communities in Jinan was studied using the International Consultation on Incontinence QuestionnaireeUrinary Incontinence Short Form,modified Social Impact Scale,and a coping efficacy questionnaire.The influencing factors of bothersomeness were identified using one-way analysis of variance,χ^(2) test,and logistic regression.Results:Of the participants,33.4%were bothered byUI symptoms;logistic regression indicated that severity of UI,stigma,coping efficacy,and duration of symptoms were independent factors of bothersomeness,which clarified 49.8%of the variation.Conclusion:UI patients should receive individualised intervention.Healthcare workers can provide targeted intervention to patients bothered by UI to alleviate symptoms,decrease the senseof stigma,andincreaseconfidence incopingwithsymptomstodecrease bothersomeness.

Is There Any Relationship between Total Hip Arthroplasty and Urinary Incontinent?

Introduction: In my daily practice as a hip surgeon, I have observed some circumstances where urinary incontinence (UI) improves after total hip arthroplasty (THA). We investigated UI symptoms before and after THA at our facility and considered the factors that influence UI. Patients and Method: The subjects were 113 female patients who underwent primary THA in our facility. An anterior lateral approach was used in all cases. Using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), we conducted an investigation into the presence of UI before and 2 weeks after THA. An improvement in UI was defined as a decrease of 1 point or more, a worsening is defined as an increase of 1 point or more. Results: The responses from the 113 subjects were analyzed. Of the 113 patients, prior to THA, UI was prevalent among 59 patients and was absent among 54 patients. In the group where UI was prevalent, it improved after THA in 50 patients (85%), remained unchanged in 5 (8%) and worsened in 4 (7%). In the group where UI was absent, 49 patients (91%) remained unchanged and UI appeared in 5 (9%). Compared with the non-prevalence group (62 patients), the prevalence group (50 patients) had a noticeable improvement rate of internal rotation of the surgical hip side (P Conclusion: UI greatly reduces the quality of life (QOL). In this study, there is a possibility that THA improves UI.

Analysis of coping styles of elderly women patients with stress urinary incontinence

Objective:The aim of this study was to survey the coping style and related factors of elderly women with stress urinary incontinence(SUI)and provide a strong theoretical basis for promoting a positive coping style to improve quality of life in these patients.Methods:Cross-sectional surveys addressing SUI cognition and coping techniques of 520 elderly women patients with SUI were administered between July 2013 and February 2014.Results:Elderly women with SUI had significantly higher avoidance and acceptanceresignation scores than the normal population(p<0.05).Age,marital status,education level and stress urinary incontinence cognitive level all influenced the medical coping style of these patients.Conclusions:Elderly female patients with SUI differ in the factors that influence their coping styles;therefore,clinical and community medical staff should include a comprehensive analysis that takes these factors into consideration when working with patients with SUI to guide them in adopting a positive coping style.

Treatment success of transobturator tape compared with tension free vaginal tape for stress urinary incontinence at 24 months: A randomized controlled trial

Objective: To compare the long term efficacy of transobturator Tape (TOT) with tension free vaginal tape (TVT) at 24 months postoperatively. Patients & Methods: 160 women with stress urinary incontinence (SUI) were randomly allocated to either TVT or TOT procedures and reviewed at 24 months after surgery. The primary outcomes were objective cure (a negative cough stress test, and a negative 1-hour pad test), and subjective cure (defined as “very much better” or “much better” improvement in the Patient Global Impression of Improvement scale). The secondary outcomes included incontinence related quality of life (using Urogenital Distress Inventory Questionnaire, and Incontinence Impact Questionnaire), and complications. Results: No statistical difference was reported in objective and subjective cure rates between both groups. Objective cure rate was 85.6% and 81.6% in the TOT and TVT groups respectively (P = 0.55). Subjective cure rate in the TOT and TVT groups were 87% and 83% respectively (P = 0.68). There were no significant differences in postoperative complications and incontinence related quality of life. However, the operating time was significantly shorter in the TOT group compared with the TVT group (22.6 ± 3.9, 27.1 ± 3;respectively, P < 0.001). Conclusion: TOT and TVT procedures were equally efficient and safe for treatment of SUI, with maintenance of high objective and subjective cure rates for 24 months. Longer follow-up is needed to confirm these results.

A prospective study of patient reported urinary incontinence among American, Norwegian and Spanish men 1 year after prostatectomy

Objective:To compare pre-and post-radical prostatectomy(RP)responses in the urinary incontinence domain of Expanded Prostate Cancer Index Composite-26(EPIC-26)in cohorts from the USA,Norway and Spain.Methods:A prospective study of pre-and 1-year post-treatment responses in American(nZ537),Norwegian(nZ520)and Spanish(nZ111)patients,establishing the prevalence of urinary incontinence defined according to published dichotomization.Thereafter we focused on the response alternatives“occasional dribbling”,pad use and problem experience.A multivariate logistic regression analysis(significance level≤0.01)considered risk factors for“not retaining total control”.

Catgut Implantation at Baliao and Xingfu One Acupuncture Point to Treat Urinary Incontinence in Patients with Incomplete Spinal Cord Injury: Three Cases Report

Objective: To explore the effect of catgut implantation at Baliao and Xingfu One Acupuncture point for patients with urinary incontinence secondary to spinal cord injury (SCI). Methods: Three SCI patients received catgut embedding at Baliao and Xingfu One Acupuncture point. The data of intermittent catheterization (IC) volume, intermittent catheterization frequency and the amount of using urine pad (urethral condom) were corrected. Results: Compared to the baseline data, IC volume increased and the leakage volume decreased. Conclusions: Catgut Implantation at Baliao and Xingfu One Acupuncture point is effective for patients with urinary incontinence secondary to incomplete SCI.

Effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease

BACKGROUND Patients with benign prostatic disease often experience detrusor morphological changes and dysfunction.In severe cases,it leads to bladder detrusor dysfunction,resulting in dysuria,frequent urination,urgent urination,incomplete urination,and other symptoms including renal function injury.An operation to restore normal urination function and to control postoperative complications,as far as possible,is the most common method for benign prostatic disease.AIM To observe the effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease.METHODS In total,130 patients diagnosed with benign prostatic disease,from January 2018 to June 2021,in our hospital,were selected and divided into observation and control groups according to their treatment options.Sixty-five cases in the control group were given routine nursing mode intervention and 65 cases in the observation group received precise nursing service mode intervention.The intervention with the observation group included psychological counseling about negative emotions,pelvic floor exercises,and post-hospital discharge care.The complications of the two groups were counted,and the general postoperative conditions of the two groups were recorded.The urinary flow dynamics indexes of the two groups were detected,and differences in clinical international prostate system score(IPSS)and urinary incontinence quality of life questionnaire(I-QOL)scores were evaluated.RESULTS Postoperative exhaust time(18.65±3.23 h and 24.63±4.51 h),the time of indwelling catheter(4.85±1.08 d and 5.63±1.24 d),and hospitalization time(8.78±2.03 d and 10.23±2.28 d)in the observation group were lower than in the control group.The difference was statistically significant(P<0.05).After the operation,the maximum urinary flow rate(Qmax)increased(P<0.05),the residual urine volume(RUV)decreased(P<0.05),and the maximum closed urethral pressure(MUCP)was not statistically significant(P>0.05)compared to pre-operation.The Qmax of the observation group was higher than that of the control group,while the RUV was lower than that of the control group.There was no significant difference in MUCP between the observation and control groups(P>0.05).The I-QOL score of the two groups improved(P<0.05),and the IPSS decreased(P<0.05).After the operation,the I-QOL score of the observation group was higher than that of the control group,and the IPSS was lower than that of the control group(P<0.05).There were no significant differences in the incidence of urethral injury(1.54%and 3.08%),bladder spasm(0.00%and 1.54%),and secondary bleeding(1.54%and 4.62)between the observation and control groups(P>0.05).CONCLUSION The precise nursing service mode can reduce the incidence of postoperative urinary incontinence in patients with prostate disease,thus improving postoperative urodynamics and rehabilitation,and quality of life.