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Biomedical subjects

G Lose

Publications and source records attributed to G Lose.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Intravesical drug therapy in women with severe urge incontinence. Clinical experiences from a department of gynecology].

Conventional oral pharmacotherapy for urge incontinence remains problematic because of limited efficacy and systemic side effects. In this study 27 patients with severe urge incontinence were treated with intravesical drugs (emepron 200 mg or oxybutynin 5 mg) twice a day. They had previously on average undergone 3.3 other treatment options without satisfactory effect. The average age was 62 years, and their incontinence had on average lasted for 15 years. Seven percent were cured and 41% were improved. Fifty-two percent had no satisfactory effect of the treatment. The number of side effects was low, and none left the study for this reason. Intravesical anticholinergic pharmacotherapy can be a treatment option in women with severe urge incontinence.

Administration, Intravesical↗
PubMed1999

A vaginal device (continence guard) in the management of urge incontinence in women.

The aim of the study was to assess the efficacy of a disposable vaginal device in the management of urge incontinence. A total of 38 women with urge incontinence and uninhibited bladder contractions during cystometry were included. They wore the device from morning to night. Before, and again after, using the device for 1 month the women were assessed by pelvic examination, uroflowmetry, postvoid residual urine, two 24-hour pad-tests, a 3-day voiding diary and vaginal and urine cultures. A questionnaire about the subjective effect and adverse events was completed. Thirty women (79%) completed the study. Two (6.7%) were subjectively cured when using the device, 15 (50%) were improved, and 13 (43.3%) experienced unchanged incontinence. The 24-hour pad-test leakage showed a statistically significant decrease (P=0.001) - in 11 women (36.7%) the decrease was more than 50%. The other urodynamic results were unchanged. A significant decrease in the number of daily micturitions was found in the group of responders (P=0.02). No vaginal infections were found; 4 women (13%) had uncomplicated urinary tract infection during the test-period. Subjective complaints were few, and 21 women (70%) wanted to continue the treatment with the device. The vaginal device constitutes a new option in the management of urge incontinence, with a subjective and objective cure/improvement rate of 56.7%. The device is easy to use and well accepted.

Adult↗
PubMed1999

Effect of a vaginal device on quality of life with urinary stress incontinence.

OBJECTIVE: To assess the effect of a vaginal device (Continence Guard) on urine leakage and quality of life. METHODS: Fifty-five women with stress incontinence participated in a 3-month study. They were assessed by the Incontinence Impact Questionnaire, two incontinence-related quality-of-life questions, a generic quality-of-life questionnaire (Short Form-36), two 24-hour home pad weighing tests, a 2-day voiding diary, uroflowmetry, urine cultures, and a questionnaire about subjective effectiveness of the device. RESULTS: Forty-one (74.5%) women completed the study. Estimated on an intent-to-treat basis, the vaginal device was associated with subjective cure in 11 women (20%) and improvement in 27 (49%). The mean 24-hour pad test leakage and leakage episodes in the voiding diary decreased significantly. Fifty-eight percent of the 55 women enrolled wanted to continue using the device after 3 months. The quality of life measured by the Incontinence Impact Questionnaire showed highly significant improvement, and the results of the two incontinence-related quality of life questions also showed significant improvement. Responses to the Short Form-36 general health questionnaire showed no significant changes. Improvement on the Incontinence Impact Questionnaire correlated with improvements in incontinence, whereas the Short Form-36 scores were unchanged. CONCLUSION: Treatment with the Continence Guard significantly decreases leakage and improves quality of life in women with symptoms of urinary stress incontinence. An incontinence-specific, rather than a generic, quality-of-life questionnaire was important in assessing treatment outcomes.

Adult↗
PubMed1999

Urinary incontinence: prevalence and risk factors at 16 weeks of gestation.

OBJECTIVE: To evaluate the prevalence of urinary incontinence at 16 weeks of gestation and to identify possible maternal and obstetric risk factors. DESIGN: Cross-sectional study and cohort study. SETTING: Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark. POPULATION: Cross-sectional study: 7795 women attending antenatal care. Cohort study: a sub-group of 1781 pregnant women with one previous delivery at our department. RESULTS: Prevalence and maternal risk factors: the prevalence of urinary incontinence within the preceding year was 8.9% among women at 16 weeks of gestation (nulliparae, 3.9%, para 1, 13.8%, para 2+, 16.2%). Stress or mixed incontinence occurred at least weekly in 3% of all the women. After adjusting for age, parity, body mass index, smoking, previous abortions, and previous lower abdominal or urological surgery in a logistic regression model, primiparous women who had delivered vaginally had higher risk of stress or mixed urinary incontinence than nulliparous women (OR 5.7; 95% CI 3.9-8.3). Subsequent vaginal deliveries did not increase the risk significantly. Young age, body mass index > 30, and smoking were possible risk factors for developing urinary incontinence. Obstetric factors: weight of the newborn > 4000 g (OR 1.9; 95% CI 1.0-3.6) increased the risk of urinary incontinence; mediolateral episiotomy in combination with birthweight > 4000 g also increased the risk (OR 3.5; 95% CI 1.2-10.2); a number of other intrapartum factors did not increase the risk of urinary incontinence. CONCLUSIONS: The first vaginal delivery was a major risk factor for developing urinary incontinence; subsequent vaginal deliveries did not increase the risk significantly. Birthweight > 4000 g increased the risk; episiotomy in combination with birthweight > 4000 g also increased the risk.

Adolescent↗
PubMed1998

[Anal and urinary incontinence after obstetric anal sphincter rupture].

The aim of the study was to assess the long term impact of obstetric anal sphincter rupture on the frequency of anal and urinary incontinence, and identify factors to predict patients at risk. In 94 consecutive women who had sustained an obstetric anal sphincter rupture, anal manometry, anal sphincter electromyography and pudendal nerve terminal motor latency at three months post partum was performed. A questionnaire regarding incontinence was sent between two to four years post partum. Forty-two percent of responders had anal incontinence, 32% had urinary and anal incontinence. Overall, 56% of the women had incontinence symptoms. The occurrence of anal incontinence was associated with pudendal nerve terminal motor latencies > 2.0 milliseconds and the occurrence of urinary incontinence was associated with the degree of rupture, the use of vacuum extraction and previous presence of urinary incontinence. Thirty-eight percent of the women with incontinence wanted treatment, but only a few had sought medical advice.

Adult↗
PubMed1998

[Treatment of stress and urge incontinence in women].

Urinary incontinence has a great impact on the quality of life in many patients. This article gives simple regulations and advice which can improve the situation. The treatment of stress- and urge incontinence is discussed. In stress incontinence conservative treatment in the form of pelvic floor muscle exercise should always be the first choice of treatment. This treatment can be aided by biofeedback, cones or electrostimulation. Mechanical devices and pharmacological treatment is another option. Different surgical methods are discussed. Urge incontinence can be treated with bladder drill, biofeedback, hypnosis, acupuncture, pharmacological treatment electrostimulation or rarely surgery. Any treatment should consider the expectations and motivation of the patient and the need for treatment.

Female↗
PubMed1998

Aspects on the actual practice of surgical management of urinary incontinence in Norway and Finland.

OBJECTIVE: To elucidate aspects of the actual practice of surgical management of urinary incontinence in Norway and Finland. METHOD: A questionnaire about preoperative diagnostic procedures, type of surgery, follow-up procedure and number of operations per center and per surgeon per year (1995) was sent to all departments of Gynecology and Obstetrics in Norway and Finland. RESULT: Thirty-one (86%) of the Norwegian and 26 (90%) of the Finnish departments returned the questionnaire. More than 90% of the departments performed preoperative urodynamic evaluation. Burch colposuspension was used by more than 90% of the departments in the two countries. Generally the number of procedures per center and per department was low. Twenty-nine and 12% of the departments respectively did not perform any follow-up after surgery. Only 16% of the Norwegian and 23% of the Finnish centers had controlled results of surgery. CONCLUSION: There seems to be a need for criteria of good clinical practice or a reference program for all steps of surgical management of stress incontinence in order to stimulate the process of quality development of this treatment.

Female↗
PubMed1998

Laparoscopic Burch colposuspension.

OBJECTIVE: To review the available information on laparoscopic colposuspension. METHOD AND MATERIAL: One randomized controlled trial, four non-randomized comparative studies and ten open observational clinical series were reviewed. RESULTS: The available information was generally poor characterized by the small size of series, considerable variation in surgical techniques, short follow-up and mainly subjective assessment of outcome. CONCLUSIONS: Laparoscopic colposuspension has been shown to be technically feasible but the therapeutic usability of the procedure remains to be documented. There is an urgent need for some large, rigorous prospective randomized studies

Colposcopy↗
PubMed1997

Pudendal nerve function during pregnancy and after delivery.

The aim of the study was to assess pudendal nerve function serially during pregnancy and after delivery. Twenty-eight women participated at 14, 30 and 36 weeks of pregnancy and 12 weeks postpartum. A prospective study of pudendal nerve terminal motor latency during pregnancy and after delivery was carried out. Results showed that pudendal nerve terminal motor latency did not increase significantly during pregnancy but increased significantly after delivery.

Adult↗
PubMed1997

Long-term efficacy and safety of a disposable vaginal device (continence guard) in the treatment of female stress incontinence.

The aim of the study was to evaluate the long-term efficacy and safety of a new disposable vaginal device in the treatment of female stress incontinence. Nineteen out of 22 women with stress incontinence were subjectively and objectively cured or improved in a short-term study, and continued the treatment with the device for 1 year. All 19 completed the study: 13 (68%) were subjectively dry, 5 (26%) were improved and 1 (5%) reported unchanged incontinence. All but 1 had decreased leakage at the 24-hour pad test, and 67% a greater than 50% decrease. No significant changes were found in the other urodynamic tests. The gynecologic examination showed no signs of irritation or erosion from the device, and the subjective complaints were modest and few. It was concluded that the disposable vaginal device maintains its positive effect in alleviating the symptoms of stress incontinence in the long term, it is safe and patient compliance is good.

Adult↗
PubMed1997

Reliability of pudendal nerve terminal motor latency.

AIM: To evaluate reliability of Pudendal Nerve Terminal Motor Latency (PNTML). METHODS: Forty healthy subjects, 24 women and 16 men, and eight female patients were included. Four patients had idiopathic faecal incontinence and 4 an anal sphincter rupture after child-birth. PNTML measurement was performed by two observers with the patient in left lateral and supine position. Examinations were repeated on another day to evaluate intraindividual reproducibility. RESULTS: Interobserver reproducibility was 92%-116% for PNTML. Degree of agreement for PNTML between left lateral and supine position was 86%-111%. Intra-individual reproducibility in the supine and left lateral positions was 89%-109% and 88%-113% respectively. Normal values for mean PNTML were higher in women compared with men, 1.91 msec (2 SD, 0.52 msec) and 1.74 msec (2 SD, 0.33 msec) respectively, t = 2.44, 37 DF, P < 0.01. CONCLUSIONS: Reliability of PNTML in terms of interobserver and intraindividual reproducibility was high. Women had higher normal values for PNTML than men.

Adult↗