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Biomedical subjects

I Nygaard

Publications and source records attributed to I Nygaard.

10 recordsLinked to original sources
PubMed2001

The standardization of terminology for researchers in female pelvic floor disorders.

The lack of standardized terminology in pelvic floor disorders (pelvic organ prolapse, urinary incontinence, and fecal incontinence) is a major obstacle to performing and interpreting research. The National Institutes of Health convened the Terminology Workshop for Researchers in Female Pelvic Floor Disorders to: (1) agree on standard terms for defining conditions and outcomes; (2) make recommendations for minimum data collection for research; and (3) identify high priority issues for future research. Pelvic organ prolapse was defined by physical examination staging using the International Continence Society system. Stress urinary incontinence was defined by symptoms and testing; 'cure' was defined as no stress incontinence symptoms, negative testing, and no new problems due to intervention. Overactive bladder was defined as urinary frequency and urgency, with and without urge incontinence. Detrusor instability was defined by cystometry. For all urinary symptoms, defining 'improvement' after intervention was identified as a high priority. For fecal incontinence, more research is needed before recommendations can be made. A standard terminology for research on pelvic floor disorders is presented and areas of high priority for future research are identified.

Fecal Incontinence↗
PubMed2000

Reproducibility of the seven-day voiding diary in women with stress urinary incontinence.

In this study we aimed to assess the reproducibility of the 7-day voiding diary in women with stress urinary incontinence. We compared two 7-day voiding diaries completed at 4-week intervals by 138 women with stress urinary incontinence enrolled in an interventional trial. The correlation coefficient for the number of weekly incontinence episodes between the two diaries was 0.831. For 280 voiding diaries the results of the first 3 days correlated well with results of the last 4 days (r = 0.887). The number of incontinence episodes, as recorded on a 7-day voiding diary, is a reproducible outcome measure in women with stress urinary incontinence. Results from the first 3 days of a diary correlate well with the last 4 days, suggesting that a 3-day diary is an appropriate outcome measure for clinical trials evaluating treatments for stress incontinence.

Adult↗
PubMed2000

Proceedings of the American Urogynecologic Society Multidisciplinary Symposium on Defecatory Disorders.

The Multidisciplinary Symposium on Defecatory Disorders was created to delineate the breadth of defecatory disorders and propose investigations to address identified knowledge deficits. Seven experts in defecatory disorders and 24 members of the American Urogynecologic Society were invited. The experts provided brief summaries of the scope of defecatory disorders from the perspectives of their specialties. The group then divided into 3 subgroups that focused on pathophysiology, imaging, and evaluation and treatment. Defecatory disorders, including anal incontinence and constipation, are common among women of all ages. Determination of their prevalence is complicated by a lack of standardized definitions. Defecatory disorders carry lengthy differential diagnoses. Imaging studies and anorectal testing, although not standardized, can aid in distinguishing different causes of dysfunction. The lack of uniformity in diagnosis and evaluation compromises comparisons of different treatments. Standardization of diagnoses and diagnostic modalities is essential to the design of meaningful evaluations of treatments for defecatory disorders.

Aging↗
PubMed1999

Antenatal diagnosis of vesicouterine fistula.

BACKGROUND: In pregnancy, vesicouterine fistulas usually are diagnosed postpartum after cesarean deliveries. CASE: An 18-year-old woman, gravida 3, para 2, with two prior cesarean deliveries had pain and apparent rupture of membranes at 23 weeks' gestation. At 26 weeks' gestation, she developed increasing suprapubic pain and irregular contractions. Ultrasonographic findings included a small uterine defect and possible ballooning of membranes into her bladder. Cytoscopy showed ballooning of amnion into the bladder dome. A viable 900-g female infant was delivered by classic cesarean, the fistulous tract was excised, and the rupture sites were repaired. CONCLUSION: Vesicouterine fistulas might be diagnosed antenatally. With continued contractions and associated uterine rupture, cesarean delivery can be done with excision of the fistulous tract and repair of the rupture sites.

Adolescent↗
PubMed1997

Thirst at work--an occupational hazard?

Of 1492 teachers 791 (53%) responded to a survey addressing whether voiding habits at work or behavioral factors influenced by this occupation predisposed women to urinary tract infection. The mean number of voids during the work day was 2.7 +/- 1.4; 24.5% voided infrequently (never or only once) and 26.5% voided four or more times during the work day; 15.8% had had a urinary tract infection in the preceding year. Half of the respondents made a conscious effort to drink less while working, to avoid needing to use the toilet. There was no association between the prevalence of urinary tract infection and the number of voids or infrequent voiding at work. Compared to women who drank the volume they desired at work, those who drank less had a 2.21-fold higher risk (95% CI 1.45-3.38) of urinary tract infection after controlling for being parous, voiding infrequently at work, and urge incontinence. Further study is warranted to determine whether modification of behavioral factors at work can reduce the incidence of urinary tract infections. If this association holds, public policy must be changed to allow workers more adequate access to toilet facilities.

Adult↗
PubMed1995

Exercise pad testing in continent exercisers: reproducibility and correlation with voided volume, pyridium staining, and type of exercise.

This study was undertaken to determine normal values for a modified pad test to be used for testing outcomes of studies addressing therapy for exercise incontinence. Fourteen asymptomatic volunteers who were continent by history completed three similar exercise sessions wearing pre-weighed pads after ingesting phenazopyridine hydrochloride (Pyridium, Parke-Davis, Sandy, UT). The mean pad weight gain for all exercise sessions combined was 3.19 +/- 3.16 g (range 0.1-12.4). The mean area of pyridium staining was 2.66 +/- 3.14 mm. Mean volume voided after the exercise sessions was 193 +/- 108 cc (range 10-625). The Kendall coefficient of concordance used to test the interest reliability was 0.96 for pad weight gain, 0.76 for area of stain, and 0.60 for volume voided. All but one of the subjects had at least one spot of pyridium stain on at least one of the three pads. The increase in pad weight attributable to sweat and vaginal moisture is reproducible in a given individual performing the same exercise routine, but due to the large variation between subjects, we were unable to establish a cut-off value separating continence from incontinence. Adding pyridium did not improve the specificity of the test, despite instructing subjects to milk the urethra and blot before applying the pad.

Adult↗
PubMed1995

Prevention of exercise incontinence with mechanical devices.

A prospective, randomized, single-blind study addressed the hypothesis that simple mechanical barriers are helpful in controlling urinary incontinence during exercise. Eighteen incontinent exercisers aged 33-73 participated in three 40-minute standardized aerobics sessions wearing either a Hodge pessary with support, a super tampon or no mechanical device. Urine loss was determined by a change in the weight of the pad worn while exercising. Statistical analysis of the log of urine loss revealed that women lost significantly less urine when exercising with either the pessary or the tampon than when exercising with no device. Thus, both devices studied are useful, nonsurgical alternatives for some women for the treatment of exercise incontinence.

Adult↗
PubMed1990

Sexuality and reproduction in spinal cord injured women.

Sexuality, reproduction, and childbearing are essential issues for the spinal cord injured women. The medical complications, including urinary tract infections, anemia, pressure sores, sepsis, and autonomic hyperreflexia are significant in each of these areas with both physical as well as emotional ramifications. Patient and family education is of primary importance in both anticipating as well as dealing with the potentially serious consequences. A consultant knowledgeable in the problems of the spinal cord injured can be of utmost benefit especially in the labor and delivery process.

Delivery, Obstetric↗
PubMed1990

Exercise and incontinence.

Three hundred twenty-six women filled out questionnaires to assess the relationship between exercise and incontinence. Two hundred ninety participants stated that they exercised regularly. Overall, 152 (47%) noted some degree of incontinence, which correlated positively with the number of vaginal deliveries (P less than .0005). Eighty-seven exercisers (30%) noted incontinence during at least one type of exercise. Incontinence exclusively during exercise was seen in only one woman. Exercises involving repetitive bouncing were associated with the highest incidence of incontinence. Seventeen incontinent exercisers (20%) stopped an exercise because of incontinence, whereas 16 (18%) changed the way a specific exercise was done and 48 (55%) wore a pad during exercise. Thirty-five percent had discussed their incontinence with a health care professional. These data suggest that incontinence during exercise is a common, although little known, problem. In addition to the behavioral adaptations which women initiate on their own, surgical and nonsurgical treatments may be of benefit.

Adolescent↗