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PubMed1998

[Urethral implantation of collagen in the treatment of urinary incontinence. Comparison of transurethral and periurethral approach].

BACKGROUND: In mini-invasive surgery for the treatment of urinary incontinence injectable substances such as politef, autologous fat or bovine collagen, which can increase urethral resistance or support the sphincteric one are particularly used. It's a simple procedure in which patients may undergo local anesthesia, in short time and in "day hospital" regimen. Collagen, used as an injectable bulking agent, is the gold standard for this surgical technique because of complete biocompatibility, no evidences of adverse immunogenic effects, foreign-body reaction, migration of injected material, and because of higher fluidity which allows the use of thin needles compared to Politef (polytetrafluoroethylene) where an injection device is requested. Bovine collagen is partially reabsorbed within 24-36 months and a reinjection is often necessary. Although autologous fat is cheaper than bovine collagen, its injection shows more difficulties due to the need of higher needle diameter and time to store and prepare the material to inject. METHODS: The results obtained by two different approaches: transurethral injection of collagen and periurethral injection of collagen have been studied. A total of 48 patients underwent collagen injection for treatment of urinary incontinence: 24 treated by transurethral approach and 24 by periurethral approach. Follow-up at 6, 12, 24 months after treatment includes: objective exam, PAD test, functional evaluation, complete urodynamic evaluation (uroflow, cystomanometry, LPP, pressure/flow study, UPP). RESULTS: No clinical differences between peri/trans-urethral approach were found although collagen injection via transurethral technique need fewer material, reducing cost of treatment: an efficacy of treatment in 80% of patients and restoration of a complete urinary continence in 50% of patients was obtained. Although no clinical differences were demonstrated between the two different sites of injection, transurethral approach can be used similarly in both sexes even if without a modified resector as "injection device" it's more difficult to inject collagen in the right position, at the level of bladder neck submucosa. Perineal approach, exclusive of female sex, realizes the procedure without bleeding of urethral mucosa and no waste of collagen, though a longer period of training by surgeon is requested. After four years of experience the authors agreed that with an adequate injection device (modified resector), transurethral approach should be preferred, thus depending on the possibility to inject collagen in a correct position, just under bladder neck mucosa, which is possible to manage with this technique, in order to reduce reabsorption process of collagen and to obtain a longer efficacy of treatment reducing the number of reinjection and of course the cost of treatment. Collagen injection should be considered within an integrated therapeutical picture together with topic and systemic pharmacotherapy, physiotherapy, not excluding surgery techniques such as implantation of an artificial sphincter device in man or a sling procedure in woman. CONCLUSIONS: The urethral collagen injection for the treatment of urinary incontinence is a safe, durable and valid technique to improve urinary continence through a non obstructive effect increasing urethral resistance. Performed under local anesthesia this procedure allows the treatment of patients who may not be candidates suitable for general anesthesia and conventional surgery.

Adult↗
PubMed1994

Sequelae of radical prostatectomy.

OBJECTIVE: To evaluate the sequelae of radical prostatectomy, using a survey instrument. PATIENTS AND METHODS: Ninety-three consecutively treated patients who had undergone radical prostatectomy and who had been followed-up for between 12 and 48 months (mean 22.5) were sent a questionnaire by post. Of these, 86 (92%) completed and returned the questionnaire. The mean age of the patients at time of surgery was 64 years (range 49-75) and at time of follow-up was 66 years (range 50-77). RESULTS: Of the 86 patients who responded, 47% used a pad and 59% leaked urine daily. Thirty per cent dripped more than a few drops of urine daily and 34% found their incontinence bothersome. Eighty-four per cent of patients recalled that they had erectile potency before surgery. At follow-up, 9% were able to have a full erection and 38% were able to have a partial erection. Fifty-one per cent reported a substantial problem with reduced or absent erection. Twenty per cent had undergone treatment for bladder neck contracture and more than half of these had had more than one intervention. In all, 24% of the patients reported some persisting degree of physical unpleasantness which they believed to be secondary to their prostate cancer or the effects of treatment. Despite this, 74% were satisfied with their surgery and 88% said they would undergo surgery again. CONCLUSIONS: Using this survey instrument, we found adverse sequelae of radical prostatectomy to be surprisingly high. However, patients were generally satisfied with their decision to undergo surgery.

Aged↗
PubMed2001

The tension-free vaginal tape procedure in women with previous failed stress incontinence surgery.

PURPOSE: The tension-free vaginal tape procedure is an increasingly popular choice for treating female urinary stress incontinence. This ongoing, prospective, open label study presents the results of tension-free vaginal tape surgery at 1 year in women who have previously undergone unsuccessful stress incontinence surgery. MATERIALS AND METHODS: A total of 67 women with previous failed surgery for stress urinary incontinence underwent the tension-free vaginal tape procedure. Treatment outcome was categorized as cure, significant improvement or failure based on cystometry findings and urinary pad loss results at 3 months of followup, and on subjective questioning at 3 months and 1 year of followup. RESULTS: At 12 months 54 women (81%) were cured, 4 (6%) were significantly improved and 9 (13%) were no better. No serious morbidity was noted after the procedure. CONCLUSIONS: The tension-free vaginal tape procedure provides the prospect of a success rate similar to that of a conventional sling procedure in patients with previous failed surgery. It has a low rate of operative complications and postoperative morbidity.

Adult↗
PubMed2006

One year follow-up on the SPARC sling system for the treatment of female urodynamic stress incontinence.

AIM: To evaluate the safety and efficacy of the SPARC sling in women with urinary incontinence. METHODS: Women who presented with urinary incontinence symptoms were included in this prospective study. In total, 103 women underwent evaluation of subjective and objective cure rates, quality of life and urodynamic parameters following the SPARC procedure. RESULTS: The objective cure rate, defined as a pad weight test less than 1 g and negative cough stress test, was 84.4% at 12 months. Subjective cure rates, defined as no usage of pads/no urine loss during daily activities, were also encouraging: 75.0% at 12 months. Quality of life evaluation included asking patients to rate the amount of bother caused by their incontinence symptoms on a scale from 0 to 100. Preoperatively, the average was 76.7, dropping to 15.9 at 12 months. At 6 months, 93.7% (75/79) were 'very satisfied' and 5.1% (4/79) were 'satisfied;' one patient was 'dissatisfied' (1.2%, 1/79). Seventy-eight of 79 patients (98.7%) would recommend the procedure to a friend and undergo the procedure again. Patients returned to inside work an average of 1.4 days and to outside work 5.4 days after the procedure. The maximum flow rate decreased from a mean of 43.4 mL/s preoperatively to 37.08 mL/s at 12 months postoperatively (P = 0.049). Detrusor pressure at maximum flow and maximal urethral closure at rest increased from 16.94 and 50.85 cmH(2)O preoperatively to 21.69 and 60.61 cmH(2)O at 12 months, respectively (P = 0.015; P < 0.001). There were few postoperative complications, with no reported infections, erosions or hematomas. CONCLUSIONS: This prospective study demonstrates that the SPARC suprapubic sling is a safe and effective treatment for female stress urinary incontinence. Both objective and subjective measures of success were achieved, with low complication rates. Quality of life and urodynamic parameters were improved. The SPARC method provides safe and highly effective treatment for female stress urinary incontinence at one year.

Adult↗
PubMed1996

Pyuria among chronically incontinent but otherwise asymptomatic nursing home residents.

OBJECTIVE: To determine the prevalence of pyuria and its relationship to bacteriuria in a representative sample of chronically incontinent nursing home residents. DESIGN: Prospective, descriptive case series. SETTING: Six nursing homes. PARTICIPANTS: Two hundred fourteen chronically incontinent, but otherwise asymptomatic, nursing home residents who were enrolled in a clinical intervention trial for urinary incontinence. MEASURES: Two hundred fourteen urine specimens were collected by a validated clean catch technique. Each specimen underwent dipstick testing for leukocyte esterase, microscopic urinalysis to determine the number of white blood cells per high power field of centrifuged urine, and quantitative urine culture using standard laboratory techniques. RESULTS: The overall prevalence of pyuria was 45%, as defined by > 10 white blood cells per high field of spun urine, and the overall prevalence of bacteriuria was 43%, as defined by the growth of > 100,000 colony forming units of a urinary pathogen. Fifty-nine percent of the specimens with bacteriuria and 34% of the specimens without bacteriuria had pyuria. Of specimens with pyuria, 56% had bacteriuria, and of specimens without pyuria, 31% had bacteriuria. When any colon change on the leukocyte esterase pad was considered positive, this finding had a sensitivity of 83% and a specificity of 52% for pyuria on microscopic urinalysis. CONCLUSIONS: Pyuria is common among chronically incontinent nursing home residents, both in the presence and absence of bacteriuria. Clinicians must therefore be cautious in interpreting the presence of pyuria to indicate symptomatic infection in this population. Using pyuria to determine the need for antimicrobial treatment could result in unnecessary expense and morbidity as well as contribute to the development of resistant organisms in nursing homes. Research is needed to define pyuria better, to determine its prevalence and relationship to bacteriuria among nursing home residents with symptoms of acute urinary tract infection, and to elucidate the etiology and significance of sterile pyuria in this population.

Aged↗
PubMed2002

Predictive value of urethral mobility before suburethral tape procedure for urinary stress incontinence in women.

PURPOSE: We determined whether preoperative urethral mobility predicts the outcome of the suburethral tape procedure outcome in women with urinary stress incontinence. MATERIALS AND METHODS: This retrospective study included 78 women who underwent preoperative cystourethrography while standing. Proximal urethral support was assessed by lateral cystourethrograms at rest and during straining. The 2 images were anatomically superimposed and the angle formed by the 2 proximal urethra axes determined urethral mobility. Surgical outcome was assessed by stress and pad tests. RESULTS: Median followup was 9 months (range 1 to 37) and the objective success rate was 85% (66 of 78 cases). Median rotation of the proximal urethra was 67 degrees in cases without previous surgery for incontinence, 33 degrees in those with 1 and 28 degrees in those with 2 or more procedures (p <0.0001). The success rate was 97% (29 of 30 cases) when urethral mobility exceeded 60 degrees versus 86% (18 of 21) for mobility between 30 and 60 degrees, and 70% (19 of 27) when it was less than 30 degrees (p = 0.023). The success rate was 96% (26 of 27 cases) without previous surgery for incontinence versus 84% (31 of 37) when 1 unsuccessful procedure had been performed and 64% (9 of 14) with 2 or more surgical failures (p = 0.026). Patient age at surgery, menopausal status, mixed incontinence, body mass index, parity, overactive bladder and low maximal urethral closure pressure had no significant prognostic value. CONCLUSIONS: The suburethral sling procedure takes advantage of urethral mobility to avoid leakage. The more the proximal part of the urethra moves while under stress, the better the continence achieved. Risk factors for failure are poor proximal urethral mobility and previous surgery for incontinence.

Adult↗
PubMed2004

Transurethral injection of bulking agents for stress urinary incontinence following orthotopic neobladder reconstruction in women.

PURPOSE: The clinical efficacy of transurethral bulking agents for the treatment of new onset urinary incontinence following radical cystectomy and orthotopic lower urinary tract reconstruction in women was evaluated. MATERIALS AND METHODS: Between 1990 and 2002, 101 female patients with primary transitional cell carcinoma of the bladder were treated with radical cystectomy and orthotopic ileal neobladder reconstruction. Of the 101 patients 12 (12%) underwent treatment for new onset urinary incontinence following exenterative surgery with transurethral injection of bulking agents, including collagen in 11 and nonabsorbable pyrolytic carbon coated beads in 1. RESULTS: A total of 25 injections were administered to 12 female patients with a mean age of 75.4 years following orthotopic neobladder reconstruction. Mean followup was 22.5 months (range 2 to 51). Two of the 12 patients (16.7%) reported complete continence and were considered cured, although subjective complaints of urinary frequency persisted. Four patients (33%) had decreased objective average daily pad use (6.75 to 2.25) and 6 (50%) showed no subjective or objective improvement in symptomatology. CONCLUSIONS: Although injection of urethral bulking agents is a minimally invasive treatment for stress urinary incontinence following orthotopic neobladder reconstruction, long-term results in patients with severe disease show a less than optimal durable response.

Aged↗
PubMed2003

Urodynamically age-specific prevalence of urinary incontinence in women with urinary symptoms.

AIMS: To determine the age-specific prevalence rates of different types of urinary incontinence in women with urinary symptoms using urodynamic studies (UDS). METHODS: One thousand five hundred women with urinary symptoms who underwent UDS in our department from January 1997 through December 1999 were enrolled. A detailed history, physical examination, and data of multi-channel UDS including uroflowmetry, filling and voiding cystometry, stress urethral pressure profile, and 20-minute pad test were obtained for each patient. The urodynamic findings of each patient were analyzed and correlated with age in decades. RESULTS: Of 1,500 women, 329 were excluded from analysis because they had undergone anti-incontinence surgery (n=27), had undergone treatment for cervical cancer (n=147), or were being followed-up after medication (n=155). Of the remaining 1,171 patients, 656 (56%) had genuine stress incontinence (GSI), 68 (5.8%) had detrusor instability (DI), 187 (16%) had mixed GSI/DI, 245 (20.9%) had either voiding or storing dysfunction without concomitant incontinence, and 15 (1.3%) had normal urodynamic findings. The 41-50- and 51-60-year age groups had the highest prevalence rates of urinary incontinence, accounting for 31% and 28% of GSI cases, 35% and 25% of DI cases, and 40% and 27% of mixed GSI/DI cases, respectively. The prevalence of GSI and mixed GSI/DI increased consistently with age, but the prevalence of DI decreased after age 66. Thus, the prevalence rates of GSI, DI, and mixed GSI/DI were 56%, 5.8%, and 16%, respectively, in women with urinary symptoms. CONCLUSIONS: Female urinary incontinence had a biogenic peak prevalence in the 41-50-year and 51-60-year age groups.

Adult↗
PubMed1996

The effect of vesical volume on Valsalva leak-point pressures in women with genuine stress urinary incontinence.

OBJECTIVE: To determine the effect of increasing vesical volume on the Valsalva leak-point pressure, examine the relationship between leakage at a given volume and clinical incontinence severity, and evaluate the relationships between leakage at a given volume and other measures of urethral resistance. METHODS: One hundred twenty women with genuine stress urinary incontinence (GSI) underwent serial Valsalva leak-point pressure determinations at vesical volumes of 100, 200, and 300 mL, and at maximum cystometric capacity. Urinary diary data, quantitative pad testing, and passive and dynamic urethral profilometry were also performed. RESULTS: Thirty-three women had leakage starting at a vesical volume of 100 mL, 18 at 200 mL, and 19 at 300 mL, and 17 had leakage only at maximum cystometric capacity. The mean first positive Valsalva leak-point pressures were significantly higher than Valsalva leak-point pressures at maximum capacity in all groups: in women who began to leak at 100 mL, 57 versus 36 cm H2O (P < .001); at 200 mL, 59 versus 45 cm H2O (P < .001); and at 300mL, 61 versus 47 cm H2O (P = .01). Women who had leakage at lower vesical volumes had worse measures of clinical incontinence severity and lower maximum urethral closure pressure less than or equal to 20 cm H2O) and pure intrinsic sphincteric deficiency (low urethral pressure and the lack of urethral hypermobility), but the specificities were 63 and 50%, respectively. CONCLUSIONS: Women with GSI are more likely to leak during Valsalva with increasing vesical volume. Valsalva leak-point pressures decrease significantly with bladder filling. The volume at which leakage occurs correlates inversely with clinical severity and directly with maximum urethral closure pressure. A negative Valsalva leak-point pressure at 300 mL excludes the presence of low urethral pressure and pure intrinsic sphincteric deficiency; however, the specificity and positive predictive value are inadequate for making a clinical diagnosis of either condition.

Female↗
PubMed1987

The use of vascular clips to minimize blood loss in colpourethropexy.

A serious intraoperative and postoperative complication associated with colpourethropexy as described by Burch and Tanagho and others is hemorrhage. We performed the Tanagho modification of the Burch procedure in 13 patients, as the sole procedure in the treatment of genuine stress incontinence. Vascular clips were used to circumscribe the fat overlying the anterior part of the vaginal wall, thereby allowing en bloc resection of the vascular fat pad. Suspensory sutures of 1-0 Vicryl (polyglactin 910) were placed; no retroperitoneal drains were used. The blood loss was estimated to be less than 50 milliliters in ten instances and less than 75 milliliters in three. The average hospital stay was 4.2 days. All of the patients were given antibiotic prophylaxis and were discharged home with suprapubic drainage of the bladder. There were no intraoperative or postoperative complications. Thus, one of the serious complications of colpourethropexy can be avoided by using vascular clips to facilitate the removal of the periurethral and paravesical fat from the anterior part of the vaginal wall.

Adipose Tissue↗
PubMed1999

Comparison of treatment outcomes for imipramine for female genuine stress incontinence.

OBJECTIVE: To assess the efficacy of imipramine as a treatment of genuine stress incontinence and to explore the possible determining factors for treatment success and failure. DESIGN: A prospective study. SETTING: University department of obstetrics and gynaecology. PARTICIPANTS: Forty women with genuine stress incontinence were enrolled. METHODS: Each woman was treated with 25 mg imipramine three times a day for three months. MAIN OUTCOME MEASURES: Each woman had a 20-minute pad test and urodynamic study including uroflowmetry, both filling and voiding cystometry, and stress urethral pressure profile before and after treatment. RESULTS: After treatment, 35% (n = 14) were cured, 25% (n = 10) improved by > or = 50% and in the remaining 40% (n = 16) treatment failed. The efficacy of successful treatment was 60% (95% CI 44.8-75.2). The median age and parity, as well as menopausal status, showed no statistical differences between the two groups. The pre-treatment data including pad weight, functional urethral length, maximal urethral pressure, bladder compliance at urgency, bladder capacity, and average and maximal flow rates showed no statistical differences between the two groups except urethral closure pressure (P = 0.001). Besides, the functional urethral length and urethral closure pressure were significantly improved in the treatment success group. After medication, the median functional urethral length was 3 cm (intraquantile range [IQR] 2.3-3) in the treatment success group vs 2.3 cm (IQR 2-3) in the treatment failure group (P = 0.028). The urethral closure pressure was 77 cmH2O (IQR 61-105) for the treatment success group vs 40 cmH2O (IQR 34-53) in the treatment failure group (P < 0.0001). CONCLUSIONS: The efficacy of imipramine for genuine stress incontinence was 60% (95% CI 44.8-75.2). The pre-treatment high urethral closure pressure may serve as a predictor for treatment success.

Adrenergic Uptake Inhibitors↗
PubMed1994

Urodynamic parameters in patients with slight and severe genuine stress incontinence: is the stress profile useful?

This study evaluates the usefulness of the urethral pressure profile (UPP) parameters in assessing the severity of genuine stress incontinence (GSI). Functional length (FL), maximum urethral closure pressure (MUCP), pressure transmission ratio (PTR), residual area at stress (RAS), number of patients with incontinent spikes (IS), and distribution of IS on UPP were determined in supine and standing position for 54 patients (group 1) with a 1-hour pad test < 2 g and compared with the values of 63 patients (group 2) with a 1-hour pad test > 2 g. The results were similar: FL (supine: 24 mm +/- 6/26 mm +/- 7 [P:0.2]; standing: 26 mm +/- 8/24 mm +/- 11 [P:0.5]); MUCP (supine: 51 cm H2O +/- 23/47 cm H2O +/- 20 [P:0.3]; standing: 45 cm H2O +/- 21/38 cm H2O +/- 18 [P:0.1]); and PTR (supine: 83% +/- 27/84% +/- 31 [P:0.9]; standing: 81% +/- 25 and 88% +/- 27 [P:0.3]). But the RAS was lower (supine: 502 mm2 +/- 497/246 mm2 +/- 268 [P < 0.009]; standing: 500 mm2 +/- 534/271 mm2 +/- 306 [P < 0.05]) in group 2. If the percentage of patients with IS was higher (supine: 57/93% [P < 0.001]; standing: 54/84% [P < 0.01]) in group 2, the distribution of IS over the entire FL demonstrated no differences between group 1 and 2. In conclusion, except for the RAS, standard UPP parameters cannot be considered determinant in assessing the severity of GSI.

Cough↗
PubMed2006

[Treatment of severe chronic constipation through the antegrade continent enema procedure].

The antegrade continent enema procedure was first described in 1990 by Malone for the treatment of severe fecal neurogenic incontinence in children. Since then, this technique has been successfully carried out in adults, as well as in patients with refractory constipation. The procedure provides a continent and catheterizable channel, generally an appendicostomy, through which antegrade washouts are given to produce colonic emptying. We describe the case of a 23-year-old man with severe constipation and overflow fecal incontinence who underwent an appendicostomy. There were no immediate postoperative complications and saline washouts were started on the fourth day. Since then, the patient has had a bowel movement between 1 and 3 hours after each washout, has recovered continence, and no longer wears an absorbent pad.

Adult↗
PubMed2002

Long-term follow-up comparison of durasphere and contigen in the treatment of stress urinary incontinence.

OBJECTIVES.: This study evaluates the long-term clinical success of Durasphere (Carbon Metal Technologies, St. Paul, MN) compared with Contigen (C. R. Bard, Covington, GA) in the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency (ISD). METHODS.: Fifty-two women diagnosed with stress urinary incontinence caused by ISD were treated between March and November of 1998 in a randomized, double-blinded trial comparing Durasphere and Contigen. Pad testing, Stamey Continence Grading, and urodynamics, including abdominal leak point pressures, were performed during the initial evaluation. All patients were diagnosed with ISD and displayed abdominal leak point pressures of </= 90 cm of H2O. RESULTS.: Of 26 patients in each group, 25/26 (96%) Durasphere patients and 21/26 (81%) Contigen patients were available for this follow-up of 2.6 and 2.8 years, respectively, post initial injection. A total of 80% of Durasphere patients and 62% of Contigen patients demonstrated an improvement of >/=1 continence grade at this follow-up. Of these patients, 10/25 (40%) Durasphere patients and 3/21 (14%) Contigen patients are dry. CONCLUSIONS.: Long-term follow-up demonstrated that Durasphere had greater success than Contigen in providing improved continence grades.

Journal Article↗
PubMedDate not supplied

Self-management of urinary incontinence among women 31 to 50 years of age.

In this exploratory and descriptive study, the self-management of urinary incontinence among women 31 to 50 years old is described. Eight self-selected women participated in unstructured tape-recorded interviews that were guided by an interest in understanding women's perceptions about their incontinence. Self-management comprised five specific methods: (a) modifying or avoiding the activities that cause involuntary leaking of urine, (b) keeping the bladder empty, (c) avoiding or limiting beverages that stimulate voiding, (d) wearing protective pads, and (e) doing exercises to strengthen the pelvic floor muscles. Successful self-management was characterized by perceptions of control and normality; unsuccessful self-management by perceptions of noncontrol and abnormality and a consideration of medical management. Three types of medical encounters experienced by participants are described. The study indicates that participants responded differently to two temporal stages in their development of incontinence, and this difference affected how incontinence was managed at the time. The implications of this finding for nursing practice and nursing research are discussed.

Adult↗
PubMed2000

A simplified urinary incontinence score for the evaluation of treatment outcomes.

There are no standardized definitions for anti-incontinence therapy outcomes. The present study was conducted to evaluate whether the incorporation of several non-invasive outcome measures into a new score may serve as a meaningful outcome instrument. Ninety-four consecutive sphincteric incontinent women who underwent a pubovaginal sling by a single surgeon were enrolled. All patients underwent a full clinical evaluation, including pre- and post-operative questionnaires, 24-hour voiding diary, and 24-hour pad test. Surgery outcomes were classified twice: First, by analyzing the patient questionnaire, voiding diary, and pad test separately, according to previously published criteria, and second, by combining the three outcome tools into a new response score. The new score was constructed in a simple, easy-to-remember format and divided into five categories: cure, good response, fair response, poor response, and failure. All patients were evaluated at least 1 year post-operatively. Comparison of the old and new classifications suggests that the new response score provides a more accurate evaluation of the surgical outcomes. Although 64 to 69% of the patients were originally classified as cure according to the old classification, only 44.7% were re-classified as cure by the strict criteria employed in the new score. Furthermore, the response score also differentiates between various degrees of clinical improvement (i.e., good, fair, or poor response). Twenty-five (26.6%) patients, most of whom were previously classified as cure, were re-classified as good response, whereas 20 others were re-classified as fair (13. 9%), or poor (7.4%) response. Seven (7.4%) patients were re-classified as surgical failures. All were diagnosed pre-operatively as having complex sphincteric incontinence. Specific failure rates were therefore 11.3% for complex and 0% for simple cases. In conclusion, the suggested post-operative response score incorporates in a user-friendly format three popular outcome tools (i.e., 24-hour diary, 24-hour pad test, and patient questionnaire) and seems to reflect the surgical results more accurately. Further studies are needed to assess its validity and reproducibility in other treatment modalities. Neurourol Urodynam. 19:127-135, 2000.

Adult↗
PubMedDate not supplied

Urinary incontinence verification in elderly men.

This study considered the problem of verifying the amount and frequency of incontinent urine loss in an outpatient population. The sample consisted of elderly male community-dwelling veterans who experienced urinary incontinence. Two amount tests (60-minute and 3-day) were completed by 46 volunteer subjects and 7-day frequency records were kept by an additional 44 volunteers. Results indicated that 60-minute and 3-day absorbent pad tests for amount of urine loss classified 59% (n = 27) of the subjects the same way (normal or abnormal). Thus, the shorter test appears useful as a screening test and offers advantages of lower cost and more accurate reporting. If abnormal urine loss is not identified with the short test, the long test should be used to detect infrequent episodes. Three-day tests for incontinence frequency classified 86% (n = 28) of subjects the same as 4-day tests. Therefore, a 3-day test appears adequate to determine the number and pattern of incontinent episodes as well as associations with relevant events such as activity levels and fluid intake.

Aged↗
PubMed2001

Conservative treatment of stress incontinence with Geisha balls.

In a pilot study 6 women with stress urinary incontinence were treated with Geisha balls while performing pelvic floor muscle exercises at home half an hour a day for 12 weeks. Subjectively 4 patients were cured and 2 had improved. Before the treatment the 24-hour pad test was a mean 48 g and after the treatment a mean 10 g. There were no adverse effects.

Adult↗