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Mixed urinary incontinence

Henry J Woodford
Urinary incontinence (UI) is a common and disabling problem among older people. Anticholinergic drugs (ADs) are a pharmacological option recommended for overactive bladder or mixed UI when non-pharmacological approaches have failed. However, UI is a more prevalent and complex condition in frail older people and to simply assume that AD actions are the same across all age groups would be wrong. This article reviews evidence for the efficacy and safety of these drugs, especially when prescribed for frail older people...
August 10, 2018: Drugs & Aging
Yulei Hao, Liangshu Feng, Yongliang Teng, Yingying Cheng, Jiachun Feng
RATIONALE: Mixed connective tissue disease (MCTD) refers to an overlapping condition of different autoimmune disorders such as systemic lupus erythematosus, cutaneous systemic sclerosis, rheumatoid arthritis, polymyositis, and dermatomyositis. However, MCTD manifesting as transverse myelitis is extremely rare. Herein, we report a case of MCTD with both central and peripheral nervous system involvement. PATIENT CONCERNS: We describe and discuss the clinical findings and management of a 36-year-old man presented with a 2-week history of sudden bilateral lower-limb paralysis and dysuresia...
August 2018: Medicine (Baltimore)
Becky D Clarkson, Helmet T Karim, Derek J Griffiths, Neil M Resnick
BACKGROUND: The brain's role in continence is critical but poorly understood. Although regions activated during bladder stimulation have been identified, little is known about the interaction between regions. In this secondary analysis we evaluate resting state and effective connectivity in older women treated for urgency urinary incontinence (UUI). METHOD: 54 women ≥60 years old with UUI and 10 continent women underwent fMRI scanning during provocation of urinary urgency, both before and after therapy...
July 27, 2018: Neurourology and Urodynamics
Tiffany M Morgan, Robert H Press, Patrick K Cutrell, Chao Zhang, Zhengjia Chen, Sara Rahnema, Jaymin Jhaveri, Martin Sanda, John Pattaras, Pretesh Patel, Ashesh B Jani, Peter J Rossi
Purpose: There is limited data to support the use of hypofractionated external beam radiation (HypoF) in combination with high-dose-rate brachytherapy (HDR). We report our quality of life (QOL) outcomes when treating intermediate and high-risk prostate cancer patients with external beam radiation (EBRT) plus HDR. Material and methods: The charts of 54 patients with localized adenocarcinoma of the prostate treated with standard fractionation (SF) or HypoF EBRT plus HDR boost at a single institution between 2012 and 2015 were reviewed...
June 2018: Journal of Contemporary Brachytherapy
Amanda Maria Brito Cardoso, CláUdia Regina Oliveira De Paiva Lima, Caroline Wanderley Souto Ferreira
OBJECTIVE: To evaluate the prevalence of urinary incontinence (UI) in female athletes practising high-impact sports and its association with knowledge, attitude and practice (KAP). DESIGN: Observational study. METHODS: A semi-structured evaluation form, KAP survey and the International Consultation on Incontinence Questionnaire - Short Form were used. Univariate and multivariate analyses were performed to verify the association of UI with KAP, sociodemographic, gynaecological and sports-related variables, with significant variables remaining in the model (p < ...
July 19, 2018: European Journal of Sport Science
Leandro Arribillaga, Rubén Guillermo Bengió, Marta Ledesma, Ariel Montedoro, Sergio Orellana, Florencia Pisano, Ruben Hugo Bengió
INTRODUCTION: Various authors argued that the voiding urgency component in mixed urinary incontinence (MUI) is different than urge urinary incontinence (UUI). In this last case they suggest that incontinence in MUI could be overdiagnosed in patients with SUI, misunderstanding the leak as UUI. OBJETIVES: To evaluate clinical and urodynamic characteristics of patients with MUI and pure UUI. METHODS: A retrospective study of our urodynamics database was performed evaluating 450 women with MUI and UUI...
July 2018: Archivos Españoles de Urología
José Medina-Polo, Ana Arrébola-Pajares, Susana de la Rosa-Kehrmann, Javier Romero-Otero, Borja García-Gómez, Manuel Alonso-Isa, Alba Lara-Isla, José Manuel Duarte-Ojeda, Alfredo Rodríguez-Antolín, Juan Bautista Passas-Martínez
OBJECTIVES: Urinary incontinence (UI) is a significant complication after radical prostatectomy (RP). Although sphincter incompetence is considered the main cause; bladder dysfunction can contribute substantially. Our objective was to evaluate the results of the urodynamic study (UDS) in men with UI after radical prostatectomy and analyze the correlation between symptoms and urodynamic parameters. METHODS: We carried out a retrospective study reviewing the symptoms and urodynamics in patients with urinary incontinence after RP...
July 2018: Archivos Españoles de Urología
Patricia Briar Neumann, Michael O'Callaghan
PURPOSE: The efficacy of pelvic floor muscle training (PFMT) for men with postprostatectomy incontinence (PPI) after robotic-assisted radical prostatectomy (RARP) is controversial and the mechanism for its possible effect remains unclear. The aim of this study was to investigate the relationship between bladder neck (BN) displacement, as a proxy for puborectal muscle activation, and continence outcomes after RARP. METHODS: Data were extracted from the South Australian Prostate Cancer Clinical Outcomes Collaborative database for men undergoing RARP by high volume surgeons who attended preoperative pelvic floor physiotherapy for pelvic floor muscle (PFM) training between 2012 and 2015...
June 2018: International Neurourology Journal
Victor P Andreev, Gang Liu, Claire C Yang, Abigail R Smith, Margaret E Helmuth, Jonathan B Wiseman, Robert M Merion, Kevin P Weinfurt, Anne P Cameron, H Henry Lai, David Cella, Brenda W Gillespie, Brian T Helfand, James W Griffith, John O L DeLancey, Matthew O Fraser, J Quentin Clemens, Ziya Kirkali
PURPOSE: Women with lower urinary tract symptoms (LUTS) are often diagnosed based on a pre-defined symptom complex, or on a predominant symptom. There are many limitations to this paradigm, as often patients present with multiple urinary symptoms that do not perfectly fit the pre-established diagnoses. We utilized cluster analysis to identify novel symptom-based subtypes of women with LUTS. MATERIALS AND METHODS: Baseline urinary symptom questionnaire data were analyzed from 545 care-seeking female participants enrolled in the LURN Observational Cohort Study...
July 7, 2018: Journal of Urology
Tamara Serdinšek, Igor But
INTRODUCTION: Our aim was to compare the long-term results and complications of the outside-in (Monarc®) versus inside-out (TVT-O®) trans-obturator approaches. METHODS: We performed a 10-year follow-up of our randomised study from 2007 in which we compared short-term outcomes of both procedures in 120 women. Patients were examined at our department in a tertiary centre between March and December 2016. The primary aim of the study was to compare the cure and satisfaction rates of both procedures...
June 25, 2018: International Urogynecology Journal
Yuko M Komesu, Holly E Richter, Benjamin Carper, Darrell L Dinwiddie, Emily S Lukacz, Nazema Y Siddiqui, Vivian W Sung, Halina M Zyczynski, Beri Ridgeway, Rebecca G Rogers, Lily A Arya, Donna Mazloomdoost, Marie G Gantz
INTRODUCTION & HYPOTHESIS: Previous studies have suggested that women with urinary incontinence have an altered urinary microbiome. We hypothesized that the microbiome in women with mixed urinary incontinence (MUI) differed from controls and tested this hypothesis using bacterial gene sequencing techniques. METHODS: This multicenter study compared the urinary microbiome in women with MUI and similarly aged controls. Catheterized urine samples were obtained; v4-6 regions of the 16S rRNA gene were sequenced to identify bacteria...
June 16, 2018: International Urogynecology Journal
David A Diamond, Jonathan Swartz, Amy Tishelman, Judith Johnson, Yee-Ming Chan
INTRODUCTION: A central ethical dilemma in management of the patient with a disorder of sex development (DSD) is the potential conflict between respect for the fundamental right of the child for physical and emotional integrity and self-determination, and the right of parents to serve as surrogate decision-makers and act in their child's best interest. METHODS: Over the past 2 years we have encountered three complex DSD cases on the spectrum of mixed gonadal dysgenesis to ovotesticular DSD in which gender assignment and therefore optimal surgical management was uncertain...
June 1, 2018: Journal of Pediatric Urology
Kyle O Rove, Gino J Vricella, Tamara Hershey, Muang H Thu, Heather M Lugar, Joel Vetter, Bess A Marshall, Paul F Austin
INTRODUCTION: Wolfram syndrome (WFS) is a neurodegenerative disorder characterized by childhood-onset diabetes mellitus, optic nerve atrophy, diabetes insipidus, hearing impairment and commonly bladder and bowel dysfunction. We hypothesize that there is an association between smaller pons, which contains the pontine micturition center, and abnormal lower urinary tract function. MATERIALS AND METHODS: Patients with genetically confirmed WFS attend an annual multidisciplinary research clinic...
June 5, 2018: Journal of Urology
I Čadková, I Huvar
OBJECTIVE: To evaluate the effect, risks and benefits of vaginal reconstruction surgery for pelvic organ prolapse (POP). This article (part II of the study) focuses on the urinary tract. DESIGN: Clinical prospective non-randomized trial, two years follow-up. SETTING: Obstetrics and Gynecology Department, Merciful Brothers Hospital, Brno. MATERIALS AND METHODS: The cohort consisted of 410 women who underwent anterior and/or posterior vaginal repair in our hospital in the period from 1...
December 0: Ceská Gynekologie
Dobrochna Globerman, Louise-Helene Gagnon, Selphee Tang, Erin Brennand, Shunaha Kim-Fine, Magali Robert
INTRODUCTION AND HYPOTHESIS: Patient history is often insufficient to identify type of urinary incontinence (UI). Multichannel urodynamic testing (UDS) is often used to clarify the diagnosis. Dynamic cystoscopy (DC) is a novel approach for testing bladder function. The primary objective of this study was to investigate the diagnostic agreement of UDS and DC in evaluating women with mixed urinary incontinence (MUI). METHODS: Women presenting with MUI were approached for enrollment if UDS and DC were planned for further investigation...
May 29, 2018: International Urogynecology Journal
Ravishankar Jayadevappa, Sumedha Chhatre, Diane K Newman, Jerome Sanford Schwartz, Alan J Wein
AIMS: To analyze the risk of falls associated with Overactive bladder (OAB), and the effects of OAB treatment on falls among older adult Medicare fee-for-service enrollees. METHODS: Population based retrospective longitudinal cohort design study using 5% Medicare claims between 2006 and 2010. Patients with a diagnosis of OAB (ICD 9: 596.51); Urinary Incontinence (ICD 9: 788.3); Urinary incontinence, unspecified (ICD 9: 788.30); Urge incontinence (ICD 9: 788.31); Mixed incontinence (male, female) (ICD 9: 788...
May 28, 2018: Neurourology and Urodynamics
Levent Yaşar, Serpil Ortakuz Telci, Keziban Doğan, Eyüp Kaya, Murat Ekin
INTRODUCTION AND HYPOTHESIS: To investigate the role of measuring the thickness of pelvic floor muscles with static MRI in the physiopathology of urinary incontinence in women with stress and mixed types of urinary incontinence diagnosed with urodynamic studies. METHODS: A retrospective clinical study was designed in collaboration with the radiology department. We recruited only patients who had undergone static pelvic MRI to determine the etiology of pelvic pain and exclude gynecologic disorders...
May 19, 2018: International Urogynecology Journal
Samantha Lawson, Ashley Sacks
Pelvic floor dysfunction is defined as abnormal function of the pelvic floor and includes conditions that can have significant adverse impacts on a woman's quality of life, including urinary incontinence (stress, urge, and mixed), fecal incontinence, pelvic organ prolapse, sexual dysfunction, diastasis recti abdominis, pelvic girdle pain, and chronic pain syndromes. Women's health care providers can screen for, identify, and treat pelvic floor dysfunction. This article examines the case of a woman with multiple pelvic-floor-related problems and presents the evidence for the use of pelvic floor physical therapy (PFPT) for pregnancy-related pelvic floor dysfunction...
May 19, 2018: Journal of Midwifery & Women's Health
Alayne D Markland, Camille P Vaughan, Ike S Okosun, Patricia S Goode, Kathryn L Burgio, Theodore M Johnson
OBJECTIVE: To identify patterns of prevalent chronic medical conditions among women with urinary incontinence (UI). MATERIALS AND METHODS: We combined cross-sectional data from the 2005-2006 to 2011-2012 US National Health and Nutrition Examination Surveys, and identified 3 800 women with UI and data on 12 chronic conditions. Types of UI included stress UI (SUI), urgency UI (UUI), and mixed stress and urgency UI (MUI). We categorized UI as mild, moderate or severe using validated measures...
May 9, 2018: BJU International
Muhammad Jamal Khan, Mohammad Ali Omar, Marc Laniado
Introduction: There are limited studies evaluating the 3 Incontinence Questionnaire (3IQ) against urodynamics based diagnosis as a reference standard. The 3IQ has been proposed to be useful to evaluate women at the level of primary care. The aim of this study was to determine correlation between 3IQ and video-urodynamics (VUDS) in diagnosing types of urinary incontinence. Material and methods: Prospective data was collected on 200 consecutive female patients referred by primary care physicians for urinary incontinence...
2018: Central European Journal of Urology
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