Behavioral Training for Stress and Urge Incontinence in the Community

Burgio, Kathryn L.

doi:10.1159/000213239

Cited by 20 publications

(12 citation statements)

References 6 publications

(6 reference statements)

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“…The 4-year followup results in the group of urge incontinent patients are very good (60%) and even comparable with the results obtained in the stress incontinent women (84%) [Ulmsten, in press]. Nygaard and co-workers [1996] and Burgio et al [1990] showed that pelvic floor exercises were just as effective for female patients with urge as for patients with stress incontinence. If these observations have any direct connection with the EMG changes that we have been able to demonstrate remains to be elucidated.…”

Section: Discussionsupporting

confidence: 54%

Female stress, urge, and mixed urinary incontinence are associated with a chronic and progressive pelvic floor/vaginal neuromuscular disorder: An investigation of 317 healthy and incontinent women using vaginal surface electromyography

Gunnarsson

Mattiasson

1999

Neurourol. Urodynam.

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Reduction of the maximum vaginal surface electromyography (EMG) activity has previously been demonstrated in women with stress, urge, and mixed incontinence in comparison with healthy volunteers [Gunnarsson and Mattiasson, Scand J Urol Nephol 157:89–95, 1994]. The present study was performed to investigate if these EMG changes are age dependent and whether healthy parous women in general might show an age‐related decrease of vaginal and pelvic neuromuscular activity. A total of 317 women, 144 with urinary incontinence and 173 healthy volunteers, 20 to 76 years of age, were investigated. The maximum EMG activity during repeated short contractions (2 s) was measured. We found that parous women who have maintained continence through the years had a normal pelvic floor function as estimated with vaginal surface EMG. In contrast, all three groups of incontinent women showed a successive decrease of the EMG activity with increasing age. This difference was highly significant (P < 0.001) in women above the age of 50. No significant differences could be seen between groups when stress, urge, and mixed incontinent women were compared. Even though any convincing correlation between the amount of urinary leakage and the reduction of EMG activity was not found, we conclude that a chronic and progressive deterioration of the pelvic‐vaginal neuromuscular function occurs in women who develop urinary incontinence. The results support the view that a common pathophysiological mechanism in patients with stress, urge, and mixed incontinence might exist. The findings might help to establish a new perspective for the understanding of the pathophysiology, diagnosis, treatment, and prevention of female incontinence. Neurourol. Urodynam. 18:613–621, 1999. © 1999 Wiley‐Liss, Inc.

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Section: Discussionsupporting

confidence: 54%

Female stress, urge, and mixed urinary incontinence are associated with a chronic and progressive pelvic floor/vaginal neuromuscular disorder: An investigation of 317 healthy and incontinent women using vaginal surface electromyography

Gunnarsson

Mattiasson

1999

Neurourol. Urodynam.

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“…This is similar to research to improve continence care in non-acute settings, using monitoring and feedback of staff adherence to standards or treatment gains (Burgio, 1990;Engel et al, 1990).…”

Section: Svp Promotes Visibility Of Outcomementioning

confidence: 81%

Implementing a Systematic Voiding Program for Patients With Urinary Incontinence After Stroke

et al. 2016

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We explored health professionals' views of implementing a systematic voiding program (SVP) in a multi-site qualitative process evaluation in stroke services recruited to the intervention arms of a cluster randomized controlled feasibility trial during 2011-13. We conducted semistructured group or individual interviews with 38 purposively selected nursing, managerial and care staff involved in delivering the SVP. Content analysis of transcripts used normalization process theory as a pre-specified organization-level exploratory framework. Barriers to implementing the SVP included perceived lack of suitability for some patient groups; patient fear of extending hospital stay; and difficulties with SVP enactment, scheduling, timing, recording, and monitoring. Enablers included the guidance provided by the SVP; patient and relative involvement; extra staff; improved nursing skill and confidence; and experience of success.Three potential mechanisms of consistency, visibility, and individualization linked the SVP process with improvements in outcome, and should be emphasized in SVP implementation.

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“…The mean (SD) difference in pressures between the cough sets without and with the Knack maneuver was −2.6 (21. 7 …”

Section: Equivalency Of Coughs Produced Under No-knack and Knack Condmentioning

confidence: 99%

Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence

et al. 2008

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The aim of the study was to determine the immediate effect of timing a pelvic muscle contraction with the moment of expected leakage (the Knack maneuver) to preempt cough-related stress incontinence. Women performed a standing stress test using three hard coughs without and then with the Knack maneuver. Volume of urine loss under both conditions was quantified with papertowel test. Two groups of women were tested: nonpregnant women (n=64) and pregnant women (n=29). In nonpregnant women, wetted area decreased from a median (range) of 43.2 (0.2−183.7) cm 2 without the Knack maneuver to 6.9 (range of 0 to 183.7 cm 2 ) with it (p<0.0001); while in pregnant women it decreased from 14.8 (0−169.7) cm 2 to 0 (0−96.5) cm 2 , respectively (p=0.001). This study confirms the effect from the Knack maneuver as immediate and provides a partial explanation for early response to widely applied pelvic muscle training regimens in women with stress incontinence.

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Behavioral Training for Stress and Urge Incontinence in the Community

Cited by 20 publications

References 6 publications

Female stress, urge, and mixed urinary incontinence are associated with a chronic and progressive pelvic floor/vaginal neuromuscular disorder: An investigation of 317 healthy and incontinent women using vaginal surface electromyography

Female stress, urge, and mixed urinary incontinence are associated with a chronic and progressive pelvic floor/vaginal neuromuscular disorder: An investigation of 317 healthy and incontinent women using vaginal surface electromyography

Implementing a Systematic Voiding Program for Patients With Urinary Incontinence After Stroke

Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence

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