Changes in urethral sphincter size following rehabilitation in older women with stress urinary incontinence

Madill, Stéphanie J.; Pontbriand-Drolet, Stéphanie; Tang, An; Dumoulin, Chantale

doi:10.1007/s00192-014-2507-6

Cited by 27 publications

(14 citation statements)

References 30 publications

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“…At week 12, the change was −4.1 (−5.4 to −2.8) and −6.6 (−7.3 to −5.8), respectively. A previous study investigated the effects of a pelvic floor muscle rehabilitation programme among elderly women with SUI (age >60 years); after 12-week intervention, the 3-day leakage episodes decreased from 4.6±4.2 to 1.1±1.6 (p=0.003), which were similar to our results 28. Changes from the baseline of the AUL were measured by 1-hour pad test, which is used to quantify urine leakage due to SUI.…”

Section: Discussionsupporting

confidence: 90%

Electroacupuncture for stress-related urinary incontinence in elderly women: data analysis from two randomised controlled studies

Sun

Liu

et al. 2020

BMJ Support Palliat Care

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ObjectiveTo compare the efficacy of electroacupuncture (EA) in elderly and non-elderly women with stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI).MethodsThis study was a secondary analysis of two randomised controlled trials involving 252 women with SUI and 132 women with stress-predominant MUI who were treated with the same EA regimen. Elderly women were defined as those aged >60 years. The main outcome measure was the proportion of patients with ≥50% decrease in the mean 72-hour urinary incontinence episode frequency (IEF) from baseline to week 6. Overall, 1004 women were recruited in the SUI and MUI trials. In the EA group, those with urge-predominant or balanced MUI at baseline were excluded from the current study, resulting in a sample size of 384.ResultsOut of 384 patients with SUI or stress-predominant MUI who were treated with EA, 371 completed the study. After 6-week treatment, the proportion of women who achieved ≥50% decrease in mean 72-hour IEF from baseline was 57.3% (51/89) in the elderly group and 60.70% (173/285) in the non-elderly group; the between-group difference was not significant (3.11%, 95% CI −9.83% to 16.05%; p=0.637). Similar outcomes were observed at weeks 4, 16 and 28. Both groups showed reduction in the 72 -hour IEF, amount of urine leakage (assessed by 1-hour pad test) and International Consultation on Incontinence Questionnaire-Short Form score from baseline with no significant between-group difference. No obvious EA-related adverse events were observed during the study.ConclusionEA may be an effective and safe alternative treatment for SUI or stress-predominant MUI in both elderly and non-elderly women. Age may not affect the treatment outcomes of acupuncture.Trial registration numerNCT01784172, NCT02047032.

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Section: Discussionsupporting

confidence: 90%

Electroacupuncture for stress-related urinary incontinence in elderly women: data analysis from two randomised controlled studies

Sun

Liu

et al. 2020

BMJ Support Palliat Care

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“…Adequate pelvic floor muscle (PFM) function may prevent or improve pelvic floor disorders . Clinical PFM evaluation incorporates imprecise and subjective integer scales, and overlooks dynamic properties which may be relevant to understanding the pathomechanics of pelvic floor disorders.…”

Section: Introductionmentioning

confidence: 99%

An automated intravaginal dynamometer: Reliability metrics and the impact of testing protocol on active and passive forces measured from the pelvic floor muscles

Bérubé

Czyrnyj

McLean

2018

Neurourology and Urodynamics

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“…Wiseman et al showed that urethra‐sphincter complex volumes (USCv) measured with ultrasonography can be used as a proxy for the MUCP, with enlarged USCv correlating with raised MUCP . USCv can also be measured on MRI with less operator dependence …”

Section: Introductionmentioning

confidence: 99%

Urethral diverticula in women are associated with increased urethra‐sphincter complex volumes: A potential role for high‐tone nonrelaxing sphincter in their etiology?

Mukhtar

Solomon

Naaseri

et al. 2019

Neurourology and Urodynamics

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Aims: Functional obstruction secondary to a high-tone nonrelaxing sphincter (HTNRS) may lead to the formation of a proximal-to-mid-urethral diverticulum (pmUD) in patients without a history of anatomical obstruction, vaginal delivery, vaginal and/or urethral surgery, or periurethral gland infection, that is, a functional pmUD (fpmUD). We used measurements of the urethra-sphincter complex volume (USCv) as a proxy for the maximal urethral closure pressure to evaluate this potential etiological factor. Methods: We compared 17 consecutive women with fpmUD (mean age ± SD of 49.4 ± 13.2 years) with a control group consisting of 24 age-matched women (mean age: 50.8 ± 11.2 years) with no previous urological symptoms having MRI for posthysterectomy vesicovaginal fistula, and in all 71 women (mean age: 48.1 ± 11.6 years) with classical urethral diverticulum (cpmUD) referred in the same time period. The urethra-sphincter complex was measured using T2-weighted MRI and OsiriX © was then used to determine the USCv.Results: The mean USCv of the fpmUD group was 10.01 ± 6.97 cm 3 . The mean USCv of the cpmUD was 5.19 ± 1.19 cm 3 and for the control group was 3.92 ± 1.60 cm 3 . There was a high statistically significant (P = .01) difference between the USCv in the fpmUD group and the USCv of both the cpmUD and the control groups.Conclusions: Women with fpmUD demonstrated USCv that were significantly higher than those in women with cpmUD and the control group. These findings suggest that high pressure in the proximal urethra during voiding secondary to a HTNRS may contribute to the formation of urethral diverticula. K E Y W O R D Shigh-tone nonrelaxing sphincter, MRI volume, sphincter complex, urethral diverticulum

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Changes in urethral sphincter size following rehabilitation in older women with stress urinary incontinence

Abstract: Introduction and hypothesis

Cited by 27 publications

References 30 publications

Electroacupuncture for stress-related urinary incontinence in elderly women: data analysis from two randomised controlled studies

Electroacupuncture for stress-related urinary incontinence in elderly women: data analysis from two randomised controlled studies

An automated intravaginal dynamometer: Reliability metrics and the impact of testing protocol on active and passive forces measured from the pelvic floor muscles

Urethral diverticula in women are associated with increased urethra‐sphincter complex volumes: A potential role for high‐tone nonrelaxing sphincter in their etiology?

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