Urinary incontinence, overactive bladder, and quality of life in women submitted to total hip replacement

Martines, Guilherme Augusto; Tamanini, José Tadeu Nunes; Mota, Gabriel Milhomem da Silva; Barreto, Eduardo Tavares; Santos, Jair Lício Ferreira; Sartori, Marair Grácio Ferreira; Girão, Manoel João Batista Castelo; Castro, Rodrigo Aquino

doi:10.1002/nau.24888

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…In both cases, improving mobility may be more beneficial than focusing specifically on the pelvic floor or detrusor muscle. A prospective study, with a cohort of 183 women submitted to total hip replacement due to hip OA, observed significant improvements in UI and mobility, assessed by the physical component of SF‐12, 3,‐ and 6‐month postoperatively 25 . However, higher levels of evidence are necessary, including older women with knee OA.…”

Section: Discussionmentioning

confidence: 99%

Urinary incontinence in middle‐aged and older women with hip and knee osteoarthritis: An outpatient study of frequency and risk factors

de Melo,

Fernandes,

Costa

et al. 2024

Neurourology and Urodynamics

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AimsTo investigate the frequency and the factors associated with urinary incontinence (UI) in a sample of middle‐aged and older women with lower limb osteoarthritis (OA).MethodsWomen aged 50 years or older with clinical hip/knee OA diagnoses were recruited for this cross‐sectional study. Self‐reported UI and type, sociodemographic characteristics, medical conditions, physical activity level, anthropometric and body composition measurements, muscle strength, and physical function were assessed. Uni and multivariable logistic regression were used to investigate the factors associated with UI.ResultsAmong 100 middle‐aged and older women (mean 67.27 ± 8.77 SD years), 67% reported UI. In the UI group, 33% reported stress UI, 36% reported urgency UI, and 31% reported mixed UI. In the univariate analysis, age, level of physical activity, pulmonary disease, number of medications, body mass index (BMI), number of deliveries, and activity limitation were significantly associated with UI. In the multivariable analysis, older age (60−69 years OR: 4.91, 95% CI: 1.25−19.36; ≥70 years OR: 8.06, 95% CI: 1.96−33.22), compared to 50−59 years, morbid obesity (OR: 14.10, 95% CI: 1.36−146.48), compared to BMI < 30 kg/m2, and activity limitation (OR: 5.31, 95% CI: 1.61−17.54), assessed as short physical performance battery ≤8, remained significantly associated with UI.ConclusionsUI was highly frequent among middle‐aged and older women with hip/knee OA. Older age, activity limitation, and morbid obesity were independently associated with UI. Interventions targeting physical function and weight management must be considered to prevent and treat UI in this population.

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Section: Discussionmentioning

confidence: 99%

Urinary incontinence in middle‐aged and older women with hip and knee osteoarthritis: An outpatient study of frequency and risk factors

de Melo,

Fernandes,

Costa

et al. 2024

Neurourology and Urodynamics

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“…Studies of randomized controlled trials on rehabilitation have reported that hip rehabilitation contributed to the strengthening of the pelvic floor muscles and the improvement of stress urinary incontinence (Jordre & Schweinle, 2014; Tuttle et al, 2016). Several studies, including a prospective cohort, reported that improved hip function with total hip arthroplasty improved urinary incontinence (Baba et al, 2014; Martines et al, 2022; Okumura et al, 2017; Tamaki et al, 2014). An electromyography study reported that electrophysiological stimulation of the fascia of the obturator internus resulted in the contraction of the levator ani (Chin et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Anatomical basis for contribution of hip joint motion by the obturator internus to defaecation/urinary functions by the levator ani via the obturator fascia

et al. 2022

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The functional association between hip joint motion and defaecation/urinary function has attracted considerable research and clinical attention owing to the potential novel approaches for pelvic floor rehabilitation; however, the anatomical basis remains unclear. This study, therefore, aimed to analyse the anatomical basis of force transmission between the obturator internus, a muscle of the hip joint, and the levator ani, a muscle of the pelvic floor. Twenty‐three cadavers were used for macroscopic and histological analyses. The three‐dimensional structures of the muscles and fascia were recorded using a high‐definition camera and a 3D scanner. The arrangement and attachment of the muscle fibres, tendons and fascia were visualised using histological sections stained with Masson's trichrome. The obturator internus and levator ani were in broad contact through the obturator fascia. The height of their contact area was 24.6 ± 9.1 mm. Histologically, the obturator internus and levator ani shared a large area of the obturator fascia, and the obturator fascia provided the attachment of several muscle layers of the levator ani. The contribution of hip joint motion to defaecation/urinary function can be explained by the broad ‘planar’ contact between the obturator internus and levator ani. This anatomical feature suggests that movement of the obturator internus creates the foundation for the function of the levator ani and contributes to pelvic floor support through the obturator fascia. This study provides an anatomical basis for the effectiveness of the hip muscles in improving defaecation/urinary function by enabling balanced and proper movements.

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“…This suggests that balanced and proper movements of the obturator internus contribute to the function of the LA, that is, pelvic floor support. Various aspects of the functional relationship between the LA and obturator internus have been suggested, including reports that hip rehabilitation contributed to the strengthening of the pelvic floor muscles and the improvement of stress urinary incontinence (Jordre and Schweinle 2014 ; Tuttle et al 2016 ), reports that hip function with total hip arthroplasty improved urinary incontinence (Baba et al 2014 ; Martines et al 2022 ; Okumura et al 2017 ; Tamaki et al 2014 ), and a report that electrophysiological stimulation of the fascia of the obturator internus resulted in LA contraction (Chin et al 2021 ).…”

Section: Skeletal Muscles Of Pelvic Outletmentioning

confidence: 99%

Pelvic floor and perineal muscles: a dynamic coordination between skeletal and smooth muscles on pelvic floor stabilization

Muro

Akita

2023

Anat Sci Int

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The purpose of this review is to present our researches on the pelvic outlet muscles, including the pelvic floor and perineal muscles, which are responsible for urinary function, defecation, sexual function, and core stability, and to discuss the insights into the mechanism of pelvic floor stabilization based on the findings. Our studies are conducted using a combination of macroscopic examination, immunohistological analysis, 3D reconstruction, and imaging. Unlike most previous reports, this article describes not only on skeletal muscle but also on smooth muscle structures in the pelvic floor and perineum to encourage new understanding. The skeletal muscles of the pelvic outlet are continuous, which means that they share muscle bundles. They form three muscle slings that pass anterior and posterior to the anal canal, thus serving as the foundation of pelvic floor support. The smooth muscle of the pelvic outlet, in addition to forming the walls of the viscera, also extends in three dimensions. This continuous smooth muscle occupies the central region of the pelvic floor and perineum, thus revising the conventional understanding of the perineal body. At the interface between the levator ani and pelvic viscera, smooth muscle forms characteristic structures that transfer the lifting power of the levator ani to the pelvic viscera. The findings suggest new concepts of pelvic floor stabilization mechanisms, such as dynamic coordination between skeletal and smooth muscles. These two types of muscles possibly coordinate the direction and force of muscle contraction with each other.

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Urinary incontinence, overactive bladder, and quality of life in women submitted to total hip replacement

Cited by 3 publications

References 22 publications

Urinary incontinence in middle‐aged and older women with hip and knee osteoarthritis: An outpatient study of frequency and risk factors

Urinary incontinence in middle‐aged and older women with hip and knee osteoarthritis: An outpatient study of frequency and risk factors

Anatomical basis for contribution of hip joint motion by the obturator internus to defaecation/urinary functions by the levator ani via the obturator fascia

Pelvic floor and perineal muscles: a dynamic coordination between skeletal and smooth muscles on pelvic floor stabilization

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