Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al.. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence
[Show abstract][Hide abstract] ABSTRACT: Introduction
Of women aged >40 years, 6% have voiding dysfunction (VD), but the definition for VD in women with respect to detrusor underactivity (DU) and bladder outlet obstruction (BOO) is not yet clear. In this review we address the current literature to define the diagnosis and treatment of VD more accurately.
We used the PubMed database (1975–2012) and searched for original English-language studies using the keywords ‘female voiding dysfunction’, ‘detrusor underactivity’, ‘acontractile detrusor’ and ‘bladder outlet obstruction and urinary retention in women’. We sought studies including the prevalence, aetiology, pathogenesis, diagnosis and treatment of female VD.
In all, 20 original studies were identified using the selected search criteria, and another 45 were extracted from the reference lists of the original papers. All studies were selected according to their relevance to the current topic and the most pertinent reports were incorporated into this review.
Female VD might be related to DU or/and BOO. Voiding and storage symptoms can coexist, making the diagnosis challenging, with the need for a targeted clinical investigation, and further evaluation by imaging and urodynamics. To date there is no universally accepted precise diagnostic criterion to diagnose and quantify DU and BOO in women. For therapy, a complete cure might not be possible for patients with VD, therefore relieving the symptoms and minimising the long-term complications associated with it should be the goal. Treatment options are numerous and must be applied primarily according to the underlying pathophysiology, but also considering disease-specific considerations and the abilities and needs of the individual patient. The treatment options range from behavioural therapy, intermittent (self-)catheterisation, and electrical neuromodulation and neurostimulation, and up to urinary diversion in rare cases.
"Isolated hematuria, whether microscopic (> 3–5 red blood cells per high power field) or gross, should prompt upper tract imaging and urology referral. A UTI can present as incontinence and should be treated if found [Abrams et al. 2010]. "
[Show abstract][Hide abstract] ABSTRACT: Urinary incontinence is a common problem in both men and women. This review article addresses its prevalence, risk factors, cost, the various types of incontinence, as well as how to diagnose them. The US Preventive Services Task Force, the Cochrane Database of Systematic Reviews, and PubMed were reviewed for articles focusing on urinary incontinence. Incontinence is a common problem with a high societal cost. It is frequently underreported by patients so it is appropriate for primary-care providers to screen all women and older men during visits. A thorough history and physical examination combined with easy office-based tests can often yield a clear diagnosis and rule out other transient illnesses contributing to the incontinence. Specialist referral is occasionally needed in specific situations before embarking on a treatment plan.
Therapeutic Advances in Urology 08/2013; 5(4):181-7. DOI:10.1177/1756287213489720
"In Italy, nurses may decide in autonomy which treatment to perform: after the initial patient assessment, they follow international guidelines (Abrams et al., 2010) to choose the appropriate rehabilitation method. The evidence coming from this study about the effects of ExMI and PFMEs will help nurses to choose effective treatments and to reduce treatment times, not only in Italy but also in countries in which medical prescriptions are needed to treat patients. "
[Show abstract][Hide abstract] ABSTRACT: In Italy, nurses can use pelvic floor muscle exercises (PFMEs) and extracorporeal magnetic innervation (ExMI) to treat urinary incontinence after radical retropubic prostatectomy (RRP). The efficacy of these treatments remains unclear. Purpose: To compare PFMEs, ExMI, in the management of post-RRP urinary incontinence. Methodology: This study compared PFMEs versus no treatment in reducing bladder continence difficulties, and PFMEs versus ExMI in reducing urine leakage. A total of 87 patients were treated with PFMEs, 23 with ExMI; 22 refused rehabilitation (control group).
Three months after RRP, both interventions reduced the International Prostate Symptom Score, when compared to control group. After 6 months, no significant differences between the treatments were found (p = .8346). After a complete ExMI treatment (6 weeks), 63.88% lost less than 10 grams of urine per day (32.73% in the PFMEs group, p < .0001).
PFMEs are useful up to the 3rd month after surgery; ExMI reduces leakages faster than PFMEs.
Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses 05/2013; 38(3):153-60. DOI:10.1002/rnj.72 · 0.85 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.