Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence.

Neurourology and Urodynamics (Impact Factor: 2.46). 12/2009; 29(1):213-40. DOI: 10.1002/nau.20870
Source: PubMed
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    ABSTRACT: The ability to express one's sexuality and engage in sexual activity requires multisystemic coordination involving many psychological functions as well as the integrity of the nervous, hormonal, vascular, immune, and neuromuscular body structures and functions. The purpose of this study was to investigate the associations among pelvic floor function, sexual function, and demographic and clinical characteristics in a population of women initiating physical therapy evaluation and treatment for pelvic floor-related dysfunctions (urinary incontinence, pelvic organ prolapse, vulvodynia, vaginismus, and constipation). We consented and collected completed demographic data and data related to symptoms and clinical condition on 85 consecutive patients in an outpatient physical therapy clinic. Clinical and anthropometric characteristics were analyzed descriptively. Analysis of variance and linear regression analyses were used to analyze Female Sexual Function Index (FSFI) scale ratings, whereas zero-inflated beta-binomial regression was applied to the pain subscale. Main outcome measure was FSFI score, whereas the secondary outcome measure was the FSFI subscale score related to pain. Women in our sample were 38 years old on average, 33% of whom had given birth and 82% of whom had high tone pelvic floor. Being in the middle-tercile age group and exhibiting low pelvic floor tone (Beta = 6.8; 95% confidence interval [CI] = [1.4; 12.0]) were significantly associated with lower levels of sexual dysfunction. Women with low tone pelvic floor also reported lower pain (odds ratio = 4.0; 95% CI = [1.6; 9.6]), whereas younger aged and physically unsatisfied subjects were more likely not to have sexual activity in the month prior to scale measurement. In female patients with pelvic floor muscle dysfunction undergoing physical therapy and rehabilitation, sexual dysfunction appears to be significantly correlated with age and high pelvic floor muscle tone. Bortolami A, Vanti C, Banchelli F, Guccione AA, and Pillastrini P. Relationship between female pelvic floor dysfunction and sexual dysfunction: An observational study. J Sex Med **;**:**-**. © 2015 International Society for Sexual Medicine.
    Journal of Sexual Medicine 04/2015; DOI:10.1111/jsm.12882 · 3.15 Impact Factor
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    ABSTRACT: Mixed urinary incontinence (MUI) is the involuntary loss of urine associated with the sensation of urgency and also with exertion, effort, sneezing, or coughing. The underlying cause of MUI is poorly understood. Without clearly understanding the pathophysiological and anatomical changes associated with MUI, treatment is often misdirected. This review presents an analysis of the most recent studies and pathophysiological mechanisms thought to be associated with MUI-related voiding dysfunction. A suggested algorithm is provided for the workup of these women with a review of medical and surgical treatment options used to treat MUI.
    Current Urology Reports 03/2015; 16(3):483. DOI:10.1007/s11934-015-0483-0
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    ABSTRACT: To describe the quality of incontinence care in nursing homes. Main outcome measures were: (1) availability of structural quality indicators on ward and institutional levels; (2) use of nursing interventions as quality indicators on a process level; (3) prevalence of incontinence as an outcome indicator. Incontinence in older people is a major problem in nursing care that presents a high workload for nurses, increases costs and places a high burden on affected individuals. The availability of structural indicators, and the use of nursing interventions, is recommended to improve the quality of care. Only limited amounts of reliable and valid data are available regarding the quality of incontinence care in nursing homes. A cross-sectional multicentre study in 16 nursing homes (N = 1302) in 2013. A standardized and validated questionnaire was used for data collection. Each resident was assessed by two trained nurses. The primary outcome of the study indicated that structural indicators, such as the availability of information brochures, are limited in nursing homes. On a process level, the provision of body worn pads or underlay pads to protect beds or chairs were most frequently used and training interventions were only delivered to a small proportion of residents with incontinence. The prevalence of all types of incontinence, particularly double incontinence, was high (69·2%). Due to the high prevalence of double incontinence and low rate of training interventions regarding this type of incontinence, ongoing efforts to improve the quality of incontinence care are warranted. © 2015 John Wiley & Sons Ltd.
    Journal of Advanced Nursing 04/2015; DOI:10.1111/jan.12676 · 1.69 Impact Factor