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Treatment of urinary incontinence in overweight women by a multidisciplinary lifestyle intervention.

通过多学科生活方式干预治疗超重女性尿失禁。

  • 影响因子:2.02
  • DOI:10.1007/s00404-019-05371-x
  • 作者列表:"Fjerbæk A","Søndergaard L","Andreasen J","Glavind K
  • 发表时间:2020-02-01
Abstract

PURPOSE:Urinary incontinence (UI) is a frequent and complex condition that negatively affects women's quality of life (QoL). Weight loss and pelvic floor muscle training (PFMT) are first-line treatments of UI. The study aimed to reduce the symptoms of UI on QoL in overweight women by a multidisciplinary intervention including diet, physical exercise, and PFMT. METHODS:In this non-blinded prospective interventional study, women with stress or mixed UI were included in an intervention combining dietary counseling, physical exercise in groups, and individually planned PFMT. The primary outcome measure was the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). The Patient Global Impression of Improvement (PGI-I) was used at 12 and 36 weeks. Also, anthropometric measures, pelvic floor muscle strength (PFMS), and physical performance were measured at baseline, 12, and 36 weeks. The primary aim of this study was to reduce the ICIQ-UI SF score by minimum of 2.6 points. RESULTS:Thirty-three women participated in the study. Nine dropped out during the intervention. The ICIQ-UI SF score was reduced by 6.8 and 4.5 points at 12 and 36 weeks, respectively. PGI-I revealed satisfaction with the results. Furthermore, weight was reduced by 2.6 and 3.6 kg at 12 and 36 weeks, respectively, and PFMS improved significantly. CONCLUSION:Despite a limited mean weight loss of 3.6 kg, participants reported a significant decrease in the symptoms and the burden of UI. Using PFMT as an integrated part of the intervention might have contributed to the improvements and could be subject to future research.

摘要

目的: 尿失禁 (UI) 是一种频繁且复杂的病症,对女性的生活质量 (QoL) 产生负面影响。减肥和盆底肌肉训练 (PFMT) 是UI的一线治疗。该研究旨在通过多学科干预 (包括饮食,体育锻炼和PFMT) 减少超重女性的生活质量 (QoL) 的UI症状。 方法: 在这项非盲性前瞻性干预研究中,有压力或混合性UI的女性被纳入饮食咨询、团体体育锻炼和单独计划的PFMT相结合的干预。主要结局指标为国际尿失禁咨询问卷-尿失禁简表 (ICIQ-UI SF)。在12周和36周时使用患者总体改善印象 (PGI-I)。此外,在基线、12周和36周时测量人体测量指标、盆底肌肉力量 (PFMS) 和身体表现。本研究的主要目的是将ICIQ-UI SF评分至少降低2.6分。 结果: 33名女性参与了这项研究。干预期间有9人退出。ICIQ-UI SF评分在12周和36周时分别降低6.8和4.5分。PGI-I显示对结果满意。此外,在12周和36周时,体重分别减少了2.6和3.6千克,并且PFMS显著改善。 结论: 尽管平均体重减轻3.6千克,但参与者报告的症状和UI负担显着减少。使用PFMT作为干预的一个综合部分可能有助于改进,并可能需要进行未来的研究。

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影响因子:1.46
发表时间:2020-01-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000461
作者列表:["Lee J","Kim HY","Goh HJ","Heo JE","Almujalhem A","Alqahtani AA","Chung DY","Chang K","Choi YD","Rha KH"]

METHODS:PURPOSE:We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy. MATERIALS AND METHODS:Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome. RESULTS:After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001). CONCLUSIONS:Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.

翻译标题与摘要 下载文献
影响因子:1.46
发表时间:2020-01-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000458
作者列表:["McCrery R","Lane F","Benson K","Taylor C","Padron O","Blok B","De Wachter S","Pezzella A","Gruenenfelder J","Pakzad M","Perrouin-Verbe MA","Le Normand L","Van Kerrebroeck P","Mangel J","Peters K","Kennelly M","Shapiro A","Lee U","Comiter C","Mueller M","Goldman HB"]

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排尿障碍方向

因为输尿管阻塞等原因,导致排尿不顺畅或者无法排尿的症状。

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