Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042024 (incontinence)
 13,409 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The terminology of lower urinary tract function will be standardized by the ICS. This report contains the recommendations dealing with urinary incontinence, procedures related to the evaluation of urine storage (cystometry, urethral closure pressure profile) and units of measurement.
 ...
PMID:The standardization of terminology of lower urinary tract function. 103 65

Among the female population of Aarhus Municipality, Denmark, 3,114 women were drawn at random and sent a postal questionnaire about the occurrence of urinary incontinence (UI) in adult life. The response rate was 85%. 26% of the respondents had experienced one or more episodes of UI in adult life. 14% had perceived UI as a social or hygienic problem cf. the UI definition of The International Continence Society. The mean 1987 period prevalence was observed to be 17% (ICS defined UI, 10%). UI incidence rose with increasing age, especially in age groups 25-29 and 45-49 years. By the age of 59, 30% had experienced UI (ICS defined UI, 18%). Pure stress UI and combined stress and urge UI were the most frequent clinical types.
 ...
PMID:[Urinary incontinence in women aged 30-59 years. An epidemiological study]. 223 8

The basis of any quality control after surgery for SUI is objective control by pre- and postoperative quantification of urinary loss. Whereas a clinical stress test or the ICS pad-weigh-test allows to quantify, history as well as urodynamic data do not. For analysis of failures the whole diagnostic range (history, urodynamic, radiology/sonography, gynecologic examination) is needed, which enables to decide about second line therapy. Voiding difficulties and urge-incontinence after surgery for SUI are major complications and have to be critically analysed.
 ...
PMID:[Clinical, urodynamic and radiologic parameters for determining success following surgery of incontinence]. 280 68

Standard interviews were obtained from 185 women with urinary incontinence over three years to collect information about their individual complaints. All probands then were urometrically examined. The selection had been by negative criteria, as 40.5 per cent of the women had undergone one or several unsuccessful operations earlier in the past. Information based on case histories was grouped by three categories of complaint; only stress symptoms (n = 66), stress and urge symptoms (n = 116), only urge symptoms (n = 3). The following findings were obtained, in terms of ICS classification, by urometric diagnosis: stress incontinence due to urethral insufficiency (n = 51), stress incontinence with accompanying urge component (n = 72), sensorial urge incontinence (n = 26), motor urge incontinence (n = 16), overflow incontinence (n = 7), no urometric findings (n = 13). Sizeable variation was found to exist by comparison between complaint groups on the basis of case history and groups based on urometric classification. Such discrepancy applied primarily to the grey area of combined stress-urge symptoms from which the majority of bladder-dependent incontinence forms was recorded. Yet, pure stress incontinence, too, signalized genuine urethral insufficiency only in 51 of 66 cases. Hence, even detailed case history can provide only limited information for proper diagnosis.
 ...
PMID:[Anamnestic and urometric classification of 185 cases of urinary incontinence]. 716 41

The aim of this study was to use the previously validated Dowell Bryant Incontinence Cost Index (DBICI) as a post-treatment outcome measure after non-surgical therapy and to determine whether the magnitude of reduced leakage would correlate with the magnitude of reduced personal cost. A simple urethral occlusive device (Femassist) was employed in 57 women with stress, urge, or mixed incontinence for 1 month. The DBICI was administered at baseline and after device use, along with a visual analogue scale (VAS) for severity of incontinence impact, a 3-day frequency volume chart (FVC) that documented leaks per 24 hours and pad usage, a 1-hour ICS pad test at standard volume, and two disease-specific quality of life measures (Urogenital Distress Inventory [UDI] and Incontinence Impact Questionnaire [IIQ]). The severity of leakage was significantly reduced on all parameters, and the median personal costs of incontinence fell from AU$6.52 per week (IQR 1.50-10.59) to a median of AU$ 1.57 per week (IQR 0-4.89). A significant correlation (Kendall's rank, tau) was observed between reduction in personal costs and reduction in VAS (tau = 0.24, P= 0.01), leaks/day (tau = 0.20, P = 0.03), pad test loss (tau = 0.29, P = 0.002), and quality of life scores (UDI, tau = 0.23, P = 0.01; IIQ, tau = 0.26, P = 0.005). The personal costs subset of the DBICI appears to be a useful outcome measure for urinary incontinence research and could be widely employed to assess the impact of continence treatments on the patient's economic burden.
 ...
PMID:Use of the Dowell Bryant Incontinence Cost Index as a post-treatment outcome measure after non-surgical therapy. 1113 85

The QUIBUS study is the largest investigation ever performed in Italy with an extensive use of the ICS-BPH questionnaire. The internal consistency of each of its three domains was high for ICS-Male (Cronbach's alpha = 0.83 and 0.89 for symptoms and bother, respectively) and lower for ICS-Sex (Cronbach's alpha = 0.63 and 0.75, see a following paper of this issue) and ICS-QoL (Cronbach's alpha = 0.53), as previously reported in the validation study of this tool. Voiding symptoms were more frequently reported, with reduced urinary stream, terminal dribble and incomplete bladder emptying as the most frequently represented. The first storage symptom in the ranking by frequency was 'rush to toilet' (70% of the population), in 7th position; however, the relevant bother was among the highest reported. Items related to urinary incontinence appeared, when present, highly bothersome (87-92% of patients), even though exhibited by a minority of the population (5-34%). The mean (+/-SD) IPSS, calculated on 970 patients, was 15 (+/-7). Two major discrepancies were found in the comparison between IPSS and ICS-Male. First, terminal dribble, which is not considered in the IPSS, is often reported in the ICS-Male. Second, some storage symptoms (nocturia and day-time frequency) are less frequently reported in the ICS-Male than in the IPSS, while being, in general, highly bothersome. As regards QoL, 95% of subjects declared that they would not be completely happy to spend the rest of their life with their actual symptoms (ICS-QoL item 33) and 79% that BPH influences their life from 'a little' to 'a lot' (ICS-QoL item 30). The mean (+/-SD) IPSS-QoL single question score was 3.0 +/- 1.4 (n = 970), and the frequency distribution of scores was equivalent to the one detected by the corresponding question of ICS-QoL (item 33). SF-36, a disease-independent questionnaire about QoL, after a 1-year follow-up is expected to clarify which among the IPSS and ICS-BPH items better describe the impact of BPH on QoL.
 ...
PMID:Symptoms, bothersomeness and quality of life in patients with LUTS suggestive of BPH. 1159 48

We attempted to grade treatment outcomes in female urinary incontinence by the perceived importance of these outcomes for patients, nursing staff and medical staff. One hundred millimeter visual analog scales (VAS) quantifying the relative importance of five clinical outcomes were sent to 100 patients, 50 nursing staff and 135 medical staff involved in continence care and median VAS scores for each outcome were compared between groups. Subjective improvement and improvement in quality of life were rated most highly. Median scores for subjective cure were 93 (76-99) for nurses, 93 (11-100) for patients and 91 (50-100) for ICS (UK) members. Median quality of life improvement scores were 92 (67-100), 93 (3-100) and 93 (74-100), respectively (not significant). There was a striking concordance of opinion regarding the importance of subjective improvement and improvement in quality of life. We suggest that these should become primary outcome measures in all future clinical trials and audits of incontinence treatments.
 ...
PMID:Important clinical outcomes in urogynecology: views of patients, nurses and medical staff. 1205 89

Our objective was to systematically review clinical studies of incontinence treatments for women that used pad tests to assess outcome, to determine how closely the ICS guidelines had been followed. Our review (Medline 1988-2000, plus referenced studies) identified 75 relevant papers, carrying out pad tests in clinics ( n = 53) or patients' homes ( n = 28). Clinic pad tests lasted between 60 seconds and 2 hours, with inconsistent starting bladder volumes, activities carried out, other test details and presentation of results. Home pad tests lasted between 1.5 and 48 hours: the conduct and reporting of these tests were also variable. Only 25 studies used pad tests that were apparently consistent with ICS guidelines. Pad tests are important in identifying urine loss in clinical evaluations; however, we found wide variations in their conduct and reporting. We recommend that the ICS should review the guidelines, and that further research should develop clinically valid pad tests. Authors and journal editors should ensure that pad test details are fully reported.
 ...
PMID:Perineal pad test in evaluating outcome of treatments for female incontinence: a systematic review. 1214 Jul 10

It is accepted that pelvic organ prolapse impairs voiding, in particular as regards the anterior vaginal wall. The influence of central and posterior prolapse is more controversial. Mechanical effects, i.e. urethral distortion and compression, have been advanced as causative mechanisms. This study attempts to further elucidate the effect of prolapse on voiding. We investigated 228 patients with symptoms of lower urinary tract dysfunction and/or prolapse using independent flowmetry, clinical and ICS prolapse assessment and translabial ultrasound. As expected, age ( P<0.001), previous hysterectomy ( P = 0.002) and/or incontinence surgery ( P<0.001) negatively influenced flow. As regards prolapse, only enterocele had a consistently negative effect on flow ( P<0.001 for clinical staging, P = 0.002 for ICS assessment, P = 0.005 for ultrasound imaging). The relationship between anterior vaginal wall prolapse and voiding was complex: funneling and opening of the retrovesical angle on ultrasound was associated with improved voiding ( P<0.001), but a cystocele with intact retrovesical angle had the opposite effect ( P<0.001).
 ...
PMID:Female pelvic organ prolapse and voiding function. 1235 86

Lower urinary tract symptoms (LUTS) are common in middle-aged and elderly men and are frequently caused by an enlarged prostate. Increasing severity of LUTS may negatively affect patients' health-related quality of life (QoL) to varying degrees. Sexual function is an important aspect of QoL and studies show that sexual dissatisfaction increases with increased severity of LUTS. The ICS-BPH International Study of 1271 men aged 45 y and over who reported to one of 12 clinics examined the relationship between urodynamic parameters, LUTS, sexual dysfunction and QoL. Results showed that nearly 90% of men found that the effect of LUTS on their sex lives was a problem and 45% reported that their sex lives were spoilt by LUTS. Storage symptoms, in particular incontinence, had a greater association with sexual dysfunction than voiding symptoms. Similar results were reported in the ICS-BPH UK Community Study, which involved 423 men aged 40 y and over. In contrast, a French Community Study of 2011 men aged 50-80 y reported that symptoms of hesitancy, straining, reduced stream and wet underclothes were most strongly associated with sexual dysfunction. Sexuality is clearly of concern to men with LUTS and should be included in discussions on treatment decisions.Prostate Cancer and Prostatic Diseases (2001) 4, S2-S6
 ...
PMID:The Relationship between LUTS and sexual function. 1249 52


1 2 Next >>