A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand,Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology. MMed (O & G) Johannesburg 2015 / Background: Stress urinary incontinence is a common problem in a woman’s life and has a negative affect on her quality of life (QOL). The trans obturator tape (TOT) is a safe procedure used to treat urinary incontinence. The operative change in the quality of life was determined using the Kings Health Questionnaire (KHQ). This study assesses patient reported outcomes of the TOT procedure as the primary measure of success. Objectives: The primary objectives of the study were to determine the subjective outcome of the QOL and symptoms for women that underwent the TOT procedure using the King’s Health Questionnaire (KHQ) in a tertiary academic centre. The secondary objectives assessed the cure rate of the impact on QOL and the subjective symptoms, evaluated the outcome of pre-operative urgency and determined if post-operative change in urinary incontinence correlates with personal relationships (sexual function). Method: This was a prospective cohort study design whereby patients answered the KHQ pre operatively on admission and post operatively at 6-24 months from January 2010 until June 2013. Seventy-seven patients took part in this study. Ten of these patients were excluded. The results were analysed separately in 3 groups.Stress urinary incontinence SUI (n=50), Mixed urinary incontinence MUI (n=4), SUI with a sensation of urgency (n=13). Logistic regression was used to determine the results. Results: Those patients who improved their QOL score by >75% for the SUI and MUI groups were 83% and 50% respectively. The positive improved change in QOL for the SUI and MUI groups were 98% and 100% respectively. Those patients who improved their subjective symptoms score by >75% for the SUI and MUI groups were 69%, and 92% respectively. The positive change in improvement of the symptoms for SUI and MUI groups were 100% and 75% respectively. Those patients who improved their stress symptoms score by >75% for SUI and MUI groups were 91% and 82% respectively. The subjective disappearance of urgency post operatively was 69% for the SUI with sensation of urgency group and 25% for the MUI group. Conclusions The trans obturator tape procedure conclusively improves the quality of life for women with stress urinary incontinence.There are very few studies that use subjective outcomes as their primary outcome measure. While most studies use the objective cure rate by using a negative cough test and more stringently a pad weight test. It is important to compare the study outcome results to other comparative studies using subjective outcomes rather than objective outcomes. Women should be counseled preoperatively about realistic expectations after surgery as this effects the operative outcome. In other studies subjective cure has been inconsistently assessed. There is a strong need for a standardized definition for subjective cure rate by the International Continence Society.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1992.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 4 uppsatser.

Stress urinary incontinence is prevalent among women. Pelvic floor muscle exercise has been found to be an effective treatment for management of women with stress urinary incontinence. Women's non-adherence to pelvic floor muscle exercise has been the major obstacle for achieving desirable treatment outcomes. The purpose of this study was to examine the relationships between the severity of stress urinary incontinence, impact of incontinence, self-esteem, and intrinsic motivation among Chinese women with stress urinary incontinence and to examine the implications of these relationships on Chinese women's adherence to pelvic floor muscle exercise. / The model developed from the study explained that Chinese women's adherence to pelvic floor exercise is influenced by the interaction among contextual, intrinsic and extrinsic components. Throughout learning and practicing pelvic floor muscle exercise, women's level of motivation to learn and adhere to exercise can be increased or decreased as these components interacted with each other. Finally, the study also highlights implications for nursing practice including the importance of assessment of women with urinary incontinence, awareness of factors influencing adherence to the exercise, and promoting women's adherence to the exercise by fostering women's exercise competency and commitment to exercise and raising women's awareness of the benefits of exercise. / The phase two findings showed that women's perception of severity of incontinence was influenced by sociocultural factors, self-esteem, and level of knowledge. The findings also indicated that about one-third of women were reluctant to disclose their incontinence problems to their partner. This was partly due to their beliefs of linkage between incontinence and deterioration of sexual function, and their conservative view regarding incontinence as a private matter which should not be discussed with their partner. Furthermore, the findings indicated that women's competency, commitment, perceived benefits of pelvic floor muscle exercise and perceived support from family and health professionals were the factors influencing women's adherence to pelvic floor muscle exercise. Importantly, the study revealed that motivation is dynamic in nature from women's initial learning to maintenance of the exercise. Furthermore, motivation was influenced by beliefs in effectiveness of the exercise, perceived exercise benefits and severity of incontinence. / The study employed a mixed method approach using a quantitative design in phase one and a qualitative design in phase two. The results of phase one of the study showed that the majority of women had low level of severity and impact of incontinence; however, 70% of women had high level of motivation to engage in pelvic floor muscle exercise. The results also demonstrated that women's self-esteem was influenced by the severity of incontinence in terms of consumption of pads, as well as the impact of incontinence on different aspects of life being affected by stress urinary incontinence. In addition, those women who had a higher level of severity in terms of increased wetting in previous year and previous week, as well as increased numbers of activities being affected by incontinence were more likely to have a higher level of motivation to adhere to pelvic floor muscle exercise. Furthermore, women with higher levels of impact of incontinence in terms of being affected on sexual life also demonstrated to have a higher level of motivation to adhere to pelvic floor muscle exercise. / Siu Lai Sheung Katherine. / "August 2006." / Adviser: Sheila Twinn. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1562. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 266-300). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Incontinência Urinária de Esforço (IUE) é a queixa de perda involuntária de urina durante esforços ou exercício físico ou espirro ou tosse. A prevalência mundial varia de 8,5 a 68,8%. Tem como principais fatores de risco a paridade, menopausa, obesidade, cirurgias vaginais e Diabetes Mellitus, e causa impacto negativo na qualidade de vida das mulheres podendo levar a depressão, problemas sexuais e pessoais. Existem poucos trabalhos epidemiológicos no Brasil e não existem informações sobre a prevalência de IUE em mulheres ribeirinhas (origem indígena) da Amazônia ou sobre avaliação de fatores de risco e influência do parto domiciliar nesta população. O Objetivo deste estudo foi avaliar prevalência e fatores de risco para IUE em mulheres ribeirinhas da Amazônia e comparar com mulheres que moram em um centro urbano da mesma região. Após cálculo amostral foram entrevistadas 120 mulheres ribeirinhas e 260 mulheres da região urbana, sendo pesquisados a prevalência e os fatores de risco para IUE e, realizado exame físico para avaliar prolapso genital e avaliação funcional do assoalho pélvico em cada população. No grupo de mulheres com queixa de IUE, foi aplicado questionário de qualidade de vida (Kings Health Questionnaire) e realizado estudo urodinâmico. No grupo de mulheres ribeirinhas a prevalência de IUE foi de 25.8% e no grupo urbano de 20% (p > 0.05). Na avaliação dos fatores de risco, paridade, número de partos normais e partos domiciliares foram estatisticamente maiores no grupo ribeirinha. Em relação a qualidade de vida, foi encontrada diferença significativa em alguns domínios (impacto da incontinência, limitação de atividades diárias e físicas, relações pessoais e emoção) sendo pior na população urbana / Stress Urinary Incontinency (SUI) is the complaint of an involuntary loss of urine during efforts or physical exercises, sneezing or coughing. The worldwide prevalence ranges from 8,5 to 68,8%. The main risk factors are: parity, menopause, obesity, vaginal surgeries and Diabetes Mellitus and it causes a negative impact in women\'s quality of life that may lead to depression, sexual and personal problems. There are few epidemiological works in Brazil and there is no information about the prevalence of SUI in riverside community women (indigenous origin) from the Amazon or about the evaluation of the risk factors and influence of home births in this population. The aim of this study was to evaluate the prevalence and the risk factors for SUI in riverside women from the Amazon and to compare them to women that live in urban areas at the same region. After sample calculation, 120 riverside women were interviewed, as well as 260 women from urban areas, when the prevalence and the risk factors were studied. In addition, physical examination was carried out in order to verify genital prolapse and functional evaluation of the pelvic floor in each population. In the group of women with complaints of SUI a questionnaire on quality of life was applied (Kings Health Questionnaire) and also the conduction of an urodynamic study. In the group of riverside women the prevalence of SUI corresponded to 25,8% and in the urban group it was 20.0% (p > 0.05). In the evaluation of risk factors, parity, number of normal deliveries and home births were statistically higher in the riverside women group. In relation to the quality of life, significant difference in some domains was found (incontinency impact, limitation of the daily and physical activities, personal relations and emotion) and it was worse in the urban population

Incontinência Urinária de Esforço (IUE) é a queixa de perda involuntária de urina durante esforços ou exercício físico ou espirro ou tosse. A prevalência mundial varia de 8,5 a 68,8%. Tem como principais fatores de risco a paridade, menopausa, obesidade, cirurgias vaginais e Diabetes Mellitus, e causa impacto negativo na qualidade de vida das mulheres podendo levar a depressão, problemas sexuais e pessoais. Existem poucos trabalhos epidemiológicos no Brasil e não existem informações sobre a prevalência de IUE em mulheres ribeirinhas (origem indígena) da Amazônia ou sobre avaliação de fatores de risco e influência do parto domiciliar nesta população. O Objetivo deste estudo foi avaliar prevalência e fatores de risco para IUE em mulheres ribeirinhas da Amazônia e comparar com mulheres que moram em um centro urbano da mesma região. Após cálculo amostral foram entrevistadas 120 mulheres ribeirinhas e 260 mulheres da região urbana, sendo pesquisados a prevalência e os fatores de risco para IUE e, realizado exame físico para avaliar prolapso genital e avaliação funcional do assoalho pélvico em cada população. No grupo de mulheres com queixa de IUE, foi aplicado questionário de qualidade de vida (Kings Health Questionnaire) e realizado estudo urodinâmico. No grupo de mulheres ribeirinhas a prevalência de IUE foi de 25.8% e no grupo urbano de 20% (p > 0.05). Na avaliação dos fatores de risco, paridade, número de partos normais e partos domiciliares foram estatisticamente maiores no grupo ribeirinha. Em relação a qualidade de vida, foi encontrada diferença significativa em alguns domínios (impacto da incontinência, limitação de atividades diárias e físicas, relações pessoais e emoção) sendo pior na população urbana / Stress Urinary Incontinency (SUI) is the complaint of an involuntary loss of urine during efforts or physical exercises, sneezing or coughing. The worldwide prevalence ranges from 8,5 to 68,8%. The main risk factors are: parity, menopause, obesity, vaginal surgeries and Diabetes Mellitus and it causes a negative impact in women\'s quality of life that may lead to depression, sexual and personal problems. There are few epidemiological works in Brazil and there is no information about the prevalence of SUI in riverside community women (indigenous origin) from the Amazon or about the evaluation of the risk factors and influence of home births in this population. The aim of this study was to evaluate the prevalence and the risk factors for SUI in riverside women from the Amazon and to compare them to women that live in urban areas at the same region. After sample calculation, 120 riverside women were interviewed, as well as 260 women from urban areas, when the prevalence and the risk factors were studied. In addition, physical examination was carried out in order to verify genital prolapse and functional evaluation of the pelvic floor in each population. In the group of women with complaints of SUI a questionnaire on quality of life was applied (Kings Health Questionnaire) and also the conduction of an urodynamic study. In the group of riverside women the prevalence of SUI corresponded to 25,8% and in the urban group it was 20.0% (p > 0.05). In the evaluation of risk factors, parity, number of normal deliveries and home births were statistically higher in the riverside women group. In relation to the quality of life, significant difference in some domains was found (incontinency impact, limitation of the daily and physical activities, personal relations and emotion) and it was worse in the urban population

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.