Objectives: To compare single incision mini-slings (SIMS) versus standard mid-urethral sling (SMUS) in the surgical management of female stress urinary incontinence (SUI) with regards; efficacy, safety and cost-effectiveness. Methods: A multicentre randomised controlled trial (RCT) comparing SIMS-Ajust® with SMUS-TVT-OTM (1-year follow-up) was performed. In addition, a systematic review and meta-analysis of RCTs comparing SIMS versus SMUS (1-3 years follow-up) was performed, incorporating the results of the RCT. Both studies assessed post-operative pain, time to return to normal activities and work, patient-reported and objective cure rates, peri-operative complications and impact on pre-operative urgency, women's quality of life (QoL), sexual function and cost effectiveness. Results: For the RCT, 137 women were randomised (SIMS-Ajust® [n=69] vs. TVT-OTM [n=68]). The SIMS Ajust® group had significantly lower post-operative pain-profile within the first four weeks (p <0.001). There were no significant differences in patient-reported success rate (p >0.999), objective success rate (p >0.999) or re-operation rates (p= 0.721) at 1-year follow-up. For the systematic review, 670 articles were identified, and 26 RCTs (n=3308 women) were included. After excluding RCTs evaluating TVT-SecurTM (recently withdrawn from clinical practice), there were no significant differences between SIMS and SMUS in patient-reported cure rates (RR 0.94, 95% CI 0.88, 1.00) and objective cure rates (RR 0.98, 95% CI 0.94, 1.01) at a mean follow-up of 18.6 months. SIMS had significantly lower post- 1 operative pain scores (WMD -2.94; 95% CI -4.16, -1.73), and earlier return to normal activities and work (WMD -5.08; 95% CI -9.59, -0.56; and WMD -7.20; 95% CI -12.43, -1.98, respectively). Conclusion: Adjustable anchored SIMS-Ajust® appears to have more favourable recovery, pain and cost effectiveness outcomes than SMUS-TVT-OTM, whilst having similar effectiveness outcomes, at 1-year follow-up. Generally, SIMS appear to have equivalent outcomes compared with SMUS at a mean follow-up of 18-months, in terms of patient-reported cure, objective cure and impact on women's QoL and sexual function. Consequently, SIMS represent a promising group of procedures in the treatment of women with SUI, and merits further research especially in terms of longer term outcomes.

No description available.

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

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M.Tech. (Homoeopathy) / Stress urinary incontinence (SUI) is the involuntary loss of urine when sudden, external forces cause a brief increase in intra-abdominal pressure during stress events such as coughing, sneezing, laughing, bending, lifting, or exercise (ICS, 2013).SUI is a subcategory of urinary incontinence (UI) and affects middle aged women predominantly due to weakened support of the bladder by the pelvic floor and surrounding structures (Beji et al 2010). Damage to the pelvic floor and pelvic structures can cause the bladder and bladder neck to move or bend into problematic positions which adds unnecessary placement of external pressures on the bladder and in turn urine loss occurs (Badlani et al., 2009). The treatments available for treating SUI is behavioural changes, pelvic floor muscle rehabilitation or invasive surgeries. Pharmacological treatment options available for incontinence focus more on different subcategories of UI and has little effect on treating SUI directly and due to various side effects of these medications many patients avoid taking it (Shamilyan et al., 2012). There is currently no known effective treatment for SUI (ICS, 2013). SUI is the loss of small amounts or a few drops of urine at a time (Beers et al., 2006). Although the symptoms of this condition may not be life threatening it can interfere with the quality of life in those who suffer from loss of bladder control (Cheung et al., 2012). The negative effects can be seen in all areas physical activities, social activities, relationship strain and even emotional status of the patient (De Ridder et al, 2013). Many women report having SUI for several years and have learned to live with the incidents and use preventative methods when severity of SUI episodes worsen (Peterson, 2008). Additionally the symptom can be distressing on a physical level and consistent SUI episodes may cause recurrent urinary tract infections, irritation, pain and discomfort of the lower urinary tract (Beers et al., 2006). The aim of this study was to determine the efficacy of the homoeopathic remedy Causticum 30cH on SUI episodes experienced by women by means of using a voiding diary and validated quality of life questionnaires. This was a five week double blind, placebo-controlled study, using forty female participants between the ages of 30-65 years old, and was conducted at a homoeopathic practice in Alberton, Johannesburg (Appendix B) under the supervision of a qualified homoeopath. There were three consultations, at the first consultation the study was explained and a full history taking and focused physical examination was conducted which included vital signs and a midstream urine dipstick test (Appendix E) to rule out any UTI. Participants were required to complete the QOLQ IIQ-7 SF (Appendix F) and the UDI-6 SF (Appendix G) (Uebersax et al., 1995). iii The first week no remedy was given (baseline week) and was followed by a four week treatment period. Participants had to complete a 7-day voiding diary (Appendix H) to evaluate symptom frequency for the duration of the study at home and were collected at the follow-up consultation after week three and week five. Participants were requested to complete the QOLQ IIQ-7 SF (Appendix F) and UDI-6 SF (Appendix G) (Uebersax et al., 1995) during the follow up consultations. Nocturnal voiding was also recorded on the voiding diaries. After week one the voiding diaries were collected and the participants were asked to select a remedy thereby, randomly allocating herself to either the experimental group or the control group. Data was collected and was analysed by STATKON. Frequencies, descriptives and crosstabulations were done for the demographic information between groups. Non-parametric test were utilized for the analysis because the sample size was small. The inter-group data analysis was performed using the Mann-Whitney test to compare between the groups. Comparisons over time for each group were assessed using the Friedman test, and a Wilcoxon Signed Ranks test was done to ascertain where in time the differences had occurred. The Bonferrani adjustment/correction test is a post-hoc test and was done after the Wilcoxon Signed Ranks test which is an adjustment to the original p value and a re-evaluation of p value of the comparisons (Becker, 2013)...

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

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

Overactive bladder (OAB) is considered to be a disorder of the urinary bladder and is defined by the International Continence Society Terminology Committee as "urgency, with or without urge incontinence, usually with frequency and nocturia". There is some preliminary evidence using functional magnetic resonance imaging (fMRI) that the brain response to bladder filling in OAB patients is abnormal. The purpose of this research is to determine whether there are Central Nervous System (CNS) differences in modulating bladder function that contribute to, or are themselves the cause of the symptoms in OAB patients. We further investigated the pharmacological fMRI changes / Electrical and Computer Engineering

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.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, 2004. / Bibliyografya var.