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)...
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:13723 |
| Date | 14 July 2015 |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
| Rights | University of Johannesburg |
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