• 농촌의학ㆍ지역보건
• /
• 제31권3호
• /
• pp.275-284
• /
• 2006

요실금 또는 과민성방광증후군은 국내외적으로 높은 유병률을 보이고 있으며, 삶의 질에 영향을 줄 수 있는 중요한 건강문제의 하나이다. 본 연구는 경상북도 일부 농촌 여성들을 대상으로 요실금 빛 과민성방광증후군의 실태를 파악하여, 예방, 조기진단 및 건강증진 등의 중재적 방안 수립의 기초 자료로 이용하고자 하였다. 연구대상자는 2001년 8월 16일부터 8월 18일까지 경상북도 울진군 북면 주민 중 자발적으로 건강검진에 참여한 여성 322명이었다. 설문조사는 본 연구진이 개발한 설문지를 사전교육을 받은 의학과 학생들이 직접 일대일 면접으로 실시하였다. 본 연구에 사용된 요실금 및 과민성방광증후군과 관련된 용어는 대한배뇨장애 및 요실금학회의 표준 용어를 사용하였으며, 요실금의 종류별 정의와 과민성방광증후군의 신 구 정의를 모두 이용하였다. 모든 자료는 Excel에 전산입력 하였고, 분석은 한글 SPSS 12.0 for Windows를 이용하였다. 조사대상자는 모두 여성으로 연령별 분포는 60대가 85명(26.4%)로 가장 많았다. 조사 대상자의 요실금 분율은 복압성요실금이 106명(32.9%)으로 가장 높았고, 절박성요실금 56명(17.4%), 혼합성요실금 48명(14.9%)의 순이었으며, 전체 요실금 분율은 114명(35.4%)이었다. 과민성방광증후군 및 요실금 관련 증상은 절박뇨 69명(21.4%), 빈뇨 77명(23.9%), 야간뇨 113명(35.1%), 절박성요실금 56명(17.4%) 등으로 과민성방광증후군 I의 분율은 36.0%이었으며, 과민성방광증후군 II의 분율은 14.0%이었다. 절박성요실금, 복압성요실금, 혼합성요실금 및 OABs와 연령과의 관련성에서는 요실금의 경우 연령이 증가함에 따라 요실금의 분율이 유의하게 증가하지는 않았으나, 40대 미만에서는 요실금 분율이 가장 낮았고, 40대에서 가장 높았으며, 50대 이상에서는 감소하는 경향을 보였다. 과민성방광증후군의 경우 OABs II의 경우 연령이 증가할수록 유의하게 OABs II의 분율이 증가하였다(p<0.05). 요실금의 증상은 '약뇨'가 가장 많았고, 과민성방광증후군은 '절박뇨'가 가장 많았다. 요실금 또는 과민성방광증후군으로 인하여 일상생활에서 경험하는 문제는 '낯선 곳에서 제일 먼저 화장실을 찾음'이 가장 많았다. 본 연구는 여러 제한점에도 불구하고, 농촌 지역 여성들을 대상으로 요실금 및 과민성방광증후군의 실태를 파악함으로서 앞으로 지역보건사업 또는 건강증진사업의 기초자료로 사용할 수 있는 자료를 제공하였다는데서 의의가 있다. 특히 본 연구를 통하여 이러한 질병들은 생명의 위중을 떠나 삶의 질을 좌우할 수 있는 중요한 건강문제라는 것을 인식할 수 있으며, 국가적 차원의 제도화된 접근이 절실히 요구되고 있다.

• 대한간호학회지
• /
• 제29권1호
• /
• pp.34-47
• /
• 1999

This study evaluated the Comparison of the Effectiveness of Pelvic Floor Muscle exercise and Biofeedback treatment for Genuine Stress Incontinence I assigned 60 participants to 2 groups : 30 to the pelvic floor muscle exercise group and 30 to the biofeedback group. Treatment protocol lasted for 6 weeks. Peak pressure, and duration time of pelvic muscle contraction were evaluated by a perineometer. Lower urinary symptoms, sexual matter and life style scores were achieved by using Jackson's scale. The treatment efficacy of the pelvic floor muscle exercise is compared with the biofeedback group and the main results of the comparison are as follows : 1. Pelvic muscle contraction 1) The peak pressure in the biofeedback group was significantly increased(P＝0.000). 2. The frequency and quantity of incontinence 1) The frequency of incontinence in the biofeedback group was significantly decreased(P＝0.000). 2) The quantity of incontinence in the biofeedback group was significantly decreased(P＝0.000). 3. The lower urinary symptoms Daily frequency(P＝0.000), nocturia(P＝0.000), urgency(P＝0.000), bladder pain(P＝0.000), unexplained incontinence(P＝0.048), wearing protection(P＝0.022), changing outer clothing(P＝0.005), hesitancy(P＝0.008), intermittent stream(P＝0.000), abnormal strength of stream(P＝0.004), retention(P＝0.000), incomplete emptying(P＝0.000), and inability to stop mid stream(P＝0.006) of the lower urinary symptoms in the biofeedbatk group were significantly decreased. 4. The sexual matters The dry vagina (P＝0.004) and pain during sexual Intercourse (P＝0.002) in the biofeedback group was significantly decreased. 5. The life style The fluid intake restriction(P＝0.007), affected daily task(P＝0.003), avoidance of places & situation(P＝0.003), interference in Physical activity (P＝0.002), interference in relationship with other people(P＝0.01), and feeling about the rest of life with urinary symptom(P＝0.000) in the biofeedback group were significantly decreased. In conclusion, the biofeedback treatment was more effective than the pelvic floor muscle exercise in genuine stress incontinence.

• 정신신체의학
• /
• 제31권2호
• /
• pp.63-71
• /
• 2023

요실금의 유병률은 전세계적으로 남성에서 3~11%, 여성에서 25~45%에 달할 정도로 매우 흔한 질환이며, 향후 고령화 진행에 따라 요실금은 더욱 증가할 것으로 예상된다. 요실금은 환자와 가족의 삶의 질을 현저히 떨어뜨리고, 우울감, 스트레스, 자존감 저하를 유발한다. 기존에 정신과 질환을 앓고있는 환자에서 요실금이 새로 발생할 때 정신과적 증상 악화, 치료 순응도 저하, 치료 효과 반감 등에 영향을 줄 수 있어 유의가 필요하다. 요실금은 대부분 방광 저장능력의 결함으로 일과성, 만성 요실금으로 구분된다. 일과성 요실금은 가역적인 요실금으로 delirium, infection, atrophic urethritis/vaginitis, psychological disorders, pharmaceuticals, excess urine output, restricted mobility, stool impaction (DIAPPERS)이 대표적인 원인이다. 만성 요실금은 복압성, 절박, 혼합, 일류성 또는 범람, 기능성, 그리고 지속성 요실금으로 구분된다. 약물 유발 요실금은 일과성 요실금의 한 종류로 임상에서 흔히 볼 수 있으며 여러 가지 정신과 약제에 의해서도 유발될 수 있다. 항정신병 약제가 가장 대표적으로 알려졌으며, 비정형 항정신병 약제의 알파 아드레날린성 차단효과로 인한 요도 괄약근 근긴장도 저하, 항콜린성작용에 의한 요폐, 세로토닌 길항 효과로 인한 pudendal nerve 반사 저하, 심한 진정효과, 약물유발 당뇨, 경련 등 여러가지 메커니즘이 작용하는 것으로 추정된다. 리튬은 요실금과 관련된 증례가 보고된 사례는 미미하나 신성 요붕증으로 인한 일류성 요실금과 연관될 수 있고, 발프로산도 명확하지 않은 기전으로 야뇨증을 유발할 수 있다. 항우울제의 경우 SSRI는 세로토닌 경로와 배뇨근 활성에 영향을 줌으로써, SNRI와 TCA는 요저류를 유발함으로써 요실금을 일으킬 수 있다. 부프로피온과 멀타자핀도 드물지만 요실금 사례가 보고된 바 있다. 벤조디아제핀의 경우 방광의 근이완으로 요저류와 요실금을 모두 유발할 수 있으며 항치매제로 쓰이는 아세틸콜린 분해효소 억제제는 말초의 아세틸콜린을 증가시켜 요실금을 유발한다. 이렇듯 요실금은 여러 정신과 약제로 인하여 발생될 수 있으므로, 요로 증상을 면밀히 확인하여 약물 선택과 조절에 주의해야 하며, 요실금이 약물로 인한 것임이 밝혀졌을 경우 원인 약물의 중단, 감량 또는 분복 변경이 필요하며 약물치료로는 desmopressin, oxybutynin, trihexyphenidyl, amitriptyline을 추가해볼 수 있다.

• 대한한방부인과학회지
• /
• 제33권4호
• /
• pp.1-22
• /
• 2020

Objectives: The purpose of this review is to evaluate the efficacy of moxibustion for stress urinary incontinence (SUI) in women. Methods: For relevant randomized controlled trials (RCTs), we searched the following databases from their inception to September 1, 2020: The Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database (CNKI), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), and National Digital Science Library (NDSL). The key search terms were 'stress urinary incontinence' and 'moxibustion'. Data extraction and assessment of risk of bias were conducted by two authors independently. Results: A total of 11 RCTs were finally included in this systematic review. In all studies, moxibustion treatment was applied as an adjuvant therapy to the conventional treatment, and the most common conventional treatment was pelvic floor muscle training (PFMT). The treatment group (conventional treatment plus moxibustion) showed statistically more significant effect than the control group (conventional treatment only) in various evaluation indicators including urinary incontinence frequency, 1 hour urine pad test, quality of life, the clinical efficacy rate, and pelvic muscle strength. Conclusions: In this study, we investigated the efficacy of moxibustion as an adjuvant therapy for female SUI patients. Further studies are needed to supplement the safety of moxibustion and the evaluation of moxibustion dose.

• 대한한방부인과학회지
• /
• 제30권4호
• /
• pp.149-174
• /
• 2017

Objectives: The aim of this study is to establish a base for further research by reviewing studies on electroacupuncture (EA) for stress urinary incontinence (SUI). Methods: Clinical studies concerning the effects of EA for SUI, were obtained from Cochrane Library, PubMed, CNKI, RISS, NDSL, KISS and OASIS. Results: Forty-five studies met the criteria, which included 33 RCTs, 1 pilot RCT, 4 non-randomized Clinical Trials, 6 Case studies and 1 Orthogonal design study with 3638 patients. There was only one article published in Korea. In these study, the most common primary outcome measurement was the pad test. Most of the studies showed the group treated by EA effects compared to the control group. Also, many interventions that combined with EA were found and all complex therapy group had significantly better than control group. 7 studies observed adverse events (AEs), four of which referred to EA related AEs among them. And 4 studies reported no AEs associated with EA. Conclusions: Despite several limitations, various studies to prove limited yet effective EA on SUI provides much significance. Subsequent studies conducted by the complementary systematic review of the studies and well-designed clinical trials using the methodological quality will be needed to more firmly validate the therapeutic effect of EA on SUI.

• 대한한방부인과학회지
• /
• 제27권4호
• /
• pp.133-140
• /
• 2014

Objectives: This study aims to identify effects of Korean medical treatment for stress urinary incontinence patient. Methods: The patient was treated by moxibustion at Shuidao (ST28), Sa-Am acupuncture lung tonification, Bojungikkitang-gamibang and Boshimdan for 2 weeks. These treatments are Korean medical treatment, and non-invasive. Results: After 2 weeks of Korean medical treatment, the symptoms of stress urinary incontinence disappeared. Conclusions: This case report shows that non-invasive Korean medical treatments are effective against stress urinary incontinence.

• Journal of Yeungnam Medical Science
• /
• 제20권1호
• /
• pp.36-44
• /
• 2003

Background: To evaluate the efficacy of EMG biofeedback and pelvic floor electrical stimulation in the stress urinary incontinence patients by Kontinence HMT2000. Materials and Methods: A group of 14 patients with stress urinary incontinence were treated with combined biofeedback and intravaginal electrical stimulation during 12 sessions from 2 weeks to 6 weeks. Results: At immediate post treatment, subjective cure rate was 28% and improvement rate was 57% and failure rate was 15%. Thus the overall success rate for this treatment was 85%. The result of 3 months after treatment showed cure rate 14% and improvement rate was 43%. Intravaginal pressure increased by an average of 11.9 cmH2O. Increased vaginal pressure was found in 93% of the patients and more than 50% increment of intravaginal pressure was 71%. Conclusions: Combined biofeedback and pelvic floor electrical stimulation by use of Kontinence HMT2000 is effective for the patients who have good compliance, relative low degree stress urinary incontinence. In order to attain good results, a well structured program that teaches specific muscle exercise and the patients should be followed by regular interval reinforcement treatment.

• 대한물리치료과학회지
• /
• 제9권2호
• /
• pp.49-66
• /
• 2002

This study was designed to evaluate the effect of pelvic floor muscle strengthening exercise treatment program for the older women with stress incontinence. The researcher developed 8 weeks training program which was implemented at a social welfare center in Seoul. The exercise method followed the Kegel criteria. Verbal instructions were given to the subjects. Subjects were confirmed of the exercises and evaluated by description of the exercise method. Fourteen elderly women(mean age 75.7) with stress incontinence participated and completed this program. The training sessions were held twice a week and each session took 45 minutes ; 15 minutes for pelvic floor muscle strengthening program and 30 minutes for other physical therapy. Pelvic floor muscle strengthening exercise program was applied using verbal instruction and practice at social welfare center, twice a week and daily home exercise program were given to each individual. The results were as follows ; 1. There was significant decrease of lower urinary symptoms in the subjects (p = 0.00) 2 But there was no significant change in the sexual matters (p = 0.44) and the life style (p = 0.41) In conclusion, further study with larger sample group is suggested in order to confirm the study result. Because of limited sample size, the study results were not conclusive. But the pelvic floor muscle strengthening exercise treatment program could be a safe and effective program and is suggestive for the community residing older women with stress incontinence as a geriatric physical therapy intervention.

• 대한한방내과학회지
• /
• 제42권3호
• /
• pp.293-307
• /
• 2021

Objectives: This study investigates the effects and safety of Bojungikgi-tang for stress urinary incontinence by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: RCTs were selected from articles published until December 2019 in seven domestic and foreign databases. The quality of the literature was evaluated using Cochrane's risk of bias (RoB) tool, and RevMan 5.3 was used to synthesize the results. Results: A total of 694 patients with stress urinary incontinence participated in eight RCTs. Meta-analysis showed that the total effective rate of treatment that combines pelvic floor muscle training (PFMT) and Bojungikgi-tang was significantly higher than that of PFMT alone. The volume of urine leakage per hour after the combined treatment was significantly lower than that of PFMT alone. The International Consultation on Insurance Questionnaire-Short Form (ICIQ-SF) scores from combining PFMT and Bojungikgi-tang were significantly lower than those for PFMT alone. Conclusion: This study suggests that Western medical treatment combined with Bojungikgi-tang for urinary incontinence from stress might be more effective in improving symptoms than conventional Western medical treatment alone. However, the number of studies included in the meta-analysis was insufficient, and the quality of the selected literature was generally low. Therefore, high-quality clinical studies on herbal medicine treatment for urinary incontinence would be required in the future.