• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.60-68
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• 2017

Purpose: The purpose of this study was to analyze the relationship between lower urinary tract symptoms and urodynamic parameters to investigate the characteristics of mixed urinary incontinence (MUI) and stress urinary incontinence (SUI). Methods: The subjects were 318 women with MUI and 128 women with SUI. Data were collected retrospectively from electronic medical records including Bristol Female Lower Urinary Tract Symptoms-Scored Form (BFLUTS-SF), Incontinence Quality of Life Instrument (I-QOL), voiding diaries, and urodynamic parameters. Results: Compared with the SUI group, the MUI group was older and showed lower I-QOL and more severe urinary tract symptoms. The MUI group had more urinary frequency, more nocturia, and a higher urgency score than the SUI group. In the correlation analysis, the greatest difference between the two groups was that urgency was associated with Qmax, maximal cystometric capacity, and detrusor overactivity only in the MUI group (r = -.175, p= .004; r = -.281, p< .001; r= .232, p< .001, respectively). Conclusion: As a result of this study, we propose that a customized management program that emphasizes the control of urgency for the MUI group, and one that effectively strengthens the weak pelvic floor for the SUI group.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.4
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• pp.149-174
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• 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.

• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.4
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• pp.1-22
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• 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.

• Journal of Medicine and Life Science
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• v.20 no.4
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• pp.166-171
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• 2023

Mixed urinary incontinence (UI) is common in women. This study aimed to assess the efficacy of anti-incontinence surgery in female patients with equally severe stress UI (SUI) and urge UI (UUI). All patients had equal severity of SUI and UUI. The postoperative cure rate was categorized into the cure group (CG) and failure group (FG). Postoperative satisfaction was categorized into the satisfaction group (SG) and the dissatisfaction group (DG). Statistical significance was set at P<0.05. Ninety patients (SG, 73.3%; DG, 26.7%; CG, 93.3%; FG, 6.7%) were included in the study. In the univariate analysis, body mass index (BMI), total bladder capacity, and overactive bladder symptom score (OABSS) were significantly different between the SG and DG groups. Peak urinary flow, Valsalva leak point pressure (VLPP), and OABSS were significantly different between the CG and FG groups. In the multivariate analysis, OABSS (P=0.001) and BMI (P=0.032) were independent predictors of postoperative satisfaction. VLPP (P=0.023) was the only independent factor associated with the postoperative cure rate. In equal severity of SUI and UUI, VLPP was found to be the only independent factor associated with postoperative cure rates. Higher VLPP values were associated with higher cure rates. BMI and OABSS were identified as independent predictors of postoperative satisfaction, with lower BMI and OABSS associated with higher postoperative satisfaction.

• Animal cells and systems
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• v.14 no.4
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• pp.237-244
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• 2010

Stress urinary incontinence (SUI) is a common condition that primarily affects women. Here, we investigate the effects of human adipose-derived stem cells (ADSCs) in a rodent model of SUI. Female Sprague-Dawley rats at 7 weeks of age were randomly divided into three groups (n=8 per group): sham-operation, SUI-induction by transabdominal urethrolysis, and SUI-induction followed by transplantation of human ADSCs into the urethra. The abdominal leak point pressure at 8 weeks after the operation was markedly decreased by transabdominal urethrolysis, confirming successful induction of SUI. Interestingly, transplantation of human ADSCs into the urethra significantly blunted the decrease of abdominal leak point pressure in SUI-induced rats. Accordingly, we observed expression of ${\alpha}$-smooth muscle actin in a significant proportion of transplanted ADSCs, indicating differentiation of ADSCs into smooth muscle cells in the urethra. Moreover, the SUI-induced elevations of c-Fos immunoreactivities in the pontine micturition center (PMC) and in the ventrolateral periaqueductal gray (vlPAG) were clearly suppressed by transplantation of human ADSCs. These results imply that human ADSCs can be an effective therapeutic modality to ameliorate the symptoms of SUI.

• Journal of IKEEE
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• v.12 no.2
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• pp.87-94
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• 2008

Pelvic floor muscle is the main subsystem that maintains urinary continence. It is possible to diagnose the degree of the stress urinary incontinence(SUI) by evaluating the contraction pressure of the pelvic floor muscle. Bio-signal measurement system was developed to measure the contraction pressure. Diagnostic parameters were drawn out by analyzing the measured data. Statistical evaluations were done to classify the all subjects with five groups each has similar characteristics. SUI diagnostic algorithm was implemented to each group separately. The accuracy of the algorithm was about 78.9% and utility was confirmed by clinical trial.

• Physical Therapy Korea
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• v.26 no.3
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• pp.67-75
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• 2019

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.207-214
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• 2004

Purpose: This study was carried out to evaluate the efficacy of intravaginal pelvic floor electrical stimulation (FES) therapy on bladder irritability symptoms in stress urinary incontinent women. Materials and Methods: The evaluation before and after treatment included the Blaivas's female Bladder Questionnaire, the quality of life questionnaires and the overall satisfaction with present voiding state using visual analogue test (VAT). All patient were treated for 20 minutes, twice a week for 6 weeks, using a new intravaginal electrical stimulator with microchip (PIC16C74). Results: After the FES therapy, the overall success rate of the SUI was 50.4.% at 9 months. The bladder irritability symptoms such as frequency, nocturia, urgency, residual urine sensation and lower abdominal discomfort were improved. In particular, the symptoms of frequency, urge incontinence, dysuria were significantly improved after the FES therapy at 9 months. The VAT score of the overall satisfaction with the present voiding state was significantly lower after the FES therapy. 73.7% of patients were satisfied with the FES therapy and complications such as hemorrhage, vaginitis, urinary tract infection and pain were not encountered. Conclusion: These results suggest that FES therapy with microchip improves some bladder irritability in SUI women. Therefore, electrical stimulation therapy should be considered as a first line therapy in SUI women with bladder irritability symptoms.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.277-287
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• 2018

Pelvic floor muscle is the main sub-system that maintains urinary continence. The weakness of pelvic floor muscles causes the stress urinary incontinence, and therefore the degree of functioning of pelvic floor muscles could be used as an index to assess the degree of stress urinary incontinence. In this study, the quantitative diagnosis algorithm was proposed to estimate the degree of stress urinary incontinence (SUI) by measuring the contraction pressure of pelvic floor muscle. For these reason, the contraction pressure measurement system from pelvic floor muscle was developed, and the measuring protocol was suggested to analysis the obtained data. As the results of clinical test, the proposed diagnosis algorithm shows the 80% of accuracy, and 20% of false positive diagnosis. On the other hand, false negative results were not confirmed. Consequentially, we thought that the proposed urinary incontinence diagnosis algorithm can quantitatively diagnose the progression of the stress urinary incontinence and it can be used for the development of the incontinence diagnosis system.

• Journal of Biomedical Engineering Research
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• v.44 no.1
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• pp.85-91
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• 2023

Stress urinary incontinence (SUI) occurs when abdominal pressure increases, such as sneezing, exercising, and laughing. Surgical and non-surgical treatments are the common methods of SUI treatment; however, the conventional treatments still require continuous and invasive treatment. Laser have been used to treat SUI, but excessive temperature increase often causes thermal burn on urethra tissue. Therefore, the optimal conditions must be considered to minimize the thermal damage for the laser treatment. The current study investigated the feasibility of the laser irradiation condition for SUI treatment using non-ablative 980 nm laser from a safety perspective through numerical simulations. COMSOL Multiphysics was used to analyze the numerical simulation model. The Pennes bioheat equation with the Beer's law was used to confirm spatio-temporal temperature distributions, and Arrhenius equation defined the thermal damage caused by the laser-induced heat. Ex vivo porcine urethral tissue was tested to validate the extent of both temperature distribution and thermal damage. The temperature distribution was symmetrical and uniformly observed in the urethra tissue. A muscle layer had a higher temperature (28.3 ℃) than mucosal (23.4 ℃) and submucosal layers (25.5 ℃). MT staining revealed no heat-induced collagen and muscle damage. Both control and treated groups showed the equivalent thickness and area of the urethral mucosal layer. Therefore, the proposed numerical simulation can predict the appropriate irradiation condition (20 W for 15 s) for the SUI treatment with minimal temperature-induced tissue.