• 한국임상수의학회지
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• 제31권6호
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• pp.515-518
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• 2014

배뇨실금, 변비를 보이는 중성화된 수컷 요크셔테리어가 내원하였다. 신체검사에서 배뇨곤란 증상이 확인되었고 신경학적 이상은 발견되지 않았다. 또한 요검사에서 세균이 확인 되지 않았으며 직장 검사에서 정상 크기의 전립선을 확인 할 수 있었다. 요도 카테터는 저항감 없이 삽입 되었으며 비뇨기계 조영 촬영에서 골반강 내에 위치한 방광이 확인 되었다. 이소성 요관과 같은 선천적 이상은 확인 되지 않았으며 골반강 내 방광을 동반한 요도 조임근 기능 부전증이 진단 되었다. 방광을 복강내 정상 위치로 환납하기 위한 방광 고정술이 결정 되었다. 와욕 봉합을 이용 방광목 부분을 복벽 및 치골 앞 인대에 고정하였으며 추가적으로 방광 외측 부분을 복벽에 고정하였다. 방광 상단 부위는 복벽 절개창 부위에 고정 하였다. 수술 후 배뇨를 돕기 위해 방광내 카테터를 장착하였으며 수술 후 3일 째 제거하였다. 카테터 제거 후 3 일째 정상 배뇨가 확인되었으며 수술 후 2 달째 방광 조영 촬영을 통해 방광이 복강 내에 정상적으로 위치한 것을 확인하였다. 보호자와의 지속적인 전화 통화를 통해 수술 후 3년 11개월까지 정상 배뇨를 확인하였다.

• 대한간호학회지
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• 제28권1호
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• pp.171-183
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• 1998

The purpose of this study was to identify the incidence of urinary incontinence in adult women and to identify factors related to life style and sexual intercourse that were related to incontinence. The sample consisted of 1,065 women living in Seoul or one of five provinces. Data for this study were collected from January 16 to June 23 using structured questionnaires. The Urinary Symptom Questionnaire developed by Jackson and a demographic questionnaire were used to collect the data. The data were analyzed using frequency, percentage with an SPSS/PC$^{+}$ program. The major finding are as follows : 1. The distribution of age of subjects was as follows : 20-29(10.1%), 20-39(17.8%), 40-49(27.3%). 50-59(22.3%), 60-69(12.9%), 70-79(6.1%). 80-89(2.8%), more than 90(0.6%). The frequency of normal delivery, 0(155%), 1-2(36.0%), 3-4(29.2%), 5-6(13.0%). more than 7(6.3%). The rate of subjects with menopause was 40.8%. 2. It was reported that 50.7% of the subjects experienced urinary incontinence with stress, mixed. and urgency incontinence being 49.8%, 43.4%, 6.8% respectively. 3. The lower urinary symptoms and incidence with urinary incontinence were as follows : Daily frequency. 22.3%, nocturia. 40.8%, urgency, 71.2%, bladder pain 47.8%, unexplainned incontinence, 32.4%, noctural incontinence, 16.1%, and frequency of incontinence, 37.7%. In term of quantity of incontinence, drop/pants damp, 29.5%, dribble/pants wet, 20.5%, flood or soaking through to outer clothing, 1.7%, and flood or running down legs or onto floor, 0.2%. 4. The symptoms related to sexual intercourse and incidence of urinary incontinence were as follows : dry vagina, 39.1%, sex life trouble, 10.8%, pain during sexual intercourse, 27.4%, and urine leakage during sexual intercourse. 8.8%. 5. Life style problems related to urinary incontinence were as follows : fluid intake restriction, 20.0%, affected daily task, 24.5%. avoidance of placess and situations, 35.0%, interference in physical activities, 30.6%, interference in relationships with other people. 19.0%. interference in relationships with husband/companion, 8.1%, and time after attack of urinary symptoms, 76.9%. In term of the feeling about the rest of their lifves the women reported : perfectly happy, 11.3%. pleased, 16.9%. mostly satisfied, 20.2%, mixed feelings, 21.0%, mostly dissatisfied, 21.0%, very unhappy 8.5%, and desperate. 1.0%. In conclusion. this study was a preliminary study to provide nursing practices guidelines for incontinence in adult women. Nurse working with adult women should develop and provide adequate care for these women.n.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.473-476
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• 2010

Sacral nerve stimulation (SNS) is an effective treatment for bladder and bowel dysfunction, and also has a role in the treatment of chronic pelvic pain. We report two cases of intractable pain associated with cauda equina syndrome (CES) that were treated successfully by SNS. The first patient suffered from intractable pelvic pain with urinary incontinence and fecal incontinence after surgery for a herniated lumbar disc. The second patient underwent surgery for treatment of a burst fracture and developed intractable pelvic area pain, right leg pain, excessive urinary frequency, urinary incontinence, voiding difficulty and constipation one year after surgery. A SNS trial was performed on both patients. Both patients' pain was significantly improved and urinary symptoms were much relieved. Neuromodulation of the sacral nerves is an effective treatment for idiopathic urinary frequency, urgency, and urge incontinence. Sacral neuromodulation has also been used to control various forms of pelvic pain. Although the mechanism of action of neuromodulation remains unexplained, numerous clinical success reports suggest that it is a therapy with efficacy and durability. From the results of our research, we believe that SNS can be a safe and effective option for the treatment of intractable pelvic pain with incomplete CES.

• 여성건강간호학회지
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• 제17권3호
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• pp.294-303
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• 2011

Purpose: This study aimed to describe bladder dysfunction in elderly women such as frequency, nocturia, and residual urine. Methods: One hundred elderly women aged 60 and over. The Bristol Female Lower Urinary Symptoms (BFLUT) was used to evaluate the bladder function and to measure the residual urine amount by using a bladder scanner. Data was analyzed with the differences between voiding dysfunction by age group and life habits by t-test, ANOVA and correlation by Pearson correlation coefficient. Results: the mean daytime frequency was 6.8 times and night-time frequency 2.7 times. Sixty three percent of subjects had urgency and 41% had urgent incontinence. Over half of subjects had problem in voiding function. There were significant differences in frequency by age groups and constipation, but not in daytime frequency and residual urine. Lastly, there were significant positive relations between daytime frequency and night-time frequency. Also results indicate that more frequency in daytime equaled to a less residual urine amount. Conclusion: We know many elderly women have lower urinary tract symptoms. Specially women over 75 years have more daytime frequency and night-time frequency. This suggests further research needed in order to understand the relation of voiding patterns and life habits and its influence on quality of life.

• 한국임상약학회지
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• 제18권1호
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• pp.28-37
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• 2008

Objectives: Overactive bladder(OAB), defined as 'urgency, with or without urge incontinence, usually with frequency and nocturia', is a major burden for patients and impairs quality of life. The aim of this study is to evaluate the cost-effectiveness of antimuscarinic agents for the treatment of overactive bladder including quality of life in societal perspective. Methods: A decision-analysis model was developed to compare the cost-effectiveness of solifenacin and tolterodine IR over 12 weeks. We used data from the published literature to develop the framework for the model. Resource utilization and costs were calculated with public institutional data and supplemented this information with clinical expert opinion, where necessary. Results: The expected costs per patient for solifenacin were 48,762 KRW less expensive than tolterodine IR over 12 weeks. Also, all outcomes including quality of life for solifenacin were more effective than tolterodine IR over 12 weeks. In conclusion, solifenacin dominates tolterodine IR and appears to be cost-effective options for the management of overactive bladder.

• 대한한방부인과학회지
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• 제22권3호
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• pp.169-184
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• 2009

Purpose: The aim of this study was to estimate the effect of Korean medicine treatment on overactive bladder. Methods: 64 patients of overactive bladder received Korean medicine treatment for at least 30days. We studied retrospectively symptom disappearance rate, the relationship between the improvement rate and age, scale of symptoms, BMI(Body Mass Index), WHR(Waist Hip Ratio). Results: Symptoms of 27 patients were disappeared, and those of 28 patients were improved. But 9 patients didn't show the improvement of their urination problems. The symptom disappearance rate was 43.08%. The improvement rate was 85.15%. The mean${\pm}$standard deviation of daily frequency was reduced from 10.05128 to 7.44872 after treatment(p<0.0001) The symptom disappearance rate was reverse-related with the OABSS score, KHQ and WHR. The improvement rate of married patients was higher than unmarried patients. And especially that was co-related with the frequency of acupuncture and moxibustion treatment. Conclusion: The results of this study suggested that Korean medicine treatments, such as acupuncture, moxibustion and herbal prescriptions have positive efficacy on overactive bladder patients in ordinary clinical practice.

• Journal of Acupuncture Research
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• 제22권3호
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• pp.123-135
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• 2005

국내외 학술지중 배뇨장애에 대한 침치료의 연구 동향을 문헌고찰 연구, 생리적 기전 연구, 임상효과 연구로 나누어 분석한 결과 다음과 같은 결과를 얻었다. 1. 23 편의 논문 중 review study가 3편, experimental study 6편, clinical study가 14 편이었다. 다양한 Journal에 발표되고 있었는데, review study는 모두 국내 학술지에 게재 된 논문이었고, 2000년 이후로 점차 연구의 양과 관심이 증대되고 있는 추세였다. 2. 배뇨장애는 하부요로증상의 다양한 증상을 포괄하는 것으로 한의학적인 측면에서는 융폐, 소편부금(小便不禁), 빈요(頻尿), 급박요(急迫尿), 요실금(尿失禁), 림증(淋證), 야뇨(夜尿), 난요(難尿), 점적요(點滴尿), 지연요(遲延尿)등에 해당하는데, 그 대부분의 유발 원인은 신기부족(腎氣不足)등의 하초허한(下焦虛寒)에 기인하는 것으로 판단되며, 간기울결(肝氣鬱結)등의 정서적 자극과 습열(濕熱) 및 어혈(瘀血)등의 원인에 의해서도 발생할 수 있다. 3. 배뇨장애에 대한 침구치료의 생리적 기전을 대략적으로 요약한다면 침자극에 의해 부교감 신경, 대뇌의 수면-각성 체계, 뇌교 및 척추 배뇨 센타, 음부신경/골반신경을 통해 방광에 영향을 주어 방광용량의 확장 또는 배뇨 수축의 억제작용을 하는 한편, 척추 환상 회로 나 신경연접부의 지속성 흥분을 통하여 요도주의 근육에 영향을 주는 것으로 생각되어 진다. 4. 배뇨장애에 대한 침구치료의 임상효과를 요약 한다면, 융폐, 소편부통(小便不通)에 속하는 신경인성 방광(Neurogenic Bladder), 소편부금(小便不禁), 빈요(頻尿), 급박뇨(急迫尿)에 해당하는 요실금(尿失禁)(Incontinence), 림증(淋證)에 해당하는 방광염(Cycitis), 액요(液尿) (Nocturnal Enuresis), 잡요(雜尿), 점적요(點滴尿), 지연요(遲延尿)에 해당하는 전립선염/골반통 증후군 (Prostatitis/Pelvic Pain Syndrom)등의 하부 요로증상에 침구치료는 유의미한 효과가 있다. 이상으로 국내 및 해외 연구는 최근들어 더욱 활발히 연구되고 있는데, 특히 해외연구는 배뇨 장애의 침구치료의 생리적 기전 분야에서 다양 하게 시도되고 있었다. 향후 고령화 사회로 진입 하는등 사회여건상 이와같은 다양한 배뇨장애 환자의 증가는 물론 치료욕구의 증대가 예상되는 바 이러한 생리적 치료기전의 연구 및 다양한 질환에 대한 임상연구를 시도함으로써 표준적인 치료기술의 개발이 필요할 것으로 사료된다.

• 한국전문물리치료학회지
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• 제26권3호
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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.

• 대한의료기공학회지
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• 제17권1호
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• pp.83-108
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• 2017

Objects : The purpose of this study was to investigate Urinary Incontinence improvement effect of Moosim Gi-Gong Riding stance and to propose urinary incontinence treatment Program. Methods : We analyzed the effect of Moosim Gi-Gong Riding stance, and compared to Behavior theraphy which includes Kegel Exercise, Riding Stance of Ki-chum, Zhan-Zhuang-Gong. Results : 1. Moosim Gi-Gong Riding stance can correct the pelvic strain with principles such as horseback riding and help restore organs in the abdominal cavity. 2. Moosim Gi-Gong Riding stance can restore the ability to recover bladder and proximal urethra in right place through changes in the abdominal pressure by breathing and posture 3. Moosim Gi-Gong Riding stance can help restoring the ability to control the urination by increasing the intensity of the abdominal pressure and reinforcing Kidney, Liver, Spleen Meridian muscles. 4. Reinforcing Kidney, Liver, Spleen Meridian muscles can help to treat urinary incontinence through strengthening the tension between organs and activating the intestinal tract. Conclusions : This study shows that treatment program for Urinary Incontinence using Moosim Gi-Gong Riding stance can be useful to patient.

• 대한의용생체공학회:의공학회지
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• 제22권1호
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• pp.101-108
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• 2001

본 논문에서는 뇨실금 환자들에 대한 지원 기술의 일환으로 인체에 무해하고 비침습적인 초음파를 이용하여 배뇨시기를 알려주기 위한 재택용 뇨의 경보기용 뇨량검출 센서의 개발과 이를 이용한 방광 벽간거리와 뇨량과의 상관관계에 관하여 연구하였다. 개발된 센서는 인체내에 침투력이 가장 좋은 중심 주파수가 2.25 MHz인 초음파를 사용하여 분해능을 높여 오차를 감소시킬 수 있는 구조로 설계하였다. 이 센서를 이용하여 방광전.후벽간의 거리를 검출하여 이로부터 뇨량을 정량적으로 측정하기 위한 기초 실험을 실시하였다. 기초실험은 건강한 성인 남자 3명을 대상으로 초음파 뇨량검출 센서를 이용한 초음파 RF 반사신호 획득장치와 초음파 진단기에 의한 2가지 방법으로 이루어졌고 그 결과 뇨량과 벽간거리와의 사이에는 높은 상관성이 있음을 확인할 수 있었다. 결론적으로, 실험 결과를 토대로 하여 제작된 초음파 뇨의 센서를 부착한 초음파 뇨의 경보 시스템은 뇨실금 환자로 하여금 배뇨시기를 알려주는 경보 시스템으로 보건.복지적인 측면에서 현대사회에 기여할 공헌도가 매우 클 것이라 생각된다.