• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.59-66
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• 2001

Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication. success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication. bladder perforation occurred in one patient(2.4%). residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instability were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.

• International Neurourology Journal
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• v.22 no.4
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• pp.305-312
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• 2018

Purpose: The aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon's specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset. Methods: We enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon's specialty and whether a preoperative UDS was performed. Results: The hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103-1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon's specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122-1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed. Conclusions: This population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon's specialty and that the reoperation rate according to the surgeon's specialty varied based on whether a preoperative UDS was performed.

• Journal of Korean Biological Nursing Science
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• v.11 no.2
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• pp.176-182
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• 2009

Purpose: This study was performed to investigate demographic and disease-related characteristics that influence lower urinary tract symptoms in middle-aged women. Methods: The participants in this study were 301 middle-aged women and they completed structured questionnaire between May to June, 2008. Lower urinary tract symptoms (LUTS) were measured with Bristol Female Lower Urinary Tract Symptoms-short form (BFLUTS-SF) and categorized as voiding, filling and incontinence symptoms. The data were analyzed by using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, and multiple regression with SPSS PC 15.0 version. Results: The participants who have higher economic status and drink alcohol were more likely to have LUTS score than other woman who have lower economic status and don't drink alcohol at all. Also, frequent childbirth experiences and chronic diseases conditions such as diabetes and heart disease are positively associated with LUTS score. The symptoms of filling and incontinence were affected by number of childbirth, alcohol drinking habit and chronic disease conditions while voiding symptom was influenced only by alcohol drinking habit. In multiple regression analysis, LUTS were significantly predicted by parity, drinking carbonated beverage and alcohol. Conclusion: For proper nursing care related to lower urinary tract symptoms, nursing intervention should focus on improving alcohol drinking habit and carbonated beverage comsumption.

• 한국보건간호학회:학술대회논문집
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• 2006.06b
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• pp.137-138
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• 2006

• Journal of Biomedical Engineering Research
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• v.27 no.4
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• pp.197-202
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• 2006

Devices in current market to perform electrical stimulation therapy of the urinary incontinence frequent in aging women are very much impractical to us ε due to the wired configuration. The present study implemented new wireless device to enhance self as well as in-hospital therapy with the easiest and the most convenient application. The therapy system consisted of two modules, called 'master' and 'slave', communicating with each other by the wireless Bluetooth protocol. The patient controls therapy processes on the master module in hand, transmitting the required informations to operate the slave module placed within her pants with the viginal electrode connected, delivering appropriate electrical stimulation. Wireless communication enabled self therapy with clothes on, leading to a great convenience for the patient. The stimulation output signal was comparable to commercialized products in both waveform and stimulation capacity.

• Journal of Korean Academy of Nursing
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• v.45 no.1
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• pp.35-45
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• 2015

Purpose: This study was done to determine whether muscle strength training programs have an impact on improving symptoms of urinary incontinence (UI) and physical function among elderly women with UI who reside in long-term care facilities. Methods: A randomized controlled trial was conducted. Participants had to be over 65 years, score over 15 score on the mini-mental state examination, and be able to walk alone or with an assistant. Seventy residents were randomly allocated to either the training group (n=35) or control group (n=35). The program consisted of 50 minutes, twice a week for 8 weeks, and included Kegel's exercise, Thera-band training and indoor walking. Main outcomes were UI symptoms, peak vaginal pressure and physical functions measured with timed up and go test (TUG), one leg standing test (OLST), activities of daily living (ADL) and grip strength. Changes in outcome measurements were calculated from baseline to 4 weeks and to 8 weeks using repeated measures ANOVA. Results: There were significant differences in peak vaginal pressure (p<.001), TUG (p<.001), OLST (p=.012) and grip strength (p<.001) in the interaction between groups and time. Conclusion: Future studies are suggested to confirm the effect of muscle strength training in long-term care facilities where elderly women with UI reside.

• 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.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.3
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• pp.123-138
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• 2010

Purpose: The purpose of this study is to identify the real condition of urinary incontinence(UI), interstitial cystitis(IC), atrophic viginitis(AV) for elderly women and analyze the cognition of traditional korean medicine(TKM) for them. Methods: We utilized questionnaire from May to June, 2010. Questionnaires were taken from 125 women using senior welfare center and nursing home, aged over 65 up to 92. The data were analyzed by $X^2$-test using SPSS/PC ver 18.0 program. Results: The prevalences of UI, IC and AV symptoms were 50.4%, 40.8%, 56%, respectively. The average I-QoL score for UI was $82.62{\pm}21.16$, and the average ICSI score for IC was $8.16{\pm}2.50$. After adjustment for each of the variables considered in this study, alcohol was associated with UI and age, BMI(body mass index) were associated with IC. Most of respondents have no experience(94.4%) or don't know (79.2%) about TKM for UI, IC and AV. 44 women(37.3%) indicated that they weren't willing to use TKM for UI, IC and AV. Reasons for not taking TKM were because of 'no knowledge of TKM(34.1%)' and 'more accustomed to western treatment(34.1%)'. Conclusion: Although the prevalence of UI, IC, AV for elderly women was high, the actual percentage of treatment for these diseases was low, furthermore, patients were not aware of TKM and had very few experiences of TKM for these diseases. The development and increased promotion about TKM program for elderly women's urogenital diseases is needed.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.2
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• pp.180-189
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• 2002

Purpose : This study focused on affirming of the effects of Dan-jun breathing exercise experienced by women in midlife. Method: The data were collected via direct interview from 20 participants, who participated in a Dan-Jun exercise program during three months. Collected data were analyzed by content analysis. Result : 1. As for the health problems of women in midlife before the Dan-jun exercise program, 93 items were extracted in the content analysis These items were categorized into 59 attributes and 15 higher attributes. 1) Of the 59 attributes of health problems, shoulder pain (30%) was the most dominant. 2) The 15 higher attributes consisted for the physical domain of, weakness, pain, joint stiffness, sexual problem, sleep disorder, gastro-intestinal disorder. menstrual irregularity. circulatory disorder, respiratory disorder. constipation, urinary incontinence, and for the psychological domain, anger, emptiness, depression, and anxiety. 2. As for the effects experienced by women in midlife after the Dan-jun exercise program, 169 items were extracted in the content analysis. These items were categorized into 85 attributes and 14 higher attributes. 1) Of 85 attributes, lightening of physical condition (55%) was the most dominant. 2) The higher attributes consisted in physical domain of, recovery of vigor, pain relief, menstrual regularity and improvements in flexibility. sexual problem, sleep disorder, gastro-intestinal disorder, circulatory disorder constipation, respiratory disorder and urinary incontinence, and for the psychological domain, relaxation, cultured mind and self-confidence. Conclusions : Dan-jun breathing exercise program for three months showed positive effects on physical and psychological health in women in midlife. In this context, it can be also considered as a significant nursing intervention for maintenance and promotion of the health of these women.