Carol A. Brink

A digital test for pelvic muscle strength in women with urinary incontinence.

This article reports further experience with a Version 2 digital test performed on 208 community-residing women, 25 to 87 years old. Test-retest (n = 208) and interrater reliability (n = 36) scores for pressure, displacement, and duration were r = .54, .51, and .53 and r = .67, .73, and .55, respectively. Interrater reliability percentage agreement figures were exact for 94% of the women on pressure and 67% on displacement. With duration permitted to vary by 1 second, agreement was 75%. Validity was tested using vaginal electromyography score with correlation coefficients ranging from .37 to .63. A weak but significant correlation was found between the digital score and the stand-up test pad gain (r = -.12). No significant relationship was found between the digital test and a history of being able to stop the urine stream or other leakage measures. To address limitations in Version 2, a third version of the digital scale is proposed.

Pelvic Muscle Exercise for Stress Urinary Incontinence in Elderly Women

To compare pelvic muscle exercise to pharmacologic treatment of stress urinary incontinence, the most common cause of urine leakage reported by community‐living elderly women.

Psychological factors associated with urinary incontinence.

This nursing study about women with urinary incontinence was designed to explore (1) the incidence of depression in women with urinary incontinence, (2) the correlation between mastery and depression and/or self-esteem and depression in women with urinary incontinence, and (3) depression as a mediating factor in the quality of life (QOL) in these women. This study found a higher incidence of depression in women with urinary incontinence compared with the general population. Correlational and multiple regression analyses both revealed strong and significant relationships between the independent variables of mastery and self-esteem and the dependent variable of depression. Depression did not emerge as a mediator in QOL. When mastery, depression, and self-esteem were considered together, mastery was the only predictor with a direct effect on QOL in women with urinary incontinence. Nursing interventions aimed at increasing womens sense of mastery may be effective in decreasing depression and improving the QOL.

Comparison of self-reported voided volume with cystometric bladder capacity

We determined the validity of cystometric bladder capacity compared to self-reported voided urine volumes measured by the patient at home. The subjects included 200 ambulatory incontinent women 55 or more years old who were evaluated with a prospective protocol of home diaries, history, physical examination and urodynamic studies. The mean smallest and largest daily voided volumes, and the daily mean of all voided volumes were determined from the diary. Comparison of the cystometric bladder capacity with the daily voided volumes showed a significant positive correlation between cystometric bladder capacity and the largest voided volume (r equals 0.4938, p less than 0.01). Comparison of the mean daily and mean largest daily void, and the cystometric capacity with the different urodynamic diagnoses using analysis of variance revealed a statistical significance among the groups (p less than 0.01). We established the validity of cystometric bladder capacity in the measurement of functional bladder volume and that a home diary may be useful in clinical practice.

Digital measurement of pelvic muscle strength in childbearing women.

Fourteen primigravidas were evaluated at 32 and 36 weeks antepartum (AP) and 6 weeks postpartum (PP) to test the reliability and validity of a digital measure of pelvic muscle strength using urine control as the criterion. In- terrater reliabilities ranged from .67 to .77. Convergent validity was shown by negative correlations between clinical muscle scores and time required to interrupt urine flow at 32 weeks AP (r = −.41), 36 weeks AP (r = −.64) and 6 weeks PP (r = −.71). Validity was also demonstrated in a pattern of lower scores in women who had urine loss during coughing or reported incontinence as compared with those who did not. Women who had cesarean births had higher postpartum pelvic muscle scores with progressively lower scores demonstrated by those who gave birth vaginally without laceration, with episiotomy, and with laceration, F (3, 10) = 5.40, p = .02.

Relationship between drug use and urinary incontinence in elderly women.

Two hundred older women with urinary incontinence were studied to observe the influence of their prescription and nonprescription drug use on symptoms of incontinence. Ninety percent of women reported using medication, with an average use of four drugs. Medications statistically associated with urinary incontinence symptomatology were prostaglandin inhibitors, diuretics, and estrogen therapy. Further studies are needed to clarify the relationship between medication usage and the presence and severity of urinary incontinence.