Onay Yalcin

Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence.

We investigated the effectiveness of pelvic floor muscle (PFM) exercises or biofeedback for the treatment of urinary stress incontinence (USI). Fifty patients with USI were included in this randomized, controlled, prospective study. Twenty patients were taught PFM exercises via digital palpation and instructed to perform regularly as home program. The second group of 20 patients had PFM exercises via biofeedback three times a week for 2 months. The third group of 10 patients did not have any exercises. The patients were evaluated via pad test, perineometry, digital palpation based PFM strength, incontinence frequency, and visual analog scale based social activity index prior to and 8 weeks after the treatment. The first two groups had significant improvement in USI with respect to the control group (p < 0.001). The rise in PFM strength with perineometry of the biofeedback group was higher than in the digital palpation group after treatment (p < 0.001). PFM exercises are effective for the treatment of USI; the biofeedback method revealed better PFM strength results with respect to digital palpation.

Urinary Incontinence: Its Prevalence, Risk Factors and Effects on the Quality of Life of Women Living in a Region of Turkey

Background: The aim of this population-based cross-sectional study was to determine the prevalence and risk factors of urinary incontinence (UI) in women aged 20 years or older and to assess its influence on the quality of life (QOL). Materials and Methods: The study group was comprised of 625 women determined using the stratified sampling technique according to age and residence. The data were collected through a questionnaire and the Urinary Incontinence Quality of Life Instrument. Results: The prevalence of UI was 25.8%. UI was significantly associated with body mass index (OR 12.75, 95% CI 6.68–24.6), diabetes mellitus (OR 3.55, 95% CI 1.44–8.73), neurological disorders (OR 3.80, 95% CI 1.69–8.58), recurrent urinary tract infections (OR 4.73, 95% CI 2.52–8.88). Impairment of QOL was related with the type of UI, frequency of UI episodes, amount of leakage and UI during sexual intercourse. Conclusion: Our study results determined that UI is common in women. The QOL of women was either mildly and moderately affected by UI.

A study on urogenital complaints of postmenopausal women aged 50 and over

Objective.  The objective of this study was to determine the prevalence of urogenital complaints in postmenopausal women aged 50 and over.

Bladder Training and Kegel Exercises for Women with Urinary Complaints Living in a Rest Home

Background: Urinary incontinence is an annoying, uncomfortable and unpleasant condition affecting the elderly. The problem of bedwetting and other urinary complaints are common in rest homes. Objective: Our study aimed to determine the efficiency of bladder training and Kegel exercises for older women living in a rest home. Methods: This is an experimental prospective research study. Through a randomization process, 25 women were included in the treatment group, and another 25 were included in the control group. Participants were living in a rest home for women aged older than 65 years with urinary complaints. The pretreatment interview form, Quality of Life Scale, Mini-Mental Test, Rankin Scale, daily urinary forms and pad tests were administered to the treatment and control groups. Bladder training and Kegel exercises were given to the treatment group for 6–8 weeks. The second evaluation was performed 8 weeks after treatment, and the last evaluation was carried out 6 months after treatment. Results: The average age of the treatment group was 78.88 ± 4.80 years, and the average age of the control group 79.44 ± 5.32 years. Urgency, frequency and nocturia were common complaints. Pretreatment, 8-week and 6-month evaluations revealed that the amount of urinary incontinence with urgency, frequency and nocturia complaints statistically and significantly decreased in the treatment group compared to the control group. In the pad test results, a statistically significant decrease was observed in the treatment group compared to the control group. A significant increase in pelvic floor strength was observed in the treatment group compared to the control group upon all evaluations. Conclusion: Behavioral therapy can be used easily as an effective treatment for urinary incontinence in elderly women living at a rest home.

The effect of pelvic floor training on sexual function of treated patients

The aim of this study was to determine the effects of improvements in urinary incontinence resulting from pelvic floor rehabilitation on the sexual function of patients. The study involved 42 clinic patients who received pelvic floor rehabilitation treatment. Their sexual histories were obtained through face-to-face interviews. Pelvic muscle strength was measured with a perineometer. Improvement in incontinence was measured with the pad test. Seventeen women reported decreased sexual desire before the treatment; 5 of these indicated improvement after treatment. Nine of 17 women who experienced dyspareunia prior to treatment reported an improvement afterwards, and four women reported complete relief from pain. Five of 15 women who complained of difficulty in reaching climax before the treatment experienced improvement in this area. In conclusion, an improvement in sexual desire, performance during coitus and achievement of orgasm were observed in women who received pelvic floor muscle rehabilitation. No change was seen in the arousal and resolution stages of sexual activity.

Effect of pelvic floor muscle exercises in the treatment of urinary incontinence during pregnancy and the postpartum period

Introduction and hypothesisThe aim of this study was to determine the effectiveness of pelvic floor muscle exercises on urinary incontinence during pregnancy and the postpartum period.MethodsThe study was carried out on 80 pregnant women (study group, 40 subjects; control group, 40 subjects).The study group was trained by the researcher on how to do the pelvic floor muscle exercises. Both groups were evaluated for pelvic floor muscle strength and urinary complaints in their 36th to 38th week of pregnancy and postpartum sixth to eighth week.ResultsThe study group had a significant decrease in urinary incontinence episodes during pregnancy and in the postpartum period, and their pelvic floor muscle strength increased to a larger extent. Control group had an increase in the postpartum muscle strength and decrease in the incontinence episodes in the postpartum period.ConclusionsPelvic floor muscle exercises are quite effective in the augmentation of the pelvic floor muscle strength and consequently in the treatment of urinary incontinence.

Connective tissue alterations in women with pelvic organ prolapse and urinary incontinence

Background. Alterations in collagen synthesis and metabolism have previously been reported in patients with pelvic organ prolapse (POP) and/or urodynamic stress incontinence (USI). Since urinary incontinence does not always associate with POP, the objective of this study was to examine connective tissues from patients with USI plus POP, and patients with prolapse only. Methods. Biopsies from the uterosacral ligaments were obtained during the operation from POP patients (n =28), and from continent women (control group, n =12) who underwent surgery for other benign reasons. POP patients were classified following urodynamic tests and symptom questionnaire with respect to the presence (n =14) or absence (n =14) of USI. N‐terminal propeptides of collagen (PINP and PIIINP), TGF‐β and leptin were measured in plasma. Hydroxyproline and glycosaminoglycan (GAGs) concentrations and total hexosaminidase activity were measured in tissue samples. Histological sections were prepared using Massons trichrome technique, and digitised solutions were used for imaging provided by Soft Imaging System GmBh. Statistical evaluations were made by the Kruskal‐Wallis test. Results. A significant decrease in hydroxyproline content was found in USI+POP women in comparison to controls (p<0.05). In contrast, histopathological examination revealed an increased density of collagen in USI+POP patients. Hexosaminidase activity was decreased in both groups with POP, but no change in the amount of GAGs was observed. Markers of collagen synthesis (PINP, PIIINP), and factors related to the collagen synthesis (TGF‐β, leptin) remained unaltered. Conclusion. Our biochemical and morphological findings suggest a different organisation of collagen fibres in tissues of patients with USI+POP, when compared with both the controls and the POP patients.

Effect of Urinary Leakage on Sexual Function during Sexual Intercourse

Aim: This study was planned to determine the effect of urinary leakage on sexual function during sexual intercourse. Methods: The study group included 32 incontinent women who had urinary leakage during sexual intercourse and the control group consisted of 60 women with no such problem. The Sexual History Form of Schover and Jensen was completed in face-to-face interviews in a private room. Results: When compared with the women without any problem, the women with urinary incontinence were 4.7 times less satisfied with their sexual life and their partners had ejaculation without full erection 3.1 times more. In order to cope with the problem of urinary incontinence during coitus the women themselves adopted several methods. Trying to keep their partners unaware of the problem and deferring the intercourse were among the most frequently adopted methods. 43.7% of the study group indicated that this problem affected their sex life. Conclusions: The results of this study support the view that urinary leakage during coitus affects women’s sex life adversely.

Urinary incontinence (UI) and quality of life (QoL) of the elderly residing in residential homes in Turkey.

The objective of this study was to evaluate urinary incontinence (UI) and its effect on the quality of life (QoL) of older people dwelling in residential homes in Turkey. A cross-sectional study was applied in residential homes. A total of 1110 people older than 60 years residing in five selected residential homes were studied. An interview was conducted with the residents who had sufficient cognitive function and agreed to participate. The QoL and the mental and the functional state of the residents were analyzed using the Kings Health Questionnaire (KHQ), Mini Mental State Examination (MMSE), and the Rankin Scale, respectively: Of the total pool, 694 residents were included in the study of which 56.48% (n=392) were female and 43.52% (n=302) were male. UI was present in 170 women and 63 men. Pad usage was more common in women (88%) than that in men (29.1%). The QoL subdimensions showed that women had higher scores than men. Urge UI (UUI) had more impact on the QoL than that on functional, mixed or stress incontinence. We concluded that UI negatively affects the QoL of older people living in residential homes. In particular, women and patients suffering from UUI are more severely affected.

Effects of Percutaneous Tibial Nerve Stimulation Therapy on Chronic Pelvic Pain

Objective: This research is a prospective study which was designed to determine the effects of percutaneous tibial nerve stimulation (PTNS) therapy on the quality of life and sexual life of patients with chronic pelvic pain (CPP). Methods: The sample consisted of an experimental group (n = 12) and a control group (n = 12), in total 24 patients. The experimental group was treated with PTNS once a week (in total 12 sessions), while the control group received routine intervention. Results: The pain frequency and intensity in women who underwent PTNS decreased considerably. Women had less pain during sexual intercourse after PTNS. We determined in our study that PTNS improved the quality of life of women with CPP by decreasing the intensity of pain and contributed to a more comfortable performance of their daily activities. Conclusions: PTNS is a type of treatment which contributes to the quality of life of women with CPP by decreasing the intensity of pain.