Continence (Amsterdam, Netherlands)最新文献

{"title":"Is there any association between socio-demographic characteristics and presenting complaints in patients with posterior compartment pelvic floor disorders?","authors":"Tanzeela Gala ,&nbsp;Abigail Fernandes ,&nbsp;Mehak Saini ,&nbsp;Carlotta Sarzo ,&nbsp;Noman Shahzad ,&nbsp;Carlene Igbedioh ,&nbsp;Alexis Schizas ,&nbsp;Alison Hainsworth ,&nbsp;Linda Ferrari","doi":"10.1016/j.cont.2024.101736","DOIUrl":"10.1016/j.cont.2024.101736","url":null,"abstract":"<div><h3>Introduction:</h3><div>Posterior compartmental pelvic floor disorders (PC-PFD) include symptoms of anal incontinence, obstructed defaecation (ODS) and functional anal pain <span><span>[1]</span></span>. According to the pelvic floor report in 2021, 6.5 million people suffered from bowel problems in the UK.</div><div>We determined the association of socio-demographic and clinical characteristics with presenting complaints in patients with PC-PFD and prevalence of the type of presenting complaint.</div></div><div><h3>Methods:</h3><div>This is a cross-sectional single-institution study of patients with (PC-PFD)reviewed in a tertiary pelvic floor unit between 2013 and 2019. Data was collected for socio-demographics from a prospectively maintained database and retrospectively for clinical factors.</div></div><div><h3>Results:</h3><div>Initial appointment was attended by 1956 patients with a mean age of 52.9 <span><math><mrow><mo>+</mo><mo>/</mo><mo>−</mo></mrow></math></span> 15.5 years. The. Main presenting complaints reported were obstructive defaecation (ODS – <span><math><mi>n</mi></math></span> = 819, 42.2%), anal incontinence (AI) (503, 25.9%), mixed (ODS and AI) (411, 21.2%), rectal prolapse (84, 4.3%), other complaints (rectal pain or bleeding – <span><math><mrow><mi>n</mi><mo>=</mo><mn>84</mn></mrow></math></span>, 4.3%) and symptoms of vaginal prolapse (38,2.1%).</div><div>ODS was associated with age &lt; 50 years, female gender and episiotomy while AI was associated with parity and prior hysterectomy and pelvic floor surgery. Rectal prolapse was associated with female gender while other complaints with age &lt; 50 years.</div></div><div><h3>Conclusion:</h3><div>This study reports socio-demographic and clinical risk factors associated with presenting complaints in patients with PC-PFD. This can form a basis for future prospective research to take initiatives for creating awareness about PC-PFD and identify symptoms in high-risk patients early to offer treatment or make timely referral from the community or primary care.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101736"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in colorectal Pelvic Floor Disorders among low Socioeconomic Status and ethnic groups","authors":"Aliki Rompou,&nbsp;Carlotta Sarzo,&nbsp;Abigail Fernandes,&nbsp;Fernando Safadi,&nbsp;Maxwell Renna,&nbsp;Alison Hainsworth,&nbsp;Linda Ferrari","doi":"10.1016/j.cont.2024.101734","DOIUrl":"10.1016/j.cont.2024.101734","url":null,"abstract":"<div><h3>Rationale:</h3><div>While anxiety and depression are noted in Pelvic Floor Disorders (PFD) patients, their influence on care and association with Socioeconomic Status (SES) and ethnicity are unstudied.</div></div><div><h3>Objective:</h3><div>To assess the impact of psychiatric conditions on PFD among ethnic minorities and different SES.</div></div><div><h3>Methods:</h3><div>A retrospective study conducted at Guy’s and St Thomas’ Hospital, London, UK. Patient demographics, main complaints, symptoms, psychiatric disorders, and data related to the entire care process were collected.</div><div>To assess the patients’ SES, we used the Index of Multiple Deprivation scores and grouped them into quintiles, with the lowest quintile representing the most deprived. Statistical tests evaluated how the care process differed between patients with and without psychiatric disorders, anxiety, or depression.</div></div><div><h3>Findings:</h3><div>Out of 2001 patients, 399 had at least one psychiatric disorder. These patients had higher rates of fecal​ incontinence (p = 0.02) and missed follow-up appointments more often (p = 0.005). No significant differences in clinical variables were found between patients with and without anxiety. Patients with depression had higher rates of anal incontinence (p = 0.005) and higher rates of referrals from the Telephone Assessment Triage Clinic to tests, diagnostic tests, and discussions in multidisciplinary meetings (p = 0.03, p = 0.04, p = 0.04). Furthermore, they were less likely to complete the care cycle (p = 0.02).</div></div><div><h3>Conclusions:</h3><div>This study highlights the impact of depression on patient care, underscoring the need to prioritize mental health for optimal treatment. No significant associations were found between psychiatric disorders and SES or ethnicity. Larger future studies are needed to explore potential correlations and develop targeted emotional support strategies.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101734"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urodynamic assessment of lower urinary tract function for women with symptoms of stress urinary incontinence. ICS Educational Module","authors":"Maurizio Serati ,&nbsp;Tufan Tarcan ,&nbsp;Anna Padoa ,&nbsp;Hashim Hashim ,&nbsp;Andrea Braga ,&nbsp;Karl Dietrich Sievert ,&nbsp;Peter F.W.M. Rosier","doi":"10.1016/j.cont.2024.101722","DOIUrl":"10.1016/j.cont.2024.101722","url":null,"abstract":"<div><h3>Aims:</h3><div>To present the body of evidence about the practice of objective assessment of lower urinary tract (LUT) function and dysfunction of female patients with stress urinary incontinence symptoms It serves as a scientific background review and evidence base for a presentation made available on the International Continence Society (ICS) website.</div></div><div><h3>Methods:</h3><div>This narrative review has been prepared by a working group instituted by the ICS Urodynamics Committee. The method to develop the educational module used included narrative literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel.</div></div><div><h3>Results:</h3><div>On the basis of the available guidelines and articles, we addressed the following topics: Indications for comprehensive urodynamic study (UDS); the best way to inform and prepare the patient; the urodynamic study protocol in women with SUI; the practice of the different tests (cystometry with pressure flow study, leak point pressure and urethral pressure profile).</div></div><div><h3>Conclusions:</h3><div>This ICS teaching module includes an expert-based profile of patients with signs and symptoms of SUI that can be considered complicated and includes specific recommendations for the practice of testing. UDS helps diagnosing the dysfunction that leads to the symptoms. Most of the testing for women with stress urinary incontinence can be performed in the already standardized manner; some adaptions of practice and evaluation are mentioned.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101722"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of missed hospital appointments in patients with posterior compartment pelvic floor disorders in a tertiary referral centre","authors":"Tanzeela Gala ,&nbsp;Mehak Saini ,&nbsp;Abigail Fernandes ,&nbsp;Carlotta Sarzo ,&nbsp;Noman Shahzad ,&nbsp;Carlene Igbedioh ,&nbsp;Alexis Schizas ,&nbsp;Linda Ferrari ,&nbsp;Alison Hainsworth","doi":"10.1016/j.cont.2024.101729","DOIUrl":"10.1016/j.cont.2024.101729","url":null,"abstract":"<div><h3>Aim:</h3><div>Missed hospital appointments pose a major challenge to the healthcare system leading to worse patient outcomes. We ascertained the incidence of missed hospital appointments in patients with Posterior Compartment Pelvic Floor Disorders (PC-PFD) and associated socio-demographic and clinical predictors.</div></div><div><h3>Methods:</h3><div>This is a cross-sectional single-institution study from a tertiary pelvic floor unit (PFU) with data collected from a prospectively maintained database.</div><div>A missed appointment was marked if patients did not​ attend two consecutive appointments without informing or asking to re-schedule and were recorded for Telephone Triage Assessment Clinic (TTAC), Specialist-nurse, face-to-face bowel function clinic (BFC), Investigations including endoanal (EAUS) and pelvic floor ultrasound (PFUS) and defaecating proctogram (DP). All results yielding p&lt;0.05 were considered significant.</div></div><div><h3>Results:</h3><div>PFU received 2001 referrals between 2013 and 2019 with a mean age of 52 years. Missed appointments recorded were: TTAC — 45 (2.2%), BFC — 309 (15.8%), EAUS — 476(24%), PFUS — 484(37.2%) and DP — 432(26.2%).</div><div>Predictors determined were: Male gender, age &lt;50 years, complaints of rectal pain and bleeding for missing telephone and face-to-face appointments, low socioeconomic status for missing face-to-face appointments, and mixed and other ethnic groups with missing telephone appointments.</div></div><div><h3>Conclusion:</h3><div>This is the first study to report the incidence and socio-demographic and clinical predictors for missed appointments in patients with PC-PFD. Future prospective research, including qualitative studies interviewing patients, is needed to identify and address potential barriers patients face when accessing care for PC-PFD. This will help improve patient care and allow better utilisation of already constrained healthcare resources.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101729"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive therapies for older patients with urgency urinary incontinence: Current evidence and recommendations","authors":"Jacqueline Zillioux ,&nbsp;Amrita Ladwa ,&nbsp;Parker Holum ,&nbsp;Howard B. Goldman","doi":"10.1016/j.cont.2024.101733","DOIUrl":"10.1016/j.cont.2024.101733","url":null,"abstract":"<div><div>Overactive bladder (OAB) and urgency urinary incontinence (UUI) disproportionately affect older patients and overlap with multiple geriatric syndromes including frailty and cognitive impairment. Given concerns regarding polypharmacy and anticholinergic risks in older patients, there has recently been a push from multiple societies to eliminate the concept of “step therapy” and offer patients more individualized treatment options. This may involve offering minimally invasive therapies, traditionally referred to as “third line therapies”, without requiring trials of non-invasive or pharmacologic management. This narrative review considers current evidence and recommendations for minimally invasive therapies (onabotulinumtoxin A (BTX), sacral neuromodulation (SNM), percutaneous tibial nerve stimulation (PTNS), and implantable tibial nerve stimulation (ITNS)) in older and frail patients. There are no data to support one minimally invasive therapy over another. BTX and SNM may have slightly lower efficacy compared to younger patients, but the clinical relevance of this difference is unclear. BTX may have a higher risk of UTI and retention in older frail patients. While cognitive impairment alone should not preclude SNM, it is important to consider if planning for SNM. PTNS is the lowest risk option but carries a significant logistical burden that may reduce adherence. ITNS may mitigate this logistical burden; however, there are minimal data specific to this group and older frail patients may not be appropriate candidates. Ultimately, older patients with or without frailty should be considered candidates for minimally invasive therapies for OAB/UUI as available data support their safety and efficacy in these populations. However, there may be unique considerations for this group and treatment decisions should be individualized and based on shared decision making.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101733"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Fowler’s syndrome—Patient led phenotyping of 265 patients","authors":"Peter F.W.M. Rosier","doi":"10.1016/j.cont.2024.101730","DOIUrl":"10.1016/j.cont.2024.101730","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101730"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-mesh stress incontinence surgery review: Bulking agents, autologous fascial slings and colposuspension","authors":"Victoria Asfour ,&nbsp;Stergios Doumouchtsis ,&nbsp;Gamal Ghoneim ,&nbsp;Simon Emery ,&nbsp;Wael Agur","doi":"10.1016/j.cont.2024.101727","DOIUrl":"10.1016/j.cont.2024.101727","url":null,"abstract":"<div><div>Increasing concerns over pelvic mesh procedures have resulted in a revival, development and modifications of older procedures. In this review we will discuss indications, procedure details, as well as risks and benefits of non-mesh alternative procedures. This review covers bulking agents, autologous fascial slings and colposuspension. Urethral bulking agent injections offers the lowest risk and quickest recovery, often performed with local anaesthetic in the out-patient setting, making it suitable even for the most frail and elderly patients.</div><div>The evolution of technique in autologous fascial slings is described: from an obstructive continuous loop, to the current technique that is less invasive; with likely better safety profile. Graft can be harvested from the rectus sheath or the fascia lata. ‘Colposuspension’ constitutes of a constellation of retropubic urethropexy procedures that are technically different, in terms of approach,e.g. open/ laparoscopic, access, e.g. intra- or extra peritoneal, as well as suture placement characteristic to named techniques. The evidence on safety and efficacy presented in Cochrane reviews is summarised. The efficacy data from the randomised controlled trials comparing bulking agents, autologous fascial slings,and colposuspension techniques at long term follow up is discussed.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101727"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A database structure for urodynamic records","authors":"A. Gammie ,&nbsp;L. Thomas ,&nbsp;A. Bacon ,&nbsp;H. Yasmin ,&nbsp;R. Axell ,&nbsp;T. Greenwell ,&nbsp;H. Hashim","doi":"10.1016/j.cont.2024.101728","DOIUrl":"10.1016/j.cont.2024.101728","url":null,"abstract":"<div><div>A database of reliable, screened, good quality data is a vital tool for research. We present the structure of a database for urodynamic data that has been developed and proven in use by two major UK urology centres. We share with this paper a spreadsheet of the data structure for others to copy and use in their own departments, in the hope that clinical services can be streamlined, research encouraged and data easily combined for large studies. We also describe screening criteria to facilitate the removal of anomalous or erroneous data entries.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101728"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal LASER and estrogen comparison in Genitourinary Syndrome of Menopause","authors":"Aytaj Jafarzade ,&nbsp;Aydan Biri ,&nbsp;Osman Ufuk Ekiz ,&nbsp;Tamer Mungan","doi":"10.1016/j.cont.2024.101724","DOIUrl":"10.1016/j.cont.2024.101724","url":null,"abstract":"<div><h3>Aim:</h3><div>This study aims to compare the efficacy of CO2 fractionated laser therapy and topical estrogen treatment in managing Genitourinary Syndrome of Menopause (GSM).</div></div><div><h3>Materials and Methods:</h3><div>A total of 88 patients diagnosed with GSM were included in this retrospective study. Of these, 39 received CO2 fractionated laser treatment, while 49 were treated with topical estrogen. Patients whose treatment was completed 1 to 1.5 months prior and had pre-treatment Vaginal Health Index (VHI) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scored recorded were included in the study. These patients were invited for a follow-up visit, during which post-treatment VHI and ICIQ-SF scores were assessed by a physician.</div></div><div><h3>Results:</h3><div>Both the laser and estrogen groups showed significant improvements in VHI and ICIQ-SF scores after treatment (p &lt; 0.00001 for both groups). No statistically significant difference was found between the post-treatment VHI and ICIQ-SF scores of the two groups (p &lt; 0.923 and p &lt; 0.579, respectively).</div></div><div><h3>Conclusion:</h3><div>Although there was no significant difference in the treatment efficacy between estrogen and CO2 fractionated laser therapy, there was a considerable difference in cost, with CO2 fractionated, with laser treatment being 23–24 times more expensive. Therefore, CO2 fractionated laser therapy, which shows similar short-term efficacy to topical estrogen, may be more suitable for patients where hormone therapy is contraindicated.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101724"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short and long-term clinical results of a minimally invasive syringe adapter for catheter free instillation of intravesical treatments","authors":"Ria Pothoven ,&nbsp;Judith A.M. Derks ,&nbsp;Erik Arendsen ,&nbsp;Dick A.W. Janssen","doi":"10.1016/j.cont.2024.101723","DOIUrl":"10.1016/j.cont.2024.101723","url":null,"abstract":"<div><h3>Introduction:</h3><div>Intravesical treatment is currently dependent on catheterization which can cause urethral discomfort and risk of urinary tract infections in selected patient groups such as interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder syndrome (OAB) and recurrent urinary tract infections (rUTI). This study describes real-life clinical experience of a minimally invasive syringe adapter (Ialuadapter®) for catheter-free instillation of intravesical treatment.</div></div><div><h3>Methods:</h3><div>A retrospective study from a single center was performed. Quantitative and qualitative data was obtained on the use of the syringe adapter (Ialuadapter®) in 61 patients with IC/BPS (n=48), rUTI (n=6) and mixed /other diagnoses (including OAB; n= 7) who were receiving intravesical therapy. The evaluation period was 6 months during 2018–2019. Reasons for trying the syringe adapter, reasons for continuing with it and occurrence of UTIs before and during the evaluation period were recorded. In addition, 3 year follow-up data were obtained to assess long-term usage of the syringe adapter.</div></div><div><h3>Results:</h3><div>Mean follow-up was 4 months. The use of the syringe adapter was successful in 75% and a positive experience in 74% with the latter continuing to use the syringe adapter. Long-term (&gt;3 yrs) adherence of 40% was observed. The patients reported less pain (41%) while 23% reported that it was easier to use compared to conventional catheters. Only 6 UTIs were observed in the follow-up period.</div></div><div><h3>Discussion and conclusions:</h3><div>This retrospective study shows that the Ialuadapter® is a good, safe alternative to conventional catheterization for intravesical treatment.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101723"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}