OBJECTIVES: To determine and summarize the available data on urinary, sexual, and health-related quality-of-life (HRQOL) outcomes after traditional radical cystectomy (RC), reproductive organ-preserving RC (ROPRC) and nerve-sparing RC (NSRC) for bladder cancer (BCa) in female patients. METHODS: The PubMed, SCOPUS and Web of Science databases were searched to identify studies reporting functional outcomes in female patients undergoing RC and urinary diversion for the treatment of BCa. The outcomes of interest were voiding function (for orthotopic neobladder [ONB]), sexual function and HRQOL. The following independent variables were derived and included in the meta-analysis: pooled rate of daytime and nighttime continence/incontinence, and intermittent self-catheterization (ISC) rates. Analyses were performed separately for traditional, organ- and/or nerve-sparing surgical approaches. RESULTS: Fifty-three studies comprising 2740 female patients (1201 traditional RC and 1539 organ-/nerve-sparing RC, and 264 nerve-sparing-alone RC) were eligible for qualitative synthesis; 44 studies comprising 2418 female patients were included in the quantitative synthesis. In women with ONB diversion, the pooled rates of daytime continence after traditional RC, ROPRC and NSRC were 75.2%, 79.3% and 71.2%, respectively. The pooled rate of nighttime continence after traditional RC was 59.5%; this rate increased to 70.7% and 71.7% in women who underwent ROPRC and NSRC, respectively. The pooled rate of ISC after traditional RC with ONB diversion in female patients was 27.6% and decreased to 20.6% and 16.8% in patients undergoing ROPRC and NSRC, respectively. The use of different definitions and questionnaires in the assessment of postoperative sexual and HRQOL outcomes did not allow a systematic comparison. CONCLUSIONS: Female organ- and nerve-sparing surgical approaches during RC seem to result in improved voiding function. There is a significant need for well-designed studies exploring sexual and HRQOL outcomes to establish evidence-based management strategies to support a shared decision-making process tailored towards patient expectations and satisfaction. Understanding expected functional, sexual and quality-of-life outcomes is necessary to allow individualized pre- and postoperative counselling and care delivery in female patients planned to undergo RC.
- MeSH
- cystektomie škodlivé účinky MeSH
- diverze moči * škodlivé účinky MeSH
- inkontinence moči * epidemiologie etiologie prevence a kontrola MeSH
- lidé MeSH
- močení MeSH
- močový měchýř chirurgie MeSH
- nádory močového měchýře * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
Cieľ: Primárnym cieľom práce bolo hodnotenie efektu pohybového tréningu a tréningu svalov panvového dna (PFMT – pelvic floor muscle training) s dvojitými – kognitívnymi úlohami u senioriek s dopadom na symptómy úniku moču, aktivity každodenného života a kvalitu života. Vzorka: Výskumnú vzorku tvorilo 80 senioriek s urgentnou inkontinenciou moču (s priemerným vekom 75 ± 4,3 roka). Boli rozdelené do dvoch skupín – experimentálnej (n = 40) a kontrolnej (n = 40). Intervencia: Dĺžka trvania intervencie – 12 týždňov. Obe skupiny mali pohybový tréning (cviky na posilnenie svalov dolných končatín, balančné cviky na statickú a dynamickú zložku rovnováhy) 3× týždenne v dĺžke trvania 30 min. Experimentálna skupina mala edukáciu o anatómii, fyziológii a funkcii svalov panvového dna. PFMT v rôznych polohách. PFMT s dvojitými úlohami 2× týždenne v dĺžke trvania 30 min. Metódy: Symptómy úniku moču boli hodnotené Modifikovaným mikčným denníkom, aktivity každodenného života boli hodnotené Dotazníkom funkčných aktivít a Barthelovým indexom. Kvalita života bola hodnotená dotazníkom EuroQol-5 Dimension (EQ-5D-5L). Výsledky: V počte močení cez deň a v noci boli po liečbe medzi skupinami zaznamenané signifikantné rozdiely p ≤ 0,001 v prospech experimentálnej skupiny. V počte urgencií po liečbe neboli medzi skupinami zaznamenané signifikantné rozdiely. V hodnotení funkčných aktivít, v Geriatrickej škále depresie, v Barthelovom indexe, v hodnotení kvality života dotazníkom EQ-5D-5L neboli po liečbe medzi skupinami zaznamenané signifikantné rozdiely. Záver: PFMT s dvojitými – kognitívnymi úlohami sa ukazuje byť efektívna intervencia v zlepšení symptómov úniku moču. Pohybový tréning a PFMT majú pozitívny vplyv na aktivity každodenného života a kvalitu života senioriek s urgentnou inkontinenciou moču.
Aim: The aim of the work was to evaluate the effect of pelvic floor muscle training (PFMT) combined with cognitive tasks in older women with an impact on the symptoms of urine leakage, activities of daily life and quality of life. Sample: The research sample consisted of 80 senior women with mixed urinary incontinence (with a mean age of 75 ± 4.3 years). They were divided into two groups – experimental (n = 40) and control (n = 40). Interventions: Duration of the intervention – 12 weeks. Both groups – physical training (exercises to strengthen the muscles of the lower limbs, and balance exercises for the static and dynamic components of balance) 3 times a week for 30 minutes. Experimental group – education on the anatomy, physiology and function of the pelvic floor muscles. PFMT in different positions, combined with cognitive tasks – 2 times a week for 30 minutes. Methods: Symptoms of urinary incontinence were assessed by a voiding diary, Activities of Everyday Life were assessed by the Functional Activity Questionnaire and the Barthel Index. Quality of life was assessed by the EuroQol-5 Dimension questionnaire (EQ-5D-5L). Results: In the number of urinations during the day and at night, significant differences p ≤ 0.001 in favour of the experimental group were noted between the groups after treatment. There were no significant differences in the number of urgencies after the treatment between the groups. There were no significant differences between the groups in the evaluation of functional activities, in the Geriatric Depression Scale, in the Barthel Index and in the evaluation of quality of life by the EQ-5D-5L questionnaire after treatment. Conclusion: PFMT with cognitive tasks with movement training proves to be a more effective therapeutic intervention not only in improving the symptoms of urine leakage compared to movement training alone. Physical training and PFMT have a positive effect on activities of daily living and the quality of life in older woman with mixed urinary incontinence.
Inkontinence neboli samovolný únik moči či stolice je onemocnění úzce spjaté s otázkou kvality života pacientů trpících tímto onemocněním, jelikož je vylučuje z řady společenských, pracovních i osobních aktivit. Dlouhodobé neřešení tohoto problému způsobuje nejen diskomfort pacienta, ale může vést až k tělesné i duševní invaliditě. Cílem tohoto článku je proto představit základní typy absorpčních zdravotnických prostředků, které lze poskytnout pacientům s močovou/fekální inkontinencí, se zřetelem na správné zacházení a používání těchto pomůcek.
Incontinence (spontaneous leakage of urine or stool) is a disease closely related to patients' quality of life as it excludes patients from a lot of social, work, and personal activities. A long-term overlooking of this problem causes discomfort to patients and can also lead to physical and mental invalidity. This article aims to present the basic types of absorbent medical devices that can be provided to patients with urinary/faecal incontinence, with a particular focus on the proper handling and use of these devices.
Cieľ: Hlavným cieľom článku je poukázať na benefity cvičenia počas tehotenstva a po tehotenstve. Typ štúdie: Prehľadový článok. Metodika: Vyhľadávanie metaanalýz a systémových prehľadov v databázach Pubmed, JCR, Medline, Scopus. Výsledky: Pravidelné cvičenie je asociované s nižším rizikom makrozómie a cisárskeho rezu počas pôrodu. Depresia je častou komplikáciou v prenatálnom a postnatálnom období v dôsledku zvýšeného stresu a nedostatočnej sociálnej podpory. Potenciálnu nefarmakologickú terapiu predstavuje cvičenie. Pravidelné cvičenie je spojené tiež so znížením glykémie a zlepšením inzulínovej senzitivity. Pre optimalizáciu hmotnosti a nadváhy patrí cvičenie medzi hlavné časti liečby. Ďalšou terapeutickou možnosťou využitia cvičenia je ovplyvnenie bolesti lumbosakrálnej oblasti a tiež bolesti v oblasti panvy. Samostatnou variantou cvičení sú cvičenia na posilnenie panvového dna. Cvičenie svalov panvového dna v perinatálnom období je účinnou metódou na prevenciu popôrodnej inkontinencie moču. Záver: Cvičenia predstavuje významnú časť terapie v prenatálnom a postnatálnom období.
Aim: The main aim of the article is find benefits of exercise during and after pregnancy. Study type: Review article. Methods: Search for meta-analyzes and system reports in PubMed, JCR, Medline, Scopus databases. Result: Regular exercise is associated with a lower risk of macrosomy and caesarean section during childbirth. Depression is a common complication in the prenatal and postnatal period due to increased stress and insufficient social support. Exercise is a potential non-pharmacological therapy. Regular exercise is also associated with lowering blood glucose and improving insulin sensitivity. To optimize weight and overweight, exercise is one of the main parts of treatment. Another therapeutic possibility of using the exercise is to influence the pain in the lumbosacral area and also the pain in the pelvic area. Another variant of exercises are exercises to strengthen the pelvic floor. Exercise of the pelvic floor muscles in the perinatal period is an effective method for preventing postpartum urinary incontinence. Conclusion: Exercise is an important part of therapy in the prenatal and postnatal period.
- MeSH
- cvičení * MeSH
- deprese prevence a kontrola MeSH
- gestační diabetes prevence a kontrola MeSH
- inkontinence moči prevence a kontrola MeSH
- lidé MeSH
- těhotenství * MeSH
- Check Tag
- lidé MeSH
- těhotenství * MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Aim:The study aimed to identify risk factors for urinary incontinence in women over 20 years of age in Istanbul.Design:Thestudy was designed as a descriptive, retrospective, case control study.Methods:The study was conducted inaurogynecological unit at a university hospital in Istanbul. In total, 367 incontinent women who visited theurogynecological unit, and 401 continent women who visited outpatient clinics with other gynecological symptoms were included. Data were gathered via face-to-face interviews, using a questionnaire on risk factors for urinary incontinence. Adjusted odds ratios were given using logistic regression.Results:Variables which were found to be significantly different inchi-square analysis for urinary incontinence were age, education, marital status, number of pregnancies, birthand curettage, characteristics of first vaginal delivery (delivery mode, place, interventions), menopause, hormone therapy,history ofgynecological operation, pulmonary disease, diabetes mellitus, hypertension, medicine use,constipation, flatus, hemorrhoids, herniated disc/varicose veins,stria during pregnancy, caffeine > 2cups/day,body mass index (BMI ≥ 25kg/m2), weight gain ≥10kg, fecal incontinence, and history of urinary incontinence in childhood, in patients’ mothers and relatives. When these variables were assessed inmultivariate logistic regression analysis, number of births (“1-birth” OR=38.8;CI=2.2–669.5; “2-births” OR=20.1;CI=1.2–327.4; “≥ 3-births” OR=35.0;CI=1.9–621.8), BMI ≥ 25 kg/m2(OR=7.2;CI=2.1–24.1),andhistory of incontinence in mothers (OR=7.2;CI=1.3–37.2) were identified as significant risk factors.Conclusion:The main risk factors for urinary incontinence in the population under study wereidentified to be the number ofbirths as an obstetric risk factor, obesity as alifestyle factor, and ‘incontinence in mothers’ as a familial factor.
- MeSH
- dospělí MeSH
- inkontinence moči * epidemiologie etiologie komplikace prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- regresní analýza MeSH
- rizikové faktory MeSH
- rozhovory jako téma MeSH
- statistika jako téma MeSH
- studie případů a kontrol * MeSH
- těhotenství statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- těhotenství statistika a číselné údaje MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Turecko MeSH
- MeSH
- erektilní dysfunkce diagnóza terapie MeSH
- hyperplazie prostaty diagnóza farmakoterapie MeSH
- inkontinence moči * diagnóza farmakoterapie klasifikace prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- primární zdravotní péče MeSH
- symptomy dolních močových cest diagnóza etiologie farmakoterapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- novinové články MeSH
- rozhovory MeSH
- MeSH
- fekální inkontinence komplikace prevence a kontrola psychologie MeSH
- inkontinence moči komplikace prevence a kontrola psychologie MeSH
- lidé středního věku MeSH
- pomůcky pro sebeobsluhu využití zásobování a distribuce MeSH
- senioři MeSH
- vložky pro inkontinentní pacienty využití zásobování a distribuce MeSH
- ženy MeSH
- Check Tag
- lidé středního věku MeSH
- senioři MeSH
Inkontinence moče je jakýkoliv (i malý) nedobrovolný únik moče. Postihuje všechny věkové kategorie, děti nevyjímaje. Jelikož se ale močové cesty vyvíjí až do 12 let, je možno do tohoto věku únik tolerovat jako fyziologický. Následně se stává zatěžujícím jak psychicky i sociálně, tak ekonomicky. Přesná statistika o výskytu není zcela objektivní. Mnozí pacienti o problému nemluví, zejména pacienti v sociálních zařízeních nebo osoby starší 60 let, ale i mladší, kteří se za svůj problém stydí, i když se osvěta o tomto problému zlepšila.
Urine incontinence is any (even small) involuntary leakage of urine. It affects all ages, including children. However, as the urinarytract develops for up to 12 years, the leakage can be tolerated as physiological until this age. Then it becomes burdensome psychologicallyand socially as well as economically. Accurate statistics on occurrence are not entirely objective. Many patients donot talk about the problem. For example: patients in social facilities, persons over the age of 60th or many younger patients whoare ashamed to talk about their problem, despite the raising the awareness of this issue.
- MeSH
- inkontinence moči * diagnóza klasifikace prevence a kontrola terapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: The advent of robotics has facilitated new surgical techniques for radical prostatectomy. These allow adjustment of pelvic anatomical and functional relationships after removal of the prostate to ameliorate postprostatectomy incontinence (PPI) and reduce the time to complete continence. OBJECTIVES: To describe the results of a new surgical technique for reconstruction of vesicourethral anastomosis using the levator ani muscle for support during robot-assisted radical prostatectomy (RARP). DESIGN, SETTING, AND PARTICIPANTS: A prospective, randomised, single-blind study among 66 consecutive patients with localised prostate cancer (cT1-2N0M0) undergoing RARP from June to September 2014, 32 using the new technique and 34 using the standard posterior reconstruction according to Rocco. SURGICAL PROCEDURE: In the advanced reconstruction of vesicourethral support (ARVUS) intervention group, the fibres of the levator ani muscle, Denonvilliers fascia, retrotrigonal layer, and median dorsal raphe were used to form the dorsal support for the urethrovesical anastomosis. Suture of the arcus tendineus to the bladder neck served as the anterior fixation. MEASUREMENTS: We compared demographic data and preoperative and postoperative functional and oncologic results for the two groups. The primary endpoint was continence evaluated at different time points (24h, 2, 4, and 8 wk, and 6 and 12 mo). The secondary endpoints were perioperative and postoperative complications and erectile function. RESULTS AND LIMITATIONS: Using a continence definition of 0 pads/d, the continence rates for the ARVUS versus the control group were 21.9% versus 5.9% at 24h (p=0.079), 43.8% versus 11.8% at 2 wk (p=0.005), 62.5% versus 14.7% at 4 wk (p<0.001), 68.8% versus 20.6% at 8 wk (p<0.001), 75.0% versus 44.1% at 6 mo (p=0.013), and 86.66% versus 61.29% at 12 mo (p=0.04). International Index of Erectile Function questionnaire results at 6 and 12 mo after surgery showed similar potency rates for the control group (40.0% and 73.33%) and the ARVUS group (38.8% and 72.22%). There were four postoperative complications (2 in each group): three haematomas requiring transfusion and one lymphocele that needed drainage. No urinary retention, anastomosis leak, or perineal pain was observed. Limitations include the small sample size and the single-institution design. CONCLUSIONS: The ARVUS technique yielded better urinary continence results than standard posterior reconstruction, with no negative impact on erectile function, complication rate, or oncologic outcome. External validation is warranted before clear recommendations can be made. PATIENT SUMMARY: We showed that postprostatectomy incontinence can be assuaged using a new technique for vesicourethral anastomosis reconstruction during robot-assisted radical prostatectomy (RARP). This could significantly improve the quality of life of patients after RARP. More studies are needed to support our results.
- MeSH
- anastomóza chirurgická metody MeSH
- inkontinence moči prevence a kontrola MeSH
- jednoduchá slepá metoda MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- močový měchýř chirurgie MeSH
- nádory prostaty chirurgie MeSH
- netěsnost anastomózy epidemiologie MeSH
- pánevní dno chirurgie MeSH
- pooperační komplikace epidemiologie prevence a kontrola MeSH
- prostatektomie metody MeSH
- retence moči epidemiologie MeSH
- roboticky asistované výkony metody MeSH
- senioři MeSH
- uretra chirurgie MeSH
- výsledek terapie MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
