Urinary Incontinence: Diagnosis and Treatment in the Elderly

Greer, Joy A.; Arya, Lily A.; Smith, Ariana L.

doi:10.1007/s13670-013-0037-6

Cited by 13 publications

(7 citation statements)

References 97 publications

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“…In the case of pelvic floor muscle hypertonic dysfunction, many non-invasive techniques are available. Physiotherapy is the first-line conservative therapy but has the disadvantage of having slow progression and low patient adherence and compliance with treatment [ 49 , 50 ]. The same thing can be said for Kegel exercises, whose effectiveness is reduced because they are often performed inconsistently or incorrectly over time by patients.…”

Section: Discussionmentioning

confidence: 99%

Changes in Pelvic Floor Ultrasonographic Features after Flat Magnetic Stimulation in Women with Chronic Pelvic Pain and Levator Ani Muscle Hypertonicity

Barba,

Cola,

De Vicari

et al. 2024

Medicina

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Background and Objectives: Chronic pelvic pain (CPP) represents a major public health problem for women with a significant impact on their quality of life. In many cases of CPP, due to gynecological causes—such as endometriosis and vulvodynia—improper pelvic floor muscle relaxation can be identified. Treatment of CPP with pelvic floor hypertonicity (PFH) usually involves a multimodal approach. Traditional magnetic stimulation has been proposed as medical technology to manage muscle hypertonicity and pelvic pain conditions through nerve stimulation, neuromodulation, and muscle relaxation. New Flat Magnetic Stimulation (FMS)—which involves homogeneous rather than curved electromagnetic fields—has the potential to induce sacral S2–S4 roots neuromodulation, muscle decontraction, and blood circulation improvement. However, the benefits of this new technology on chronic pelvic pain symptoms and biometrical muscular parameters are poorly known. In this study, we want to evaluate the modification of the sonographic aspect of the levator ani muscle before and after treatment with Flat Magnetic Stimulation in women with chronic pelvic pain and levator ani hypertonicity, along with symptoms evolution. Materials and Methods: A prospective observational study was carried out in a tertiary-level Urogynaecology department and included women with CPP and PFH. Approval from the local Ethics Committee was obtained before the start of the study (protocol code: MAGCHAIR). At the baseline, the intensity of pelvic pain was measured using a 10 cm visual analog scale (VAS), and patients were asked to evaluate their pelvic floor symptoms severity by answering the question, “How much do your pelvic floor symptoms bother you?” on a 5-answer Likert scale. Transperineal ultrasound (TPU) was performed to assess anorectal angle (ARA) and levator ani muscle minimal plane distance (LAMD). Treatment involved Flat Magnetic Stimulation alone or with concomitant local or systemic pharmacological therapy, depending on the patient’s preferences. FMS was delivered with the DR ARNOLD system (DEKA M.E.L.A. Calenzano, Italy). After the treatment, patients were asked again to score the intensity of pelvic pain using the 10 cm visual analog scale (VAS) and to evaluate the severity of their pelvic floor symptoms on the 5-answer Likert scale. Patients underwent TPU to assess anorectal angle (ARA) and levator ani muscle minimal plane distance (LAMD). Results: In total, 11 patients completed baseline evaluation, treatment, and postoperative evaluation in the period of interest. All patients underwent eight sessions of Flat Magnetic Stimulation according to the protocol. Adjuvant pharmacological treatment was used in five (45.5%) patients. Specifically, we observed a significant increase in both ARA and LAMD comparing baseline and post-treatment measurements (p < 0.001). Quality of life scale scores at baseline and after treatment demonstrated a significant improvement in both tools (p < 0.0001). Conclusions: Flat Magnetic Stimulation, with or without adjuvant pharmacological treatment, demonstrated safety and efficacy in reducing pelvic floor hypertonicity, resulting in improvement in symptoms’ severity and sonographic parameters of muscular spasm.

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Section: Discussionmentioning

confidence: 99%

Changes in Pelvic Floor Ultrasonographic Features after Flat Magnetic Stimulation in Women with Chronic Pelvic Pain and Levator Ani Muscle Hypertonicity

Barba,

Cola,

De Vicari

et al. 2024

Medicina

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“…Consequently, the effectiveness of PFMT may be impaired because the patient is not performing it correctly and consistently over time [ 39 ]. Moreover, PFMT has the disadvantage of slow progression, patients’ low compliance, and low adherence rates [ 40 ]. Both biofeedback and functional electrical stimulation involve the use of an endocavitary probe, which can greatly reduce compliance.…”

Section: Discussionmentioning

confidence: 99%

Flat Magnetic Stimulation for Stress Urinary Incontinence: A Prospective Comparison Study

et al. 2023

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Background: Flat Magnetic Stimulation (FMS) is characterized by a stimulation generated by electromagnetic fields with a homogenous profile. One possible application is the treatment of stress urinary incontinence (SUI). We aimed to compare the objective, subjective, quality of life, and instrumental outcomes in women with SUI not eligible for surgery undergoing either FMS or pelvic floor muscle training (PFMT). Methods: This was a prospective interventional study. After proper counseling, patients with isolated SUI were divided according to their treatment of choice into FMS and PFMT groups. At baseline and after treatment, patients completed the International Consultation on Incontinence Questionnaire-Short Form, the Female Sexual Function Index, and the Incontinence Impact Questionnaire, and volumetric measurement of the urethral rhabdosphincter (RS) was performed. The Patient Global Impression of Improvement questionnaire and stress test defined subjective and objective cure rates, respectively. Results: We observed improvements in urinary-related quality of life scores and an increase in RS volume after FMS compared to baseline. All these outcomes were significantly better compared to women who underwent PFMT. Conclusion: Our study demonstrated that FMS is a safe and effective conservative option for SUI management in terms of objective and subjective cure rates.

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“…Examination should assess the neurologic system (gait and balance, mobility, ability to transfer between positions, cognitive impairment), abdomen (scars, hernias, tenderness to palpation, suprapubic distension), genitals (perineal sensation, tissue quality/breakdown), rectum (fecal impaction, rectal masses, rectal tone, prostate nodularity), and extremities (peripheral edema) [9]. The examination for UI is preferably performed with a comfortably full bladder so as to allow for observation of UI [47]. Observation of urine leakage from the urethra with coughing or Valsalva or as a result of a sudden, compelling desire to void, strongly suggests SUI and UUI, respectively [48].…”

Section: Physical Examinationmentioning

confidence: 99%

Evaluation and treatment of urinary incontinence in the aging male

Pearlman

Kreder

2020

Postgraduate Medicine

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Risk of urinary incontinence (UI) increases with age and can have detrimental effects on patients and caregivers. UI should not be considered a normal part of aging and warrants a comprehensive evaluation. Treatment of UI in the aging male requires special consideration, particularly when it comes to comorbid conditions and potential side effects of intervention. The aim of this review is to discuss the evaluation of, risk factors for, and management of UI in the aging male.

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Urinary Incontinence: Diagnosis and Treatment in the Elderly

Cited by 13 publications

References 97 publications

Changes in Pelvic Floor Ultrasonographic Features after Flat Magnetic Stimulation in Women with Chronic Pelvic Pain and Levator Ani Muscle Hypertonicity

Changes in Pelvic Floor Ultrasonographic Features after Flat Magnetic Stimulation in Women with Chronic Pelvic Pain and Levator Ani Muscle Hypertonicity

Flat Magnetic Stimulation for Stress Urinary Incontinence: A Prospective Comparison Study

Evaluation and treatment of urinary incontinence in the aging male

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