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URINARY INCONTINENCE
Edited by Ammar Alhasso
and Ashani Fernando
Urinary Incontinence
Edited by Ammar Alhasso and Ashani Fernando
Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia
Copyright © 2012 InTech
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Publishing Process Manager Danijela Duric
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team
First published April, 2012
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from orders@intechopen.com
Urinary Incontinence, Edited by Ammar Alhasso and Ashani Fernando
p. cm.
ISBN 978-953-51-0484-1
Contents
Preface IX
Part 1 The Basics 1
Chapter 1 The Role of Altered Connective Tissue
in the Causation of Pelvic Floor Symptoms 3
B. Liedl, O. Markovsky, F. Wagenlehner and A. Gunnemann
Chapter 2 Epidemiology of Urinary
Incontinence in Pregnancy and Postpartum 17
Stian Langeland Wesnes,
Steinar Hunskaar and Guri Rortveit
Chapter 3 A Multi-Disciplinary Perspective
on the Diagnosis and Treatment
of Urinary Incontinence in Young Women 41
Mariola Bidzan, Jerzy Smutek, Krystyna Garstka-Namysł,
Jan Namysł and Leszek Bidzan
Chapter 4 Effects of Pelvic Floor Muscle Training with
Biofeedback in Women with Stress Urinary Incontinence 59
Nazete dos Santos Araujo, Érica Feio Carneiro Nunes,
Ediléa Monteiro de Oliveira, Cibele Câmara Rodrigues
and Lila Teixeira de Araújo Janahú
Chapter 5 Incontinence: Physical Activity
as a Supporting Preventive Approach 69
Aletha Caetano
Chapter 6 Elderly Women and Urinary
Incontinence in Long-Term Care 89
Catherine MacDonald
Chapter 7 Geriatric Urinary Incontinence
– Special Concerns on the Frail Elderly 113
Verdejo-Bravo Carlos
VI Contents
Chapter 8 A Model of the Psychological Factors
Conditioning Health Related Quality of Life
in Urodynamic Stress Incontinence Patients After TVT 131
Mariola Bidzan, Leszek Bidzan and Jerzy Smutek
Chapter 9 The Concept and
Pathophysiology of Urinary Incontinence 145
Abdel Karim M. El Hemaly, Laila A. Mousa and Ibrahim M. Kandil
Part 2 The Overactive Bladder 161
Chapter 10 Diagnosis and Treatment of Overactive Bladder 163
Howard A. Shaw and Julia A. Shaw
Chapter 11 Biomarkers in the Overactive Bladder Syndrome 189
Célia Duarte Cruz, Tiago Antunes Lopes,
Carlos Silva and Francisco Cruz
Part 3 Surgical Options 205
Chapter 12 Preoperative Factors as Predictors
of Outcome of Midurethral Sling
in Women with Mixed Urinary Incontinence 207
Jin Wook Kim, Mi Mi Oh and Jeong Gu Lee
Chapter 13 Suburethral Slingplasty Using
a Self-Fashioned Mesh for Treating Urinary
Incontinence and Anterior Vaginal Wall Prolapse 219
Chi-Feng Su, Soo-Cheen Ng, Horng-Jyh Tsai and Gin-Den Chen
Chapter 14 Refractory Stress Urinary Incontinence 233
Sara M. Lenherr and Arthur P. Mourtzinos
Chapter 15 Surgical Complications with Synthetic Materials 241
Verónica Ma. De J. Ortega-Castillo and Eduardo S. Neri-Ruz
Chapter 16 Treatment of Post-Prostatic
Surgery Stress Urinary Incontinence 263
José Anacleto Dutra de Resende Júnior, João Luiz Schiavini,
Danilo Souza Lima da Costa Cruz, Renata Teles Buere,
Ericka Kirsthine Valentin, Gisele Silva Ribeiro and Ronaldo Damião
Chapter 17 Continent Urinary Diversions in Non Oncologic Situations:
Alternatives and Complications 279
Ricardo Miyaoka and Tiago Aguiar
Contents VII
Chapter 18 Futuristic Concept in Management of Female SUI:
Permanent Repair Without Permanent Material 291
Yasser Farahat and Ali Abdel Raheem
Preface
Urinary incontinence is a condition that affects a significant proportion of the
population. The prevalence increases with age and there is a female preponderance.
With the advent of more aggressive management strategies for prostate cancer, there is
an increase in the proportion of men struggling with incontinence as well.
Incontinence has social, physical, psychological and economic implications for the
individual as well as society as a whole. This book attempts to look at the aetiology,
investigation and current management of urinary incontinence along with setting it
within the framework of clinical practice.
Management strategies are framed within a multidisciplinary team structure and as
such a range of specialists ranging from psychologists, specialist nurses,
gynaecologists and urologists author the chapters. There are some novel methods
outlined by the authors with their clinical application and utility described in detail,
along with exhaustive research on epidemiology, which is particularly relevant in
planning for the future. We would like to acknowledge all the authors for all the hard
work and dedication to excellence in completing this book.
Mr Ammar Alhasso
Consultant Urological Surgeon
and Honorary Clinical Senior Lecturer
at University of Edinburgh,
UK
Ms Ashani Fernando
Fellow in Urologic Reconstructive Surgery
Western General Hospital, Edinburgh,
UK
[...]... methodological reasons for the diverging estimates, and try to help the reader understand why estimates differ Hopefully this will give a better 22 Urinary Incontinence understanding of incidence and prevalence estimates of urinary incontinence in association with pregnancy 2 Urinary incontinence in pregnancy 2.1 Incidence of urinary incontinence in pregnancy Urinary incontinence (UI) is common also among women... Epidemiology of Urinary Incontinence in Pregnancy and Postpartum Stian Langeland Wesnes, Steinar Hunskaar and Guri Rortveit Department of Public Health and Primary Health Care, University of Bergen, Norway 1 Introduction Urinary incontinence is a common condition in pregnancy and postpartum There are published more than a thousand articles on urinary incontinence (UI) in pregnancy Incidence and prevalence... Integral Theory of female incontinence Acta Obstetrica et Gynecologica Scandinavia, Supplement 153, Vol 69: 1-79 Petros PE, Ulmsten U (1993) An Integral Theory and its Method for the Diagnosis and Management of Female Urinary Incontinence Part II The biomechanics of vaginal tissue, and supporting ligaments with special relevance to the pathogenesis of female urinary incontinence Scand J Urol Nephrol Supp... = interview, PP = postpartum, (s) = stress UI Table 2 Prevalence of urinary incontinence in pregnancy by parity 26 Urinary Incontinence 3 Urinary incontinence postpartum 3.1 Incidence of urinary incontinence postpartum Prevalence of UI postpartum is a so called “mixed bag” of incident UI before pregnancy, incident UI in pregnancy and incident UI postpartum (Iosif, 1981, Nygaard, 2006) Risk factors... dysfunctions and through practical experiences with the patients that had different forms and degrees of descensus/prolapse of the vaginal wall Many symptoms are associated with these different forms of descensus/prolapse: stress urinary incontinence, abnormal emptying of the bladder, urgency and frequency, nocturia, faecal incontinence, obstructed defecation and pelvic pain 14 Urinary Incontinence. .. wall is stretched and moved backward and downward during micturition (figures 4b) The bladder also moves backward and downward and the proximal urethra funnels (figure 4a) This can only be explained by active muscle contractions of levator plate (LP) and longitudinal muscle of anus (LMA) Relaxation of the forward force (PCM) and relaxation of urethral sphincter allows the backward and downward forces... functions has been a subject of controversy (Corton 2009) With increasing age women can develop vaginal and pelvic organ prolapse as well as symptoms such as stress urinary incontinence, voiding dysfunction, urgency and frequency and nocturia, and may also develop fecal incontinence, obstructive defecation and pelvic pain (Petros 2010) All of these symptoms can be associated - to a greater or lesser extent... Quest = Questionnaire, Interv = interview, Ex = examination, PP = postpartum, (s) = stress UI Table 1 Incidence of urinary incontinence in pregnancy by parity 24 Urinary Incontinence 2.2 Prevalence of urinary incontinence in pregnancy Data from a large number of cross-sectional studies and cohort studies indicate that UI in women is highly prevalent in pregnancy More than 50 % of all pregnant women... has been published The International consultation on incontinence published in 2009 their latest report “Epidemiology of Urinary (UI) and Faecal (FI) Incontinence and Pelvic Organ Prolapse (POP)” (Milsom et al., 2009) It describes period prevalence of any UI in pregnancy of 32 – 64% among all women 25 Epidemiology of Urinary Incontinence in Pregnancy and Postpartum Author, year (Burgio et al., 2003)... the directional muscle forces (Petros and Ulmsten 1993, Petros and Ulmsten 1997) and their significant role in pelvic floor dysfunctions From a functional and clinical aspect, it is important to consider 4 major muscle groups of the pelvic floor which are able to move the vaginal wall and pelvic floor organs (Petros 2010): 6 Urinary Incontinence 1 The anterior and medial portions of the pubococcygeus . URINARY INCONTINENCE
Edited by Ammar Alhasso
and Ashani Fernando
Urinary Incontinence
Edited by Ammar Alhasso and Ashani Fernando. can be obtained from orders@intechopen.com
Urinary Incontinence, Edited by Ammar Alhasso and Ashani Fernando
p. cm.
ISBN 978-953-51-0484-1
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