• Journal of International Academy of Physical Therapy Research
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• v.7 no.1
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• pp.972-978
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• 2016

The purpose of this study was to identify correlations among the continence function, cognitive function, and activities of daily living(ADL) in elderly male patients with dementia in geriatric hospitals. The subjects were 64 patients aged 65 or above who were diagnosed with dementia among the hospitalized male patients in a geriatric hospital. For the subjects' cognitive function, a questionnaire developed for the Korean Mini Mental Status Examination(K-MMSE) was used. For the continence function and ADL, data were collected using a patient evaluation table. As a result, a lower level of cognitive function resulted in corresponding higher levels of dependence in all items of ADL except bathing(p<.05), and a lower level of cognitive function led to corresponding declines in the continence function(bowel control, bladder control)(p<.01). In addition, a higher level of dependence in ADL resulted in corresponding higher levels of difficulty in bowel and bladder control(p<.01). This study showed correlations among the cognitive function, ADL, and continence function of elderly men with dementia. The results of this study may be used as basic data for the management and treatment of hospitalized elderly male patients with dementia in geriatric hospitals.

• International Neurourology Journal
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• v.22 no.4
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• pp.287-294
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• 2018

Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

• Women's Health Nursing
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• v.9 no.4
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• pp.439-448
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• 2003

Purpose: This study was accomplished to apply and to evaluate the 10-week Urinary tract Function Promotion for the Elderly Women (UFPE), and to suggest guideline and to be utilized on the community level. Method: Subjects were 30 persons of 16 healthy elderly and 14 hemiplegic elderly. This UFPE was composed of diagnosis of incontinence & evaluation of physical condition, understanding of urogenital system & urinary incontinence management. UFPE was evaluated by subjective urinary condition, intra-vaginal contraction power, continence self-efficacy (CSE), incontinence stress, geriatric depression. The collected data was analyzed using Wilcoxon Matched Signed-Ranks test by SPSS/WIN program. Result: 5 subjects (31.2%) in healthy group and 2 subjects(14.3%) in hemiplegic group have a daytime frequency, 14 subjects(87.5%) in healthy- group and 14 subjects(100%) have a nocturia. After program, subjective urinary condition was increased just only healthy elderly (Z=-2.545, p<0.05), while intra-vaginal contraction power and CSE were increased significantly only in the hemiplegic elderly (Z=-2.57, P<0.05: Z=-2.29, p<0.05). There were barriers not to comply program guidance such as inadequate perception of pelvic floor muscle, forget to do exercise, fatigue. Conclusion: UFPE was effective in increasing subjective urinary condition for healthy elderly and in increasing intra-vaginal contraction power and continence self-efficacy for the hemiplegic elderly women. I suggest that this UFPE be utilized at the health center and elderly center, and public health nurse counsel and guide the elderly's work through phone service.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.4
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• pp.340-346
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• 2022

Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes. Results: Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices. Conclusion: This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.496-500
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• 2023

Fournier's gangrene is a life-threatening infection which requires prompt recognition, early surgical debridement of unhealthy tissue, and initiation of broad-spectrum antibiotics. Relook debridement are usually performed until all the devitalized tissue has been removed. Involvement of the anal sphincter may result in significant morbidity such as permanent incontinence. Dynamic reconstruction of the anal sphincter has always been one of the holy grails in the field of pelvic reconstruction. We demonstrate a new method of camera shutter style double-opposing gracilis muscle flaps that allows dynamic sphincteric function without the need for electrostimulation. The bilateral gracilis muscles are inset in a fashion that allows orthograde contraction of the muscle to narrow and collapse the neoanal opening. With biofeedback training, the patient is able to regain dynamic continence and return to function without a stoma. There was also no need for neurotization or microsurgery techniques to restore sphincteric function to the anus. The patient was able to reverse his stoma 14 months after the initial insult and reconstruction with biofeedback training without the use of electrostimulation.

• Journal of Korean Neurosurgical Society
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• v.39 no.1
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• pp.40-45
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• 2006

Objective : To determine the relationship between the clinical outcome and the extent of surgical laminectomy for adequate decompression on the cases of cauda equina syndrome, the authors review and analyze their cases and compared with those of literatures. Methods : The authors reviewed 655 patients retrospectively who had underwent surgery on the cases of lumbar disc herniation from January 2000 to December 2004. There were 19 patients [2.9%] who presented for clinical cauda equina syndrome. Among them, we selected and analyzed 15 patients who were treated by unilateral partial hemilaminectomy with discectomy or bilateral partial laminectomy with discectomy, and they had been followed from 5 weeks to 47 months postoperatively [mean, 13.47 months]. The levels of the disc herniations were L4-5 in 8 patients, following L5-S1 in 4 patients and 2 levels [L4-5 and L5-S1] in 3 patients. Motor and sensory recoveries were recorded. Postoperative urinary function recovery Was defined according to Gleave and Macfarlane. Results : In 12 months postoperatively, the bladder function was obtained in 14 of 15 patients[93%] with regaining urinary continence. Thirteen of 15 patients[86%] with preoperative motor weakness of lower extremities were recovered. Sensory deficit of lower extremities, perianal and saddle anesthesia were all recovered. Patients had recovered on lumbosciatic pain and saddle hypesthesia, in turn, motor function and urinary incontinence. Conclusion : In treating cauda equina syndrome, the authors did less extensive surgery, such as unilateral partial hemilaminectomy with discectomy or bilateral partial laminectomy with discectomy for adequate decompression. The outcome is satisfactory and comparable with those of subtotal or total laminectomy.

• Physical Therapy Rehabilitation Science
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• v.4 no.2
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• pp.103-107
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• 2015

Objective: Pelvic floor muscles (PFMs) form the base of the abdomino-pelvic cavity and also the PFMs function is important for urinary continence. PFMs training (PFMT) is considered to be the first method for PFM dysfunction. This study demonstrated correct PFMs contraction among commonly used different contraction methods for PFMT. Design: Cross-sectional study. Methods: In this study, nineteen middle-aged (40-70 years) women participated. To evaluate PFM function, ultrasonography was used to measure the distance of the bladder base movement. The distance of the PFM movements were calculated at rest and during the other contractions. The following four different contraction methods were performed randomly: (1) PFM contraction, (2) abdominal drawing-in maneuver (ADIM), (3) anal contraction, and (4) hip adductor muscle contraction. The participants held the contraction for 3 seconds for a total of 3 times with a 30 seconds rest period between each trial. The mean of three measurements in each position were obtained and compared with that in the resting position. Results: The bladder base movement values were significantly greater when comparing PFM with ADIM and hip adductor contractions (p<0.05). The bladder base movement values were significantly greater when comparing ADIM and anal contractions with hip adductor contractions (p<0.05). Conclusions: The results of this study suggest that performing PFM contractions is the best method among the common methods for PFMT. Performing PFM contractions was more effective than the other contraction methods.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.943-952
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• 1997

This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone & Salisbury(1991) was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of dally life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack & Peck(1960), elderly mental depression, using the tool developed by Sheikh & Yesavage(1986), and the ADL(activities of dally living), through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems nth their cognitive, mental and physical functions.