• International Neurourology Journal
• /
• v.22 no.4
• /
• pp.305-312
• /
• 2018

Purpose: The aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon's specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset. Methods: We enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon's specialty and whether a preoperative UDS was performed. Results: The hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103-1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon's specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122-1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed. Conclusions: This population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon's specialty and that the reoperation rate according to the surgeon's specialty varied based on whether a preoperative UDS was performed.

• The Journal of Internal Korean Medicine
• /
• v.42 no.3
• /
• pp.293-307
• /
• 2021

Objectives: This study investigates the effects and safety of Bojungikgi-tang for stress urinary incontinence by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: RCTs were selected from articles published until December 2019 in seven domestic and foreign databases. The quality of the literature was evaluated using Cochrane's risk of bias (RoB) tool, and RevMan 5.3 was used to synthesize the results. Results: A total of 694 patients with stress urinary incontinence participated in eight RCTs. Meta-analysis showed that the total effective rate of treatment that combines pelvic floor muscle training (PFMT) and Bojungikgi-tang was significantly higher than that of PFMT alone. The volume of urine leakage per hour after the combined treatment was significantly lower than that of PFMT alone. The International Consultation on Insurance Questionnaire-Short Form (ICIQ-SF) scores from combining PFMT and Bojungikgi-tang were significantly lower than those for PFMT alone. Conclusion: This study suggests that Western medical treatment combined with Bojungikgi-tang for urinary incontinence from stress might be more effective in improving symptoms than conventional Western medical treatment alone. However, the number of studies included in the meta-analysis was insufficient, and the quality of the selected literature was generally low. Therefore, high-quality clinical studies on herbal medicine treatment for urinary incontinence would be required in the future.

• Journal of Yeungnam Medical Science
• /
• v.38 no.2
• /
• pp.142-147
• /
• 2021

Background: This study was performed to investigate the association between cystographic anastomotic urinary leakage (UL) after retropubic radical prostatectomy (RRP) and early urinary incontinence (UI). Methods: The medical records of 53 patients who had undergone cystography after RRP at our institution between January 2015 and December 2018 were retrospectively analyzed. Cystography was performed 7 to 10 days after surgery. The duration of catheterization depended on the degree of UL, which was classified as mild, moderate, or severe. The study subjects were divided into the non-UL group and the UL group. Continence was defined as the use of no pads. The prostate was dissected in an antegrade fashion, and urethrovesical anastomosis was performed with a continuous suture. Results: Incontinence rates at 1 and 3 months postoperatively were significantly higher in the UL group than the non-UL group (83.3% vs. 52.2%, p=0.014 and 76.7% vs. 47.8%, p=0.030, respectively); however, those at 6 and 12 months were not significantly different (23.3% vs. 17.4%, p=0.597 and 4.3% vs. 10.0%, p=0.440, respectively). The severity of UL was not found to influence the duration of incontinence. The presence of cystographic anastomotic UL was found to be predictive of UI during the first 3 postoperative months (odds ratio, 3.3; p=0.045). Conclusion: The presence of anastomotic UL on cystography was associated with higher rates of UI in the early postoperative periods. However, incontinence rates in patients with or without anastomotic UL immediately after RRP equalized at 6 months and the severity of UL did not affect the duration of postoperative UI.

• Journal of the Korea Society of Computer and Information
• /
• v.26 no.12
• /
• pp.201-212
• /
• 2021

This study attempted to compare the pattern with the absorption layer by analyzing the pattern of commercially available urinary incontinence panty products. Through this, it tried to obtain basic data necessary for the development of functional urinary incontinence panty for active seniors. Twelve commercially available products were decomposed to analyze size and patterns, and appearance and clothing pressure were evaluated through 3D simulation. As a result of comparing the size and pattern of urinary incontinence panty, it was analyzed that the size difference between parts was large even though the product was called the same. Products from the same brand also showed a big difference depending on design and absorption. As a result of the appearance evaluation for the 3D simulation, it was found that there were significant differences between products in all items such as the front, side, and back. Product No. 9 was analyzed to be the best except for the waist fit on the side. In the evaluation of clothing pressure, most of them were marked in red except for products 1, 2, and 8 due to the nature of the panty product. In the future, it is thought that actual wearing experiments and size standardization studies on urinary incontinence pants should be conducted.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.35 no.4
• /
• pp.121-142
• /
• 2022

Objectives: The purpose of this study is to review the acupuncture treatment Urinary incontinence (UI) and Overactive bladder (OAB) in postmenopausal women. Methods: We searched articles in 8 search engines with keywords related to 'Overactive bladder', 'Urinary incontinence' and 'Menopause' in July 2022. Randomized Controlled Trials (RCT) that used acupuncture on Urinary incontinence (UI) and Overactive bladder (OAB) after menopause were included. Animal studies and non RCT data were excluded. Data on acupuncture treatment such as methods, site, duration, frequency, and period were analyzed. Also, network analysis between acupoints was conducted. Results: 15 articles were selected and analyzed. Studies were conducted using manual acupuncture, electroacupuncture, pharmacopuncture and fire acupuncture. Most studies used more than one acupoint, and there were 32 acupoints selected for acupuncture treatment for UI and OAB after menopause. The most commonly used acupoint was 中極 (CV3) (n=8). In terms of the correlation of acupoints, 太谿 (KI3) had the highest value of degree centrality at 0.75. The mean treatment time, number of treatments, and duration were 26.42±6.10 minutes, 18.71±9.09 times, and 6.87±4.77 weeks. Conclusions: The results of this study could be useful in establishing the evidence for performing standardized acupuncture treatment for Urinary incontinence and Overactive bladder in postmenopausal women.

• Journal of the Korea Society of Computer and Information
• /
• v.27 no.11
• /
• pp.209-218
• /
• 2022

This study sought to measure the absorption of commercially available urinary incontinence panty by applying a method of measuring the maximum saline amount of adult diapers in an international standard. The subject was 15 products from 3 brands on the market, and the SPSS 27.0 program was used for analysis. As a result of measuring the maximum absorption of commercial incontinence panty, it was found that the maximum absorption of product B was the highest and the maximum absorption of product C was the lowest. Even though the product was marked with the same absorption amount, it showed differences in the same product of the same brand, and it also showed differences depending on the brand. The reflux amount of the injected physiological saline and the urinary incontinence panty showed a positive (+) correlation, and as the amount of the injected physiological saline increased, the reflux amount of the urinary incontinence panty increased. It was analyzed that the time when the leakage begins and the amount of leakage have a negative (-) correlation. In future research, it is believed that the development of functional pads that can increase absorption and reduce reflux and leakage should be carried out.

• Archives of Plastic Surgery
• /
• v.50 no.6
• /
• pp.578-585
• /
• 2023

An artificial sphincter implanted in the bulbous urethra to treat severe postprostatectomy urinary incontinence is effective, but embedding-associated complications can occur. We assessed the feasibility, efficacy, and safety of urethral graciloplasty cross-innervated by the pudendal nerve. A simulation surgery on three male fresh cadavers was performed. Both ends of the gracilis muscle were isolated only on its vascular pedicle with proximal end of the obturator nerve severed and transferred to the perineum. We examined whether the gracilis muscle could be wrapped around the bulbous urethra and whether the obturator nerve was long enough to suture with the pudendal nerve. In addition, surgery was performed on a 71-year-old male patient with severe urinary incontinence. The postoperative 12-month outcomes were assessed using a 24-hour pad test and urodynamic study. In all cadaveric simulations, the gracilis muscles could be wrapped around the bulbous urethra in a γ-loop configuration. The length of the obturator nerve was sufficient for neurorrhaphy with the pudendal nerve. In the clinical case, the postoperative course was uneventful. The mean maximum urethral closure pressure and functional profile length increased from 40.7 to 70 cm H₂O and from 40.1 to 45.3 mm, respectively. Although urinary incontinence was not completely cured, the patient was able to maintain urinary continence at night. Urethral graciloplasty cross-innervated by the pudendal nerve is effective in raising the urethral pressure and reducing urinary incontinence.

• Journal of the Korean Society of Radiology
• /
• v.12 no.2
• /
• pp.277-287
• /
• 2018

Pelvic floor muscle is the main sub-system that maintains urinary continence. The weakness of pelvic floor muscles causes the stress urinary incontinence, and therefore the degree of functioning of pelvic floor muscles could be used as an index to assess the degree of stress urinary incontinence. In this study, the quantitative diagnosis algorithm was proposed to estimate the degree of stress urinary incontinence (SUI) by measuring the contraction pressure of pelvic floor muscle. For these reason, the contraction pressure measurement system from pelvic floor muscle was developed, and the measuring protocol was suggested to analysis the obtained data. As the results of clinical test, the proposed diagnosis algorithm shows the 80% of accuracy, and 20% of false positive diagnosis. On the other hand, false negative results were not confirmed. Consequentially, we thought that the proposed urinary incontinence diagnosis algorithm can quantitatively diagnose the progression of the stress urinary incontinence and it can be used for the development of the incontinence diagnosis system.

• 한국노년학
• /
• v.37 no.4
• /
• pp.893-907
• /
• 2017

This study aimed to investigate factors affecting frailty by urinary incontinence groups among the vulnerable elderly woman in Korea. In this secondary analysis, data were collected from records for 3,251 elders registered in the Visiting Health Management program of Public Health Centers in 2012. body mass index, waist circumference, timed up & go, depression, self rated helath, walking exercise, flexibility exercise, strengh exercise and frailty were assessed. Data were analyzed using $x^2$-test, t-test, ANOVA, Pearson's correlation and stepwise regression to determine the associated factors of frailty by urinary incontinence. Depression, walking exercise, timed up & go and age were found to be factors significantly associated with frailty among the elders with incontinence(F=38.321, p<.001). Age, depression, walking exercise, self rated health and tined up & go were found to be factors associated with frailty in the elders without incontinence(F=265.666 p<.001). The findings show that frailty of elders and associated factors were different by urinary incontinence, and common factors affecting frailty were depression, walking exercise, timed up & go, age. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to urinary incontinence.

• Journal of Yeungnam Medical Science
• /
• v.18 no.1
• /
• pp.59-66
• /
• 2001

Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication. success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication. bladder perforation occurred in one patient(2.4%). residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instability were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.