• 여성건강간호학회지
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• 제9권4호
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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.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.67-75
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• 2019

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

• Animal cells and systems
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• 제14권4호
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• pp.237-244
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• 2010

Stress urinary incontinence (SUI) is a common condition that primarily affects women. Here, we investigate the effects of human adipose-derived stem cells (ADSCs) in a rodent model of SUI. Female Sprague-Dawley rats at 7 weeks of age were randomly divided into three groups (n=8 per group): sham-operation, SUI-induction by transabdominal urethrolysis, and SUI-induction followed by transplantation of human ADSCs into the urethra. The abdominal leak point pressure at 8 weeks after the operation was markedly decreased by transabdominal urethrolysis, confirming successful induction of SUI. Interestingly, transplantation of human ADSCs into the urethra significantly blunted the decrease of abdominal leak point pressure in SUI-induced rats. Accordingly, we observed expression of ${\alpha}$-smooth muscle actin in a significant proportion of transplanted ADSCs, indicating differentiation of ADSCs into smooth muscle cells in the urethra. Moreover, the SUI-induced elevations of c-Fos immunoreactivities in the pontine micturition center (PMC) and in the ventrolateral periaqueductal gray (vlPAG) were clearly suppressed by transplantation of human ADSCs. These results imply that human ADSCs can be an effective therapeutic modality to ameliorate the symptoms of SUI.

• 성인간호학회지
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• 제14권1호
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• pp.15-25
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• 2002

Purpose: This study was performed to identify the prevalence and type of urinary incontinence (UI) after a stroke, to find the differences in urinary symptoms according to continence or incontinence, and to find the degree of impact of UI on daily life. Method: For data collection, we had a structured interview with a questionnaire. The subjects were 239 post stroke patients. Results: Among the subjects(mean age: $65{\pm}10$), 66.1 percent had an infarction, and 25.5 percent had a hemorrhage. And 26.4 percent of subjects were within 2 weeks and 28.9 percent from 1 year to 5 years since their episodes of a stroke. Forty five point six percent of subjects had various types of UI: urge 25.7 percent, stress 14.7 percent, functional 20.2 percent, and mixed 39.4 percent. There were significant differences in frequency, nocturia, decreased stream, and incomplete emptying between the incontinent and continent groups. Subjects reported UI influenced various aspect of daily life, 54.1 percent as cause of distress, 53.2 percent on overall quality of life, and 40.4 percent on sleep. The Mixed UI, including urge UI, had higher impact on daily life than others. Conclusion: There was a high prevalence of UI, mixed, urge, and functional type as most prevalent, and it had a strong impact on daily life of post stroke patients.

• 대한간호학회지
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• 제32권1호
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• pp.28-39
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• 2002

The purpose of this study was to measure the prevalence of urinary incontinence (UI), urologic symptoms, chronic health problems they have, and to explore whether the differences in incidence of UI ware by age, sex, voiding pattern, and chronic health problems. Method: 298 subject were selected, age range from 60 to 94 years residing in one city, in republic of Korea. Data was collected presence of UI, urologic symptoms, chronic health problems, knowledge, and the discomfort with incontinent. Collected data was analyzed with frequency, percentage, t-test, and $\chi$2-test. Result: The results of this study are as follows: 1. Mean age was 71.4 years. Prevalent rate of UI was 17.0%, woman showed more than man. 2. UI incidence was significant in age (t=7.84, p=.000), sex ($\chi$2 =9.47, p=.002), and voiding frequency ($\chi$2=18.34, p=.000). Also, UI incidence was significant relationship with chronic health problem of heart disease ($\chi$2 =10.65, p=0.001), hypertension ($\chi$2=4.04, p= 0.046) and respiratory problem ($\chi$2=9.67, p=0.002). 3. The UI was grouped into urgent incontinence (45%), stress incontinence (33%), and combined (22%). UI occurred during the daytime 48% and 17% at night. 4. Only 9.8 % of the UI seek advice and/or treatment for their symptoms, almost 90 % remained untreated due to lack of knowledge or improper information. 5. The discomforts due to their UI was no significant difference in their condition, the urgent use of the rest room, leaking urine, and nocturia. Conclusion: This study suggests that 1 year and 3 year follow-up study is needed to compare health status of UI. Also suggests intervention study for urologic discomfort of incontinent and behavioral education for the elderly are needed.

• Journal of Yeungnam Medical Science
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• 제21권2호
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• pp.207-214
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• 2004

복압성 요실금에 동반되는 다양한 방광 자극증상은 빈뇨, 잔뇨감, 야간뇨, 절박뇨, 절박성 요실금, 배뇨통의 순이었으며, 이 증상들의 복합 정도가 많으면 삶의 질에 영향을 주고 있음을 알 수 있었다. 그리고 마이크로칩을 이용한 전기자극기는 특별한 부작용 없이 환자의 만족도가 높은 치료기로 생각되었으며, 복압성 요실금과 동반되는 야간뇨, 배뇨통 등의 방광 자극증상을 경감시킴으로 인해 현재의 배뇨 상태가 일상생활에 미치는 영향을 감소시키는 것을 관찰할 수 있었다.

• 지역사회간호학회지
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• 제19권4호
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• pp.696-703
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• 2008

Purpose: To Perform a randomized comparative study investigating the effects of Pelvic Floor Muscle Exercise(PME) and Magnetic Stimulation Therapy(MST) and to identified the problems in each of PME & MST Method: Forty-nine patients with mild stress incontinence were randomly assigned to either of two treatment groups (24 patients in the PME group and 25 in the MST group). The PME group had a video exercising program for 40 times every day during 6 weeks. The MST group was treated with BioCon-2000TM, 2times/ week for six weeks. Pre-test and post-test were performed by Prineometer, 1-hour pad test. and Jackson's BFLUTS questionnaire of Jackson. Collected data were analysed using SAS 9.1 by frequency, Kolmogorov-Smirnov Z. Chi Square-test, t-test, Fisher Exact probability test, Paired t-test, and Wilcoxon's rank sum test. Results: In comparison between before and after PME and MST, statistically significant difference was observed in maximal vaginal pressure, duration of vaginal contraction, amount of urine, and symptom of urination. In the comparison of the effectiveness between PME & MST, only the maximal of vaginal pressure (Z=2.58, p= .010) was significantly different. Conclusion: The factor more effective in the MST group than in the PME group was high compliance.

• 대한물리치료과학회지
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• 제9권2호
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• pp.49-66
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• 2002

This study was designed to evaluate the effect of pelvic floor muscle strengthening exercise treatment program for the older women with stress incontinence. The researcher developed 8 weeks training program which was implemented at a social welfare center in Seoul. The exercise method followed the Kegel criteria. Verbal instructions were given to the subjects. Subjects were confirmed of the exercises and evaluated by description of the exercise method. Fourteen elderly women(mean age 75.7) with stress incontinence participated and completed this program. The training sessions were held twice a week and each session took 45 minutes ; 15 minutes for pelvic floor muscle strengthening program and 30 minutes for other physical therapy. Pelvic floor muscle strengthening exercise program was applied using verbal instruction and practice at social welfare center, twice a week and daily home exercise program were given to each individual. The results were as follows ; 1. There was significant decrease of lower urinary symptoms in the subjects (p = 0.00) 2 But there was no significant change in the sexual matters (p = 0.44) and the life style (p = 0.41) In conclusion, further study with larger sample group is suggested in order to confirm the study result. Because of limited sample size, the study results were not conclusive. But the pelvic floor muscle strengthening exercise treatment program could be a safe and effective program and is suggestive for the community residing older women with stress incontinence as a geriatric physical therapy intervention.

• 정신신체의학
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• 제31권2호
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• pp.63-71
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• 2023

요실금의 유병률은 전세계적으로 남성에서 3~11%, 여성에서 25~45%에 달할 정도로 매우 흔한 질환이며, 향후 고령화 진행에 따라 요실금은 더욱 증가할 것으로 예상된다. 요실금은 환자와 가족의 삶의 질을 현저히 떨어뜨리고, 우울감, 스트레스, 자존감 저하를 유발한다. 기존에 정신과 질환을 앓고있는 환자에서 요실금이 새로 발생할 때 정신과적 증상 악화, 치료 순응도 저하, 치료 효과 반감 등에 영향을 줄 수 있어 유의가 필요하다. 요실금은 대부분 방광 저장능력의 결함으로 일과성, 만성 요실금으로 구분된다. 일과성 요실금은 가역적인 요실금으로 delirium, infection, atrophic urethritis/vaginitis, psychological disorders, pharmaceuticals, excess urine output, restricted mobility, stool impaction (DIAPPERS)이 대표적인 원인이다. 만성 요실금은 복압성, 절박, 혼합, 일류성 또는 범람, 기능성, 그리고 지속성 요실금으로 구분된다. 약물 유발 요실금은 일과성 요실금의 한 종류로 임상에서 흔히 볼 수 있으며 여러 가지 정신과 약제에 의해서도 유발될 수 있다. 항정신병 약제가 가장 대표적으로 알려졌으며, 비정형 항정신병 약제의 알파 아드레날린성 차단효과로 인한 요도 괄약근 근긴장도 저하, 항콜린성작용에 의한 요폐, 세로토닌 길항 효과로 인한 pudendal nerve 반사 저하, 심한 진정효과, 약물유발 당뇨, 경련 등 여러가지 메커니즘이 작용하는 것으로 추정된다. 리튬은 요실금과 관련된 증례가 보고된 사례는 미미하나 신성 요붕증으로 인한 일류성 요실금과 연관될 수 있고, 발프로산도 명확하지 않은 기전으로 야뇨증을 유발할 수 있다. 항우울제의 경우 SSRI는 세로토닌 경로와 배뇨근 활성에 영향을 줌으로써, SNRI와 TCA는 요저류를 유발함으로써 요실금을 일으킬 수 있다. 부프로피온과 멀타자핀도 드물지만 요실금 사례가 보고된 바 있다. 벤조디아제핀의 경우 방광의 근이완으로 요저류와 요실금을 모두 유발할 수 있으며 항치매제로 쓰이는 아세틸콜린 분해효소 억제제는 말초의 아세틸콜린을 증가시켜 요실금을 유발한다. 이렇듯 요실금은 여러 정신과 약제로 인하여 발생될 수 있으므로, 요로 증상을 면밀히 확인하여 약물 선택과 조절에 주의해야 하며, 요실금이 약물로 인한 것임이 밝혀졌을 경우 원인 약물의 중단, 감량 또는 분복 변경이 필요하며 약물치료로는 desmopressin, oxybutynin, trihexyphenidyl, amitriptyline을 추가해볼 수 있다.

• 대한한방내과학회지
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• 제27권4호
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• pp.1035-1045
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• 2006

Junggi-haham (中氣下陷) is a term referring to lethargic symptoms such as digestive system disorder originating from energy deficiency. The authors applied therapy including Bojungikgi-tang(or Seungyangikgi-tang) and Bi-jeonggyuk method to two patients, one having ptosis and the other stress urinary incontinence, respectively, as Junggi-haham. Bojungikgi-tang is an herbal medication preparation and Bi-jeonggyuk is an acupuncture therapy method, and both are used to treat Junggi-haham symptoms. The combined treatment showed positive outcome, and the result suggests that Bojungikgi-tang and Bi-jeonggyuk are effective treatments for patients diagnosed as Junggi-haham.