Urinary Incontinence: Difference between revisions

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== Outcome Measures  ==
== Outcome Measures  ==


[[Patient Global Impression of Improvement (PGI-I)|Patient Global Impression of Improvement (PGI-I)]]  
*Incontinence Quality of Life Instrument (IQOL)
 
*[[Patient Global Impression of Improvement (PGI-I)|Patient Global Impression of Improvement (PGI-I)]]  
[[Patient Global Impression of Severity (PGI-S)|Patient Global Impression of Severity (PGI-S)]]  
*[[Patient Global Impression of Severity (PGI-S)|Patient Global Impression of Severity (PGI-S)]]  
 
*[[Pelvic Floor Distress Inventoy (PFDI - 20)|Pelvic Floor Distress Inventory - 20 (PFDI - 20)]]  
Pelvic Floor Distress Inventory (PFDI)
*[[Pelvic Floor Incontinence Questionnaire (PFIQ - 7)|Pelvic Floor Impact Questionnaire - 7 (PFIQ - 7)]]
 
[[Pelvic Floor Distress Inventoy (PFDI - 20)|Pelvic Floor Distress Inventory - 20 (PFDI - 20)]]  
 
Pelvic Floor Incontinence Questionnaire (PFIQ)
 
[[Pelvic Floor Incontinence Questionnaire (PFIQ - 7)|Pelvic Floor Impact Questionnaire - 7 (PFIQ - 7)]]


== Management / Interventions<br>  ==
== Management / Interventions<br>  ==

Revision as of 02:48, 11 February 2011

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Clinically Relevant Anatomy
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Mechanism of Injury / Pathological Process
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Definitions: [edit | edit source]

  • Urinary incontinence (symptom):  Complaint of involuntary loss of urine.
  • Stress (urinary) incontinence:  Complaint of involuntary loss of urine on effort or physical exertion (e.g. sporting activities), or on sneezing or coughing.
  • Urgency (urinary) incontinence:  Complaint of involuntary loss of urine associated with urgency.
  • Mixed (urinary) incontinence:  Complaint of involuntary loss of urine associated with urgency and also effort or physical exertion or on sneezing or coughing.
  • Urgency:  Complaint of a sudden, compelling desire to pass urine which is difficult to defer.
  • Overactive bladder (OAB, Urgency) syndrome:  Urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology.[1]

Clinical Presentation[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Outcome Measures[edit | edit source]

Management / Interventions
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Differential Diagnosis
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Pelvic Floor Muscle Strength[edit | edit source]

Modified Oxford grading system:

  • 0 - no contraction
  • 1 - flicker
  • 2 - weak squeeze, no lift
  • 3 - fair squeeze, definite lift
  • 4 - good squeeze with lift
  • 5 - strong squeeze with a lift

Palpation of the pelvic floor muscles per the vagina in females and per the rectum in male patients.[2]

PERFECT mnemonic assessment, described by Jo Laycock[2]:[edit | edit source]
  • P - power, may use the Modified Oxford grading scale
  • E - endurance, the time (in seconds) that a maximum contraction can be sustained
  • R - repetition, the number of repetitions of a maximum voluntary contraction
  • F - fast contractions, the number of fast (one second) maximum contractions
  • ECT - every contraction timed, reminds the therapist to continually overload the muscle activity for strengthening

Key Evidence[edit | edit source]

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Resources
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Case Studies[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. Abrams P, Cardozo L, Fall M, et al. The standardization of terminology in lower urinary tract function: report from the standardization sub-committee of the International Continence Society. Urology 2003;61:37-49.
  2. 2.0 2.1 Laycock J. Pelvic muscle exercises: physiotherapy for the pelvic floor. Urol Nurs 1994;14:136-40.