November 6, 2013 Pelvic Physiotherapy Distance Journal Club

DON'T MISS THIS ONE!!!

Time - 8:30 PM EST for one hour

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This month’s discussion

Surgery versus Physiotherapy for Stress Urinary Incontinence. Labrie J,  Berghmans BCLM, et al., N Engl J Med 2013;369:1124-33.

 Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update.  Bernards ATM, Berghmans BCM, Slieker-ten Hove MC, Staal BJ, de Bie RA, Hendriks EJM. Int Urogynecol J DOI 10.1007/s00192-013-2219-, published on line October 1, 2013.

Guidelines on Urinary Incontinence of the European Association of Urology

Professional association guidelines have become more common and this paper includes about 20 pages of review of the research on conservative therapy for UI. Recommendations are given for various aspects of therapy with high levels of recommendations for PFM exercises. Good marketing tool especially for urologists. http://www.uroweb.org/gls/pdf/16052013Urinary_Incontinence_LR.pdf

The Effect of Age on Lower Urinary Tract Function: A Study in Women

Pfisterer MDH, Griffiths DJ, Schaefer W, Resnick NM.
J Am Geriatr Soc. 2006; 54: 405-412.

MJ Strauhal, PT, BCB-PMD

October 9, 2013

Primary Aim:  To identify age-associated changes in female lower urinary tract (LUT) function across a wide age spectrum, controlling for detrusor overactivity (DO).  DO is common in old age, but may not represent normal aging.

 Subjects:  Ambulatory, nondemented, community-dwelling females with and without bladder symptoms suggestive of DO who were recruited by local advertising; efforts were made to recruit equal numbers of subjects in each age bracket who did and did not have symptoms of overactive bladder (OAB).

• Exclusion criteria: dementia, Alzheimer’s disease, diabetes mellitus, neurological disease (such as stroke, MS, Parkinson’s), disc disease, SCI or malformations resulting in gross neuropathy, detrusor-sphincter dyssynergia, current UTI, history of pelvic irradiation or bladder cancer, history of vitamin B12 deficiency, history of ETOH abuse, radical hysterectomy, abdominoperineal resection, agents acting on cholinergic or sympathetic nervous system that were given for bladder problems that could not be stopped for 2 weeks

Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women.

Capobianco G, Donolo E, Borghero G, Dessole F, Cherchi PL, Dessole S.
Arch Gynecol Obstet. 2012; 285: 397-403.

MJ Strauhal, PT, BCB-PMD

October 9, 2013

 Primary Aim:  To assess the effects of the combination of pelvic floor rehabilitation (PFR) and intravaginal estriol administration on stress urinary incontinence (SUI), urogenital atrophy (UGA), and recurrent urinary tract infections (UTI’s) in postmenopausal women

 Subjects:  Italian women between the ages of 55-70 years old living in Sassari, Italy were recruited by issuing a leaflet explaining the aim of the study and requesting their participation

• Inclusion criteria- symptoms and signs of SUI (loss of urine on exertion with coughing, sneezing, intercourse, etc.), vaginal atrophy (vaginal dryness and dyspareunia), and history of recurrent UTI’s, no previous estrogen replacement, patients with hysterectomy were eligible
• Exclusion criteria- pathologies or anatomical lesions of the urogenital tract (such as grade II and II pelvic organ prolapse per Baden and Walker classification), the presence of severe systemic disorders, thromboembolic diseases, biliary lithiasis, previous breast or uterine cancer, abnormal uterine bleeding, BMI >25 kg/m2, DO, and abnormal cystometric capacity