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Women Veterans constitute a distinctive cohort whose exposure to military service can contribute to development of bladder conditions, such as urinary incontinence (UI), as they age. Behavioral therapies are recommended as first-line treatment for incontinence, yet many VA Medical Centers do not have staff trained to administer them. The purpose of this research study was to conduct a qualitative program evaluation of MyHealth e Bladder, a mobile telehealth version of an evidence-based eight-week behavioral treatment program designed for women Veterans with incontinence. MyHealth e Bladder uses mobile telehealth technology to teach pelvic floor muscle exercises, bladder control strategies, fluid management, risk factor reduction, and self-monitoring. Eighteen women Veterans who completed a pilot study of MyHealtheBladder participated in semi-structured telephone interviews exploring their experience with the program. A directed content analysis was conducted of the transcribed interview data. Participants described ease of accessing MyHealth e Bladder using smart phones and other mobile devices, emphasizing the flexibility of using the program at home, work, or while traveling. Most participants described program content as understandable, relevant, and easy to follow. They discussed how the program increased knowledge of UI, promoted consistency in practicing behavioral therapy, strengthened pelvic floor muscles, reduced urine leakage, and improved psychosocial wellbeing. Suggestions for improvement included more interaction with staff, more individualized tailoring of content to UI type, incorporating in-person clinic visits, and including supplementary material. Participants uniformly endorsed the program and recommended it for other women Veterans, as well as for those in active duty to prevent or treat UI earlier in the life course.

Aims: To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways., Design: A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China., Methods: Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism., Results: A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant., Conclusion: The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement., Implications for the Profession And/or Patient Care: The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence., Impact: What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence., Reporting Method: The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines., Patient or Public Contribution: No patient or public contribution., (© 2024 John Wiley & Sons Ltd.)

Aim: To develop a conceptual framework for proactive health behavior among middle-aged and older adult females with urinary incontinence., Design: Qualitative grounded theory study., Background: There is a growing body of research emphasizing the pivotal significance of proactive health behavior. Proactive health behavior can empower patients to actively manage their illnesses and facilitate disease recovery. Clearly defining patients' relevant beliefs and assumptions regarding proactive health behavior can effectively promote their adoption. However, there is currently a lack of relevant research in this area., Methods: We conducted in-depth interviews with middle-aged and older adult females with urinary incontinence (n = 17) and nursing caregivers (n = 9). We used theoretical sampling, whlie conducting continuous comparative analysisi and data collection., Results: The study has yielded a substantive theory to facilitate healthcare professionals' comprehension of proactive health behavior in middle-aged and older adult females with urinary incontinence. The foundation for middle-aged and older adult females to adopt proactive health behavior is having a certain level of health literacy regarding their conditions. Patients' internal motivation to engage in proactive health behavior includes a sense of health responsibility and health demands. Additionally, external support received by patients can also facilitate their adoption of proactive health behavior. The proactive health behavior practices of middle-aged and older adult females mainly include proactive medical care behavior and establishing a healthy lifestyle., Conclusions: The conceptual framework established in this study offers theoretical support for middle-aged and older adult females with urinary incontinence to adopt proactive health behavior. It provides a basis for future exploration of proactive health behavior among this demographic and informs the development of more effective health interventions and support measures tailored to their needs., Impact: The study specifically elucidates the mechanisms and manifestations of proactive health behavior adopted by middle-aged and older adult females with urinary incontinence, laying the foundation for clarifying the level of proactive health among patients and implementing corresponding intervention measures. Additionally, it can also serve as a reference for related research on other diseases., (© 2024 Wiley Periodicals LLC.)

Background: Female pelvic floor dysfunction (PFD) is a common condition affecting the emotional well-being of women., Objective: To estimate the prevalence of depressive and anxiety symptoms in women with PFD. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION AND ANALYSIS: Following prospective registration (PROSPERO CRD42022362095) we conducted a search of three electronic databases (PubMed, Web of Science and Scopus) from inception to April 2023 without language restriction to capture studies reporting the prevalence of depression/anxiety among women with PFD (chronic pelvic pain [CPP], urinary incontinence [UI], pelvic organ prolapse [POP], and/or fecal incontinence [FI]). Only studies with validated tools were included. Data extraction and study quality assessment were performed by two independent reviewers. Stratifying by type of PFD, rates of depression and anxiety were pooled using random effects model computing 95% confidence interval (CI) and assessing heterogeneity using the I 2 statistic. Funnel plots were used to detect potential reporting biases and small-study effects., Main Results: The search yielded 767 articles, from which 54 studies containing 632 605 women were included. All the studies were high quality. The prevalence of depression was: CPP 26.8% (95% CI: 19.2-34.4, I 2  = 98.7%; 12 studies, 4798 participants with 491 cases; Egger's P value = 0.009); UI 26.3% (95% CI: 19.4-33.2, I 2  = 99.9%; 26 studies, a total of 346 114 participants with 25 050 cases; Egger's P value = 0.944); POP 34.9% (95% CI: 24.3-45.6, I 2  = 68%; three studies, 297 participants with 104 cases; Egger's P value = 0.973); and FI 25.3% (95% CI: 0.68-49.9, I 2  = 99.7%; six studies, 14 663 participants with 1773 cases; Egger's P value = 0.780). The prevalence of anxiety was: CPP 29.5% (95% CI: 16.3-42.7, I 2  = 97.7%; nine studies, 2483 participants with 349 cases; Egger's P value = 0.001); UI 46.91% (95% CI: 39.1-54.6, I 2  = 99.6%; 11 studies, 198 491 participants with 40 058 cases; Egger's P value = 0.337); and POP 28% (95% CI: 13.6-42.4, I 2  = 89%; three studies with 355 participants with 90 cases; Egger's P value = 0.306)., Conclusion: The prevalence of mental health illness was variable in the different types of PFDs. This meta-analysis helps quantify the burden of depression and anxiety in PFD and will help inform the policies regarding screening of emotional well-being by healthcare professionals engaged in care of women with PFD., (© 2024 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)

Background: Men frequently underestimate the significance of urinary incontinence and fail to disclose their condition owing to embarrassment and the associated social stigma. Therefore, successful incontinence management with absorbent products helps individuals cope with the emotional and social challenges arising from incontinence, including visible urine leakage, frequent urination, unpleasant odours, and isolation., Aim: To assess the most essential performance features of the newly developed MoliCare Premium Men Pad., Methods: Computer-assisted personal interviews were conducted to obtain the opinions and satisfaction levels of 69 male users with incontinence in Germany regarding different performance characteristics of the newly designed MoliCare Premium Men Pad after using the product., Findings: All performance characteristics of the new MoliCare Premium Men Pad design received positive ratings from all interviewees. Notably, 90% of participants were 'highly satisfied' and 'satisfied' with the new MoliCare design., Conclusions: The new MoliCare SkinGuard absorbent core technology, anti-leakage guards, and well-engineered product design provide protection, discretion, and comfort to individuals with incontinence. The newly developed MoliCare Premium Men Pad is specifically tailored to meet the primary needs of male pad users and help them maintain a normal lifestyle.

Objectives: The Mitrofanoff principle has been extensively evaluated in terms of associated morbidity and mortality. However, there is limited literature specifically addressing quality of life (QoL), particularly concerning the laparoscopic procedure. The aim of this study was to assess the impact of laparoscopic appendicovesicostomy (LA) on QoL by using a specific questionnaire targeted at patients and their families., Materials and Methods: This observational and descriptive study involved patients who underwent LA between May 2018 and December 2023. A survey consisting of 29 questions, organized into three sections was used: satisfaction with the surgery, outcomes, and current continence status. Responses were graded according to the Likert scale (1-5) (1 = strongly disagree, 5 = strongly agree)., Results: Of the 29 contacted families, 24 (82.8%) responded. The average age was 12.3 years (SD 4.4), with 75.9% being male. The primary indication for surgery was pain during urethral catheterization (69%). Mean postoperative follow-up was 36.5 months. Regarding satisfaction with surgery: overall satisfaction,hospitalization duration and pain control was rated with a score of 5 by 66.7%, 58.3% and 58.3%, respectively. In terms of outcomes: 54.2% rated aesthetic results with a score of 5, and 83.3% rated improvement in QoL with a score of 4 or 5. Concerning current continence status, 66.6% were very satisfied with the results and reported total absence of leakages or on a very specific occasion (score of 4 or 5)., Conclusions: This study supports the improvement in perceived QoL among patients requiring an LA. Overall satisfaction with the procedure and outcomes related to continence were perceived as very good by both patients and their families.

Background: The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) is a questionnaire for evaluating the frequency, severity, and impact on quality of life of persons with. Urinary incontinence is a stigma, and a Nepali version of the change women to persons will help to screen for incontinence, and be valuable for clinicians, researchers, and for persons with urinary incontinence., Methods: After receiving ethical clearance and permission from ICIQ, the translation and cross-cultural adaptation was conducted using the ICIQ module protocol. This incorporated initial translation of the questionnaire, backward translation with involvement of ICIQ. The necessary adjustments were made during a meeting with the reconciliation expert team. After the approval from the ICIQ, interviews were conducted with eight women with urinary incontinence for conceptual equivalence. After cognitive debriefing, the comments were checked and proofreading of the questionnaires for comprehensibility, readability and accuracy of the grammar were done. Final typesetting and formatting were checked to match the original ICIQ-UI SF., Results: The IICIQ-UI SF was successfully translated and cross-culturally adapted while maintaining the characteristics of the original source., Conclusions: Through translation, review from the experts and interviews conducted with Nepalese women experiencing urinary incontinence, a relevant and comprehensive ICIQ-UI SF was developed to use in Nepal. The questionnaire will be of great value for clinical use and future studies involving Nepalese women.

Urinary incontinence affects the physical, psychological, social and well-being of older adult women and requires adaptation. This study aimed to explain the inhibiting factors of adaptation to urinary incontinence in community-dwelling older adult women. A qualitative content analysis approach was adopted. Participants were 15 older women with urinary incontinence, three family members, and three healthcare team members. Data were collected by individual, in-depth semistructured interviews and analysed using the Graneheim and Lundman approach. The data analysis yielded the theme of neglecting urinary incontinence and the older adult, with four categories of "s silence-inducing beliefs", "worthlessness for the family", "non-adaptation of urban spaces", and "deficiencies in the healthcare service structure". Elucidating the inhibiting factors for older women's adaptation to urinary incontinence will lead to a change in the attitude of social policymakers and healthcare officials. This changes will then facilitate the establishment and adjustment of the necessary infrastructure to overcome these barriers., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Inc.)

Introduction and Hypothesis: Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population., Methods: Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach's alpha coefficient), and test-retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales., Results: A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach's alpha values 0.60-0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61-0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms., Conclusions: The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders., (© 2024. The International Urogynecological Association.)

Objective: Postpartum depression is one of the most common complications after childbearing. Urinary incontinence is a frequent symptom during pregnancy and the postnatal period, often being the first time that women experience it. This systematic review and meta-analysis aimed to synthesize the evidence on the association between urinary incontinence and postpartum depression and to assess whether this association becomes weaker at 6 months after childbirth., Data Sources: MEDLINE, Embase, Cochrane Library, Web of Science, and PsycINFO were searched from inception to December 26, 2023., Study Eligibility Criteria: Cross-sectional and cohort studies addressing the association between urinary incontinence and postpartum depression were included., Methods: Pooled odds ratios and their 95% confidence intervals, and 95% prediction intervals were estimated using a DerSimonian and Laird random-effects model for the association between urinary incontinence and postpartum depression. Subgroup analyses were conducted on the basis of time after delivery (<6 or ≥6 months). The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort Studies., Results: Eleven published studies were included in the systematic review and meta-analysis. Overall, the odds ratio for the association between urinary incontinence and postpartum depression was 1.45 (95% confidence interval, 1.11-1.79; 95% prediction interval, 0.49-2.40; I 2 =65.9%; P=.001). For the 7 cohort studies, the odds ratio was 1.63 (95% confidence interval, 1.35-1.91; 95% prediction interval, 1.14-2.13; I 2 =11.1%; P=.345). For the 4 cross-sectional studies, the odds ratio was 1.05 (95% confidence interval, 1.04-1.05; 95% prediction interval, 1.04-1.06; I 2 =0.0%; P=.413). According to the time after delivery, the odds ratio estimates for cohort studies with a postpartum period <6 months were 1.44 (95% confidence interval, 1.07-1.81; prediction interval, 0.63-2.25; I 2 =0.0%; P=.603) and 1.53 (95% confidence interval, 1.16-1.89; prediction interval, 0.41-2.65; I 2 =50.7%; P=.087) for those with a postpartum period ≥6 months., Conclusion: This systematic review and meta-analysis suggests that urinary incontinence may be a potential predictor of postpartum depression. Thus, it is important that health care professionals offer support and treatment options to women who experience these conditions., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: The aim of this study is to examine the relationship between the frequency of use of non-medication coping strategies with urinary incontinence (UI) and depression in older adults., Methods: This study followed a descriptive design and was conducted with 345 older adults over the age of 65. The data of the study were collected using the Geriatric Depression Scale Short Form and the Frequency of Non-Medication Coping Strategies with Urinary Incontinence Scale. The data analysis of the study was conducted using descriptive statistics, Pearson correlation analysis, and hierarchical multiple regression analysis. The significance level was accepted as P < 0.05., Results: The mean age of the participants was 71.86 ± 5.43 years. Among the older adults, 58.8% were male and 50.2% were primary school graduates. It was determined that 43.8% of the participants experienced the frequency of UI more than once a week, 36.2% experienced stress incontinence, 51.9% consulted a physician due to UI, 53.6% received treatment for UI, and 47.8% reported that UI had an impact on their social life. The relationship between the frequency of use of non-medication coping strategies with UI and geriatric depression (β = -0.017; P = 0.043) was found to be significant and negative. It was found that there was a significant and positive relationship between age, frequency of UI, type of UI, the impact of UI on social life, and geriatric depression (P < 0.05)., Conclusion and Suggestions: The older adults in this study were found to have moderate depression. It was determined that the level of depression was higher in the older adults who experienced UI more than once a week, those who experienced stress UI, those whose social lives were impacted, and those who had a higher frequency of non-medication coping strategies., (© 2024 Japanese Psychogeriatric Society.)

Objective: To determine the prevalence of pelvic floor dysfunction (PFD) among pregnant women, their clustering and their association with body image disturbance (BID) up to 1 year postpartum., Design: Monocentric prospective cohort study., Setting: University Hospitals Leuven., Population: Pregnant women attending for pregnancy care, first assessed prior to 14 weeks of gestation and agreeing to follow-up until 1 year postpartum., Methods: Standardised questionnaires reporting on PFD and BID at 12-14 and 28-32 weeks of gestation, and again at 6-8 weeks and 1 year postpartum. We calculated the prevalence of PFD, how the cases clustered and how the cases correlated with BID using a linear mixed-model analysis. A minimum of 174 women with complete follow-up were required., Main Outcome Measures: The questionnaires used were the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF), St. Mark's Incontinence Score (SMIS), Patient Assessment of Constipation Symptoms (PAC-SYM), Pelvic Organ Prolapse Distress Inventory (POPDI), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire IUGA Revised (PISQ-IR) and the Body Image Disturbance Questionnaire (BIDQ)., Results: Out of 208 women, 92.8% reported one or multiple symptoms of PFD at 28-32 weeks of gestation, dropping to 73.6% by 1 year postpartum. The most common symptoms were constipation (65.3% at 28-32 weeks of gestation and 42.8% at 1 year postpartum) and urinary incontinence (56.8% at 28-32 weeks of gestation and 35.1% at 1 year postpartum). After correcting for body mass index, parity and mode of delivery, the severity of BID was associated with the ICIQ-UI SF score (β = 0.016, range 0.007-0.024), the PAC-SYM score (β = 0.006, range 0.002-0.011) and the POPDI score (β = 0.009, range 0.005-0.012), but not with the SMIS score (β = 0.015, range -0.001 to 0.031) or the PISQ-IR score, in sexually active women., Conclusions: Urinary incontinence, constipation and symptoms of prolapse have a measurable impact on BID., (© 2024 John Wiley & Sons Ltd.)

Over half of women in the United States report urinary incontinence (UI). This condition can be treated conservatively, but many people do not seek treatment. The current correlational study assessed women's knowledge of UI. Specifically, we investigated the relationships between knowledge level about UI and quality of life (QoL), and between severity level of UI and QoL. A convenience cross-sectional sample of 39 older women was obtained from two YMCA locations. Data were analyzed using the Spearman rank-order correlation coefficient. A significant relationship was found between severity of UI and QoL, r s = -.73, p < .001; no relationship was found between knowledge level of UI and QoL, r s = .24, p = .13. Results suggested women's knowledge about the causes of UI and conservative therapy is limited. Occupational therapists need to address UI with their patients and educate them about treatment options and availability., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Gestational diabetes mellitus (GDM) is a common metabolic disease that contributes to urinary incontinence (UI) in pregnant women. The aim of this study was to investigate the therapeutic potential of stable pelvic floor muscle (PFM) training with transverse abdominal muscle for pregnancy-specific UI in patients with GDM., Methods: This was a randomised controlled trial. A total of 73 pregnant women with GDM and pregnancy-specific UI were screened, 35 of whom received stable PFM training with transverse abdominal muscle in the second trimester. After six weeks of training, UI status was assessed by the quantity of fluid loss and the International Consultation on Incontinence Questionnaire short form (ICI-Q-SF), and the quality of life was evaluated by the Incontinence Quality of Life Questionnaire score. Additionally, the thickness of the transverse abdominal muscle was measured by ultrasonography., Results: At 6 weeks later, the quantity of fluid loss and ICI-Q-SF score were significantly lower, and the overall healing rate was significantly higher in the training group than those in the control group. The training also significantly improved the quality of life, especially in terms of behavioural limitation and psychosocial impact. Additionally, the thickness of transverse abdominal muscle under the status of maximal contractions of transverse abdominal muscle and PFM was significantly higher in the training group than in the control group after 6 weeks., Conclusions: Stable PMF training with transverse abdominal muscle alleviated UI and improved the quality of life in patients with GDM. The thickening of transverse abdominal muscle induced by the training contributes to the remission of UI through the cooperation of PMF.

Background: Urinary incontinence (UI) negatively affects the well-being of women globally. Pelvic Floor Muscle Training (PFMT) is a complex intervention that aims to decrease UI symptoms. Information about how the multiple complex components involved in PFMT achieve and maintain the desired effect are rarely studied as a whole. The evidence base lacks data about how women experience PFMT over time and in the longer-term. This study explored women's experiences of biofeedback-assisted PFMT and PFMT alone, to identify and understand what influenced self-reported adherence to PFMT, and UI outcomes over time., Methods: This rigorous longitudinal qualitative case study, nested within a randomised controlled trial, recruited forty cases (women with stress or mixed UI; 20 in biofeedback-assisted and 20 in PFMT alone group). A case included up to four semi-structured interviews with each woman (prior to starting PFMT, end of treatment [6 months], 12 months, 24 months). Analysis followed case study analytic traditions, resulting in a Programme Theory about PFMT from the perspectives of women with UI., Findings: The theory demonstrates factors that motivated women to seek UI treatment, and how these influenced long-term adherence. Therapists who delivered PFMT played a crucial role in supporting women to know how to undertake PFMT (to have capability). Some, but not all, women developed self-efficacy for PFMT. Where women did not have PFMT self-efficacy, adherence tended to be poor. When women had PFMT self-efficacy, the conditions to support adherence were present, but contextual factors could still intercede to inhibit adherence. The intercession of contextual factors was individual to a woman and her life, meaning any particular contextual factor had inconsistent influences on PFMT adherence over time for individual women and exerted varying influences across different women., Conclusion: Long term adherence to PFMT is a complex interaction between many different factors. Enquiring about an individual woman's motivation to seek treatment and understanding the contextual factors that affect an individual woman will enable a practitioner to support longer-term adherence., (© 2024. The Author(s).)

Objective: To explore the experience of patients with incontinence and incontinence-associated dermatitis (IAD) in acute care hospitals and their family caregivers, including their perceptions and management, as well as the impact on their wellbeing., Method: A qualitative exploratory study design was employed in 18 wards across six acute/subacute hospitals in New South Wales, Australia. Patients with incontinence (with or without IAD) were invited to participate. Where interviews were not possible with the patient, their family caregiver was invited to participate. Semi-structured interviews were conducted., Results: There were 45 interviewees in the study; 41 were patients with incontinence (11 of whom had IAD) and four were family caregivers. The experience of incontinence was captured by three themes: 'incontinence interrupts every aspect of my life'; 'actively concealing and cloaking'; and 'perceived as irreversible'. Incontinence was expected by the patients at their age and did not come as a surprise. It was normalised and approached with stoicism. As such, patients self-managed their incontinence by developing strategies to ensure they avoided episodes of incontinence during their stay. Incontinence left patients feeling anxious, embarrassed and with a sense of shame, and they did not communicate these feelings, or engage with health professionals about their incontinence, nor did health professionals discuss their incontinence with them. There was a strong sense of resignation that incontinence was irreversible and nothing could be done to improve it. All participants displayed little knowledge of IAD. The experience of having IAD was characterised by the theme 'debilitating and desperate for relief' and was experienced as a particularly painful, itching and burning condition that left patients distressed and irritable., Conclusion: Patients with incontinence in acute settings required further education from health professionals to reduce the stigma of incontinence, and provide further support to manage their incontinence. Health professionals can also play a key role in educating patients about the risks of developing IAD and how it can be prevented.

Background: A pragmatic randomised controlled trial has confirmed the effectiveness of Urinary Incontinence for Women (UIW) app-based intervention in improving postpartum urinary incontinence (UI) severity among pregnant women. However, the causal mechanisms underlying this intervention effect remain unclear., Objective: To examine the mediating role of self-efficacy with pelvic floor muscle training (PFMT) on the effect of the UIW app-based intervention in improving postpartum UI severity., Methods: This was a secondary causal mediation analysis of a single-center, 2-arm, unblinded pragmatic randomised controlled trial. Singleton pregnant women without UI before pregnancy aged ≥18 years and between 24 and 28 weeks of gestation were recruited from a tertiary public hospital in China and randomised to receive the UIW app intervention plus oral PFMT instructions (n = 63) or oral PFMT instructions alone (n = 63). The primary outcome was postpartum changes in UI severity at 6 weeks. Changes in self-efficacy with PFMT 2 months after randomisation were a hypothesised mediator. Causal mediation analysis was used to estimate the average causal mediation effect (ACME), average direct effect (ADE), average total effect (ATE), and proportion mediated. A sensitivity analysis was conducted to examine the robustness of the ACME in relation to potential unmeasured confounding., Results: Data from 103 participants were analyzed. The ATE of UIW app-based intervention on postpartum UI severity was 2.91 points (95 % confidence intervals [CI] 1.69 to 4.12), with ADE of 1.97 points (95 % CI 0.63 to 3.41) and the ACME 0.94 points (95 % CI 0.27 to 1.72). The proportion of ATE mediated by self-efficacy with PFMT was 0.32 (95 % CI 0.08 to 0.67). Sensitivity analysis revealed the robust ACME with respect to the potential effects of unmeasured confounding., Conclusion: An increase in self-efficacy with PFMT partially mediated the effect of the UIW app intervention on improvements in postpartum UI severity., Trial Registration: The original trial was prospectively registered in the Chinese Clinical Trial Registry under the reference number ChiCTR1800016171 on 16/05/2018. Further details can be accessed at: http://www.chictr.org.cn/showproj.aspx?proj=27455., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction and Hypothesis: Enhancing women's knowledge, attitude, and practice (KAP) concerning urinary incontinence (UI) through diverse educational strategies has been a focal point for professionals in recent years. This study was aimed at assessing the impact of the educational application Continence App® on the KAP of postpartum women experiencing UI. We hypothesized that access to the app would lead to improved KAP among these women., Methods: Postpartum women who had undergone vaginal birth, aged 18 years or above, literate, admitted in a maternity ward, delivered a full-term or large-for-gestational-age infant, and possessed a smartphone or compatible device for app usage were included. Changes in KAP were evaluated using a survey specifically designed for this purpose. The Mann-Whitney U test was employed to compare KAP scores between control and intervention groups, as well as between baseline and post-intervention assessments., Results: Among the 542 women screened for eligibility, 349 were enrolled in the study, with 138 completing post-intervention assessments. The mean (standard deviation [SD]) age of participants was 25.9 (5.8) years. Post-intervention scores for knowledge and practice demonstrated a decline among non-app users, whereas a significant increase was observed among those in the intervention group. Attitudinal changes remained insignificant., Conclusions: The findings highlight the effectiveness of an app-based educational intervention in enhancing the knowledge and practice related to UI among postpartum women., (© 2024. The International Urogynecological Association.)

Introduction and Hypothesis: Urinary incontinence (UI) is relatively common among middle-aged and elderly women and can have significant impacts on patients' physiological, psychological, and quality-of-life aspects. A higher level of autonomy can encourage better health behaviors in patients, so as to promote rehabilitation of the disease and improve their quality of life. The study is aimed at exploring the level of autonomy and influencing factors among middle-aged and elderly women with UI., Methods: A cross-sectional study was conducted at a tertiary hospital in Shenzhen, China. Middle-aged and elderly women were asked to complete the Index of Autonomous Functioning scale (IAF), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and the Urinary Incontinence Quality of Life (I-QOL) scale. Data were collected in January 2024 to March 2024. Descriptive statistics, univariate analysis, bivariate correlation and multivariate linear regression were used to analyze data., Results: A total of 646 women completed the questionnaire. The means and standard deviations (SD) of the IAF section were 45.40 ± 8.92, those of the ICIQ-UI SF section were 11.54 ± 3.67, and those of the I-QOL section were 43.95 ± 9.83. Multivariate linear regression models for the IAF revealed that questionnaire scores were independently associated with family's monthly income, education level, regular exercise, UI severity, and I-QOL score (p < 0.05)., Conclusions: The factors influencing the level of autonomy among middle-aged and elderly women with UI include family's monthly income, education level, regular exercise, UI severity, and I-QOL score. Higher levels of autonomy were observed among women with high family income, high education level, regular exercise habits, mild to moderate UI, and high quality of life., (© 2024. The International Urogynecological Association.)

Introduction: Pelvic organ prolapse is the implosion of one or more pelvic floor structures which affect womens quality of life by compromising overall health, physical, social, structural, functional and emotional well-being., Objective: To assess the quality of life and its associated factors among women with pelvic organ prolapse who attend gynecology clinics at Gurage zone hospitals, Southern Ethiopia 2022., Methods: Facility-based cross-sectional study was applied in gurage zone hospital from April, 30 to Jun 30, 2022. Systematic random sampling was employed to select 416 women. Interview based structured questionnaires were applied to collect the data. The collected data were analyzed using Statistical Produte and Service Solution. Binary and multivariable logistic regressions were fitted to assess the association between dependent and independent variables. P-value < 0.05 was used to declare the final statistical significance., Result: The mean (SD) score of quality of life in this study was 53.57 (21.59). The most affected domains were general health perception and physical limitation (mean (SD) score 67.45 29.24) and (64.26 32.36)) respectively. Had no formal education (AOR = 1.50, 95% CI: 1.02, 3.12), stage III/IV POP (AOR = 2.02, 95% CI: 1.19, 3.60), constipation (AOR = 3.51, 95% CI: 2.12, 7.21), urge urinary incontinence (AOR = 3.89, 95% CI: 2.32, 6.95), and not did regular physical exercise (AOR = 2.18, 95% CI: 1.41, 3.37) were significantly associated with poor quality of life., Conclusion: More than half of the participants in this study had impaired quality of life. The factor associated with quality of life was had no formal education, stage III/IV, constipation, urge urinary incontinence, and regular physical activity. It is recommended to have access education, counseling regular physical activity, detection, and management of its comorbidity., (© 2024. The Author(s).)

This article shares the personal account of the author who is living with double incontinence, and the impact this condition can have on the individual and their carers.

Introduction and Hypothesis: Pelvic floor disorders (PFDs), significantly impacting women's quality of life, are often underdiscussed owing to misconceptions and limited understanding of treatment options. This study is aimed at validating an Arabic version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) to assess knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) among Arabic-speaking women, addressing knowledge gaps in these areas., Methods: The study obtained ethical approval and followed a two-stage process, including a pilot study for preliminary validation and a larger study involving 300 participants. The PIKQ, a self-administered tool with two scales focusing on UI and POP, was translated into Arabic with cultural and linguistic adaptations. The study evaluated the reliability and validity of the Arabic PIKQ, employing Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman's rho for reliability assessments, as well as factor analysis for construct validity., Results: The Arabic PIKQ demonstrated high internal consistency (Cronbach's alpha > 0.8) and test-retest reliability (ICC > 0.79) for both the UI and the POP scales. The questionnaire also showed significant construct validity. Among the 300 participants, knowledge gaps were evident, influenced by educational and professional backgrounds. Notably, 22% reported UI and 14.7% reported pelvic organ prolapse, with less than half seeking treatment., Conclusions: The Arabic PIKQ has been validated as a reliable tool for improving knowledge and addressing misconceptions regarding PFDs among Arabic-speaking women. The study underscores the importance of culturally sensitive educational tools in enhancing awareness and facilitating access to medical care for pelvic floor disorders., (© 2024. The Author(s).)

Background: Cross-sectional and short-term cohort studies have demonstrated an association between urinary incontinence and dementia, as well as lower performance on cognitive testing. The Health and Retirement Study, a longitudinal study of community-dwelling older adults, offers an opportunity to assess the temporal association between these conditions because it included an assessment of incontinence symptoms and biennial assessments of cognitive function., Objective: This study aimed to evaluate if urinary incontinence before the age of 70 years had an effect on changes in cognitive function among women participating in the Health and Retirement Study., Study Design: This secondary analysis included data from female respondents in the Health and Retirement Study aged 58 to 67 years with ≥2 cognitive assessments. Urinary incontinence was defined as any involuntary loss of any urine in the preceding 12 months. A control group without incontinence was reweighted for better comparability using coarsened exact matching for age and comorbidities. Validated methods, including neuropsychological test data, estimated a memory score and dementia probability for each participant biennially. Coprimary outcomes were the changes in memory score and dementia probability. Linear regression models were used to estimate the association of urinary incontinence with change in memory score and dementia probability, adjusting for baseline demographics and comorbidities. A subgroup analysis was performed to assess the effects of urinary incontinence frequency on these outcomes. The infrequent subgroup reported <15 days of leakage per month and the frequent subgroup reported ≥15 days of leakage per month., Results: Among eligible female respondents, 40.6% reported urinary incontinence between the ages of 58 and 69 years. Baseline memory scores and dementia probability were similar between those with urinary incontinence (n=1706) and controls (n=2507). Memory score declined significantly in both cohorts, indicating poorer memory over time (-0.222 among those with incontinence [95% confidence interval, -0.245 to -0.199] vs -0.207 in controls [95% confidence interval, -0.227 to -0.188]). The decline of memory score was not statistically significantly different between cases and controls (mean difference, -0.015; 95% confidence interval, -0.045 to 0.015). Dementia probability increased significantly in both groups, indicating a greater probability of developing dementia by 0.018 among those with incontinence (95% confidence interval, 0.015-0.020) and by 0.020 among controls (95% confidence interval, 0.017-0.022). The change in dementia probability was not significantly different between groups (mean difference, -0.002; 95% confidence interval, -0.006 to 0.002). Frequent urinary incontinence was reported in 105 of 1706 (6%) of those with urinary incontinence. Memory score declined and dementia probability increased with time (P<.001) in frequent and infrequent urinary incontinence subgroups. There was no dose-response relationship., Conclusion: Measures of cognitive performance declined during approximately 10 years of observation. The changes in performance were not associated with the presence of urinary incontinence in the participants' younger years., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This article explores men's experiences of and management strategies for urinary incontinence (UI) following treatment for prostate cancer. Qualitative interviews with 29 men, recruited from two prostate cancer support groups, explored their post-treatment experiences. Drawing on a conceptual toolkit connecting theories of masculinities, embodiment, and chronic illness, this paper identifies older men's experiences and strategies for managing UI and explores how these are shaped by their masculinities. This article identifies interdependence between managing stigma for UI and maintaining masculinity. Men's embodied practices for engaging in activities in public, crucial to masculine identity, were disrupted. In response, they adopted new reflexive body techniques to manage and resolve their UI, and thereby address the threat to their masculine identities, characterised in three strategies: monitoring, planning , and disciplining . The new embodied practices men described suggest three factors as important components for adopting new reflexive body techniques: routine, desire , and unruliness ., Competing Interests: Declaration of conflicting interestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: The aim of this study was to develop a model to determine the correlation between comfort level and quality of life in women with UI., Design: Cross-sectional, descriptive correlational research design with causal modeling., Subjects and Setting: The study was conducted in the urology outpatient clinic of a university hospital in the Central Anatolia region of Turkey. The sample comprised 233 women admitted to the outpatient clinic between December 2017 and May 2018. Participants had a mean age of 52.5 (SD = 13.9) years., Methods: Data were collected using a researcher-designed Descriptive Characteristics Form, the Incontinence Quality of Life (I-QOL) form, the Urinary Incontinence and Frequency Comfort Questionnaire (UIFCQ), and the Short Form-36 (SF-36). Multivariate correlations were analyzed using structural equation modeling; an AMOS covariance-based structural equation model was developed., Results: The correlational pathway between I-QOL, UIFCQ, and SF-36 was statistically significant. As a result of the confirmed model, I-QOL scores were moderately correlated with SF-36 scores (r = .65, P = .001) and highly correlated with UIFCQ scores (r = .76, P = .001). Mean UIFCQ scores were moderately correlated with SF-36 scores (r = .66, P = .001). The structural equation modeling resulted in a model with a good fit., Conclusions: The higher the comfort level, the higher the UI-specific and health-related quality of life. Risk factors related to UI should be monitored, and necessary training and counseling should be provided to eliminate this common problem., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 by the Wound, Ostomy, and Continence Nurses Society.)

Background: Female sexual dysfunction is common in the general population, with age emerging as a significant determinant of sexual activity and functioning., Aim: To establish age-specific reference scores for the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in the general Dutch female population., Methods: A retrospective, cross-sectional, questionnaire-based study was conducted in the Netherlands. The study population comprised 2518 Dutch-speaking women aged ≥18 years, representing a cross section of the general Dutch population. The PISQ-12 was used to assess sexual functioning in heterosexual women. The Groningen Defecation and Fecal Continence questionnaire was utilized to demonstrate demographic factors., Outcomes: We established age-specific reference scores for the PISQ-12 in the general Dutch population., Results: Of the 2518 women, 1592 (63.2%) were sexually active and 926 (36.8%) were not. Further analysis focused on the sexually active group: we found a decrease in mean total PISQ scores, ranging from 38.34 among 18- to 34-year-olds to 36.98 among ≥65-year-olds. Older women scored lower in the behavior domain, specifically pertaining to sexual desire (P < .001) and sexual excitement (P < .001). They also had lower scores in the partner-related domain regarding partner problems of erection (P < .001) and orgasm perception (P < .001). With increasing age, negative emotional reaction scores were higher (P < .001). In the physical domain, we observed significantly different scores for pain during sexual intercourse (P < .001) and restrictions in sexual activity due to fear of urinary leakage (P < .001), with the lowest scores in the youngest group., Clinical Implications: These age-specific references scores of the PISQ-12 provide an overview of sexual functioning of a general population, which enables caregivers to assess and interpret patients' individual scores more accurately., Strengths and Limitations: We included only sexually active women in our subanalyses, potentially introducing selection bias for older women with better physical conditions. The study's strength lies in its extensive sample size, representing a cross section of the general Dutch population. Furthermore, the self-administered questionnaire approach helped minimize embarrassment and obtain realistic responses., Conclusion: Our study demonstrated age-specific PISQ-12 reference scores and highlighted associations between aging and diminishing scores of sexual desire, sexual excitement, erection problems, and orgasm perception, while women aged 18 to 34 years reported the lowest scores for pain during intercourse and limited sexual activity due to fear of urinary leakage., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction and Hypothesis: The world including Iran is facing population aging. Urinary incontinence (UI) is one of the most common health concerns of older women that can be accompanied by an increased sense of loneliness, social restrictions, and disruption in activities of daily living in addition to the regular challenges of old age. This study was aimed at explaining the concerns of community-dwelling older women living with UI., Methods: This study used the conventional, qualitative, content analysis approach with purposive sampling. Twenty interviews were conducted with 18 participants, including 15 community-dwelling older women with UI and three family members (a husband and two daughters), over the span of 14 months (from August 2021 to October 2022). The data were collected via semi-structured, face-to-face interviews until data saturation was achieved, and were analyzed using Graneheim and Lundman's method., Results: The findings revealed that the concerns of older women with UI include the impasse of UI, being powerless in life, distorted social identity, and marital frustration, which fell under the main theme of sense of inadequacy., Conclusions: Recognizing the concerns of older women with UI can make health care teams more sensitive to the importance of resolving these concerns and can offer some insight into how best to provide targeted training, support, and counseling services at individual, family, and society levels, to eventually resolve the older adult's sense of inadequacy., (© 2024. The International Urogynecological Association.)

Purpose: This study aimed to assess nursing students' knowledge levels and attitudes towards the etiology, risk factors, and preventive measures of incontinence-associated dermatitis (IAD) using an escape room game., Design: A mixed-method study., Subjects and Setting: The sample size of the study was 32 students., Methods: Quantitative data obtained with the Knowledge, Attitude and Practice of Nurses in Managing Incontinence-Associated Dermatitis Questionnaire (KAP-IAD-Q) and qualitative data obtained through FGDs following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist were analyzed using a thematic approach., Results: The average age of the participants was 22.63 ± 0.90, 87.5% of them were female (n=28), and 50% were third (n=16) and fourth-year students (n=16). KAP-IAD-Q total posttest score (88.06+7.00) was found to be high. Data obtained from the FGDs were categorized under 3 main themes: main focus areas during participation in the IAD-themed escape room game; advantages and disadvantages of teamwork in IAD management; and the game's contribution to a better understanding and classification of IAD., Conclusions: The use of the escape room game facilitated high, fast, and efficient learning of IAD knowledge and attitudes. It revealed challenges in collaborative decision-making, accurate diagnosis, distinguishing from other wounds, and attitude development in the management of IAD.

Background: Urinary incontinence (UI) might be linked to suicidal ideation, but we do not yet have all the relevant details. This study aimed to dig deeper into the connection between UI and suicidal ideation using data from the National Health and Nutrition Examination Survey (NHANES)., Methods: We examined 31,891 participants aged ≥ 20 years from NHANES 2005-2018 who provided complete information. We used standardized surveys to check for UI and signs of suicidal ideation. To better understand this relationship, we used statistical tools such as multivariable logistic regression, subgroup analysis, and sensitivity analyses., Results: Among the 31,891 participants, 28.9% reported UI and 10.7% reported suicidal ideation. Those with UI exhibited a significantly greater incidence of suicidal ideation (15.5%) than did those without UI (8.8%, P < 0.001). After adjusting for various factors, including age, sex, marital status, socioeconomic status, educational level, lifestyle factors, and chronic comorbidities, UI remained significantly associated with suicidal ideation (OR:1.54, 95% CI = 1.39-1.7, P < 0.001). Among all types of UI, MUI participants were more likely to experience suicidal ideation. Compared with no UI, higher odds of suicidal ideation suffered from MUI (OR:2.11, 95%CI:1.83-2.44, P < 0.001), SUI (OR:1.4, 95%CI:1.19-1.65, P < 0.001), UUI(OR:1.37,95%CI:1.16-1.62, P < 0.001) after full adjustment. With the exception of individuals living with a partner, the remaining subgroups exhibited a positive correlation between urinary incontinence and suicidal ideation, considering that factors such as age, sex, and prevalent comorbidities such as hypertension, depression, and diabetes did not reveal any statistically significant interactions (all P > 0.05). Sensitivity analyses, incorporating imputed missing covariates, did not substantially alter the results (OR: 1.53, 95% CI: 1.4-1.68, P < 0.001)., Conclusion: Urinary incontinence may correlate with increased suicidal ideation risk, priority screening for suicidal ideation and timely intervention are essential for individuals with urinary incontinence, but prospective studies are needed to verify the results., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Pan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions., (© 2024. The Author(s).)

Purpose: The purpose of this study was to examine the feasibility of delivering a bladder control self-management program through a multiuser health kiosk and to evaluate the program's effect on urinary incontinence (UI) and incontinence-specific quality of life (QoL)., Design: Secondary analysis of data collected during participants' interactions with the Bladder Control Module (BCM) from the parent study., Subjects and Setting: One hundred eleven participants from the parent study were eligible to be included in this secondary analysis. Their mean age was 72.8 years, and most were female (n = 95, 85.6%); 81 (75.7%) identified themselves as Caucasian. Each participant could access the BCM at a health kiosk situated at one of several sites: senior centers, subsidized senior housing, retirement communities, and a public library., Methods: The BCM comprised 6 sessions self-administered at least 1 week apart. The content focused on lifestyle modification, pelvic floor muscle training, and bladder (habit) retraining, with encouragement of behavioral self-monitoring between sessions. The feasibility of delivering the intervention was measured by the proportion of participants completing each session. The effect of the BCM on incontinence episodes and incontinence-specific QoL was measured, respectively, by a 7-day bladder diary and the Incontinence Impact Questionnaire Short Form., Results: Sixty-one of the 111 eligible participants accessed the BCM. Participants recording incontinence episodes in their baseline bladder diary and completing at least 3 BCM sessions experienced significant decreases in median total UI (P = .01), urge UI (P < .001), and stress UI (P = .02) episodes per day. Incontinence-related QoL significantly improved (P = .03)., Conclusions: Our findings support the potential effectiveness of providing community-based, kiosk-enabled access to a conservative behavioral intervention designed to improve incontinence-related outcomes among older adults with UI. Additional research with a larger sample is warranted., (Copyright © 2024 by the Wound, Ostomy and Continence Nurses Society.)

Background: Independent of physical activity, sedentary behavior has emerged as a significant risk factor for health. Particularly, older adults spent as high as 13 h daily on sedentary activities, which account for 98% of their awake times. Although there is growing evidence revealing the potential association between sedentary behavior and urinary incontinence (UI) across populations of different ages, the relationship between sedentary behavior and urinary symptoms in older women, who are twice as likely to have UI than older men, has not been reviewed. This scoping review aimed to synthesize available evidence of the relationship between sedentary behavior and urinary symptoms in noninstitutionalized older women., Methods: Six electronic databases (PubMed, Web of Science, SPORTDiscus, Ovid Nursing Database, EMBASE, and MEDLINE) were searched from their inception to April 2023. Observational and experimental studies that measured sedentary behavior using objective and/or self-reported methods in older women aged 60 + years having any type of UI, with English full texts available, were included. Relevant data, including sedentary patterns (types, definitions, measurements, and daily patterns) and UI types were tabulated. A narrative synthesis of the findings was also conducted., Results: A total of seven studies (n = 1,822) were included for review and reporting. Objective measurement showed that older women with UI were engaged in > 8 h sedentary activities daily (493.3-509.4 min/day), which accounted for 73% of their awake times. The duration of self-reported sedentary behavior was lower than the time measured objectively, and the average weekday sitting time was 300-380 min/day. With or without adjustment for confounding factors (e.g., age and number of vaginal deliveries), the daily proportion of sedentary time and average duration of sedentary bouts were positively associated with the prevalence of urgency UI. Notably, sedentary patients with UI were more likely to have lower urinary tract symptoms, including bothersome incontinence, to use incontinence products, and to have nocturia episodes, than their age-matched counterparts who were less sedentary., Conclusion: Our findings suggest a potential relationship between sedentary behavior and UI in older women, but the causality of the relationship remains unclear. To further inform the clinical role of sedentary behavior in the context of UI, a greater number of rigorous studies with a prospective study design is urgently needed., (© 2024. The Author(s).)

Introduction: Despite various studies on the impact of incontinence on patients' lives, the existing literature has not investigated the contribution of nursing care during rehabilitation in terms of quality of life. Fewer data, therefore, exist on the characteristics and perceived impact of the therapeutic relationship as part of the rehabilitation program., Aims: To investigate the characteristics of the nurse-patient therapeutic relationship and its impact throughout the rehabilitation program; to describe the levels of patient burden on everyday activities., Materials and Methods: A monocentric, retrospective, multimethod descriptive study was conducted in the nurse-led continence clinic of a major teaching hospital in Northern Italy. A phenomenological approach with semistructured interviews was adopted after 6 weeks of rehabilitation, following the method of phenomenological enquiry by Giorgi. The short form 12 questionnaire was administered upon admission of patients to the clinic, after 6 weeks, and during the last consultation to investigate the impact of urinary incontinence (UI) on daily activities and physical and psychological quality of life., Results: Ninety-one adult patients of both genders presenting for nonneurogenic nonpostpartum UI were consecutively enrolled. Physical scores (PCS-12) and MCS-12 scores significantly increased over time. Psychological scores showed great variability upon admission, which was reduced halfway through the rehabilitation program. The thematic analysis highlighted four categories based on data saturation: the impact of UI on daily activities, strategies to face the problem, feelings, and the role of nurses., Conclusions: This mixed-method investigation suggests the importance of therapeutic nursing relationships, clinical expertise, and rehabilitative skills. Quality of life is arguably related to the positive results of the rehabilitation program but also to the environment, patients perceive in terms of support, honesty, and trust., (© 2024 Wiley Periodicals LLC.)

Background: Pregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context., Methods: This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS)., Results: The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00)., Conclusions: The results showed that although UI is prevalent during pregnancy, pregnant women's knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women's awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits., (© 2024 Kamuzu University of Health Sciences.)

To evaluate the impact of perioperative comprehensive nursing intervention on postoperative urinary incontinence, various aspects of patient well-being were assessed. The comprehensive group, that received the nursing intervention, demonstrated significant improvements in self-care skills, health knowledge level, self-care responsibility, and self-concept compared to the standard group. The findings indicate that perioperative comprehensive nursing intervention has a remarkable effect on patients undergoing laparoscopic radical prostatectomy. This nursing intervention not only effectively improves postoperative urinary incontinence and alleviates negative emotions, such as anxiety and depression. Therefore, the implementation of this nursing intervention model is highly recommended for clinical practice and wider application.

Emotional/behaviour problems and exposure to stressful life events are thought to contribute to new onset of urinary incontinence (UI) amongst children who have attained bladder control. However, very few prospective studies have examined these associations. We assessed whether mental health problems and stressful life events were associated with subsequent new onset in UI using multivariable logistic regression in a prospective UK cohort (n = 6408). Mothers provided information on their child's symptoms of common mental disorders (Development and Wellbeing Assessment, 7 years), stressful life events (7-8 years) and wetting (day and night, 9 years). There was strong evidence that separation anxiety symptoms were associated with new-onset UI in the fully adjusted model (OR (95% CI) = 2.08 (1.39, 3.13), p < 0.001). Social anxiety, attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms were associated with new-onset UI, but these associations attenuated following adjustment for child developmental level and earlier emotional/behaviour problems. There was weak evidence for a sex interaction with stressful life events (p = 0.065), such that females experiencing more stressful life events were at higher risk of new-onset UI (fully adjusted model OR (95% CI) = 1.66 (1.05, 2.61), p = 0.029), but there was no association in males (fully adjusted model OR (95% CI) = 0.87 (0.52, 1.47), p = 0.608). These results suggest that separation anxiety and stressful life events in girls may lead to an increase in UI., (© 2023. The Author(s).)

Background: Urinary incontinence is a growing issue among adult women globally. Limited data exist examining the impact of occupational, environmental, and behavioral factors on urinary incontinence., Objective: This quantitative, cross-sectional pilot study examined the workplace behaviors of adult women experiencing urinary incontinence. It was hypothesized that specific jobs and work environments would be associated with increased urinary incontinence and urgency based on identified behaviors and work-related conditions., Design: This study is a quantitative, cross-sectional survey., Methods: Adult women (18 years and older) with a history of urinary incontinence were recruited from August 2022 to February 2023 to complete a one-time survey consisting of multiple-choice and short answer questions identifying specific workplace behaviors and symptoms of urinary incontinence. Descriptive statistics and data categorization were used to observe outcomes and examine relationships between urinary incontinence and particular professions., Results: Urinary incontinence and urgency-related symptoms affected healthcare and business professionals at a higher prevalence. The most commonly reported behaviors across all professions consisted of withholding urine and utilizing absorbance products., Conclusion: The results of this study will help guide women's health practitioners in exploring current workplace behaviors that may contribute to urinary incontinence in adult women. With this knowledge, practitioners can provide meaningful education to employers and employees to prioritize toileting behaviors in the workplace.

Introduction: Urinary incontinence (UI) is a prevalent condition among post-partum women, and it can significantly affect their physical and psychosocial well-being. Therefore, it's crucial for post-partum women to discuss any UI symptoms they may be experiencing with their healthcare provider and seek appropriate treatment., Purpose: To investigate what leads post-partum women with UI to seek help in China and Indonesia based on the Andersen Help-Seeking Model., Methods: A cross-sectional digital survey among post-partum women (6 weeks to 1 year) was conducted from May to November 2021 in China and Indonesia. The survey contents included: (1) demographic characteristics, (2) social support, (3) health care needs, (4) capacity and resources. For analysis, descriptive statistics, independent sample t-tests and chi-square tests were used to determine the differences between help-seeking and non-help-seeking women with UI, and logistic regression analysis and the receiver operating characteristic curve (ROC) was used to determine the predictors of heal-seeking behavior in post-partum women with UI., Results: The prevalence of UI was 25 % (215/868) and 31 % (187/605) among post-partum women in China and Indonesia. Among post-partum women with UI, the help-seeking rate was 46 % (98/215) and 52 % (98/187) in China and Indonesia. Incontinence quality of Life, support from women of the family (Yes), knowing the available department for UI (Yes), current knowledge of UI and the current status of UI were independent risk factors for China (P<0.05). Support from husband (Yes), being asked about UI by a doctor (Yes) and the current status of UI were independent risk factors for Indonesia. The obtained area under ROC curve (AUC) for the model were 0.884 and 0.935 in China and Indonesia., Conclusions: The prevalence of UI and the rate of seeking help for UI in Indonesia were higher than those in China. Social support, needs and the availability of resources and organizational support to assist patients in their help-seeking efforts, were the main predictors affecting help-seeking behavior among post-partum women with UI., Competing Interests: Declaration of Competing Interest No conflict of interest has been declared by the authors., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objectives: Depression might worsen lower urinary tract symptoms (LUTS), but the correlation is still disputed. This study examined the influence of depression on LUTS in Japanese women., Methods: This study used a web-based questionnaire to evaluate the mental status of depression and LUTS. The mental status of depression was evaluated using the Quick Inventory of Depressive Symptomatology-Japanese version (QIDS-J), and LUTS was assessed based on the Overactive Bladder Symptom Score (OABSS) and responses to the International Consultation on Incontinence Questionnaire-Short Form., Results: A total of 4151 of 5400 (76.9%) women responded to the questionnaire. The mean age was 48.3 ± 13.8 years. The OABSS gradually increased with the QIDS-J score. The incidence of overactive bladder (OAB) and urgency urinary incontinence (UUI) also increased along with the QIDS-J score. In the younger age group (20-39 years old), the risks of OAB and UUI were higher than in the elderly group (7.42 for OAB and 7.44 for UUI)., Conclusions: This study revealed that worsening of LUTS was correlated with depression., (© 2023 The Authors. LUTS: Lower Urinary Tract Symptoms published by John Wiley & Sons Australia, Ltd.)

Introduction: Urinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups., Methodology: A systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review., Results: Four themes emerged from this review: the perceived origin of UI, the physical, psychological, and social impact of UI, the impact of culture and religion on UI, and vice versa, and the interaction of women with health services., Discussion: Social determinants of health, such as religion and culture, need to be considered by professionals providing care if women from underrepresented groups experiencing UI are to receive optimal care.

Background: Urinary incontinence (UI) is a highly prevalent health concern commonly observed during and after pregnancy that can substantially impact women's physical and psychological well-being and quality of life. Owing to its numerous advantages, mobile health may be a promising solution; however, it is unclear whether the app-based intervention can effectively improve UI symptoms during and after pregnancy., Objective: This study aimed to evaluate the effectiveness of the Urinary Incontinence for Women (UIW) app-based intervention for UI symptom improvement among pregnant women in China., Methods: Singleton pregnant women without incontinence before pregnancy who were aged ≥18 years and between 24 and 28 weeks of gestation were recruited from a tertiary public hospital in China and were randomly allocated (1:1) to either an experimental group (n=63) or a control group (n=63). The experimental group received the UIW app intervention and oral pelvic floor muscle training (PFMT) instructions, whereas the control group received oral PFMT instructions alone. Neither the participants nor the researchers were blinded to the intervention. The primary outcome was UI severity. The secondary outcomes included quality of life, self-efficacy with PFMT, and knowledge of UI. All data were collected at baseline, 2 months after randomization, and 6 weeks post partum through electronic questionnaires or by checking the electronic medical record system. Data analysis followed the intention-to-treat principle. A linear mixed model was used to examine the intervention effect on primary and secondary outcomes., Results: Participants in the experimental and control groups were comparable at baseline. Of the 126 overall participants, 117 (92.9%) and 103 (81.7%) women completed follow-up visits at 2 months after randomization and 6 weeks after delivery, respectively. A statistically significant difference in UI symptom severity was observed between the experimental group and control group (2 months after randomization: mean difference -2.86, 95% CI -4.09 to -1.64, P<.001; 6 weeks post partum: mean difference -2.68, 95% CI -3.87 to -1.49, P<.001). For the secondary outcomes, a statistically significant intervention effect on the quality of life, self-efficacy, and UI knowledge was found at the 2-month follow-up (all P<.05) and 6 weeks post partum (all P<.001)., Conclusions: The app-based UI self-management intervention (UIW) effectively improved UI symptom severity, quality of life, self-efficacy with PFMT, and knowledge of UI during the late pregnancy and early postnatal periods. Larger multicenter studies with a longer postpartum follow-up are required to further extend these findings., Trial Registration: Chinese Clinical Trial Registry ChiCTR1800016171; http://www.chictr.org.cn/showproj.aspx?proj=27455., International Registered Report Identifier (irrid): RR2-10.2196/22771., (©Ling Chen, Danli Zhang, Tiantian Li, Sha Liu, Jie Hua, Wenzhi Cai. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 27.06.2023.)

We conducted a study to assess the characteristics, scope of activity, and negative emotions in elderly women with urinary incontinence (UI) based on a longitudinal follow-up conducted in Shanghai, China from 2013 to 2019. A total of 3,531 elderly women were included in the final analysis, and 697 women who experienced UI during follow-up were included in the UI group. Subjects with UI were subdivided into those with partial UI (UI once a day or less) and UI (frequent UI). Two thousand eight hundred and thirty-four women who did not have UI during the same period served as the control group. The prevalence of UI was 19.74% in this study. Logistic regression analysis revealed that being older (> 80 years of age), having a high level of education (> 12 years; elderly people with a high level of education may pay more attention to their health and notice UI more readily), a low personal monthly income (≤ 3,000 RMB), more gravidity/parity, and having a chronic disease (chronic obstructive pulmonary disease (COPD), dementia, or Parkinson's disease) were risk factors for UI (p < 0.05). About 60% of women in the partial UI group engaged in daily activities outdoors, while this number decreased sharply to 3.6% in the UI group. Women in the UI group were more likely to have negative emotions, such as depression, anxiety, irritability, or feeling worthless (p < 0.001). Among elderly women with dementia, those with UI had defects in terms of judgment in everyday life, the ability of convey information, and the ability to understand information (p < 0.05). More attention needs to be paid to the adverse effects of UI on activities of daily living (ADL) and mental health in the future.

Background: Life-space mobility represents the distance, frequency, and independence of mobility, ranging from one's bedroom to beyond their town. Older men with lower urinary tract symptoms (LUTS) may limit their life-space to stay close to a bathroom. However, it's unknown whether LUTS severity or urinary bother are associated with risk of life-space mobility restriction., Methods: We analyzed data from 3025 community-dwelling men age ≥71 years without life-space mobility restriction at analytic baseline (Year 7) of the Osteoporotic Fractures in Men (MrOS) study. The American Urologic Association Symptom Index (AUASI) was assessed at baseline and includes one question assessing urinary bother ("If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?"; score 0-1,2,3,4-6) and seven items to classify LUTS severity as none/mild (score 0-7), moderate (8-19), or severe (20-35). The University of Alabama Life-space Assessment was used to define life-space mobility restriction (≤60) at baseline and follow-up (Year 9). We used log-binomial regression with robust variance estimators to model adjusted risk ratios (ARR) for LUTS severity and urinary bother with incident life-space mobility restriction, controlling for age, site, health-related factors, and comorbidities. We then mutually adjusted for urinary bother and LUTS severity., Results: Overall, the 2-year risk of life-space mobility restrictions was 9.9%. Compared to men without urinary bother (scores 0-1), the risk of life-space mobility restriction was significantly higher among men with bother scores of 4-6 (ARR = 2.20, 95% CI: 1.52, 3.19), independent of LUTS severity and confounders. Conversely, LUTS severity was not independently associated with the risk of life-space mobility restriction., Conclusions: Urinary bother, but not LUTS severity, is independently associated with incident life-space mobility restriction among older men. To maintain life-space mobility in older men with LUTS, future studies should identify shared mechanisms and interventions that minimize urinary bother., (© 2022 The American Geriatrics Society.)

Objective: This study aimed to determine the effect of the perceived social support level on coping methods for urinary incontinence among men aged 65 years and over with urinary incontinence., Methods: A total of 92 male patients over the age of 65 years with urinary incontinence and adequate cognitive levels were included in the study. The coping methods, the environmental support, and the Multidimensional Scale of Perceived Social Support were used to collect data., Results: The most common method of coping was changing clothes (64 [69.6%]). The Multidimensional Scale of Perceived Social Support total mean score was 55.83±14.8, which was considered above the medium-level support. The perception level of social support caused significant differences in coping methods in individuals with urinary incontinence., Conclusion: The view that urinary incontinence is a problem related to aging is regarded as an obstacle to seeking healthcare. Society should be made aware that urinary incontinence is not a normal condition related to aging and that it is not an insoluble problem that the elderly must endure.

Multimorbidity (MM) is common in older people. Recent evidence, largely from cross-sectional studies, suggests that MM could be a risk factor for urinary incontinence (UI). For this reason, we aimed to explore the association between MM at baseline and incident UI, and which individual chronic medical conditions/factors might explain the association between MM and UI, using data from the English Longitudinal Study on Ageing, during ten years of follow-up. MM was defined as having two or more chronic medical conditions; the presence of UI was assessed using self-reported information. A logistic regression analysis, adjusted for baseline potential confounders, was used to assess the association between MM and UI, reporting the data as odds ratios (ORs) with their 95 % confidence intervals (CIs). Of 9432 initial participants, 6742 (mean age: 64.8 years; 53.2 % females) without UI at baseline were included in the analysis. MM was present at baseline in 48.8 % of the participants. People with MM had a significantly higher cumulative incidence of UI than their counterparts, leading to a significantly higher risk of UI also after adjusting for potential confounders at baseline (OR = 1.30; 95 % CI: 1.14-1.48). Among the medical conditions, only three were significantly associated with incident UI, namely asthma, Parkinson's disease, and psychiatric disorders. In conclusion, MM at baseline was associated with an increased risk of UI during ten years of follow-up, suggesting that UI is more likely to be present in people with several chronic medical conditions., Competing Interests: Declaration of competing interest The authors declare that they have no competing interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Currently, there is a lack of studies monitoring the relationship between lower urinary tract symptoms and mobility disorders in women with multiple sclerosis. The aim of this study was to monitor the relationship between overactive bladder and mobility impairments in women with multiple sclerosis., Methods: A number of 106 female patients with multiple sclerosis (MS) with relapsing-remitting (RR) form, disability stage: EDSS ≤ 6.5, from the specialized outpatient clinic of the Department of Neurology, Faculty of Medicine, University of Medical Sciences in Košice. Urinary leakage symptoms were assessed by the modified International Consultation on Incontinence Questionnaire (ICIQ UI-SF), and overactive bladder symptoms were assessed by the Short Overactive Bladder Symptoms Questionnaire (OAB-q). The Multiple Sclerosis Impact Scale (MSIS-29) and the Rivermead Mobility Index (RMI) were used., Conclusion: In MS patients, we found the following correlations: a significant positive mean correlation between the severity of OAB and UI symptoms and physical attributes. We found a significant positive moderate correlation between severity of OAB and UI symptoms and psychological attributes. We found a negative significant moderate correlation between OAB and UI symptom severity and mobility. It was confirmed that the more severe the symptoms of UI and OAB, the greater the difficulty of mobility in performing physical activities, and thus the negative impact of SM disease on patients' psychological health increases.

Purpose: The study was performed to determine how urinary incontinence (UI) affects women's daily lives and sexual health and how UI is perceived., Design: Qualitative descriptive phenomenological design was used., Subjects and Setting: The study was conducted in a family health center in Konya, Turkey, with official permission of the ministry of health. Study participants comprised 101 women with UI, but data from 12 women were excluded because they refused to respond to questions; therefore, data analysis is based on responses from 89 respondents., Methods: Data were compiled via in-depth interviews using a semistructured questionnaire. Data collection and analysis processes were carried out simultaneously. Study data were examined using phenomenological content and thematic analyses. Document portraits and a code map of data were created using qualitative data analysis software., Results: Participants' mean age was 46.25 (SD: 11.68) years. Thirty-three codes were identified to detect the effects of UI on women's daily lives. These codes were reviewed and combined into 5 main themes: religious issues, sexual problems, feeling restricted, psychological exposure, and internalization., Conclusions: Urinary incontinence causes women to experience environmental, psychological, and religious challenges during daily life. Healthcare professionals should give counsel and assistance by determining the issues for women with UI to promote coping with problems and offer referral for specialist care when necessary., Competing Interests: The authors declare no conflict of interest, and no institutions funded the study., (Copyright © 2023 by the Wound, Ostomy and Continence Nurses Society.)

Introduction: Urinary incontinence is a troublesome symptom that negatively affects many aspects of life among woman suffering from this disease. It disturbs social, professional and intimate relations, and thus contributes to a negative self-image, loss of self-confidence, withdrawal of a woman from social and family life, and consequently promotes negative state of mind and depression., Aim: The aim of the study was to analyse the influence of urinary incontinence on the psychosocial functioning of women suffering from this disease., Material and Methods: The study included a group of 202 women aged 40.1 ± 13.9 years. A proprietary questionnaire was used, aimed at all women who had an episode of urinary incontinence at any time in their life., Results: The impact and perception of the urinary incontinence symptoms depended on its form and severity. Comparing stress urinary incontinence with the mixed form, a greater severity of symptoms in women with the mixed form were observed, respectively 13.6% vs. 53.9%. Taking into account the aspects of life affected by urinary incontinence, it was found that the greatest impact UI had on the social (52.5%), then on the professional (28.7%), and the least impact on the family aspect of life (21.8%)., Conclusions: Research has shown that urinary incontinence has the greatest impact on the social aspect of the surveyed women's life. The reported impact largely depended on the form and severity of urinary incontinence. In over 40% of women, symptoms related to urinary incontinence caused a deterioration of wellbeing and body acceptance. The mixed form was by far the most problematic and had the greatest impact on the daily functioning of women compared to, for example, the stress form., (© National Institute of Public Health NIH – National Research Institute.)