Urinary Incontinence: Difference between revisions
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*5 - strong squeeze with a lift | *5 - strong squeeze with a lift | ||
Palpation of the pelvic floor muscles per the vagina in females and per the rectum in male patients.<ref name="Laycock">Laycock J. Pelvic muscle exercises: physiotherapy for the pelvic floor. Urol Nurs 1994;14:136-40.</ref> | Palpation of the pelvic floor muscles per the vagina in females and per the rectum in male patients.<ref name="Laycock">Laycock J. Pelvic muscle exercises: physiotherapy for the pelvic floor. Urol Nurs 1994;14:136-40.</ref> | ||
===== PERFECT mnemonic assessment, described by Jo Laycock<ref name="Laycock" />: ===== | |||
*P - power, may use the Modified Oxford grading scale | |||
*E - endurance, the time (in seconds) that a maximum contraction can be sustained | |||
*R - repetition, the number of repetitions of a maximum voluntary contraction | |||
*F - fast contractions, the number of fast (one second) maximum contractions | |||
*ECT - every contraction timed, reminds the therapist to continually overload the muscle activity for strengthening | |||
== Key Evidence == | == Key Evidence == |
Revision as of 02:46, 11 February 2011
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Clinically Relevant Anatomy
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Mechanism of Injury / Pathological Process
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Definitions: [edit | edit source]
- Urinary incontinence (symptom): Complaint of involuntary loss of urine.
- Stress (urinary) incontinence: Complaint of involuntary loss of urine on effort or physical exertion (e.g. sporting activities), or on sneezing or coughing.
- Urgency (urinary) incontinence: Complaint of involuntary loss of urine associated with urgency.
- Mixed (urinary) incontinence: Complaint of involuntary loss of urine associated with urgency and also effort or physical exertion or on sneezing or coughing.
- Urgency: Complaint of a sudden, compelling desire to pass urine which is difficult to defer.
- Overactive bladder (OAB, Urgency) syndrome: Urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology.[1]
Clinical Presentation[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
Patient Global Impression of Improvement (PGI-I)
Patient Global Impression of Severity (PGI-S)
Pelvic Floor Distress Inventory (PFDI)
Pelvic Floor Distress Inventory - 20 (PFDI - 20)
Pelvic Floor Incontinence Questionnaire (PFIQ)
Pelvic Floor Impact Questionnaire - 7 (PFIQ - 7)
Management / Interventions
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Differential Diagnosis
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Pelvic Floor Muscle Strength[edit | edit source]
Modified Oxford grading system:
- 0 - no contraction
- 1 - flicker
- 2 - weak squeeze, no lift
- 3 - fair squeeze, definite lift
- 4 - good squeeze with lift
- 5 - strong squeeze with a lift
Palpation of the pelvic floor muscles per the vagina in females and per the rectum in male patients.[2]
PERFECT mnemonic assessment, described by Jo Laycock[2]:[edit | edit source]
- P - power, may use the Modified Oxford grading scale
- E - endurance, the time (in seconds) that a maximum contraction can be sustained
- R - repetition, the number of repetitions of a maximum voluntary contraction
- F - fast contractions, the number of fast (one second) maximum contractions
- ECT - every contraction timed, reminds the therapist to continually overload the muscle activity for strengthening
Key Evidence[edit | edit source]
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Resources
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Case Studies[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Abrams P, Cardozo L, Fall M, et al. The standardization of terminology in lower urinary tract function: report from the standardization sub-committee of the International Continence Society. Urology 2003;61:37-49.
- ↑ 2.0 2.1 Laycock J. Pelvic muscle exercises: physiotherapy for the pelvic floor. Urol Nurs 1994;14:136-40.