Stress urinary incontinence: effect of pelvic muscle exercise

Article Abstract:

Urinary incontinence (inability to retain urine) occurs in women most often as a result of stress (coughing, laughing, sudden movements), and one approach to treating it is through pelvic muscle exercises. Twenty premenopausal women with this condition were evaluated before and after a pelvic exercise training program. Urodynamic studies (of urine storage, bladder emptying, and rate of passage of urine from the bladder) were performed at the beginning of the six-week program, three weeks into the program, and six weeks after completion. Half the group exercised with an intravaginal balloon (a possible aid in muscle control), while the other half simply performed the exercises. Results revealed that 18 subjects developed increased strength in their pelvic floor muscles (the muscles that support the bladder and help form the urinary sphincter), with no added training advantage for the intravaginal balloon. On follow-up of 19 patients, none rated her symptoms as worse than when the study began, but 10 had stopped exercising. Of those who continued exercising, five reported mild improvement, three underwent surgery, and one reported no change. Overall, exercises can improve stress urinary incontinence. Appropriate patient selection is undoubtedly of importance in maximizing the success of this therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Exercise therapy, Pelvis, Urinary organs, Urinary tract, Pelvic muscles

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Use of magnetic resonance imaging in the diagnosis of cortical blindness in pregnancy

Article Abstract:

The case report is presented of a patient who became temporarily blind within two days after giving birth. Visual loss was accompanied by increased blood pressure. The patient's neurologic examination was normal, and computerized tomography (CT, an X-ray imaging method) showed no abnormalities. However, results from electroencephalography (recording of the brain's electrical signals) and magnetic resonance imaging (MRI, an imaging method that provides very high resolution) revealed changes in the visual cortex (the part of the brain that processes visual information). The patient's vision improved by the third day after delivery, and she was discharged two days later with normal vision and blood pressure. Blindness in pregnancy is rare. In cases where it is temporary, blindness is most likely the result of swelling of brain tissue or spasm of a blood vessel. CT can provide valuable diagnostic information and, even in cases when it is normal, help rule out competing diagnoses. MRI may be an additional, highly useful, diagnostic aid; its clinical potential for cases of cortical blindness has not yet been explored. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Complications and side effects, Blindness, Magnetic resonance imaging, Preeclampsia, Pregnancy, Complications of, Pregnancy complications

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Transvaginal needle bladder neck suspension procedures for stress urinary incontinence: a comprehensive review

Article Abstract:

A popular method of treating stress incontinence, the involuntary discharge of urine, involves surgery using a needle to restore the neck of the bladder to its proper anatomical location (needle suspension). The authors reviewed three principle needle suspension procedures (Pereyra, Stamey and Raz). Many studies using the surgical procedure reported success rates based on subjective cures rather than demonstrable cures of involuntary urination, thus skewing the reported success rate of the needle suspension technique. Approximately 20 to 50 percent of the studies reported urination difficulties after surgery. The classification of various needle suspension techniques, details of the surgical procedure, and a review of previously published studies are reviewed and analyzed. The different procedure modifications are compared and rated as to their success in treating involuntary urination.

Methods, Urinary incontinence, Surgery, Suturing, Vagina, Urologic surgery, Bladder

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