Patient-focused Websites Related to Stress Urinary Incontinence and Pelvic Organ Prolapse: a DISCERN Quality Analysis

Objective: To evaluate the quality of information presented on English-language websites regarding treatment options for POP and SUI using a validated instrument. Methods: Utilizing the International Urogynecology Association list of continence societies worldwide, faculty nomination and a complementary Google search using the terms “professional organizations stress urinary incontinence / pelvic organ prolapse” English-language, patient-focused websites related to POP and SUI were identified. The websites were evaluated by faculty at an academic medical center, including 4 faculty members of the urogynecology division, 2 urogynecology fellows, 3 urologists, and 1 obstetrician gynecologist. The websites were independently evaluated using the validated DISCERN instrument assessing the reliability and quality of consumer health information.Results: From the IUGA continence societies worldwide list, 47 websites were identified. Five provided patient information in English. Eight additional websites were identified from the Google search or provider nomination. One website provided information only for POP (rectocele), 5 for SUI, and 7 for both. The lowest mean total score for any website was 38.7 and the highest mean total score was 61.5 across all the websites. There were no statistically significant differences in the website mean total scores (p value \u3c0.40 for POP and 0.14 for SUI). For websites covering both topics, POP scores were generally higher than SUI scores, but not statistically significantly different (p value\u3c3.75). The overall quality item scores were also not significantly different (SUI: p\u3c0.923; POP: p \u3c0.813). Missing information most commonly included lack of clear objectives, sources, and information related to the expected outcome of no intervention.Conclusions: Available English-language professional websites written to inform patients about management choices for SUI and POP miss key components of quality patient information

Prevention of urinary incontinence in adults: population-based strategies

BACKGROUND: Urinary incontinence (UI) affects large numbers of adults, especially older adults, with an estimated 200 million adults worldwide having this life-altering condition. OBJECTIVES: To identify key populations at risk for urinary incontinence and propose population-based strategies to promote continence with a substantive focus on UI prevention. METHODS: Critical review of extant literature and iterative synthesis were undertaken to generate an action plan to guide future UI prevention research. RESULTS: Key populations identified to be at risk for UI are women in selected occupations, childbearing women, older adults with lifestyle risk factors, older adults with comorbid conditions, and nursing home residents. Population-based research activities are proposed. Growing evidence supports the benefit of pelvic floor muscle training to prevent childbirth and prostatectomy-related UI. Bladder training has demonstrated preventive capacity. CONCLUSIONS: Because of its high prevalence and chronic but preventable nature, UI is most appropriately considered a public health problem. Nursing research is needed to test prevention programs for UI using a population-based public health focus

Pharmacologic management of asymptomatic bacteriuria and urinary tract infections in women

Many factors influence the decision to institute treatment for the common problems of urinary tract symptoms and/or the presence of microorganisms in the urine of women. This article summarizes current evidence related to treatment choice and compares selected treatment practice guidelines. Evidence related to prevention of recurrent infection without the use of antibiotics is included

Pharmacologic management of bladder dysfunction in adult women

Women commonly experience lower urinary tract symptoms that can severely decrease quality of life. Symptoms are often associated with diagnoses such as urinary incontinence, overactive bladder, and bladder pain syndrome. Expanding evidence supports the effectiveness of many basic nursing interventions, including behavioral management education and optimal use of various pharmacologic agents. The primary focus of this article is pharmacologic treatment of urinary symptoms in women, including new and emerging agents

Communication skills in women\u27s health care: helping students clarify values related to challenging topics in ob-gyn

Describes a women\u27s health curriculum for medical students, with the following goals: foster understanding of how biases may act as barriers to care; clarify values and strategize methods of meeting patients’ needs without compromising the provider’s values; offer opportunity for students to observe and critique counseling techniques used by experienced clinicians; review management options for patients faced with common, difficult situations; and, facilitate students’ confidence in dealing with similar situations in their later independent practice

Case and grounded theory as qualitative research methods

Case and grounded theory are two methods of qualitative research. Both methods have their roots in sociology and are focused on understanding, explaining, and/or predicting human behavior. They are ideal methods for nursing research, as they are useful for exploring human responses to health problems. The theoretical underpinnings, methodologies, strategies for data collection, requirements for trustworthiness, and examples of research using case and grounded theory are described

Acupuncture for urinary urgency in women over 50: what is the evidence

The article reports on the potential of acupuncture as a therapy for treating urinary urgency (UU) or urge urinary incontinence (UUI) in aging women. Although its efficiency has not yet been established, acupuncture as non-pharmacologic treatment for UUI or UU can be considered safe and may decrease symptoms. Other suggested treatment for urinary urgency were compared with acupuncture

Not the surgery for a young person: women\u27s experience with vaginal closure surgery for severe prolapse

INTRODUCTION: Vaginal prolapse can be debilitating, due to pelvic organ prolapse and herniation of the bladder, uterus, intestines and/or support tissues in the vaginal opening. However, there is little published information that documents women\u27s experiences in the months and years after surgery to correct prolapse. OBJECTIVE: This phenomenologic study aimed to increase understanding of the specific experiences that patients report after vaginal closure surgery. METHOD: Participants were recruited via a mailing to surgical patients from a large urogynecologic practice. Semi-structured interviews were tape-recorded and transcribed for analysis. RESULTS: Six women participated in the study. After analyzing the results, five major themes emerged: awareness and confusion, feeling alone in silence, trusting recommendation, acceptance of changed sexuality, and still coping. CONCLUSIONS: This small study shows that vaginal closure affects an intimate body part and can impact self-image, but the women did not regret their changed sexuality. The larger issues for these women were ones of communication, information, and isolation, particularly during their followup care

Uses of qualitative research, or so what good is it

This article offers guidelines for the effective use of qualitative research in various clinical studies. The authors discuss the ways to judge the quality and fit of research findings before applying them to clinical situations, ideas about uses of qualitative research in new clinical settings. They also explore the ways for the application of qualitative techniques to inform clinical questions outside of formal research settings. Qualitative research, suggestively, is well-suited for providing the opportunity for the reader to reflect on his or her own situation in a different light. Many qualitative studies are designed to explore the process of an illness. Nurses are suggested to use the reports of this type of study to measure the progress of their patients. By using qualitative research, nursing professionals, suggestively, may help their patients move through the process of their illness

Common problems of urination in nonpregnant women: causes, current management, and prevention strategies

This article uses a case-based approach to review common problems of urination in nonpregnant women, including overactive bladder; stress, urge, and mixed incontinence; and retention and prolapse. Up-to-date clinical issues related to assessment, diagnosis, treatment, and follow-up are reviewed, with a discussion of underlying pathophysiology and prevention strategies. Suggestions are made for relevant curriculum content at both the basic and advanced levels of advanced practice education