The Experts below are selected from a list of 3390 Experts worldwide ranked by ideXlab platform

Maya Basu - One of the best experts on this subject based on the ideXlab platform.

Linda Brubaker - One of the best experts on this subject based on the ideXlab platform.

  • Mixed Incontinence: Comparing definitions in non-surgical patients
    Neurourology and urodynamics, 2010
    Co-Authors: Linda Brubaker, Emily S. Lukacz, Kathryn L. Burgio, Philippe E. Zimmern, Peggy Norton, Wendy W. Leng, Harry W. Johnson, Stephen R. Kraus, Anne M. Stoddard
    Abstract:

    Purpose We aimed to explore operational definitions of Mixed urinary Incontinence (MUI) for use in Incontinence outcomes research for non-surgical patient populations. Methods A secondary analysis of women with urge Incontinence or urge predominant MUI enrolled in the Urinary Incontinence Treatment Network BE-DRI randomized clinical trial was performed. Subjects were characterized at baseline for urinary Incontinence severity and Incontinence subtype (stress or urge) using the Medical, Epidemiologic, and Social Aspects of Aging (MESA) questionnaire, the Urogenital Distress Inventory, and a 7-day urinary diary. Various different definitions of MUI, ranging from low to high threshold, were created using a combination of these baseline Incontinence measures. Prevalence of MUI based on each definition was described and compared to treatment response. Logistic regression analysis was used to estimate the association between the study outcomes and the different definitions of MUI. Results The 307 participants in the BE-DRI study had a mean age of 56.9 (±13.9) years with a mean total MESA score of 21.7 (±8.9) and a mean total UDI score of 120.5 (±49.6). The proportion of women diagnosed with MUI varied significantly by definition ranging from 63.5% to 96.4%. Low threshold symptom-based definitions resulted in nearly universal diagnosis of MUI. No strict cut-off value for these baseline measures was identified to predict clinical outcomes. Conclusions Current MUI definitions do not adequately categorize clinically relevant UI subgroups. For research purposes we believe it necessary to describe the severity of each Incontinence subtype separately in subjects with MUI. Neurourol. Urodyn. 30:47–51, 2011. © 2010 Wiley-Liss, Inc.

  • Mixed Incontinence comparing definitions in women having stress Incontinence surgery
    Neurourology and Urodynamics, 2009
    Co-Authors: Linda Brubaker, Emily S. Lukacz, Philippe E. Zimmern, Peggy Norton, Stephen R. Kraus, Anne M. Stoddard, Holly E. Richter, Pamela Moalli, Larry Sirls, Harry W. Johnson
    Abstract:

    Objective To develop an empirically derived definition of Mixed urinary Incontinence (MUI) for use in Incontinence outcomes research. Methods Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS). Participants were required to have stress Incontinence with a MESA stress subscale score > MESA urge subscale score. Several definitions of MUI were considered. Logistic and linear regression analysis methods were used to predict clinical outcomes based on the different MUI definitions. Analyses were carried out using SAS (SAS Institute, Inc., Cary, NC, Version 9.1). Statistical significance was defined at P-value <0.05. Results In 655 participants, the proportion of women with MUI varied from 8.3% to 93.3% depending on the MUI definition All definitions were associated with severity as measured by the frequency of Incontinence episodes at baseline; however little of the variability was explained by any single definition. No strict cut-off value for these baseline measures was identified to predict clinical outcomes. Conclusions These MUI definitions do not adequately categorize clinically relevant UI subgroups. For research reporting, MUI subcomponents of stress and urge UI should be described separately rather than as a single dimension. Neurourol. Urodynam. 28:268–273, 2009. © 2009 Wiley-Liss, Inc.

  • Mixed Incontinence: Comparing definitions in women having stress Incontinence surgery
    Neurourology and urodynamics, 2009
    Co-Authors: Linda Brubaker, Emily S. Lukacz, Philippe E. Zimmern, Peggy Norton, Stephen R. Kraus, Anne M. Stoddard, Holly E. Richter, Pamela Moalli, Larry Sirls, Harry W. Johnson
    Abstract:

    Objective To develop an empirically derived definition of Mixed urinary Incontinence (MUI) for use in Incontinence outcomes research. Methods Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS). Participants were required to have stress Incontinence with a MESA stress subscale score > MESA urge subscale score. Several definitions of MUI were considered. Logistic and linear regression analysis methods were used to predict clinical outcomes based on the different MUI definitions. Analyses were carried out using SAS (SAS Institute, Inc., Cary, NC, Version 9.1). Statistical significance was defined at P-value

  • Mixed Incontinence is more bothersome than pure Incontinence subtypes
    International urogynecology journal and pelvic floor dysfunction, 2008
    Co-Authors: Yashika Dooley, Lior Lowenstein, Kimberly Kenton, Mary P. Fitzgerald, Linda Brubaker
    Abstract:

    The purpose of the study was to compare Incontinence bother in women with Mixed Incontinence versus pure Incontinence subtypes. This is an institutional review board-approved study comparing physical exam findings and responses to the Medical Epidemiologic and Social Aspects of Aging (MESA) questionnaire and the Urinary Distress Inventory (UDI-6). The MESA responses were used to classify women as Mixed, pure stress, or pure urge Incontinence. This analysis includes 551 women with a mean age of 56 ± 16 years. Most women were Caucasian (86%) with 7% African American and 5% Hispanic. UDI scores were significantly higher in women with Mixed Incontinence (61 ± 23) than those with pure stress Incontinence (40 ± 26) or pure urge Incontinence (40 ± 25; p < 0.0001). Women with Mixed Incontinence report greater Incontinence bother than women with either pure stress or urge Incontinence.

  • Prevalence and impact of nocturia in a urogynecologic population
    International urogynecology journal and pelvic floor dysfunction, 2007
    Co-Authors: Lior Lowenstein, Kimberly Kenton, Linda Brubaker, Holly Kramer, Susan Shott, Mary P. Fitzgerald
    Abstract:

    To determine the prevalence of nocturia and associated bother among patients presenting to a tertiary urogynecology clinic and to describe patient characteristics related to nocturic frequency and associated bother. Chart review of sequential new patients presenting to our clinic between June 2004 and May 2005. We recorded patients’ response to a question about their frequency of nocturia, the level of associated bother, demographic data, history of chronic medical illness and clinical urogynecologic diagnosis. Seven hundred sixty patients were of mean age 56 (19–95) years. Eighty-seven percent of patients voided at least once nightly, and 60% usually voided at least twice nightly. Forty one percent of patients reported bother ≥5/10 from nocturia. High bother rating was associated with increasing number of nocturic episodes (p < 0.0005) and Mixed Incontinence (p = 0.012). Nocturia is common and bothersome to women presenting for urogynecologic care. Concomitant Mixed Incontinence significantly increases bother arising from nocturia.

Vik Khullar - One of the best experts on this subject based on the ideXlab platform.

  • Mixed Incontinence: current evidence and future perspectives.
    Neurourology and urodynamics, 2010
    Co-Authors: Vik Khullar, Linda Cardozo, Roger R. Dmochowski
    Abstract:

    The epidemiology and treatment of Mixed Incontinence has received relatively little attention. However, Mixed Incontinence--defined as the combination of stress and urge Incontinence accounts for approximately 33% of all cases of Incontinence in women. The condition often responds poorly to treatment, either pharmacologic or surgical. Potential pharmacologic approaches for Mixed Incontinence include antimuscarinic agents, estrogen replacement therapy (for postmenopausal women), and dopamine, serotonin, or norepinephrine reuptake inhibitors. In a large-scale, multinational, placebo-controlled, clinical trial, the antimuscarinic agent tolterodine significantly reduced Incontinence episodes in women with Mixed symptoms. The benefits of tolterodine continued to increase during the 8 weeks of the trial and extended to additional end points, including frequency, urgency, and urge Incontinence. A limited number of studies have examined the use of estrogen for Mixed Incontinence and have produced conflicting results. Duloxetine oxalate, a combined serotonin/norepinephrine reuptake inhibitor, has shown great promise in animal studies, as well as in phase 2 and 3 clinical trials. This agent is the first to demonstrate efficacy as a sole therapy for stress Incontinence and has exhibited favorable effects on bladder capacity, suggesting possible benefits in Mixed Incontinence. Only five studies (two of which were conducted during the 1980s) have specifically examined the use of surgery for the treatment of Mixed Incontinence; the cure rates reported have varied. The current body of information supports use of an antimuscarinic agent as initial therapy for Mixed Incontinence, although long-term trials are needed to shed more light on the duration of benefit.

  • treatment of urge predominant Mixed urinary Incontinence with tolterodine extended release a randomized placebo controlled trial
    Urology, 2004
    Co-Authors: Vik Khullar, Simon Hill, Karlulrich Laval, Hjalmar A Schiotz, U Jonas, Eboo Versi
    Abstract:

    Abstract Objectives To examine the efficacy and tolerability of antimuscarinic therapy in women with urge-predominant Mixed Incontinence. Methods This was a double-blind, randomized, placebo-controlled trial comprising 854 women with urge-predominant Mixed Incontinence, including urge Incontinence (five or more episodes per week), urinary frequency (eight or more micturitions on average in 24 hours), and urgency in combination with stress Incontinence. Women received 8 weeks of treatment with tolterodine tartrate extended-release (ER) 4 mg or placebo once daily. The outcome measures included urge Incontinence episodes per week, stress Incontinence episodes per week, micturition frequency per 24 hours, urgency episodes per 24 hours, volume voided per micturition, patient perception of bladder condition, and assessment of treatment benefit. Results After 8 weeks, tolterodine ER produced a statistically significant decrease in the weekly urge Incontinence episodes compared with placebo (−12.3 versus −8.0; P P P Conclusions Tolterodine ER is an effective treatment of urge urinary Incontinence, frequency, and urgency in women with concomitant stress urinary Incontinence. The efficacy of tolterodine ER in reducing urge Incontinence episodes was unaffected by the presence of stress Incontinence. The results of this study support the first-line use of antimuscarinic therapy to treat the urge Incontinence component of urge-predominant Mixed Incontinence.

  • Mixed Incontinence.
    Urology, 2004
    Co-Authors: Charlotte Chaliha, Vik Khullar
    Abstract:

    The epidemiology and treatment of Mixed Incontinence has received relatively little attention. However, Mixed Incontinence--defined as the combination of stress and urge Incontinence--accounts for approximately 33% of all cases of Incontinence in women. The condition often responds poorly to treatment, either pharmacologic or surgical. Potential pharmacologic approaches for Mixed Incontinence include antimuscarinic agents, estrogen replacement therapy (for postmenopausal women), and dopamine, serotonin, or norepinephrine reuptake inhibitors. In a large-scale, multinational, placebo-controlled, clinical trial, the antimuscarinic agent tolterodine significantly reduced Incontinence episodes in women with Mixed symptoms. The benefits of tolterodine continued to increase during the 8 weeks of the trial and extended to additional end points, including frequency, urgency, and urge Incontinence. A limited number of studies have examined the use of estrogen for Mixed Incontinence and have produced conflicting results. Duloxetine oxalate, a combined serotonin/norepinephrine reuptake inhibitor, has shown great promise in animal studies, as well as in phase 2 and 3 clinical trials. This agent is the first to demonstrate efficacy as a sole therapy for stress Incontinence and has exhibited favorable effects on bladder capacity, suggesting possible benefits in Mixed Incontinence. Only 5 studies (2 of which were conducted during the 1980s) have specifically examined the use of surgery for the treatment of Mixed Incontinence; the cure rates reported have varied. The current body of information supports use of an antimuscarinic agent as initial therapy for Mixed Incontinence, although long-term trials are needed to shed more light on the duration of benefit.

Jonathan Duckett - One of the best experts on this subject based on the ideXlab platform.

Harry W. Johnson - One of the best experts on this subject based on the ideXlab platform.

  • Mixed Incontinence: Comparing definitions in non-surgical patients
    Neurourology and urodynamics, 2010
    Co-Authors: Linda Brubaker, Emily S. Lukacz, Kathryn L. Burgio, Philippe E. Zimmern, Peggy Norton, Wendy W. Leng, Harry W. Johnson, Stephen R. Kraus, Anne M. Stoddard
    Abstract:

    Purpose We aimed to explore operational definitions of Mixed urinary Incontinence (MUI) for use in Incontinence outcomes research for non-surgical patient populations. Methods A secondary analysis of women with urge Incontinence or urge predominant MUI enrolled in the Urinary Incontinence Treatment Network BE-DRI randomized clinical trial was performed. Subjects were characterized at baseline for urinary Incontinence severity and Incontinence subtype (stress or urge) using the Medical, Epidemiologic, and Social Aspects of Aging (MESA) questionnaire, the Urogenital Distress Inventory, and a 7-day urinary diary. Various different definitions of MUI, ranging from low to high threshold, were created using a combination of these baseline Incontinence measures. Prevalence of MUI based on each definition was described and compared to treatment response. Logistic regression analysis was used to estimate the association between the study outcomes and the different definitions of MUI. Results The 307 participants in the BE-DRI study had a mean age of 56.9 (±13.9) years with a mean total MESA score of 21.7 (±8.9) and a mean total UDI score of 120.5 (±49.6). The proportion of women diagnosed with MUI varied significantly by definition ranging from 63.5% to 96.4%. Low threshold symptom-based definitions resulted in nearly universal diagnosis of MUI. No strict cut-off value for these baseline measures was identified to predict clinical outcomes. Conclusions Current MUI definitions do not adequately categorize clinically relevant UI subgroups. For research purposes we believe it necessary to describe the severity of each Incontinence subtype separately in subjects with MUI. Neurourol. Urodyn. 30:47–51, 2011. © 2010 Wiley-Liss, Inc.

  • Mixed Incontinence comparing definitions in women having stress Incontinence surgery
    Neurourology and Urodynamics, 2009
    Co-Authors: Linda Brubaker, Emily S. Lukacz, Philippe E. Zimmern, Peggy Norton, Stephen R. Kraus, Anne M. Stoddard, Holly E. Richter, Pamela Moalli, Larry Sirls, Harry W. Johnson
    Abstract:

    Objective To develop an empirically derived definition of Mixed urinary Incontinence (MUI) for use in Incontinence outcomes research. Methods Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS). Participants were required to have stress Incontinence with a MESA stress subscale score > MESA urge subscale score. Several definitions of MUI were considered. Logistic and linear regression analysis methods were used to predict clinical outcomes based on the different MUI definitions. Analyses were carried out using SAS (SAS Institute, Inc., Cary, NC, Version 9.1). Statistical significance was defined at P-value <0.05. Results In 655 participants, the proportion of women with MUI varied from 8.3% to 93.3% depending on the MUI definition All definitions were associated with severity as measured by the frequency of Incontinence episodes at baseline; however little of the variability was explained by any single definition. No strict cut-off value for these baseline measures was identified to predict clinical outcomes. Conclusions These MUI definitions do not adequately categorize clinically relevant UI subgroups. For research reporting, MUI subcomponents of stress and urge UI should be described separately rather than as a single dimension. Neurourol. Urodynam. 28:268–273, 2009. © 2009 Wiley-Liss, Inc.

  • Mixed Incontinence: Comparing definitions in women having stress Incontinence surgery
    Neurourology and urodynamics, 2009
    Co-Authors: Linda Brubaker, Emily S. Lukacz, Philippe E. Zimmern, Peggy Norton, Stephen R. Kraus, Anne M. Stoddard, Holly E. Richter, Pamela Moalli, Larry Sirls, Harry W. Johnson
    Abstract:

    Objective To develop an empirically derived definition of Mixed urinary Incontinence (MUI) for use in Incontinence outcomes research. Methods Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS). Participants were required to have stress Incontinence with a MESA stress subscale score > MESA urge subscale score. Several definitions of MUI were considered. Logistic and linear regression analysis methods were used to predict clinical outcomes based on the different MUI definitions. Analyses were carried out using SAS (SAS Institute, Inc., Cary, NC, Version 9.1). Statistical significance was defined at P-value