exudates and Urinary-Incontinence

Urinary incontinence is an important and common health care problem affecting the elderly population. Common types of incontinence affecting the elderly are: stress incontinence, urge incontinence, overflow incontinence and mixed type. The elderly patient suffering from urinary incontinence does not often seek treatment voluntary due to a misconception that it is part of a normal ageing process. Without treatment, urinary incontinence may lead to serious psychological and social complications such as depression, anxiety, embarrassment, low self-esteem and social isolation. Overall it is associated with significant poor quality of life for the elderly. Life style modification and behavioural therapy with or without pharmacotherapy help in improving the symptoms. Pelvic floor muscles' training is beneficial for stress incontinence in up to fifty percent of the patients. Elderly patients with urinary incontinence should be encouraged to seek treatment early, as the problem can be treated and they will have a better quality of life.

Topics: Age Factors; Aged; Aged, 80 and over; Aging; Humans; Malaysia; Quality of Life; Risk Assessment; Risk Factors; Sickness Impact Profile; Urinary Incontinence

Pelvic floor disorders are common and of concern, as the majority of maternity healthcare providers seldom discuss this issue with patients compared to other antenatal issues. The aim of this study is to determine the prevalence and to assess the knowledge and awareness of pelvic floor disorder (PFD) among pregnant women in a tertiary centre in Malaysia. We also aim to assess the association between women’s risk factors regarding their knowledge and awareness of pelvic floor disorder so that primary prevention strategies can be planned, initiated and implemented in the future. This is a cross-sectional study with a total of four hundred twenty-four pregnant women that were recruited over a 6-month duration from May to November 2017 in a tertiary centre in Malaysia. The Pelvic Floor Distress Inventory (PFDI-20) was used to evaluate pelvic floor distress symptoms during pregnancy, namely urinary incontinence, pelvic organ prolapse and faecal incontinence. A validated Prolapse and Incontinence Knowledge Questionnaire (PIKQ), which consists of 24 items, was used to assess respondents’ knowledge about urinary incontinence (UI) and pelvic organ prolapse (POP). A total of 450 participants were approached, but 424 participants agreed to participate, showing a response rate of 94.3%. The median age was 31.5 years old, and 33.3% were primiparity. Overall, 46.1% of pregnant women had at least one symptom of pelvic floor disorder during pregnancy. Of these, 62.3% experienced urinary incontinence, 41.1% experienced symptoms of pelvic organ prolapse, and 37.8% experienced symptoms of faecal incontinence. The overall median score of PIKQ was 12.0 (8.0, 17.0). The median score for PIKQ—UI was 7.0 (5.0, 9.0) and the median score for PIKQ—POP was 6.0 (4.0, 8.0). There were 341 (80.4%) pregnant women that had a low level of knowledge in UI, and 191 (45.0%) had a low level of knowledge in POP. Having a tertiary level of education and receiving antenatal specialist care were both associated with better proficiency in both the PIKQ—UI (p < 0.001) and PIKQ—POP (p < 0.001) subscales. Pelvic floor disorder during pregnancy was common. A knowledge of pelvic floor disorder was lacking among pregnant women in this study. Having a tertiary education and receiving antenatal specialist care were both associated with better knowledge proficiency. This study hopefully serves as a basic platform for future educational programs to bridge the knowledge gaps in PFD among pregnant women.

Topics: Adult; Cross-Sectional Studies; Fecal Incontinence; Female; Humans; Malaysia; Parity; Pelvic Floor Disorders; Pelvic Organ Prolapse; Pregnancy; Pregnant Women; Prevalence; Surveys and Questionnaires; Urinary Incontinence

Urinary Incontinence (UI) is when a person is unable to hold his/her urine effectively. This is a common problem which can develop and worsen during pregnancy. An effective way to manage UI is to educate patients on the Pelvic Floor Muscle Exercise (PFME) regularly. The present study aimed to ascertain the pregnant women's knowledge, attitudes, and practices (KAP) related to PFME.. This was a cross-sectional study done in a one primary care clinic located in a semi-urban area in Selangor, Malaysia. Simple random sampling was conducted among pregnant women aged 18 years old and above at any gestation. The validated study instruments used consisted of questions on socio-demography, KAP on UI, and also the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form to determine UI among the respondents.. The response rate for this study was 72.1%, where 440 pregnant women consented to take part in the study. The median age of study respondents was 30 years old and majority of the study respondents was from the Malay ethnicity (80.9%). The prevalence of UI was 40.9%. The proportion of pregnant women with good knowledge, attitude and practice scores were 58.0%, 46.6% and 45.2% respectively. There was a significant association between UI and age (p = .03), body mass index (p = .03), ethnicity (p = .04), gravida. (p = .001), knowledge on PFME (p = .007) and attitude towards PFME (p = .006).. Findings from this study fill a gap in the prevalence and KAP concerning PFME at the primary care level. The foundation areas for future education and health promotion on UI should address the importance of correct PFME. This education can be delivered through a pragmatic way to ensure its effectiveness and sustainability of the health promotion program.

Topics: Adult; Cross-Sectional Studies; Exercise Therapy; Female; Gravidity; Humans; Malaysia; Muscle Strength; Muscle, Skeletal; Pelvic Floor; Pregnancy; Pregnancy Complications; Primary Health Care; Urinary Incontinence

As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia.. This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities.. Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities.. UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

Topics: Aged; Aged, 80 and over; Female; Humans; Malaysia; Middle Aged; Prevalence; Quality of Life; Surveys and Questionnaires; Urinary Incontinence

Urinary incontinence (UI) is known to be more prevalent among women and is associated with decline in quality of life. The aim of our study was to investigate the prevalence, risk factors of urinary incontinence and its impact on quality of life among community dwelling older women living in urban and rural populations.. This study was conducted based on secondary data analysed from the third phase of the longitudinal study "Neuroprotective Model for Health Longevity among Malaysian Elderly" (LRGS TUA). Stratification of urban and rural study areas were in accordance to that determined by the Department of Statistics. A total of 814 community dwelling older women (53% urban, 47% rural), aged 60 years and above, across four states within Peninsular Malaysia were included in this analysis. Interview-based questionnaires were used to obtain respondents' sociodemographic details and clinical characteristics. The Timed Up and Go test and Handgrip Strength tests were used to assess physical function. Urinary incontinence was self-reported, and quality of life of those with incontinence was assessed using the King's Health Questionnaire (KHQ).. Prevalence of urinary incontinence was 16% and 23% among older women living in urban and rural areas, respectively. Ethnicity was significantly associated with incontinence among older women in both urban and rural population (p < 0.05). Chronic constipation, functional mobility and muscle strength were associated with UI in participants from rural setting (p < 0.05). Binary logistic regression analysis showed that risk of incontinence is lower among Chinese [OR 0.430, 95% C.I: 0.224-0.825, p = 0.011] compared to Malay older women living in urban population. Within the rural population, respondents with chronic constipation [OR: 3.384, 95% C.I: 1.556-7.360, p = 0.002] were found to be at a higher risk of UI. In terms of quality of life, respondents in rural areas experienced more role, physical, social, emotional limitations and sleep disturbance as compared to their urban counterparts (p < 0.05).. UI is more prevalent and had a more profound impact on quality of health among older women in the rural setting. The risk factors of UI were ethnicity and chronic constipation among urban and rural older women respectively. It is important to provide holistic strategies in the prevention and management of UI among older women especially within the rural population.

Topics: Aged; Aged, 80 and over; Constipation; Female; Geriatric Assessment; Hand Strength; Health Surveys; Humans; Independent Living; Longitudinal Studies; Malaysia; Middle Aged; Prevalence; Quality of Life; Risk Factors; Rural Population; Time and Motion Studies; Urinary Incontinence

The identification of risk factors associated with comorbidities and physical fitness might provide pathways for planning therapeutic targets for future falls prevention. Results from large datasets that examined falls risk factors in Asia have been limited. The aim of the present study was to identify the risk factors for falls by pooling data consisting of medical history, physical performance and self-rated health from two large Malaysian epidemiological studies.. Matching variables from the Towards Useful Aging and Malaysian Elders Longitudinal Research datasets related to falls, physical performance and determinants of falls were identified and pooled for analysis. The Timed Up and Go test and dominant handgrip strength tests were used as physical performance measures. Falls were self-reported, and functional status was assessed using activities of daily living.. Data of 3935 participants, mean age 68.9 ± 6.8 years, 2127 (54.0%) women and 1807 (46.0%) men were extracted for analyses. In an adjusted model, independent risk factors for falls from this cohort studies were diabetes (OR 1.258), arthritis (OR 1.366), urinary incontinence (OR 1.346), poor self-rated health (OR 1.293), higher body mass index (OR 1.029) and lower handgrip strength (OR 1.234).. Although the risk factors that emerged from our analyses were similar to available studies among older adults, the Timed Up and Go test did not appear as one of the risk factors in the present study that included middle-aged adults. Our findings will require confirmation in a prospective study. Geriatr Gerontol Int 2019; 19: 798-803.

Topics: Accidental Falls; Activities of Daily Living; Aged; Arthritis; Body Mass Index; Comorbidity; Correlation of Data; Diabetes Mellitus; Diagnostic Self Evaluation; Female; Hand Strength; Humans; Independent Living; Malaysia; Male; Middle Aged; Overweight; Physical Functional Performance; Risk Assessment; Risk Factors; Urinary Incontinence

To enable the use of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol) in Southeast Asia, we translated and subsequently evaluated their validity (content and discriminant validity), reliability (internal consistency and test-retest reliability), and responsiveness in female patients with stress urinary incontinence.. Permission was obtained to translate the English versions into Malay and subsequently validate them, and to validate the existing Chinese versions. The translated questionnaires were taken for pilot testing. Validation was carried out for the face/content and discriminant validity. Reliability was assessed for test-retest and internal consistency using Cronbach's alpha and intraclass correlation coefficient respectively. The responsiveness was calculated via effect size and standardized response mean.. Ten patients were recruited for the pilot testing. The English and Chinese versions had "substantial" or "almost perfect" agreement as measured by weighted Kappa. 284 participants (139 patients with stress urinary incontinence and 145 healthy volunteers) were included in the subsequent phases. The ICIQ-UI SF and ICIQ-LUTSqol had good discriminant validity. The ICIQ-UI SF had moderate internal consistency although the ICIQ-LUTSqol had good internal consistency. Both questionnaires had high test-retest reliability. Responsiveness was established with a moderate to large effect size and a standardized response mean.. The English, Chinese, and Malay versions each proved to be valid and reliable in our Malaysian population, thereby enabling more cross-cultural research in this region. Neurourol. Neurourol. Urodynam. 36:438-442, 2017. © 2015 Wiley Periodicals, Inc.

Topics: Adult; Aged; Female; Humans; Malaysia; Middle Aged; Pilot Projects; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Translations; Urinary Incontinence

Urinary incontinence is a prevalent condition in the elderly that is the spontaneous leakage of urine. It is an age-related problem and increases especially in people aged above 65 years. It can cause many psychological, behavioral, biological, economic and social effects. The treatment of urinary incontinence can reduce morbidity and mortality. Thus, this study aimed to determine the effects of variables including age, ethnicity, gender, education, marital status, body weight, blood elements and nutritional parameters on urinary incontinence among the Malaysian elderly.. The study was on 2322 non-institutionalized Malaysian elderly. The hierarchy logistic regression analysis was applied to estimate the risk of independent variables for urinary incontinence among respondents.. The findings indicated that approximately 3.80% of subjects had urinary incontinence. In addition, constipation was found a significant factor that increased the risk of urinary incontinence in samples (p=0.006; OR=3.77). The increase in dietary monounsaturated fat (p=0.038; OR=0.59) and plasma triglyceride levels (p=0.029; OR=0.56) significantly reduced the risk of incontinence in subjects. Many of suspected variables including socio-demographic factors, diseases, nutritional minerals, blood components and body weight were non-relevant factors to urinary incontinence in respondents.. Constipation increased the risk of urinary incontinence in subjects, and increase in dietary monounsaturated fat and plasma triglyceride levels decreased the risk.

Topics: Aged; Asian People; Cholesterol, HDL; Cholesterol, LDL; Constipation; Cross-Sectional Studies; Diet; Fatty Acids, Monounsaturated; Female; Humans; Logistic Models; Malaysia; Male; Prevalence; Risk Factors; Socioeconomic Factors; Triglycerides; Urinary Incontinence

To determine, in a population-based survey, the prevalence of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and incontinence in community-dwelling men in multiethnic Malaysia, as currently available Western demographic data might not be applicable in the Asian population.. A cross-sectional population-based survey was carried out in the State of Penang, Malaysia, with a target population of men aged > or = 40 years. Using a multistage study design, random systematic sampling was used to represent the target population, who were weighted based on ethnicity and rural-urban ratios so as to represent the general population distribution. Trained field-workers conducted direct interviews and administered the American Urological Association Symptom Index (AUA-SI), the International Index of Erectile Function (IIEF-5) questionnaire and questions on incontinence based on the International Continence Society 2002 definition.. In all, 418 men aged > or = 40 years were interviewed, of whom 353 completed the AUA-SI questionnaire (84.5% response rate). The prevalence of mild, moderate and severe LUTS was 80.6%, 6% and 0.3%, respectively. The prevalent symptoms were frequency and nocturia. There was moderate and severe ED in 45.9% of men, whereas incontinence was reported by 8.2%. The AUA-SI correlated strongly with age (R = 0.291, P < 0.001), IIEF-5 (R = - 0.265, P < 0.001) and diabetes mellitus.. The prevalence and severity of LUTS, ED and incontinence increased with age in this multiethnic Asian population, in which ED correlated strongly with LUTS. Compared to the Western population, the prevalence of LUTS was significantly lower, while the prevalence of ED and incontinence were comparable.

Topics: Adult; Aged; Asia; Cross-Sectional Studies; Developed Countries; Erectile Dysfunction; Health Surveys; Humans; Malaysia; Male; Middle Aged; Prevalence; Prostatism; Quality of Life; Severity of Illness Index; Surveys and Questionnaires; Urinary Incontinence

In an attempt to gather data on the menopause in Malaysia, 400 women (13% Chinese, 70% Malays and 16% Indians), representing the three major ethnic groups in Malaysia, were interviewed. The majority (76%) of these women were still married and living with their husbands and 63% of them were working. Most of them (90%) had attained menarche by the age of 15 years and 50% of them had married before the age of 20. Their reproductive record was good, since 76% of them had 3 or more children who were still alive. The mean age at menopause in the Malaysian women studied was 50.7 years. Analysis of the climacteric symptoms reported showed significant differences in the vasomotor and nervosity indices in the perimenopausal and postmenopausal groups. Eighty percent (80%) of the women saw no need to consult a doctor about their climacteric symptoms. When they did, most of them (84%) received medication, but 43% of them did not comply with the prescribed treatment. Dyspareunia and urinary incontinence were evidently regarded as embarrassing complaints in all three groups, since around 80% of the women did not seek medical advice. This is not surprising in view of the fact that 89% of them rated their health as good.

Topics: Adult; Anxiety; China; Climacteric; Dyspareunia; Female; Flushing; Humans; Incidence; India; Malaysia; Menopause; Middle Aged; Socioeconomic Factors; Urinary Incontinence; Women's Health