**11. Acknowledgements**

I am indebted to Dr. David Castro for his critical review and helpful suggestions.

#### **12. References**


Chen GD. Pelvic floor dysfunction in aging women. Taiwan J Obstet Gynecol 2007; 46: 374-8

DuBeau CE. The Aging Lower Urinary Tract. J Urol 2006; 175: S11-S15


Fedarco NS. The biology of aging and frailty. Clin Geriatr Med 2011; 27: 27-37








Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L et al. Fourth International

DuBeau CE, Kuchel GA, Johnson T, Palmer MH, Wagg A. Incontinence in the frail elderly:

Duthie JB, Herbison GP, Wilson DI, Wilson D. Botulinum toxin injections for adults with

Fulop T, Larbi A, Witkowski JM, McElhaney J, Loeb M, Mitnitski A, et al. Aging, frailty and

Fung CH, Spencer B, Eslami M, Crandall C. Quality indicators for the screening and care of urinary incontinence in vulnerable elders. J Am Geriatr Soc 2007; 55: S443-9 Gotoh M. Quality of life assessment for patients with urinary incontinence. Nagoya J Med

Griebling TL. Urinary incontinence in the elderly. Clin Geriatr Med. 2009; 25: 445-57

Prolapse, and Fecal Incontinence. Neurourol Urodyn 2010; 29: 213-40 Burgio KL. Behavioral treatment of urinary incontinence, voiding dysfunction, and

overactive bladder. Obstet Gynecol Clin North Am 2009; 36: 475-91 Chen GD. Pelvic floor dysfunction in aging women. Taiwan J Obstet Gynecol 2007; 46: 374-8

DuBeau CE. The Aging Lower Urinary Tract. J Urol 2006; 175: S11-S15

Issue 3. Art. Nº: CD005493. DOI: 10.1002/14651858

age-related diseases. Biogerontology 2011: 11: 547-63

Fedarco NS. The biology of aging and frailty. Clin Geriatr Med 2011; 27: 27-37

Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ

Report from the 4th International Consultation on Incontinence. Neurourol Urodyn

overactive bladder syndrome. Cochrane Database of Systematic Reviews 2007;

I am indebted to Dr. David Castro for his critical review and helpful suggestions.

frailest ones, are available and with high rates of effectiveness.

should be used knowing their characteristics and limits.

Stroke or Arthritis.

valid alternatives.

**11. Acknowledgements** 

2010; 29: 165-78

Sci 2007; 69: 123-31

incontinent frail elderly patients.

identified.

**12. References** 


**8** 

*Poland* 

**A Model of the Psychological** 

**Incontinence Patients After TVT** 

*Institute of Psychology, University of Gdansk* 

Mariola Bidzan1, Leszek Bidzan2 and Jerzy Smutek3,4 *1Department of Clinical Psychology and Neuropsychology,* 

*2Department of Developmental Psychiatry, Psychotic Disorders* 

*4Pro-Vita Private Medical Center for Urinary Incontinence, Gdansk* 

Urodynamic stress incontinence (USI) is the most common form of urinary incontinence (Thom, 1998; Lemack & Zimmern, 2000; Steciwko, 2002; Rechberger & Skorupski, 2005), accounting for about 50% of all patients with urinary incontinence (Foldspang & Mommsen, 1997; Rechberger, 2004; Rechberger & Skorupski, 2005). About 82% of USI patients are women (Kinchen et al., 2002, cited by Diokno, 2003; Rechberger, 2004; Barber et al., 2005). Approximately 63% of all women with urinary incontinence are diagnosed with USI, from 19% to 25% have urge urinary incontinence (UUI), while from 12% to 19% have a mixed form (Thom, 1998; Lemack, Zimmern, 2000; Steciwko, 2002; Rechberger, Skorupski, 2005). According to the International Continence Society, urodynamic stress incontinence is defined as the involuntary leakage of urine during increased abdominal pressure, in the absence of a detrusor contr action (Abrams et al.., 2002; , Kata & Antoniewicz, 1999; Rechberger & Skorupski, 2005; Kobashi & Kobashi, 2006). It occurs when the increased pressure inside the abdominal cavity caused by a cough or hard physical exertion is

accompanied by an involuntary release of urine (Rechberger & Skorupski, 2005).

USI in women is caused by the insufficiency of the apparatus that closes the urethra, and/or hypermobility of the vesico-connection, when bladder functions are completely normal (Milart et al., 2001). This means that the reason for USI lies in the weakening of the pelvic floor muscles, whose basic task is to hold up the organs located in the pelvis, including the urinary tract. Strong pelvic muscles keep the urethra closed until a conscious decision is made to urinate. When these muscles are weakened, the result is an inability to maintain a sufficiently tight hold around the urethra, so that any pressure exerted on the bladder caused by a movement of the diaphragm (e.g. a sneeze, a cough, a sudden exertion, walking

**1. Introduction** 

*and Old Age Psychiatry, Medical University of Gdansk 3Department of Obstetrics, Medical University of Gdansk* 

**Factors Conditioning Health Related Quality of Life in Urodynamic Stress** 

