**7. References**

50 Urinary Incontinence

the preliminary interview stage (including a brief psychosexual biography, focused on the problems associated with UI), would help us change the treatment plan to obtain good outcomes in the large group of female patients previously diagnosed with, and unsuccessfully treated for, high urethral pressure. Thus the application in the diagnostic algorithm of the evaluation of the occurrence and intensity of the interaction (rather typical, as it seems at the present state of our knowledge) between the development of UI and urinary dysfunctions with mental functioning, facilitates the differentiation of risk groups among young female patients in the case of even a routine visit for recurrent lower urinary

The awareness of these facts will help us avoid diagnostic errors, choose an appropriate therapy, and make use of multi-disciplinary interventions, including psychological help, or

These observations from our daily clinical practice point to the essential role of cooperation between urologists and a broad gamut of other specialists, especially uro-gynecologists, clinical psychologists, physiotherapists, and psychiatrists, in relation to patients in whom, despite several months of treatment, there are frequent relapses. They also make us aware of the need for physicians to expand their knowledge in the area of psychological factors associated with lower urinary tract symptoms and the holistic approach to treatment. And finally, they can also be a contribution to the ongoing discussion on the methodology of performing urodynamic tests (using profilometry), the need to apply surface electormyography of the pelvic floor muscles, acknowledged by numerous authors to be very useful (Garstka-Namysł, 2006, 2009; Garstka-Namysł et al., 2007, 2008), and the need to create multi-disciplinary teams and highly specialized centers for the diagnosis and therapy

The lack of relaxation in the constantly contracted muscles of the pelvic floor can significantly impede a correct urodynamic diagnosis and cause a misdiagnosis regarding the

Preparation of the patient for therapy by a multidisciplinary team, including a diagnostician, a psychologist, a psychiatrist and physiotherapist, specialized in the treatment of patients with urinary dysfunctions, can significantly increase the effectiveness of surgical treatment and limit relapses. A properly prepared questionnaire to evaluate quality of life, expanded with information about functional disorders in childhood or

The visualization of the activity of the pelvic floor muscles in standing and prone position, using a transperineal ultrasonogram and surface electromyography, is of great help in the

Developing a plan of preventive and therapeutic activities, using education and rehabilitation, can prevent the development of full-symptom urinary incontinence and other negative symptoms of dysfunction in the muscles and nerves of the pelvic floor, leading to a

traumatic experiences in the urogenital area, can facilitate a correct diagnosis.

education and therapy of patients in order to improve urination.

tract infections or sporadic episodes of UI (Bidzan, Smutek & Bidzan, 2010).

psychiatric help and rehabilitation in cases where it is needed.

**6. Conclusions** 

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**Effects of Pelvic Floor Muscle** 

and Lila Teixeira de Araújo Janahú3

*1Amazonia University, 2Federal University of Pará, 3College of Amazonia,* 

*Brazil* 

**with Stress Urinary Incontinence** 

**Training with Biofeedback in Women** 

Nazete dos Santos Araujo1,\*, Érica Feio Carneiro Nunes1, Ediléa Monteiro de Oliveira1 , Cibele Câmara Rodrigues2

This chapter addresses the effects of training of the pelvic floor muscles using an electromyographic biofeedback equipment as a tool for treatment in women with stress

The Stress Urinary Incontinence (SUI) is defined by the International Continence Society (ICS) as involuntary loss of urine during physical effort with sneezing and coughing, and it is considered a consequence of the weakness of the pelvic floor1,2. It is the most common type of urinary incontinence and its prevalence can vary from 12% to 56% depending on the population studied and the diagnostic criterion adopted3,4. In Brazil the prevalence of

Approximately 1/3 of women of the research presented mixed complaints, i.e., urinary loss during stress associated with irritative symptoms, such as increased urinary frequency,

Nowadays there are several risk factors for the onset of sui, and we can realize that the literature often relates it to obesity, menopause, smoking, parity, types of delivery and exercise. The white ethnicity is also related to risk factors; In an American study, when the authors compared white to black people, it appears an higher incidence for the first group (white one), varying from 23 to 32% and a lower incidence to the second group, with na

It is known that SUI compromises the quality of life (QOL) of women of different ages5,6. However, many women with UI believe that sporadic involuntary urinary loss is a normal part of the aging process and, also because they find it embarrassing, they do not refer to its

complaints of stress urinary incontinence is around 35% 2.

urinary urgency, nocturia, urgency incontinence and/or enuresis3.

impact on their daily activities or report these symptoms to their doctors8.

**1. Introduction** 

urinary incontinence.

average from 16 to 18% 5, 6,7.

Corresponding Author

 \*

Zorn, B.H.; Montgomery, H.; Pieper, K.; Gray, M. & Steers, W.D. (1999). Urinary incontinence and depression. *Journal of Urology*, vol. 162, pp. 82-84 **4** 
