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001-es BibID:BIBFORM116872
035-os BibID:(WoS)001111426100001 (Scopus)85178231255
Első szerző:Koroknai Erzsébet (szülész-nőgyógyász)
Cím:Correlation between the female pelvic floor biomechanical parameters and the severity of stress urinary incontinence / Koroknai Erzsébet, Rátonyi Dávid, Pákozdy Krisztina, Sipos Attila G., Krasznai Zoárd, Takacs Peter, Kozma Bence
Dátum:2023
ISSN:1471-2490
Megjegyzések:Background: Stress urinary incontinence (SUI) is a common condition that requires proper evaluation to select a personalized therapy. Vaginal Tactile Imaging (VTI) is a novel method to assess the biomechanical parameters of the pelvic floor. Methods: Women with SUI were enrolled in this cross-sectional study. Participants completed the Medical, Epidemiologic, and Social Aspects of Aging (MESA) questionnaire and the Patient Global Impression of Severity Question (PGI-S) and underwent a VTI examination. Based on the MESA and PGI-S questionnaires, participants were divided into mild, moderate, and severe SUI groups. Fifty-two biomechanical parameters of the pelvic floor were measured by VTI and compared between the groups (mild vs. moderate and severe). SUI Score and Index were calculated from the MESA questionnaire. Pearson correlation was used to determine the strength of association between selected VTI parameters and the MESA SUI Index and MESA SUI Score. Results: Thirty-one women were enrolled into the study. Significant differences were observed in the VTI parameters 16, 22-24, 38, 39 when the difference between mild and severe subgroups of SUI based on the PGI-S score was examined. Parameter 16 refers to the maximum gradient at the perineal body, parameter 22-24 refers to the pressure response of the tissues behind the vaginal walls, and parameter 38, 39 refers the maximum pressure change and value on the right side at voluntary muscle contraction. VTI parameter 49, describing the displacement of the maximum pressure peak in the anterior compartment, showed a significant difference between the mild SUI and the moderate-severe SUI according to the MESA SUI score (mean ? SD 14.06?5.16 vs. 7.54?7.46, P=0.04). The MESA SUI Index and SUI Score displayed a positive correlation concerning VTI parameters 4 (the maximum value of the posterior gradient) and 27 (the displacement of the maximum pressure peak in the anterior compartment) (VTI4 vs. MESA SUI Index r=0.373,P=0.039; VTI4 vs. MESA SUI Score r=0.376,P=0.037; VTI27 vs. MESA SUI Index r=0.366,P=0.043; VTI27 vs. MESA SUI Score r=0.363,P=0.044). Conclusions: Female pelvic floor biomechanical parameters, as measured by VTI, correlate significantly with the severity of SUI and may help guide therapeutic decisions.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
stress urinary incontinence
pelvic floor
biomechanical parameters of the pelvic floor
questionnaires
disease severity
Megjelenés:BMC Urology. - 23 : 1 (2023), p. 198-204. -
További szerzők:Rátonyi Dávid (1996-) (Szülész-nőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Sipos Attila Gergely (1990-) (szülész-nőgyógyász) Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Takács Péter (1968-) (szülész-nőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
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2.

001-es BibID:BIBFORM124422
035-os BibID:(scopus)85204968356 (WoS)001329092500001
Első szerző:Rátonyi Dávid (Szülész-nőgyógyász)
Cím:The impact of short-term pelvic floor muscle training on the biomechanical parameters of the pelvic floor among patients with stress urinary incontinence : a pilot study / Rátonyi Dávid, Koroknai Erzsébet, Pákozdy Krisztina, Sipos Attila G., Takacs Peter, Krasznai Zoárd Tibor, Kozma Bence
Dátum:2024
ISSN:0301-2115
Megjegyzések:Objective: Our study aimed to improve the understanding of the biomechanical changes occurring in the pelvic floor due to pelvic floor muscle training (PFMT), which is responsible for improving stress urinary incontinence (SUI) symptoms. Study design: In this prospective cohort study, we examined the impact of a six-week PFMT program in women with stress or stress-predominant urinary incontinence on the biomechanical parameters of the pelvic floor. Fifty-two biomechanical parameters were measured by Vaginal Tactile Imager (VTI) at baseline and at a six-week follow-up. In addition, we have assessed the Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Patient's Global Impression of Severity (PGI-S) scores at enrolment and at six-week follow-up. We have divided our cohort into two groups, Improved Group (IG) and Not-improved Group (NIG), based on the change in UDI-6 score after six weeks and compared the biomechanical changes within and between the two groups. Results: The overall cohort included twenty women with stress or stress-predominant SUI based on MESA questionnaire [MESA SUI index (mean ? SD) 63.3 % ? 24.0 %, MESA UUI index (mean ? SD) 13.3 % ? 15.3 %, p < 0.01]. Nine of the 52 VTI parameters have changed significantly after six weeks of PFMT in the entire cohort. Eleven women (IG) achieved the minimum 11-point change in the UDI-6 scaled score. In IG, we found that three VTI parameters differed significantly: Parameter 1: the maximum value of force measured during the VTI probe insertion [(N, mean ? SD) 0.55 ? 0.18 vs. 0.78 ? 0.31, p < 0.049], parameter 18: the maximum gradient at the upper third of the vagina (posterior) [(kPa/mm, mean ? SD) 0.16 ? 0.05 vs. 0.36 ? 0.28, p < 0.048], and parameter 47: integral force change in the anterior compartment at reflex pelvic muscle contraction (cough) [(N, mean ? SD) 1.61 ? 0.85 vs. 1.97 ? 0.71, p < 0.045]. Conclusion: Our study revealed a significant association between the improvement of strength in targeted muscle groups and a reduction in urinary incontinence symptoms. Identifying specific muscles changing PFMT provides valuable insights for specific interventions. Our findings may help to create personalized and targeted interventions to improve the quality of life of women affected by SUI.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Stress urinary incontinence
Pelvic floor muscle training
Vaginal Tactile Imager
Megjelenés:European Journal Of Obstetrics Gynecology And Reproductive Biology. - 302 (2024), p. 283-287. -
További szerzők:Koroknai Erzsébet (1987-) (szülész-nőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Sipos Attila Gergely (1990-) (szülész-nőgyógyász) Takács Péter (1968-) (szülész-nőgyógyász) Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

3.

001-es BibID:BIBFORM125697
Első szerző:Takács Péter (szülész-nőgyógyász)
Cím:Biomechanical Integrity Score of the Female Pelvic Floor for Stress Urinary Incontinence / Takacs Péter, Rátonyi Dávid, Koroknai Erzsébet, Pákozdy Krisztina, Sipos Attila Gergely, Van Raalte Heather, Lucente Vincent, Egorov Vladimir, Krasznai Zoárd Tibor, Kozma Bence
Dátum:2024
ISSN:0937-3462
Megjegyzések:Introduction: Urinary incontinence (UI) is a prevalent condition, affecting more than 1 in 3 women at some point in their lives. Stress urinary incontinence (SUI) occurs when unintended urine leakage occurs during coughing, sneezing, or physical exertion. SUI is the most common type overall. Even though UI is widespread, it often goes unnoticed and unreported, with fewer than 40% of affected women seeking medical attention for this issue. It is, therefore, important for healthcare providers to accurately screen for and diagnose SUI. The Vaginal Tactile Imager (VTI) was developed to provide a biomechanical mapping of the pelvic floor with a vaginal probe. A set of new clinical markers/parameters has been proposed for the biomechanical characterization of pelvic floor conditions. This set included 52 parameters automatically calculated as a result of completing eight examination procedures (tests). Biomechanical Integrity score (BI-score) for pelvic organ prolapse (POP) was proposed. In order to make biomechanical mapping in urogynecology more accessible and valuable, further work is required on developing a shorter list of easily understandable and practical biomechanical parameters for SUI characterization. Objective: This study aims to develop and validate a new integral parameter, the BI-score of the female pelvic floor for SUI conditions. Methods: A total of 130 subjects with normal and SUI conditions were included in the observational cohort study; 70 subjects had normal pelvic floor conditions, and 60 subjects had SUI. VTI was used to acquire and automatically calculate 52 biomechanical parameters for eight VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in two planes, relaxation, and reflex contraction). Statistical methods were applied (t-test, correlation) to identify the VTI parameters sensitive to the pelvic SUI conditions. Results: 27 parameters were identified as statistically sensitive to the SUI development. They were subdivided into five groups to characterize (1) tissue elasticity, (2) pelvic support, (3) pelvic muscle contraction, (4) involuntary muscle relaxation, and (5) pelvic muscle mobility. Every parameter was transformed to its standard deviation units using the dataset for normal pelvic conditions, similar to the T-score for bone density. Linear combinations with specified weights led to the composition of five component parameters for groups (1)-(5) and to the BI-score in standard deviation units. The p-value for the BI-score has p=4.0?10-28 for SUI versus normal conditions. Conclusions: Based on the analysis conveyed, five components are vital for biomechanical characterizing the pelvic floor. All these components contribute to the integral parameter of the BI-score. Objectively measurable transformations of the pelvic tissues, support structures, and functions under different diseased conditions may be studied with the BI-score in future research and practical applications.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:International Urogynecology Journal. - 35 : Suppl. 1 (2024), p. S208-S209. -
További szerzők:Rátonyi Dávid (1996-) (Szülész-nőgyógyász) Koroknai Erzsébet (1987-) (szülész-nőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Sipos Attila Gergely (1990-) (szülész-nőgyógyász) van Raalte, Heather Lucente, Vincent Egorov, Vladimir Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

4.

001-es BibID:BIBFORM116413
Első szerző:Takács Péter (szülész-nőgyógyász)
Cím:A Randomized Controlled Trial to Assess the Effectiveness of a Specially Formulated Food Supplement and Pelvic Floor Muscle Training in Women with Stress-Predominant Urinary Incontinence / Takács Péter, Krasznai Zoárd, Pákozdy Krisztina, Koroknai Erzsébet, Kozma Bence
Dátum:2023
Megjegyzések:Introduction: Pelvic floor muscle training (PFMT) is the first-line treatment approach for stress urinary incontinence (SUI). Creatine and leucine have been shown to improve muscle function. Since PFMT has been shown to improve the symptoms of SUI, and creatine- leucine supplementation may augment muscle training, we considered that women with stress urinary incontinence might benefit from supplementation with creatine-leucine while practicing FMT. Objective: To assess the effectiveness of a specially formulated creatine-leucine-zinc-calcium-magnesium based food supplement and PFMT in women with stress-predominant urinary incontinence. Methods: Women with stress or stress-predominant urinary incontinence were randomized in 1:1 ratio to receive daily oral supplementation for six weeks with either a specially formulated food supplement (treatment group) or placebo (control group). Both groups were instructed to perform standardized daily PFMT. Patients and evaluators were blinded to the allocation. Primary outcome was Urogenital Distress Inventory Short Form (UDI-6) score. Secondary outcomes were Incontinence Impact Questionnaire (IIQ?7) score, Patient's Global Impression of Severity (PGI?S), Biomechanical Integrity score (BI-score) measured by Vaginal Tactile Imager and vaginal squeeze pressure measured by perineometer. To have a power of 80% and a significance level of 5% to detect a decrease of 16 points in UDI-6 score a sample size of 32 was needed with 16 patients in each arm of our trial. The trial was registered at ClinicalTrials.gov and IRB approved. Results: Sixteen women in the control group and sixteen in the treatment group completed the trial. Between group analysis revealed no significant differences between the control and treatment group except for mean change (delta) in vaginal squeeze pressure [(cmH2O, mean +/- SD), 5+/-12 vs. 15+/-15, P=0.04] and mean change (delta) n PGI-S score [(mean +/- SD), -0.2+/-0.9 vs. -0.8+/-0.8, P=0.04]. Out of the 52 examined VTI parameters significantly more parameters improved in the treatment group compared to the control group (11/52 vs. 3/52, P=0.04). Within group analysis showed that UDI-6, IIQ-7 scores improved significantly from baseline to six weeks in the treatment group but not in the control group [UDI-6 score (mean+/-SD) 45+/-21 vs. 29+/-21, P=0.02; 43+/-18 vs. 33+/-26, P=0.22] [IIQ-7 score (mean+/-SD) 50+/-30 vs. 30+/-21, P=0.01; 48+/-23 vs. 40+/-28, P=0.36]. Similarly maximum vaginal squeeze pressure was significantly stronger in the treatment group compared to baseline after ix weeks but not in the control group [Maximum vaginal squeeze pressure (cmH2O, mean+/-SD), 30+/-15 vs. 45+/-28, P=0.001 and 36+/-18 vs. 41+/-21, P=0.13]. PGI-S scores only improved in the treatment group from baseline to six weeks after treatment [PGI-S score (mean+/-SD) 3.1+/-0.8 vs. 2.3+/-0.8, P=0.0001]. BI-score on average improved significantly, twice as much, in the treatment group compared to control group (SD unit, mean, from -1.06 to -0.58, P=0.001 and from -0.66 to -0.42, P=0.04). Conclusions: Women with stress-predominant urinary incontinence receiving a specially formulated supplement in addition to daily PFMT for six weeks had significantly improved urinary symptoms (decrease in UDI-6 score and IIQ-7) and BI-score compared to their baseline. Women in the treatment group on average improved twice as much in their BI-score as women in the control group.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:International Urogynecology Journal. - 34 : Suppl. 1 (2023), p. S26. -
További szerzők:Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Koroknai Erzsébet (1987-) (szülész-nőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

5.

001-es BibID:BIBFORM112811
035-os BibID:(WoS)001016138200002 (Scopus)85163149718
Első szerző:Takács Péter (szülész-nőgyógyász)
Cím:A randomized controlled pilot trial to assess the effectiveness of a specially formulated food supplement and pelvic floor muscle training in women with stress-predominant urinary incontinence / Takacs Peter, Pákozdy Krisztina, Koroknai Erzsébet, Erdődi Balázs, Krasznai Zoárd, Kozma Bence
Dátum:2023
ISSN:1472-6874
Megjegyzések:Background: Pelvic floor muscle training (PFMT) is the first-line treatment approach for stress urinary incontinence. Creatine and leucine have been shown to improve muscle function. Our aim was to assess the effectiveness of a food supplement and PFMT in women with stress-predominant urinary incontinence. Methods: Women with stress-predominant urinary incontinence were randomized in 1:1 ratio to receive daily oral supplementation for six weeks with either a food supplement (treatment group) or placebo (control group). Both groups were instructed to perform standardized daily PFMT. The primary outcome was the Urogenital Distress Inventory Short Form (UDI-6) score. Secondary outcomes were the Incontinence Impact Questionnaire (IIQ?7) score, Patient's Global Impression of Severity (PGI?S), and Biomechanical Integrity score (BI-score) measured by Vaginal Tactile Imager. To have a power of 80% and a significance level of 5% to detect a decrease of 16 points in the UDI-6 score, a sample size of 32 was needed, with 16 patients in each arm of our trial. Results: Sixteen women in the control group and sixteen in the treatment group completed the trial. Between-group analysis revealed no significant differences between the control and treatment group except for mean change (delta) in vaginal squeeze pressure [(cmH2O, mean?SD), 5?12 vs. 15?15, P=0.04] and mean change (delta) in PGI-S score [(mean ? SD), -0.2?0.9 vs. -0.8?0.8, P=0.04]. Within-group analysis showed that UDI-6 and IIQ-7 scores improved significantly from baseline to six weeks in the treatment group but not in the control group [UDI-6 score (mean?SD) 45?21 vs. 29?21, P=0.02; 43?18 vs. 33?26, P=0.22] [IIQ-7 score (mean?SD) 50?30 vs. 30?21, P=0.01; 48?23 vs.40?28, P=0.36]. PGI-S scores only improved in the treatment group from baseline to six weeks after treatment [PGI-S score (mean?SD) 3.1?0.8 vs. 2.3?0.8, P=0.0001]. BI-score, on average, improved significantly in the treatment and control group as well [SD unit, mean, from -1.06 to -0.58, P=0.001; from -0.66 to -0.42, P=0.04]. Conclusions: Women with stress-predominant urinary incontinence receiving a specially formulated supplement in addition to daily PFMT for six weeks had significantly improved urinary symptoms (decrease in UDI-6 score and IIQ-7) and BI-score compared to their baseline.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
urinary incontinence
Pelvic floor
Creatine
Zinc
Leucine
Megjelenés:BMC Womens Health. - 23 : 1 (2023), p. 1-12. -
További szerzők:Pákozdy Krisztina (1991-) (szülész-nőgyógyász) Koroknai Erzsébet (1987-) (szülész-nőgyógyász) Erdődi Balázs (1984-) (szülész-nőgyógyász szakorvosjelölt) Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
Borító:

6.

001-es BibID:BIBFORM111872
Első szerző:Takács Péter
Cím:A Randomized Controlled Trial to Assess the Effectiveness of a Specially Formulated Food Supplement and Pelvic Floor Muscle Training in Women With Stress-Predominant Urinary Incontinence / Peter Takacs, Erzsebet Koroknai, Bence Kozma, Zoard Krasznai, Krisztina Pakozdy
Dátum:2023
ISSN:0029-7844
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:Obstetrics And Gynecology. - 141 : 5S (2023), p. 23. -
További szerzők:Koroknai Erzsébet (1987-) (szülész-nőgyógyász) Kozma Bence (1982-) (szülész-nőgyógyász) Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Pákozdy Krisztina (1991-) (szülész-nőgyógyász)
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Intézményi repozitóriumban (DEA) tárolt változat
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