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001-es BibID:	BIBFORM121145
Első szerző:	Takács Péter (szülész-nőgyógyász)
Cím:	Biomechanical Integrity Score of the Female Pelvic Floor for Stress Urinary Incontinence / Takacs Peter, Rátonyi Dávid, Koroknai Erzsébet, van Raalte Heather, Lucente Vincent, Egorov Vladimir, Krasznai Zoard Tibor, Kozma Bence
Dátum:	2024
ISSN:	0937-3462
Megjegyzések:	Introduction and hypothesis: This study is aimed at developing and validating a new integral parameter, the Biomechanical Integrity score (BI-score) of the female pelvic floor for stress urinary incontinence conditions. Methods: A total of 130 subjects were included in the observational cohort study; 70 subjects had normal pelvic floor conditions, and 60 subjects had stress urinary incontinence (SUI). A Vaginal Tactile Imager (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: Twenty-seven parameters were identified as statistically sensitive to SUI development. They were subdivided into five groups to characterize tissue elasticity (group 1), pelvic support (group 2), pelvic muscle contraction (group 3), involuntary muscle relaxation (group 4), and pelvic muscle mobility (group 5). 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: Quantitative transformations of the pelvic tissues, support structures, and functions under diseased conditions may be studied with the SUI BI-score in future research and clinical applications.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Stress urinary incontinence Tissue elasticity Pelvic support Pelvic muscle strength Muscle mobility Biomechanical Integrity score
Megjelenés:	International Urogynecology Journal. - [Epub ahead of print] (2024). -
További szerzők:	Rátonyi Dávid (1996-) (Szülész-nőgyógyász) Koroknai Erzsébet (1987-) (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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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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