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Neural engineering
Published in Alex Mihailidis, Roger Smith, Rehabilitation Engineering, 2023
The urinary bladder performs two simple tasks. The first is urine storage (continence), which is achieved by maintaining low intra-vesical pressure and high mechanical compliance of the bladder wall. Urine excretion (micturition), on the other hand, is achieved by a rapid and sustained increase in bladder pressure coupled with inhibition of the urethral sphincter muscle. Surprisingly, the loss of normal urinary function is a rather common medical problem within the general population. Idiopathic overactive bladder (OAB) affects approximately 18% of adults and over 30% of the elderly population. The symptoms of OAB include urinary frequency (> 8 bathroom trips per 24 hours), urgency (uncontrolled urge to urinate), nocturia (> 1 bathroom trip during sleep at night), and urge incontinence (leaks associated with urgency). Individuals with neurological disorders (e.g., SCI, multiple sclerosis, Parkinson's disease) can also suffer from urinary incontinence. More commonly known as detrusor overactivity in persons with SCI, hyperactivity of the urinary bladder not only causes repeated urinary leaks but it can also lead to severe episodes of autonomic dysreflexia. It has been shown that restoring bladder function is a high priority for persons with SCI (Anderson 2004), but the problem remains a significant clinical challenge.
Designing for Lower Torso and Leg Anatomy
Published in Karen L. LaBat, Karen S. Ryan, Human Body, 2019
Understanding the relationships and positions of the digestive, urinary, and reproductive openings in the perineal region is important when designing many products—underwear, swimwear, diapers, and more. The liquid urinary waste product, urine, may also need to be managed with a wearable product. Some products are designed to contain both feces and urine, while others are designed to absorb or collect urine only. Urine is produced by the kidneys (Chapter 4, Section 4.8.3), collected in the bladder, and voluntarily or involuntarily expelled from the body. Involuntary loss of urine (urinary incontinence) increases in adults with age and with obesity. A major concern when designing products to manage urine output is preventing leakage, so understanding urinary tract structure, urine production, and bladder capacity is crucial for designers of these products.
Evolution of Current and Future Concepts of Biocompatibility Testing
Published in Severian Dumitriu, Valentin Popa, Polymeric Biomaterials, 2020
Another example is the testing of bulking agents used for treatment of stress urinary incontinence (SUI). These materials are injected next to the muscles of the pelvic floor to enhance stiffness of the soft tissue. This stiffening then allows for better closure of the urethra, and a decrease in SUI. The results of the SUI treatment are largely subjective since it is virtually impossible to get an objective readout (e.g., lower frequency of incontinence events and less urine leakage during an event) of the treatment. It is how the patients perceive their situation that indicates whether the treatment was successful and whether the patients feel that there is a decrease in urine leakage and an increase in quality of life. It is almost impossible to test such materials for their function in animal models. First of all, there are no real stress incontinent animal models available. Then it is very difficult to get an objective readout of the animals concerning the treatment. The animals cannot tell how they are doing or feeling. In such cases one feels that after well-performed biosafety experiments, there is no other option than to apply the medical implants in the clinic and carefully assess the outcome for each patient.
The prevalence of urinary incontinence in nulliparous female sportswomen: A systematic review
Published in Journal of Sports Sciences, 2019
Sania Almousa, Alda Bandin Van Loon
Urinary incontinence (UI) has been defined as the complaint of involuntary loss of urine, and occurs worldwide with a prevalence of 13.9% in males, and 51.1% in females (Markland, Richter, Fwu, Eggers, & Kusek, 2011). The two most common UI types are stress urinary incontinence (SUI) and urge urinary incontinence (UUI) (Agarwal et al., 2014). SUI is defined as the involuntary loss of urine on effort or physical exertion (sporting activities), or on sneezing or coughing, and UUI as the involuntary loss of urine associated with a sudden compelling desire to pass urine (Haylen et al., 2011).
The transvaginal mesh: an overview of indications and contraindications for its use
Published in Expert Review of Medical Devices, 2023
Alessandro Ferdinando Ruffolo, Marine Lallemant, Sophie Delplanque, Michel Cosson
There are two main typologies of female urinary incontinence (UI). The ICS/IUGA standardized document defined the SUI as the ‘complaint of involuntary loss of urine on effort or physical exertion (i.e. sporting activities), or on sneezing or coughing,’ and the urgency urinary incontinence (UUI) as the ‘complaint of involuntary loss of urine associated with urgency’ [35].