ESSAY NURS 135 Contemporary Issues In Nursing

NURS 135 Contemporary Issues In Nursing

Answer:

Topic: Treatment Options for women incontinence in the post-partum

Effectiveness of Benefit of the Kegels

While discussing about the different treatment method for the treatment options for the post-partum situation, the use of the Kegels can be mentioned. The use of the Kegels among the women facing the issues of the urinary incontinence during the post-partum period was reported to be effective in terms of reducing the severity and the incidence rate of the women (Huang & Chang, 2021). In a recent time, the longitudinal study performed by Yount, Fay and Kissler (2021), reported that the regular performance of Kegel exercises during the post partum period can improve the incontinence among the women. In this particular study the researchers included 368 multiparous white women randomly and among the women 20 per cent of the women reported about the issue of incontinence. The study result reported that the women who performed 16 Kegel two times daily had lower level of incontinence after 6 months of the post partum condition and it was reported that the presence of the urinary incontinence was related with the age group of the women (less than 35 years) and parity. The study findings were also supported by the study of Jingjing (2017) the researcher also had reported that regular performance of the Kegel exercises can improve the postpartum urinary continence situation through the application of the early pelvic floor rehabilitation. However, there are a few common negative factors associated with the use of the Kegel exercises and in this regard it was reported approximately 30 per cent of the women were not aware about the correct method of contracting the pelvic floor muscles. Apart from that, it is also reported that there were no such fixed method of performing the Kegel exercises which can not be able to achieve the desired results. In most of the cases, it is reported that the level of Kegel exercise performances generally increases at the 3 months however it decreases within 6 months in the post partum condition.

Surgery Methods

There are ways to place synthetic tapes inside to improve support of the urethra and reduce or stop the leakage of urine. This type of surgery can be done under general or local anaesthetic. It is most often only day surgery. In a recent study by Adams-Piper et al. (2016), the researchers reported about the effectiveness of the placement of midurethral sling (MUS) for managing the post partum urinary continence problem among the women. However, in this review study, the researchers mainly identified about the safety and durability of the MUS after the pregnancy. The effectiveness of this surgery method was also supported by the study of Bergman et al. (2018) as in this study the researchers reported to conduct population-based cohort study by using the validated Swedish nationwide health care registers. The study results reported to include 728 women and among them 74 per cent of the women responded properly. It was reported that the vaginal child birth after the MUS mainly reduced the risk of urinary incontinence compared to the caesarean delivery along with a confidence interval of 95 per cent (OR 0.6, 95% CI 0.2–1.4). However, the researchers did not report about any significant differences in terms of the results of the two groups analysed by using the Urogenital Distress Inventory and Incontinence Impact Questionnaire scores.

Colposuspension

The Burch colposuspension is surgery that involves placing stitches inside the vagina. The stitches attach to supportive ligaments either side of the urethra to elevate the vagina and support the urethra, reducing or stopping the leakage of urine. This can be done using open or keyhole surgery. In a comparative analysis study by Karmakar et al. (2021) the researchers reported about the effectiveness of the colposuspension surgery technique and in this research the researchers performed the comparative analysis with the MSU and it was reported that colposuspension was better in terms of lower number of reoperation for incontinence situation.

Bulking Agents

As a part of the third surgery based strategy, the use of the bulking agents can be mentioned. In the study of Siddiqui et al. (2017) the researchers reported that effectiveness of the bulking agents as the research reported the effectiveness of the bulking agents in reducing the complications associated with the urinary continence among the women.

However, it is also very important to mention the fact that there are common risk factors associated with the surgery process as there are chances of infections along with the additional cost after the surgery process.

Effectiveness of Pelvic Flood Physiotherapy

Another treatment option for treating the incontinence during the post partum situation is to apply the pelvic floor physiotherapy technique. The pelvic floor muscle training (PFMT) is the first-line treatment for women with UI due to its efficacy, low cost, lack of side effects and the absence of impact on subsequent treatments. In this regard, the study findings of Vaz et al. (2019) can be mentioned as in this randomized controlled trial study design the researchers included the participants having the issues of urinary continence through the physical therapy program comprising of the bladder training and the pelvic floor muscle training (PFMT). The study results reported that the implementation of the PFMT along with the bladder training was effective for the treatment of women during the post partum period. In another study of Woodley et al. (2020) the researchers reported that the application of the therapy improved the urinary continence beyond the 12 months during the post partum. In another systematic review study the researchers reported that the application of the Pelvic floor muscle training (PFMT) after the delivery provides positive results by providing supportive structures and the strengths to the urinary tract system of women. In the study of Kucukkaya and Kahyaoglu (2021) the researchers reported to conduct the study among 64 female patients. The application of the PFMT and abdominal training were reported to treat the conditions and it was reported by the authors that patients with pelvic floor muscle training plus abdominal training showed better results compared to the patients received only PFMT.

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