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M C Lemieux

Publications and source records attributed to M C Lemieux.

5 recordsLinked to original sources

Reliability of dynamometric measurements of the pelvic floor musculature.

AIMS: The objective of this study was to evaluate the reliability of strength and endurance dynamometric measurements of the pelvic floor musculature (PFM). MATERIALS AND METHODS: Twenty-nine female participants, primipara and multipara, aged between 27 and 42 and presenting different severity levels of stress urinary incontinence (SUI), participated in the study. They were evaluated using a new pelvic floor dynamometer, an instrumented speculum based on strain-gauged technology. Strength and endurance evaluations were repeated in three successive sessions, each followed by a 4-week period. Maximal strength values were recorded at three dynamometer openings (5 mm, 1 cm, and 1.5 cm between the two dynamometer branches). The maximal rate of force development (MRFD) and percentage of strength lost after 10 and 60 sec were computed from the endurance trial. The generalizability theory was applied to estimate the reliability of the PFM measurements. The reliability was quantified by the index of dependability and the corresponding standard error of measurement (SEM) for one and the mean of three trials performed in one session for the strength measurements and one trial completed in one session for the MRFD and endurance measurements. RESULTS: For the maximal strength measurements, the largest coefficient of dependability was obtained at the 1 cm opening, with a value of 0.88. The corresponding SEM reached 1.49 N. The reliability of the MRFD was also very good with a coefficient of 0.86 and an SEM of 0.056 N/sec. The reliability was minimally affected by the number of trials. The strength loss measurements at 10 and 60 sec were unreliable, with coefficient values of 0.38 and 0.10, respectively. CONCLUSIONS: The results of the present study indicate that the reliability of the strength parameters (maximal strength and MRTD measurements) was high enough for future investigations on pelvic floor rehabilitation programs.

Adult↗

International consultation on incontinence questionnaire short form: comparison of physician versus patient completion and immediate and delayed self-administration.

OBJECTIVES: To compare the results of International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with physician completion versus patient self-administration. The ICIQ-SF is a new self-administered questionnaire that qualifies the symptoms and quality of life in both male and female adult patients with symptoms of urine loss. METHODS: Sixty-four women consulting for urinary incontinence completed the ICIQ-SF three times: twice during the same visit, by self-administration and physician interview, and once at home, approximately 1 week later. RESULTS: All 64 patients completed the questionnaire the first two times, but only 59 of them sent back the questionnaire after 1 week. The mean patient age was 59 +/- 3.8 years. The distribution of the differences was similar among the three kinds of administration. The mean total symptom score for the self-administered, physician completed, and self-administered 1 week later ICIQ-SF was 11.31 +/- 4.6, 11.98 +/- 4.4, and 11.4 +/- 4.7, respectively. The corresponding quality-of-life assessments were 5.2 +/- 2.9, 5.5 +/- 3, and 5.18 +/- 2.9. No statistically significant differences were observed. CONCLUSIONS: The results of this study demonstrated that the information obtained by self-administration of the ICIQ-SF at the office or at home or when completed by the physician during an interview is not different. These findings, showing the intraobserver and interobserver reliability of this new questionnaire, are extremely important for clinical use and research.

Adult↗

Is there an irritable bladder in the irritable bowel syndrome?

In this prospective case controlled study 16 premenopausal women with documented irritable bowel syndrome were recruited from the gastroenterology clinic and 16 premenopausal controls without symptoms of irritable bowel syndrome were recruited from the gynaecology clinic. All women answered a standardised bowel and urinary symptom questionnaire and underwent twin channel subtracted cystometry. Women with irritable bowel syndrome also underwent oesophageal balloon distension studies for perception and pain. Oesophageal and bladder sensory thresholds were compared. Urinary frequency and urgency and the urodynamic finding of detrusor instability were significantly more common in women with irritable bowel syndrome (P < 0.05). We were unable to demonstrate a relationship between first sensation of bladder fullness and oesophageal perception or between maximum bladder capacity and oesophageal pain thresholds. These findings suggest that there is an irritable bladder in the irritable bowel syndrome and support the concept that irritable bowel syndrome is part of a generalised disorder of smooth muscle.

Adult↗

Prevalence of bowel dysfunction in patients with multiple sclerosis and bladder dysfunction.

Urinary dysfunction is common in cases of multiple sclerosis (MS). The close proximity of those neural pathways which control the bladder to those which control anorectal function might be expected to lead to a high coexistence of bladder and bowel symptoms. Seventy-seven consecutive patients with clinically definite MS attending a uroneurology clinic were interviewed about their bowel function. All patients had clinical evidence of spinal cord disease with varying degrees of impaired mobility and sufficiently severe disturbance of bladder control to seek medical advice. Thirty-six per cent of these patients had constipation. Twenty per cent had "current incontinence", although another 30% had had at least one episode of faecal incontinence more than 3 months previously. Some patients had both constipation and faecal incontinence. A total of 52% currently had at least one bowel symptom. The pattern of bowel symptoms did not correlate with the pattern of urinary disturbance, or the duration of MS, or the degree of disability. Bowel symptoms are common in patients with MS, but even in those with urinary dysfunction are not universal. Whereas bladder dysfunction in MS is clearly related to spinal cord disease, the neurological basis for the bowel dysfunction is less clear.

Adult↗

Bowel dysfunction in young women with urinary retention.

Urinary retention in young women is rare, but a syndrome has recently been described in which urinary retention is associated with abnormal periurethral electromyography. The incidence of bowel dysfunction in these women was investigated, in an attempt to determine whether this might be a more widespread disorder. Of 12 patients with this urological abnormality, eight were constipated. No consistent anorectal abnormality was identified on anorectal physiological testing. The electromyographic abnormality was not seen in the external anal sphincter. One patient had an abnormality of the internal anal sphincter smooth muscle, while another had a generalised disorder of the gastrointestinal tract and urinary bladder resembling a visceral myopathy. Bowel symptoms are common in this group of women with urinary retention, but abnormalities of bowel function are not specific. A common mechanism for bladder and bowel symptoms remains a possibility.

Adolescent↗