NURS9219 Introduction To Research

Research background

Effectiveness of pelvic muscle floor exercises in combination of medication in stress urinary incontinence

Introduction

Several women around the global world are suffering or affected through stress urinary incontinence. In general (Wood & Anger, 2014) stated that urinary incontinence is the geriatric syndromes combined with low-self esteem, pressure ulcers as well as functional declines. The increasing rate of urinary incontinence or UI is critical to determine as there are no evident data to analyze the percentage of people suffering from this disorder. As analyzed from (Bø & Herbert, 2013), the criticality of urinary incontinence in the global population ranges from 4 percent to 8 percent. Hence, it is significant that the number of people suffering through this condition in the entire world population is increasing rapidly over the last decade. In the year 2009, around 346 million people from the global world have been affected by urinary incontinence and increased to 383 million by the end of 2013. It is expected that by the end of 2018, the number of people affected by the disorder would increase to approximately 420 million with 120 million is expected to be men and around 300 million would be women. Although most of the research states evident information based on women suffering through the stress urinary incontinence disorder, this research paper would consider both men and women to offer a new dimension to reduce such criticality. This research paper would offer a significant analysis of the effectiveness of pelvic muscle exercise in order to offer a remedy in stress urinary incontinence with the combination of medicine. The research paper would follow the structure initiating with the aim, research questions and problem statement of the hypothesis followed by background and significance of the research. Lastly, it would highlight the research design that would be adopted for proving the hypothesis with the significant conclusion.

Statement of the problem

Based on previous research articles and journals proposed by scholarly, offers significant analysis about the stress urinary incontinence specifically in women. This research paper intends to offer the effectiveness of pelvic muscle floor exercises with the combination of medicine to reduce the stress urinary incontinence for the global population. In addition, very limited research has been conducted based on the hypothesis highlighting the effectiveness of pelvic muscle floor exercises with the combination of medication to act as a remedy for stress urinary incontinence. This research paper would offer significant analysis with evidence and facts to offer better assumption and judgments to assist people suffering through stress urinary incontinence by depicting a new direction in the medical world. With the steady increase in stress urinary incontinence, effective remedial strategy or approach needs to be formulated to assist people suffering through this disorder. Hence, this paper would significantly fill the gap that has been identified in past research studies focusing on a particular segment by formulating the effectiveness of pelvic muscle floor exercises with the combination of medicine to treat people suffering through stress urinary incontinence.

Research question

• What is the effectiveness of pelvic muscle floor exercises in stress urinary incontinence?
• What are the benefits of combining pelvic muscle floor exercises with medication in stress urinary incontinence?
• What are the reasons behind the event of stress urinary incontinence in people?
• What is the impact of stress urinary incontinence towards people?
• How pelvic muscle floor exercises can work as a remedy for stress urinary incontinence?

The aim of the research

The proposed research would highlight the effectiveness of pelvic muscle floor exercises in a combination of medication in stress urinary incontinence. In addition, this paper would integrate all relevant information from past researches which would assist to fill the research gaps by proving a new direction for treating stress urinary incontinence in people. It would offer a remedy by analyzing and exploring each research objective critically to treat stress urinary incontinence irrespective of gender as research states this disorder affects both men and women.

Objectives of the research

• To explore the effectiveness of pelvic muscle floor exercises in stress urinary incontinence;
• To analyze the benefits of combining pelvic muscle floor exercises with medication in stress urinary incontinence;
• To identify the reasons behind the occurrence of stress urinary incontinence in people;
• To analyze the impact of stress urinary incontinence on people;
• To explore the function of pelvic muscle floor exercises as a remedy for stress urinary incontinence.

Current context/background

As put forwarded by (Borello-France et al. 2013), the rate of urinary incontinence is increasing rapidly in a global world. In addition, the number of people affected by this disorder is also increasing over the last decade. At present, both men and women are suffering or affected by this disorder due to several critical reasons. However, (Burgio, 2013) stated that the rate of stress urinary incontinence in women is much higher than men but it affects both. Based on the past research studies, it has been analyzed that the authors primarily focused either on women suffering through stress urinary incontinence or offering particular remedies. None of the research forecasts the criticality of the disorder in both men and women. In addition, the effectiveness of pelvic muscle floor exercises in combination with the medication has not been researched. Hence, this paper intends to research the unidentified area of this particular field in order to offer a significant remedial strategy for stress urinary incontinence in people. As put forwarded by (Bo et al. 2014), based on pathophysiology and etiology urinary incontinence can be classified into 3 kinds namely Stress urinary incontinence, Urge urinary incontinence and Mixed urinary incontinence. This paper would highlight the effectiveness of pelvic muscle floor exercises in combination with medication specifically for stress urinary incontinence.

In addition, (Dumoulin et al. 2014) suggested that stress urinary incontinence can be distinct as instinctive leakage of urine during laughing, coughing or sneezing. In fact, due to physical exertion, the abdominal pressure increases which puts pressure on the bladder leading to leaking in urine. For such critical implications, poor utheral support is the most responsible part by the pelvic floor muscles as well as intrinsic sphincter deficiency. Furthermore, there is significant literature suggesting the disposing factors of stress urinary incontinence such as reduction of reproductive organs, numerous births, and genital mutilation, previous operations, hormone deficiency, generalized weakening of connective tissues as well as other relevant factors. However, the very limited contribution has been made based on prevention techniques or remedial actions for preventing the disorder of stress urinary incontinence. Through the proposed hypothesis the significance of pelvic muscle floor exercises in combination with the medication as a prevention technique can be established for stress urinary incontinence. In addition, (Fan et al. 2013) stated pelvic muscle floor exercises are generally used for people suffering through this disorder due to its effectiveness. However, the combination of medication with pelvic muscle floor exercises have not been established in past research studies which this research study intends to fulfill the gap. Furthermore, as most of the past research studies highlighted the impact and causes of stress urinary incontinence on women, the criticality that has been growing in men due to this disorder has not been discussed yet. This research paper would fulfill such conditions highlighting the effectiveness of pelvic muscle floor exercises in combination with the medication for stress urinary incontinence irrespective of gender and focusing on a generalized view.

The significance of the research

The growth of stress urinary incontinence has been in increasing over the last decades within population around the global world. As stated by (Hagen et al. 2014), the rate of increase in stress urinary incontinence has been identified primarily on women compared to men. In addition, this disorder impacts women extensively which leads to poor quality of life. Based on such context, the significance of the research is to analyze the impact of stress urinary incontinence on both men and women as well as to offer remedial action in a generic view enhancing the credibility of the research hypothesis. The past issues and gaps that have been identified in the literature due to limited information, as well as a lack of potential information irrespective of gender, can be filled with the present research hypothesis. On the other hand, (Hersh & Salzman, 2013) argued that the rate of stress urinary incontinence in women is distinct compared to men and cannot be combined together for analyzing its causes and remedial action. Based on such context, the research intends to analyze in-depth knowledge about such judgment in relation to that significant assumption to the hypothesis can be formulated. As put forwarded by (Mørkved & Bø, 2013), stress urinary incontinence occurs due to geriatric syndromes with the combination of low self-esteem, pressure ulcers as well as functional decline. Hence, it can be stated that these are the primary cause of stress urinary incontinence which cannot be distinguished based on men and women rather a generic view must be adopted to make a significant analysis.

As opined by (Hilde et al. 2013), pelvic muscle floor exercises have a significant impact on stress urinary incontinence as the research conducted by the author stated statistically depicted that the highest improvement in stress urinary incontinence was reflected due to such exercise. Based on such a context, it can be stated that this article is highly relevant as it highlights the effectiveness of pelvic muscle floor exercises in stress urinary incontinence. In addition, (Hirakawa et al. 2013) suggested that a combination of pelvic muscle floor exercises and medication would highly enhance the prevention of such disorder leading to improved quality of life. In fact, such symptom can be relevant and adapted to both men and women like this kind of exercise can benefit critically. Literature suggests that involuntary loss of urine may result in exclusion from social activities by the sufferers as it causes shame and increases barriers to physical recreation, social interests, and entertainment. As this kind of stress of urinary incontinence can be identified in both and men, the significance of this research can be established with this relevant article as it highlights the criticality of persons with the possibility of a urinary accident in public. As put forwarded by (Qaseem et al. 2014), the assistance of a physiotherapist is significant to women exercising pelvic muscle floor exercises. Based on such note, it can be stated that relevancy of physiotherapist has been attained from past research studies, however; combining it with medication would also enhance the possibility of the prevention of SUI in future terms.  

As stated by (Ghaderi & Oskouei, 2014), the effectiveness of pelvic muscle floor exercises and PFMT program have been analyzed several years ago due to its potency. In such a context, it can be stated that the significance of pelvic muscle floor exercises for treating stress urinary incontinence is extensive. In addition, the theory proposed by (Marcelissen & Van Koeveringe, 2018) states that combined therapy can be much beneficial than offering a single therapy as it would offer critical as actions in case one of them fails. Based on such a context, it can be stated that the research hypothesis would be approved as the analysis of the effectiveness of pelvic muscle floor exercises combined with medication can be essential highlighting its benefits. As opined by (Suskind et al. 2017) the role of muscle strengths and body composition have a direct impact on the stress urinary incontinence. This states that the causes and reasons behind the initiation of such disorder among people. As put forwarded by (McIntosh et al. 2015), pelvic muscle floor exercises require motivation among the people suffering through SUI. Based on such a context, it can be stated that the effectiveness of such an exercise can be analyzed in order to mitigate stress urinary incontinence. The significance of this research has been established critically based on the hypothesis filling the past research gaps and offering a new dimension in the medical world.  

Potential design

As opined by (Gray, 2013), methodology is a significant aspect of a research project. In order to maintain such paradigm, the use of deductive approach, positivism philosophy and descriptive design would be considered based on the objectives of the research hypothesis for attaining qualitative results. In contrary, others like explanatory, inductive and interpretivism approach would not be used as the research would utilize the articles and pre-published journals. Both primary and secondary analysis is a significant aspect for conducting a research and to obtain desired results. However, to conduct this research study the use of secondary resources would be analyzed based on pre-published journals and articles as it would assist to gather relevant information based on past research studies. In addition, as the research hypothesis requires significant information and credible resources the quality of information would be enhanced. The use of primary resources would not be considered for this research study as the significance of secondary resources is relevant for conducting this research study. Furthermore, the data collection technique that would be utilized in this research study would be collected from journals, articles, books and website references in order to offer relevant analysis and assumptions, (Pope et al. 2013). By cross-referencing each of the relevant secondary resources significant assumptions and critical judgments can be formulated that can fulfill the scope and significance of the research and fill the gap in the existing literature.

Ethical considerations

As the research study would require only secondary information, ethical consideration would be highly maintained. In addition, the use of primary resources would not be considered which states that there would not be any requirement of any participants or respondents for conducting this study. Hence, the need for ethical consent is negligible for proving the research hypothesis. It would offer a generic view by maintaining ethical considerations.

Conclusion

Based on the above discussions, it can be stated that the research hypothesis would extensively fill the existing literature gap while offering a new dimension towards the analysis of the effectiveness of pelvic muscle floor exercises in a combination of medication in stress urinary incontinence. In addition, as the increasing rate of stress urinary incontinence has been critically increased in both men and women over the last decade the need for effective prevention technique is significantly required. The research hypothesis would critically highlight the effectiveness of pelvic muscle floor exercises in a combination with medication for acting as a mitigating technique for stress urinary incontinence within the general population. This, in turn, would fulfill the scope and significance of the research study filling the past research gaps with significant justification based on credible resources. Furthermore, this research study would significantly use secondary resources from credible resources and references for answering each research question identified. The use of secondary resources would be credible in order to prove the hypothesis and to make significant assumptions. For conducting this research, ethical considerations would be highly maintained although the use of primary research would not be considered. In addition, this research study would fulfill the primary objective by analyzing the effectiveness of pelvic muscle floor exercises in a combination of medication in stress urinary incontinence within the population and offer a new dimension in the medical world. However, the use of secondary resources and data collected for analyzing the hypothesis would highly maintain ethical considerations to ensure ethical dilemmas.    

References

Bø, K., & Herbert, R. D. (2013). There is not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review. Journal of physiotherapy, 59(3), 159-168.

Bo, K., Berghmans, B., Morkved, S., & Van Kampen, M. (2014). Evidence-Based Physical Therapy for the Pelvic Floor-E-Book: Bridging Science and Clinical Practice. Elsevier Health Sciences.

Borello-France, D., Burgio, K. L., Goode, P. S., Ye, W., Weidner, A. C., Lukacz, E. S., … & Kenton, K. (2013). Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors. Physical therapy, 93(6), 757-773.

Burgio, K. L. (2013). Update on behavioral and physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training. Current urology reports, 14(5), 457-464.

Dumoulin, C., Hay?Smith, E. J. C., & Mac Habée?Séguin, G. (2014). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. The Cochrane Library.

Fan, H. L., Chan, S. S. C., Law, T. S. M., Cheung, R. Y. K., & Chung, T. K. H. (2013). Pelvic floor muscle training improves quality of life of women with urinary incontinence: a prospective study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 53(3), 298-304.

Ghaderi, F., & Oskouei, A. E. (2014). Physiotherapy for women with stress urinary incontinence: a review article. Journal of physical therapy science, 26(9), 1493-1499.

Gray, D. E. (2013). Doing research in the real world. Sage.

Hagen, S., Stark, D., Glazener, C., Dickson, S., Barry, S., Elders, A., … & McPherson, G. (2014). Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet, 383(9919), 796-806.

Hersh, L., & Salzman, B. (2013). Clinical management of urinary incontinence in women. American family physician, 87(9).

Hilde, G., Stær-Jensen, J., Siafarikas, F., Engh, M. E., & Bø, K. (2013). Postpartum pelvic floor muscle training and urinary incontinence: a randomized controlled trial. Obstetrics & Gynecology, 122(6), 1231-1238.

Hirakawa, T., Suzuki, S., Kato, K., Gotoh, M., & Yoshikawa, Y. (2013). Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. International urogynecology journal, 24(8), 1347-1354.

Marcelissen, T. A., & Van Koeveringe, G. A. (2018). Mirabegron versus Antimuscarinics in the Treatment of Overactive Bladder: The Final Answer?

McIntosh, L., Andersen, E., & Reekie, M. (2015). Conservative treatment of stress urinary incontinence in women: A ten year (2004-2013) scoping review of the literature. Urologic Nursing, 35(4), 179-203.

Mørkved, S., & Bø, K. (2013). Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med, bjsports-2012.

Pope, J., Bond, A., Morrison-Saunders, A., & Retief, F. (2013). Advancing the theory and practice of impact assessment: Setting the research agenda. Environmental Impact Assessment Review, 41, 1-9.

Qaseem, A., Dallas, P., Forciea, M. A., Starkey, M., Denberg, T. D., & Shekelle, P. (2014). Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 161(6), 429-440.

Suskind, A., Cawthon, P., Nakagawa, S., Subak, L., Reinders, I., & Satterfield, S. et al. (2017). Urinary incontinence in older women: the role of body composition and muscle strength from the Health, Aging, and Body Composition Study. HHS Public Access, 65(1), 42-50. Doi: 10.1111/jgs.14545

Wood, L. N., & Anger, J. T. (2014). Urinary incontinence in women. Bmj, 349, g4531.