Effect of Exercise and self care guidelines on relieving Stress Urinary Incontinence among women in Beni-Suef University Hospital Amal Roshdi A.Mostafa a, Mohamed Ibrahim Mohamed b a Doctor at Maternal and New natal health Nursing Faculty of Nursing, b Doctor in Sport Psychology Department at Faculty of Physical Education, Beni -suef University (Egypt)

Introduction Urinary incontinence (UI) is an extremely common complaint in every part of the world. It causes a great deal of distress and embarrassment, as well as significant costs, to both individuals and societies. Stress Urinary Incontinence is the most common problems in women which are difficult to deal with, because they come with shame and embarrassment. Despite of research evidence supporting the effectiveness of behavioral therapy such as exercise training changing life style to relieving urinary incontinence, there are few demonstrations of outcomes obtained.

Stress incontinence is defined by the International Continence Society (ICS) as the ‘complaint of involuntary leakage of urine on effort or exertion, on sneezing or coughing’.It is usually caused by weakness or damage to muscles and connective tissues of the pelvic floor, compromising urethral support or by weakness of the urethral sphincter itself.

"Kegel exercises can help make the muscles under the uterus, bladder, and bowel (large intestine) stronger. They can help both men and women who have problems with urine leakage or bowel control."

The pelvic floor muscles control the flow of urine, the voluntary contraction of the vagina and the anal sphincter as well. The pelvic floor is composed of several layers of muscle suspended like a hammock at two points: the front and the back of the pelvis. The pressure of pregnancy increases the likelihood that the pelvic floor will sag just as a hammock does.

The nurse plays role as teacher or health educator enable patients to understand the need for treatment; improve patient generally positive treatment of chronic cough, constipation, increased abdominal pressure such as the primary disease. Self care is personal health maintenance. It is any activity of an individual, family or community, with the intention of improving,restoring health, treating or preventing disease.

Aim of the study: Evaluate Effect of exercise and self- care guidelines on relieving Stress Urinary Incontinence among women in Beni-Suef University Hospital. Through 1. Assessing women's knowledge regarding Stress Urinary Incontinence. 2. Designing guideline booklet according to women’s needs regarding Stress Urinary Incontinence. 3. Evaluating effect of the self-care guideline on relieving stress Urinary Incontinence

Research Hypothesis: - The majority of women can't made proper kagel exescise & self-care for relieving Stress Urinary Incontinence. - After explanation and application of exercise and self-care guideline on women with Stress Urinary Incontinence; will improved and they made proper self-care.

Subjects and Methods Research design: An intervention. Setting of the study:- This study was conducted at gynaecological outpatient clinic of Beni Suef University Hospital.

Sample:- Purposive sample. their was 100 women. The sample criteria: Women in reproductive ( years), Free from medical disorders Diagnosed with stress Urinary Incontinence.

Tools of Data Collection I- Structured interviewing questionnaire sheet, which include the socio- demographic data and Women's life style that predisposed to stress Urinary Incontinence. II - Assessment sheet on five point rating scale during P.V to assess the strength of pelvic floor muscle before and after using the guide line.

Technique of kagel exercise find pelvic floor muscles which are used to stop and start urine flow (the muscles used to stop urine flow are the same muscles used for kagel exercise).

III – An instructional guideline booklet which include three parts. The first part explained definition, causes, risk factors and symptoms of Stress Urinary Incontinence. The second part explained different method of treatment and prevention The third part explained self-care practices and health habits to prevent intra-abdominal pressure and strength pelvic floor muscles and relieving stress Urinary Incontinence.

Ethical considerations Women consent for participation in the study, Every woman was free to withdraw at any time throughout the study, All data were confidential. the nature of the study was harmless.

Results

%NoItems Age | years : ≤ 33.6 ± 5.3 X ± SD Occupation : Have a work No work Education 16 high level education 84 low level education Table (1): Distribution of women as regard to their age, work, and education = 100

Figure (1): Patient grade of exercises on five point rating scale during PV before and after guideline

Recommendations: A trial of supervised PFMT of at least three months’ duration should be offered as first-line treatment to women with stress urinary incontinence. pelvic floor exercises are beneficial and have no significant adverse effects Kagel exercise must be involved and become basic part of teaching curricula in nursing faculties. Kagel exercise should be recommended during each stage of female life cycle development. Midwifes and maternity nurse should teach woman kagel exercise to prevent SUI

Amal Roshdi A.Mostafa: Tel : ; fax: address: Mohamed Ibrahim: Tel.: ; fax: address: Thank you