Understanding the Context of Northern Plains American Indian Teen Pregnancy

本项目的重点是评估门诊微创 来自北方平原农村保留区的美国印第安妇女接受手术， 患有压力性尿失禁这项研究是独一无二的，因为它是第一项研究， 流行病学发现后，将对这一人群进行尿失禁的门诊治疗。 关于美国印第安妇女尿失禁的数据很少，尽管他们面临着几个问题。 尿失禁的危险因素，包括高产次率，糖尿病和吸烟（1，2）。 美国印第安妇女谁完成了排尿困难清单将进行后续可能的 治疗，这最终取决于类型，严重程度和泌尿系统炎症的根本原因。 患有中度至重度压力性尿失禁的参与者将接受门诊手术干预， 桑福德健康在苏福尔斯，南达科他州。将用于该项目的手术是一种程序 称为无张力阴道胶带安全系统（TVT系统），一种可以在 局部麻醉，约30分钟完成。将在1、3和12个月时对患者进行随访 在最初的程序之后。将完成回顾性图表摘要，以比较这组 美国印第安妇女接受TVT程序与其他人口的妇女。 虽然许多其他干预失禁的重点是住院手术干预的压力 尿失禁，一个门诊，办公室为基础的程序，从泌尿妇科专家是必不可少的， 农村和少数民族妇女。理想情况下，这项研究将是设计更大， 对北方平原受泌尿系统疾病影响的美洲印第安妇女进行的长期临床试验 失禁的人还没有得到他们需要的护理。这项研究的最大目标是评估一个 对一组农村少数民族妇女进行门诊干预，这些妇女的问题被忽视，但却很严重。

The focus of this project is to evaluate the feasibility and effectiveness of an out-patient, minimally invasive surgery to American Indian women from a rural reservation community in the Northern Plains who are suffering from stress urinary incontinence. This study is unique because it is the first research study in which epidemiological discovery will be followed by outpatient treatment for urinary incontinence in this population. There is little data on urinary incontinence with American Indian women, although they are faced with several of the risk factors for urinary incontinence, including high rates of parity, diabetes, and smoking (1,2). American Indian women who completed the Urinary Distress Inventory will be followed-up for possible treatment, which ultimately depends on the type, severity, and underlying cause of urinary Incontinence. Participants with moderate to severe stress incontinence wiii receive outpatient surgical interventions at Sanford Health in Sioux Falls, South Dakota. The surgery that will be used for this project is a procedure called the tension-free vaginal tape secure system (TVT System), a procedure that can be performed under local anesthesia and is completed in about 30 minutes. Patients will be followed-up at 1, 3, and 12 months after the initial procedure. A retrospective chart abstraction will be completed to compare this group of American Indian women receiving the TVT procedure with other populations of women. While many other interventions for incontinence are focused on inpatient surgical interventions for stress urinary incontinence, an outpatient, office-based procedure from urogynecological specialists is essential for a rural and minority population of women. Ideally, this research will be the first step in designing larger, long-term clinical trials for American Indian women in the Northern Plains who are affected by urinary incontinence yet are not receiving the care they need. The greatest goal of the study is to evaluate an outpatient intervention with a group of rural, minority women with an overlooked but serious problem.