Understanding the Context of Northern Plains American Indian Teen Pregnancy

本项目的重点是评估门诊微创手术的可行性和有效性。 为来自北部平原农村保留社区的美国印第安人妇女做手术 患有压力性尿失禁。这项研究是独一无二的，因为它是第一个 在流行病学发现之后，将在该人群中进行尿失禁的门诊治疗。 关于美国印第安人女性尿失禁的数据很少，尽管她们面临着几个 尿失禁的风险因素，包括高产次、糖尿病和吸烟(1，2)。 完成尿路窘迫问卷的美国印第安人妇女将被尽可能地跟踪调查 治疗，最终取决于尿失禁的类型、严重程度和潜在原因。 患有中度到重度压力性尿失禁的参与者将在8点接受门诊手术治疗。 南达科他州苏福尔斯的桑福德健康中心。将用于该项目的手术是一种程序 称为无张力阴道吊带安全系统(TVT系统)，这是一种可以在 局部麻醉，大约在30分钟内完成。患者将在1、3和12个月进行随访。 在最初的程序之后。将完成回溯性图表摘要，以比较这组 接受TVT手术的美国印第安人妇女和其他人群的妇女。 虽然许多其他治疗大小便失禁的干预措施都集中在针对压力的住院手术干预上 尿失禁是一种由泌尿外科专家在门诊和办公室进行的手术，对于 农村和少数民族妇女人口。理想情况下，这项研究将是设计更大规模、 北部平原美洲印第安人妇女尿路感染的长期临床试验 大小便失禁还没有得到他们需要的治疗。这项研究的最大目标是评估一个 对一群农村少数民族妇女进行门诊干预，她们有一个被忽视但严重的问题。

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.