Understanding the Context of Northern Plains American Indian Teen Pregnancy

该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妇女进行手术 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 流行病学发现之后将对该人群进行尿失禁的门诊治疗。 关于美国印第安女性尿失禁的数据很少，尽管她们面临着一些问题 尿失禁的危险因素，包括高产次率、糖尿病和吸烟 (1,2)。 完成尿窘迫调查表的美洲印第安人妇女将接受随访，以了解可能的情况 治疗，最终取决于尿失禁的类型、严重程度和根本原因。 患有中度至重度压力性尿失禁的参与者将在以下时间接受门诊手术干预： 南达科他州苏福尔斯市的桑福德健康中心。该项目将使用的手术是一个程序 称为无张力阴道胶带固定系统（TVT 系统），该手术可以在 局部麻醉，约30分钟完成。患者将在 1、3 和 12 个月时进行随访 在初始程序之后。将完成回顾性图表抽象来比较这组 美洲印第安人妇女与其他妇女群体一起接受 TVT 手术。 虽然许多其他失禁干预措施都集中在住院压力手术干预上 尿失禁，由泌尿妇科专家进行的门诊、办公室治疗对于以下情况至关重要： 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的、 针对北部平原受泌尿系统影响的美国印第安妇女进行的长期临床试验 失禁但未得到所需的护理。该研究的最大目标是评估 对一群农村少数民族妇女进行门诊干预，她们的问题被忽视但很严重。

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.