Urogynecologic Care for Women Who Are Incarcerated.

IF 0.8 Q4 OBSTETRICS & GYNECOLOGY Urogynecology (Hagerstown, Md.) Pub Date : 2024-10-09 DOI:10.1097/SPV.0000000000001590
Rachel A Clark, Deborah Landis Lewis, Christopher X Hong
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Abstract

In the United States, approximately 180,700 women are incarcerated across jails and prisons, comprising a demographic with an aging population and a higher growth rate compared to men. Despite this demographic trend, research into urogynecologic care for women who are incarcerated is notably lacking, with few studies addressing pelvic floor disorders such as incontinence, and even fewer focusing on access to treatment options like vaginal pessaries or surgical interventions. Women who are incarcerated may face unique challenges in obtaining urogynecologic care, including limited access to medical evaluations, invasive search procedures affecting intravaginal device use, and inadequate hygiene resources, all of which hinder effective management strategies. Barriers to nonsurgical treatments like pelvic floor physical therapy are exacerbated by transportation logistics, while access to surgical interventions is impeded by complex approval processes within correctional facilities. In addition, managing incontinence with limited access to hygiene products and bathroom facilities further compromises the health and dignity of incarcerated women. Urgent attention and advocacy are needed to address disparities in research and clinical care for incarcerated populations. As a first step, we urge clinicians to acquaint themselves with the correctional facilities in their areas and the current health care pathways for women incarcerated in these facilities. It is our collective responsibility to ensure equitable and compassionate care for this vulnerable population.

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被监禁妇女的泌尿妇科护理。
在美国,大约有180,700名女性被关押在监狱和监狱中,这是一个人口老龄化和增长率高于男性的人口结构。尽管有这样的人口趋势,但对被监禁妇女的泌尿妇科护理的研究明显缺乏,很少有研究针对骨盆底疾病,如尿失禁,更少关注阴道托垫或手术干预等治疗选择。被监禁的妇女在获得泌尿妇科护理方面可能面临独特的挑战,包括获得医疗评估的机会有限、影响阴道内装置使用的侵入性搜查程序以及卫生资源不足,所有这些都阻碍了有效的管理战略。运输物流加剧了骨盆底物理治疗等非手术治疗的障碍,而矫正设施内复杂的审批程序阻碍了手术干预的获得。此外,在获得卫生用品和浴室设施有限的情况下处理大小便失禁,进一步损害了被监禁妇女的健康和尊严。需要紧急关注和宣传,以解决监禁人群在研究和临床护理方面的差距。作为第一步,我们敦促临床医生熟悉其所在地区的惩教设施以及目前在这些设施中被监禁的妇女的保健途径。确保为这一弱势群体提供公平和富有同情心的护理是我们的集体责任。
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