الفهرس 
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Abstract
Stress Urinary Incontinence (UI) is a major health problem all over the world because of its high prevalence, the financial and social burden, in addition to the negative impact on women’s health where UI results in diminished overall quality of life.
Stress urinary incontinence was prevalent in women and it occurs when the pelvic floor muscles are weekend and cannot support increased bladder pressure. Coughing, sneezing, exercising, and laughing can trigger urine flow. There are many causes of incontinence. Some of these causes include pregnancy, childbirth, and hormone changes during the menopausal years. Pelvic floor muscle exercises can help treat women with stress incontinence. The kegel exercises were developed by Arnold kegel, M.D., to help women regain bladder control after childbirth and menopause. They help decrease urine leakage in women with stress and urge urinary incontinence with overactive bladder frequency. The kegel exercise increases support to the urethral sphincter and bladder muscle. The best part of this exercise is that it is free, painless, and can be done at any time of the day (Mayo, 2012).
The aim of the study:- It is to assess the effect of kegel exercises on stress urinary incontinence on women during menopause.
Research setting:-
The research on the effect of the kegel exercise on stress urinary incontinence on women during menopause was conducted at Maternal and Child Health Center in two selected villages, namely Eldabyba and Tanbesha, at Menoufia Governorate.
Sample:-The target population of this study was menopausal women with stress urinary incontinence, sample size was (160) menopausal women. The inclusion criteria were as follows:
1- Women (age over 40 years).
2- Presenting episode of stress urinary incontinence (SUI).
Research design:- quasi experimental design was utilized to assess the effectiveness of the kegel exercise on stress urinary incontinence on women during menopause.
Tools of the study was prepared after reviewing the available and related literature
Tool I: Structured interview Questionnaire
Part (1): Biosocial characteristic which include age, educational level, occupation and number of family members
Part (2): Past history which include medical, obstetric and gynecological history
Part (3): Medical & surgical history: includes presences of medical disorder such as persistent cough, constipation, diabetes mellitus, hypertension, urological diseases, vaginal prolapse, and any diuretic drugs received.
Obstetric history such as number of abortions, number of pregnancy, number of labour, number of (living birth, death, still birth), type of delivery (normal delivery (using instrumental delivery (foreceps or ventouse), caesarean). Postpartum hemorrhage, stress urinary and stool incontinence), and place of delivery.
• Tool II: characteristic of stress urinary incontinence.
This includes questions about the precipitating condition (about coughing, sneezing, laughing, lifting or nervousness, positional changes). There are also questions about presence of any pain when the bladder is full and frequent evacuation of bladder, dribbling after urination and symptoms of urinary tract infection.
Results:- The main finding of the current study were as follows:-
• The mean age of the sample was 46.2±6.
• In relation to residence, most of the sample subjects were rural residents.
• The majority of the study participants completed their secondary level of education.
• Regarding the obstetric history: about two thirds of the study sample were multi gravida, multi para (72.5%- 68.8%) respectively, approximately more than half of studied women had vaginal delivery (67.5%).
• By comparison between control & case pre-post intervention knowledge about the kegel exercises. There was a highly significant difference between case & control in the pre and post intervention and follow up test scores in all answers regarding women’s knowledge about the kegel exercises (P <0.001).
• There was a very high percentage among women in the pre-intervention study sample regarding to symptoms of stress urinary incontinence (SUI) (Involuntary urine flow, Urine dribbling, Feeling wet, Pain with full bladder, Urine dribbling with-Cough, Sneezing, Laughing, Carrying heavy loads) , while there was a very low percentage among women in the post-intervention study samples regarding the symptoms of stress urinary incontinence (Involuntary urine flow, Urine dribbling, Feeling wet, Pain with
full bladder Urine dribbling with-Cough, Sneezing, Laughing, Carrying heavy loads).
In this light of the present study findings, it can be concluded that:
• There was a highly statistical significant improvement regarding symptoms of stress urinary incontinence (involuntary urine flow, urine dribbling, feeling wet, pain with full bladder, cough, sneezing, carrying heavy loads) after practicing the kegel exercises.
Based on the finding of the study, the following recommendations are proposed.
• A comprehensive nursing assessment should be followed with taking into consideration the risk factors that may lead to SUI as aging, overweight, menopause, vaginal delivery.
• Educational sessions are given to poor women because they are the ones most affected by SUI.
• Using media in outpatient clinic about risk factors to SUI
In further research
• Awareness of the health team work about the importance of the kegel exercise.
• Replication of this study in other sectors of Egypt.