Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis—Brazilian Guidelines

Abstract

Objective To evaluate if performing anti-incontinence procedures during surgical anterior and/or apical prolapse correction in women with asymptomatic urinary incontinence (UI) may prevent stress urinary incontinence (SUI) postoperatively. Methods We have performed a systematic review of articles published in the PubMed, Cochrane Library, and Lilacs databases until March 31, 2016. Two reviewers performed the data collection and analysis, independently. All of the selected studies were methodologically analyzed. The results are presented as relative risk (RR), with a 95% confidence interval (CI). Results After performing the selection of the studies, only nine trials fulfilled the necessary prerequisites. In the present review, 1,146 patients were included. Altogether, the review included trials of three different types of anti-incontinence procedures. We found that performing any anti-incontinence procedure at the same time of prolapse repair reduced the incidence of SUI postoperatively (RR = 0.50; 95% CI: 0.28–0.91). However, when we performed the analysis separately by the type of anti-incontinence procedure, we found different results. In the subgroup analysis with midurethral slings, it is beneficial to perform it to reduce the incidence of SUI (RR = 0.08; 95% CI: 0.02–0.28). On the other hand, in the subgroup analysis with Burch colposuspension, there was no significant difference with the control group (RR = 1.47; 95% CI: 0.28–7.79]). Conclusion Performing any prophylactic anti-incontinence procedure at the same time as prolapse repair reduced the incidence of SUI postoperatively. The Burch colposuspension did not show any decrease in the incidence of SUI postoperatively.

Incontinencia urinaria: causas y cuidados de enfermería. Una revisión bibliográfica

“…En el tratamiento de la IU de esfuerzo, es un método con peores resultados objetivos y subjetivos que el Sling pubouretral. En cambio, éste último junto al Sling mediouretal retropúbico, resulta más retencionista provocando un mayor número de reintervenciones 22,30 .…”

“…Para el tratamiento de la IU no neurogénica y en hombres tras prostatectomía retropúbica radical, se muestra como una opción fiable, eficiente, satisfactoria y segura, el esfínter artificial; ya que se produce una mejoría tanto de la calidad de vida, como del mantenimiento del flujo urinario evitando pérdidas de orina y síntomas obstructivos derivados de la intervención. El nivel de satisfacción de esta técnica se ve incrementado con características del paciente tales como la juventud y el alto nivel de actividad física [21][22][23][24][25] .…”