Change in urinary storage symptoms following treatment for female stress urinary incontinence

Padmanabhan, Priya; Panfili, Zachary; Parker, William P.; Gomelsky, Alex

doi:10.1007/s00192-016-2951-6

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Eleven per cent of the women experienced an increase in UUI 38 months after surgery. Padmanabhan et al evaluated 718 patients with MUI who were treated with a synthetic or autologous fascial sling. Seventy‐one percent of patients reported improvement of OAB symptoms following surgical intervention, whereas 3% reported worsening and 26% remained the same.…”

Section: Methodsmentioning

confidence: 99%

Overactive bladder symptoms after midurethral sling surgery in women: Risk factors and management

Marcelissen

Kerrebroeck

2017

Neurourology and Urodynamics

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Section: Methodsmentioning

confidence: 99%

Overactive bladder symptoms after midurethral sling surgery in women: Risk factors and management

Marcelissen

Kerrebroeck

2017

Neurourology and Urodynamics

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“…When offering surgical therapy, it is important to remember that in patients with mixed incontinence, satisfaction after a midurethral sling is highly related to the improvement in the urgency and urge incontinence. 25 …”

Section: Resultsmentioning

confidence: 99%

The management of mixed urinary incontinence in women

Welk¹,

Baverstock²

2017

CUAJ

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Mixed urinary incontinence is a common diagnosis among women with urinary leakage and is often present in women who are unable to characterize their incontinence. Research and optimized clinical treatment of these patients is limited by the challenges in objectively defining and stratifying this population. The evaluation of these patients should follow the same general principles as any assessment of any women with incontinence; however, it is essential to define whether urge or stress incontinence is the predominant symptom. Urodynamics (UDS) may be helpful in this regard and may help predict surgical outcomes. Behavioural therapy, weight loss, and pelvic floor muscle therapy are usually appropriate initial management strategies. In postmenopausal women, vaginal estrogen can be considered, and in women with equal parts stress and urge incontinence or urge-predominant mixed incontinence, a trial of anticholinergics or beta-3 agonists is appropriate. In women with stress-predominant or equal parts stress and urge incontinence, stress incontinence surgery can be considered, with the caveat that outcomes are generally worse among women with more severe levels of urgency, success rates may not be as durable, and a significant proportion of women may need additional medical therapy.

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“…There are numerous studies on the use of slings in women with MUI that have demonstrated efficacy, however, the main concern is that the urgency and UUI can persist or worsen after surgery. One retrospective study of 927 women undergoing either synthetic MUS or autologous PVS included 78% of women with MUI in the cohort [97]. In women with MUI, 71% had improvement of their storage symptoms following surgery, 3% had worsening symptoms, and 26% remained unchanged.…”

Section: Surgical Management Of Stress Urinary Incontinencementioning

confidence: 99%

Mixed Urinary Incontinence: Diagnosis and Management

Sebesta,

Dmochowski

2023

OBM Geriatr

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The evaluation and treatment of mixed urinary incontinence receives relatively little attention as compared to other forms of incontinence. Mixed incontinence, however, defined as the combination of stress and urgency incontinence, accounts for the largest proportion of incontinence, with an increased incidence in older women. The condition can be very challenging to manage due to the coexistence of multiple pathologies. Treating either component can worsen the other, which means careful discussion of the risks and benefits, in addition to considerations of multimodal treatment approaches are required. In the older adult population, where this condition confers a significant impact on quality of life, there are many special considerations when evaluating and treating patients. Evaluation requires a careful assessment of the impact on QOL and goals of care and may need to involve caregivers and/or family members in the discussion, in addition to considerations of more advance evaluation on an individual basis prior to invasive treatments. Conservative treatments including behavioral and lifestyle modifications and pelvic floor physical therapy should be the mainstay of first-line treatment for older women with MUI, while taking into careful consideration how cognitive and/or physical limitations may impact treatment. Pharmacologic therapy should include a consideration of vaginal estrogen replacement, however oral medications for urgency and overactive bladder have increased risks in older women, which means more advanced treatments may want to be introduced sooner. There is really limited data on the use of third-line overactive bladder treatments in older women with mixed incontinence, however there may be some demonstrated benefits. Finally, when considering surgical interventions in this population, although the data demonstrate some benefit in mixed incontinence, providers may want to utilize a formalized assessment of frailty due to the increased morbidity associated with frailty in surgeries for incontinence.

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Change in urinary storage symptoms following treatment for female stress urinary incontinence

Abstract: Patients with U/UUI experience significant symptom improvement following treatment for MUI. QoL assessment following surgery is directly correlated with improvement in U/UUI.

Cited by 7 publications

References 18 publications

Overactive bladder symptoms after midurethral sling surgery in women: Risk factors and management

Overactive bladder symptoms after midurethral sling surgery in women: Risk factors and management

The management of mixed urinary incontinence in women

Mixed Urinary Incontinence: Diagnosis and Management

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