Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews

Todhunter‐Brown, Alex; Hazelton, Christine; Campbell, Pauline; Elders, Andrew; Hagen, Suzanne; McClurg, Doreen

doi:10.1002/14651858.cd012337.pub2

Cited by 25 publications

(30 citation statements)

References 221 publications

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“…Even though this study focuses on surgical methods, it is important to note that there are also promising non-surgical methods in use for the treatment of SUI. A recent Cochrane review analysed 84 meta-analyses on the conservative management for SUI, from 14 different reviews [46]. Vaginal cones and pelvic floor muscle therapy with and without biofeedback have significant beneficial effects, substantiated with high-certainty evidence.…”

Section: Discussionmentioning

confidence: 99%

Comparing Single-Incision Midurethral Sling with Bulking Agents for Female Stress Urinary Incontinence: Rationale for a Non-Randomized Controlled Trial

Osse¹,

Schonewille²,

Engberts³

et al. 2023

Gynecol Obstet Invest

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Objectives: Midurethral slings are considered the gold standard for the surgical treatment of stress-urinary incontinence (SUI), with an efficacy up to 80%. Another therapeutic option is the use of bulking agents, which create an artificial mass into the urethral submucosa, with an efficacy varying from 64% to 74%. Although bulking agents have a lower risk of complications than midurethral sling surgery, they are mainly used in case a midurethral sling is not an option or if midurethral sling surgery failed to cure stress urinary incontinence. In this study we offer all patients with SUI in secondary care a choice between a single incision midurethral sling procedure and treatment with a bulking agent. We want to examine patient preference and patient satisfaction for both procedures. We expect that offering both interventions in combination with standardized counselling will result in high patient satisfaction. Design: In this non-randomized controlled trial 266 patients will be objectively counselled for both interventions, after which all patients will choose between single-incision midurethral slings (SIMS) and Polyacrylamide hydrogel (PAHG), followed by the standard care procedure for women with SUI. Participants/Materials, Setting, Methods: From 1 January 2021 onwards, all consecutive adult patients (between 18 and 80 years of age) attending the outpatient gynaecology department with objectively confirmed, moderate to severe SUI will be eligible for enrolment in this non-randomized study. The primary outcome is patient satisfaction at 1 year, measured by the Patient Global Impression of Improvement; secondary outcomes are patient satisfaction at 3 months, objective and subjective cure at 3 months and 1 year, adverse events, postoperative pain and cost-effectiveness. Differences in outcome measures will be assessed through logistic and linear regression analyses, both unadjusted and adjusted with covariate adjustment using the propensity score. Results: No results are available yet. Limitations: The major disadvantage of this study design is the potential confounding bias. We intend to eliminate this bias by applying propensity scoring. Conclusion: By designing a non-randomized patient preference trial, we not only expect to demonstrate high patient satisfaction with both interventions, but also provide insight in the possible role of PAHG-injections in the treatment of female SUI as a first-choice non-conservative treatment. Trial Registration: This study is retrospectively registered at the Dutch Trial Registry on 22-03-2021 under the number NL9353.

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Section: Discussionmentioning

confidence: 99%

Comparing Single-Incision Midurethral Sling with Bulking Agents for Female Stress Urinary Incontinence: Rationale for a Non-Randomized Controlled Trial

Osse¹,

Schonewille²,

Engberts³

et al. 2023

Gynecol Obstet Invest

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“…The sixth item is related to the time and type of urine leakage (not considered). The total score ranges from 0 to 21; mild (1-5), moderate (6)(7)(8)(9)(10)(11)(12), severe (13)(14)(15)(16)(17)(18), and very severe (19)(20)(21). A higher score indicates the intensity of UI.…”

Section: International Consultation On Incontinence Questionnaire-uri...mentioning

confidence: 99%

“…UI is the complaint of any unintentional passing of urine [ 7 ]. It can be classified as follows: (A) Stress incontinence; unintentional and sudden loss of urine caused by increased intra-abdominal pressure with activities such as laughing, pushing, sneezing, and coughing, (B) Urgency incontinence; a sudden, intense urge to urinate followed by an involuntary loss of urine, and (C) Mixed incontinence; a combination of stress and urgency incontinence [ 8 ]. The frequency and severity of symptoms are related to age, body mass index (BMI), drowsiness, and constipation [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

et al. 2023

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Background Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women. Methods It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021–2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence. Results The overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18–0.77) and UUI (aOR 0.38; 95% CI 0.15–0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50–55 age range (aOR 3.88; 95% CI 1.16–12.93) than those less than 50 years. Conclusion Due to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.

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“…UI treatment includes conservative treatment (e.g. appropriate fluid intake, weight loss, smoking cessation, and rehabilitation training), physical devices, medication, and surgery [ 8 , 9 ]. Compared with surgical treatments, which are associated with substantial trauma and high costs, conservative treatments are effective, safe, and acceptable and have been considered as the major treatment for UI [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have demonstrated that pelvic floor muscle and bladder exercises are effective training methods. Most evidence has shown that pelvic floor muscle training combined with bladder training is more effective than pelvic floor muscle training alone [ 8 , 11 ]. Pelvic floor muscle training (PFMT) refers to patients consciously training their pelvic floor muscles, mainly the pubic coccygeus muscle group, to autonomously contract [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a rehabilitation training compliance scale for patients with urinary incontinence

et al. 2023

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Background Urinary incontinence treatment includes conservative treatment, physical devices, medication, and surgery. Pelvic floor muscle training combined with bladder training is among the most effective, non-invasive, and economical ways to treat urinary incontinence, and compliance with training is essential in urinary incontinence treatment. Several instruments assess pelvic floor muscle training and bladder training. However, no tool has been found that assesses compliance with pelvic floor muscle training when combined with bladder training for urinary incontinence. This study aimed to develop a rehabilitation training compliance scale for patients with urinary incontinence and to evaluate its validity and reliability. Methods This study was performed in two tertiary hospitals in Hainan, China between December 2020 and July 2021, 123 patients were included. A literature review, group discussions, and two rounds of letter consultations were performed to acquire the item pool and finalise the 12 items for this scale. Exploratory and confirmatory factor analysis, Cronbach’s α, split-half reliability, test–retest reliability, content validity, construct validity, convergent and discriminant validity, and criterion-related validity were used to examine the items in the scale. Results A 12-item scale comprising three factors accounted for 85.99% of the variance in the data. The Cronbach’s α, split-half reliability, test–retest reliability, and content validity index of the scale were 0.95, 0.89, 0.86, and 0.93, respectively. Comparison with the Chen pelvic floor muscle exercise self-efficacy scale showed high calibration correlation validity (coefficient = 0.89). Conclusions The training compliance scale developed in this study is a valid and reliable measurement tool to assess pelvic floor muscle training and bladder training compliance in patients with urinary incontinence.

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Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews

Cited by 25 publications

References 221 publications

Comparing Single-Incision Midurethral Sling with Bulking Agents for Female Stress Urinary Incontinence: Rationale for a Non-Randomized Controlled Trial

Comparing Single-Incision Midurethral Sling with Bulking Agents for Female Stress Urinary Incontinence: Rationale for a Non-Randomized Controlled Trial

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

Development and evaluation of a rehabilitation training compliance scale for patients with urinary incontinence

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