EAU Guidelines on Assessment and Nonsurgical Management of Urinary Incontinence

Nambiar, Arjun; Bosch, Ruud; Cruz, Francisco; Lemack, Gary E.; Thiruchelvam, Nikesh; Tubaro, Andrea; Bedretdinova, Dina; Ambühl, David; Farag, Fawzy; Lombardo, Riccardo; Schneider, Marc P.; Burkhard, Fiona C.

doi:10.1016/j.eururo.2012.08.047

Cited by 274 publications

(161 citation statements)

References 81 publications

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“…The guidance also states that there is no consistent evidence that one antimuscarinic drug is superior to an alternative antimuscarinic drug for cure or improvement of UI or QoL 118.We recommend initiating antimuscarinics (tolterodine or solifenacin (Vesicare) most commonly used) if the main bothersome symptom of LUTS is urgency UI, followed by mirabegron if antimuscarinic drugs are contraindicated or clinically ineffective. …”

Section: Discussionmentioning

confidence: 99%

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Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

et al. 2015

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SummaryAimTo develop a non‐invasive management strategy for men with lower urinary tract symptoms (LUTS) after treatment for pelvic cancer, that is suitable for use in a primary healthcare context.MethodsPubMed literature searches of LUTS management in this patient group were carried out, together with obtaining a consensus of management strategies from a panel of authors for the management of LUTS from across the UK.ResultsData from 41 articles were investigated and collated. Clinical experience was sought from authors where there was no clinical evidence. The findings discussed in this paper confirm that LUTS after the cancer treatment can significantly impair men's quality of life. While many men recover from LUTS spontaneously over time, a significant proportion require long‐term management. Despite the prevalence of LUTS, there is a lack of consensus on best management. This article offers a comprehensive treatment algorithm to manage patients with LUTS following pelvic cancer treatment.ConclusionBased on published research literature and clinical experience, recommendations are proposed for the standardisation of management strategies employed for men with LUTS after the pelvic cancer treatment. In addition to implementing the algorithm, understanding the rationale for the type and timing of LUTS management strategies is crucial for clinicians and patients.

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Section: Discussionmentioning

confidence: 99%

“…The guidance also states that there is no consistent evidence that one antimuscarinic drug is superior to an alternative antimuscarinic drug for cure or improvement of UI or QoL 118.…”

Section: Discussionmentioning

confidence: 99%

Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

et al. 2015

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“…Sie sind nur bei geringer Belastungsinkontinenz wirksam. Die Datenlage hierfür ist ungenügend [4,55].…”

Section: Medikamentöse Therapieunclassified

Urininkontinenz beim Mann – ein Tabuthema

Kozomara-Hocke

Hermanns

Poyet

2016

Praxis

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Male urinary incontinence is an underestimated and frequently not broached issue. The urinary incontinence is divided into stress-, urge incontinence and hybrid forms as well as overflow incontinence. The fact that there are increasingly more men over 60 means that the prevalence of the urinary incontinence is up to 40%, and urinary incontinence will increasingly gain importance in daily routine practice. Many investigations and therapies can be realized by the general practitioner. Already simple therapy approaches can lead to a considerable clinical improvement of male urinary incontinence. If the initial therapy fails or pathological results (i. e. microhaematuria, recurrent urinary tract infections, raised residual urine and so on) are found, the patient should be referred to a urologist. Si la thérapie primaire ne réussit pas à résoudre l'incontinence urinaire ou on trouve des résultats pathologique (hématurie microscopique, infection urinaire récidivé, urine résiduelle augmenté etc.) le patient doit être envoyé chez le spécialiste d'urologie.4

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“…Traditionally, urodynamic studies (UDS) have been used to assess LUTS, but their routine use is now questioned. As UDS are invasive and expensive tests without evidence-based additional value in the management of women with urinary incontinence (UI), their routine use is discouraged by international professional bodies [3,4].…”

Section: Introductionmentioning

confidence: 99%

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS)

Giarenis

Musonda

Mastoroudes

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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A prediction model is able to predict detrusor overactivity more accurately than a symptomatic diagnosis alone, in women with lower urinary tract symptoms. Abstract ObjectiveTraditionally, urodynamic studies (UDS) have been used to assess lower urinary tract symptoms (LUTS), but their routine use is now discouraged. While urodynamic stress incontinence is strongly associated with the symptom of stress urinary incontinence (SUI) and a positive cough test, there is a weak relationship between symptoms of overactive bladder and detrusor overactivity (DO). The aim of our study was to develop a model to predict DO in women with LUTS. Study DesignThis prospective study included consecutive women with LUTS attending a urodynamic clinic. All women underwent a comprehensive clinical and urodynamic assessment. The effect of each variable on the odds of DO was estimated both by univariate analysis and adjusted analysis using logistic regression. Results1006 women with LUTS were included in the study with 374 patients (37%) diagnosed with DO. The factors considered to be the best predictors of DO were urgency urinary incontinence, urge rating/void and parity (p-value <0.01). The absence of SUI, vaginal Page 3 of 26 A c c e p t e d M a n u s c r i p t 3 bulging and previous continence surgery were also good predictors of DO (p-value < 0.01).We have created a prediction model for DO based on our best predictors. In our scoring system, presence of UUI scores 5; mean urge rating/void ≥ 3 scores 3; parity ≥ 2 scores 2; previous continence surgery scores -1; presence of SUI scores -1; and the complaint of vaginal bulging scores -1. If a criterion is absent, then the score is 0 and the total score can vary from a value of -3 to +10. The Receiver Operating Characteristic (ROC) analysis for the overall cut-off points revealed an area under the curve of 0.748 (95%CI 0.741, 0.755). ConclusionThis model is able to predict DO more accurately than a symptomatic diagnosis alone, in women with LUTS. The introduction of this scoring system as a screening tool into clinical practice may reduce the need for expensive and invasive tests to diagnose DO, but cannot replace UDS completely.

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EAU Guidelines on Assessment and Nonsurgical Management of Urinary Incontinence

Cited by 274 publications

References 81 publications

Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

Urininkontinenz beim Mann – ein Tabuthema

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS)

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