EAU Guidelines on Surgical Treatment of Urinary Incontinence

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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“…Von einem Therapieversagen auf AM spricht man, wenn mindestens 2 der in Tabelle 7 erwähnten Medikamente probiert wurden [38,39].…”

Section: Alternative Methodenunclassified

“…Veränderungen wie Reduktion von Alkohol-, Koffein-, und Nikotinkonsum, ausgewogene Ernährung (Normalisierung des Gewichts) können bereits eine Verbesserung erbringen [39].…”

Section: Lifestyle-veränderungenunclassified

Urininkontinenz beim Mann – ein Tabuthema

Kozomara-Hocke

Hermanns

Poyet

2016

Praxis

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“…The cost of treating urinary retention was calculated based on the cost of catheter use for those requiring CIC, taking frequency and duration of CIC into account based on clinical trial data from NCT00910520 and NCT0910845 (CIC rates of 6.9 % and 6.1 %, respectively). No costs were included for urodynamic testing for individuals receiving either onabotulinumtoxinA or BSC because such testing procedures are standard in this patient population and independent of the choice of subsequent treatment [3,5].…”

Section: Resource Use and Costmentioning

confidence: 99%

“…OnabotulinumtoxinA (BOTOX Ò , Allergan, Irvine, CA) is a purified neurotoxin complex for the treatment of OAB with symptoms of urinary incontinence (UI), urgency and frequency in adults. It is recommended in many clinical guidelines, including those of the European Association of Urology [3], the American Urological Association [4] and the UK National Institute for Health and Care Excellence (NICE) [5], for patients whose UI symptoms are not managed adequately through behavioural changes or the use of anticholinergic medication. More than half of patients stop taking anticholinergic agents because of ineffectiveness, adverse events (AEs), or cost [6].…”

Section: Introductionmentioning

confidence: 99%

“…More than half of patients stop taking anticholinergic agents because of ineffectiveness, adverse events (AEs), or cost [6]. In the absence of onabotulinumtoxinA, patients may use best supportive care (BSC), including incontinence pads and, for some individuals, continuation of pharmacological therapies and occasional use of clean intermittent catheterisation (CIC), to manage their symptoms, or they may be candidates for more invasive therapies to manage OAB such as sacral nerve stimulation (SNS) or surgery [3].…”

Section: Introductionmentioning

confidence: 99%

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OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

Freemantle¹,

Khalaf

Loveman

et al. 2015

Eur J Health Econ

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The cost-effectiveness of onabotulinumtoxinA (BOTOX Ò ) 100 U ? best supportive care (BSC) was compared with BSC alone in the management of idiopathic overactive bladder in adult patients who are not adequately managed with anticholinergics. BSC included incontinence pads and, for a proportion of patients, anticholinergics and/or occasional clean intermittent catheterisation. A five-state Markov model was used to estimate total costs and outcomes over a 10-year period. The cohort was based on data from two placebo-controlled trials and a long-term extension study of onabotulinumtoxinA. After discontinuation of initial treatment, a proportion of patients progressed to downstream sacral nerve stimulation (SNS). Cost and resource use was estimated from a National Health Service perspective in England and Wales using relevant reference sources for 2012 or 2013. Results showed that onabotulinumtoxinA was associated with lower costs and greater health benefits than BSC in the base case, with probabilistic sensitivity analysis indicating an 89 % probability that the incremental cost-effectiveness ratio would fall below £20,000. OnabotulinumtoxinA remained dominant over BSC in all but two scenarios tested; it was also economically dominant when compared directly with SNS therapy. In conclusion, onabotulinumtoxinA appears to be a cost-effective treatment for overactive bladder compared with BSC alone.

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Surgical treatment of female urinary incontinence

Gomelsky

2018

Evidence‐Based Urology

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EAU Guidelines on Surgical Treatment of Urinary Incontinence

Cited by 303 publications

References 73 publications

Urininkontinenz beim Mann – ein Tabuthema

Urininkontinenz beim Mann – ein Tabuthema

OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

Surgical treatment of female urinary incontinence

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