Effect of vaginal energy-based treatment on female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials

Zhang, Chi; Chen, Yuanzhuo; Liu, Shengzhuo; Chen, Jiawei; Shen, Hong; Luo, Deyi

doi:10.1007/s00345-022-04247-1

Cited by 2 publications

(2 citation statements)

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“…7 Newer, less invasive options such as vaginal laser therapy, and magnetic stimulation of the pelvic floor, show varied success rates in limited studies and are not yet part of recommended practice. 8 There are currently no US Food and Drug Administration (FDA)-approved drug interventions for SUI. Surgical options include midurethral synthetic slings, autologous pubovaginal slings, laparoscopic/open abdominal colposuspension, and artificial urinary sphincters.…”

Section: Why This Mattersmentioning

confidence: 99%

“…Pelvic floor physical therapy with or without biofeedback can also be used to teach pelvic floor awareness and proprioception to improve SUI 7 . Newer, less invasive options such as vaginal laser therapy, and magnetic stimulation of the pelvic floor, show varied success rates in limited studies and are not yet part of recommended practice 8 . There are currently no US Food and Drug Administration (FDA)–approved drug interventions for SUI.…”

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confidence: 99%

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Urethral Bulking

Fleischmann,

Chughtai,

Plair

et al. 2024

UROGC

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Objective This Clinical Practice Statement aims to provide clinicians with evidence-based guidance for the use of urethral bulking agents (UBAs) in the treatment of stress urinary incontinence (SUI). Methods We conducted a structured search of the English literature published from January 1960 to November 2022. Search terms identified studies of both current and historic UBAs. Data extracted at the time of full-text review included type of study, research setting, number of participants, age group, bulking agent, primary outcome, secondary outcome, efficacy, and complications. Results One thousand five hundred ninety-four nonduplicate articles were identified using the search criteria. After limiting the article types to randomized control led trials, prospective studies, guideline documents, reviews, meta-analyses, and case reports of complications, 395 studies were screened. Conclusions Based on our findings, we propose the following recommendations for clinicians when considering UBA: First, UBA is indicated in cases of demonstrable SUI. Intrinsic sphincter deficiency is not predictive of patient outcomes. Second, patients should be counseled on the risks, lack of long-term efficacy data, potential need for repeat injections, possible need for surgery for recurrent SUI, implications for future procedures, and pelvic imaging findings that may be observed after UBA. Third, UBA may be considered for initial management of SUI. Fourth, UBA is an option for patients with persistent or recurrent SUI after a sling procedure. Fifth, clinicians may prioritize UBA over surgery in specific patient populations. Sixth, polyacrylamide hydrogel demonstrates marginally improved safety and durability data over other available agents.

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confidence: 99%

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confidence: 99%