Non-surgical management of stress urinary incontinence: ambulatory treatments                 for leakage associated with stress (ATLAS) trial

Richter, Holly E.; Burgio, Kathryn L.; Goode, Patricia S.; Borello‐France, Diane; Bradley, Catherine S.; Brubaker, Linda; Handa, Victoria L.; Fine, Paul; Visco, Anthony G.; Zyczynski, Halina M.; Wei, John T.; Weber, Anne M.; Varner, R. Edward; Shore, Gregg; Willis, V. N. B.; Appell, Rodney A.; Thompson, Peter; Lotze, Peter M.; Frierson, Naomi; Kreder, Karl J.; Haury, Denise; Brandt, Debra; Nygaard, Ingrid; Rao, Satish S.; Cundiff, Geoffrey W.; Sauter, Mary Elizabeth; Wright, Jamie; FitzGerald, Mary P.; Kenton, Kimberly; Mueller, Elizabeth R.; Marchese, Kathy; Senka, Judith; Jesse, Kathleen; Brown, Morton B.; Marchant, Beverly; DeLancey, John O.L.; Janz, Nancy K.; Wren, Patricia A.; Imus, James; Casher, Yang Wang; Fenner, Dee E.; Connolly, AnnaMarie; Lavelle, John P.; Lavelle, Mary J.; Murphy, Anita K; Wells, Ellen C.; Whitehead, William E.; Fielding, Julia R.; Hakim, Christiane M.; Wald, Arnold; Gruss, Judy; Leng, Wendy W.J. de; Moalli, Pamela; Park, Robert

doi:10.1177/1740774506075237

Cited by 32 publications

(12 citation statements)

References 31 publications

(32 reference statements)

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“…Additionally, vaginal inserts can be used in cases prolapse. Medical treatment in the form of estrogen replacement is questionable [14]. Current gold standard in the treatment of SUI is the suburethral sling operation in a trial to reinforce the levator ani muscle and the supportive ligaments.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Autologous Bone Marrow Mesenchymal Stem Cells (MSCs) in the Treatment of Stress Urinary Incontinence: Short term Follow-up

ElSokkary¹

2016

JGynObsBul

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Objective : The aim of this study is to assess the effectiveness and tolerability of autologous stem cell injection for the treatment of female stress urinary incontinence. Patients and Methods:This was a prospective study which involved 12 women with stress urinary incontinence. One hundred and twenty milliliters of bone marrow were aspirated under aseptic conditions from posterior superior iliac spine. MSCs were separated using plastic adherence and verification of the cell population done by morphology, immunophenotyping and trilineage differentiation potential. Patients received transurethral endoscopic or periurethral ultrasonography-guided injections of autologous bone marrow MSCs. Patients were followed up using voiding diaries, trans-vaginal ultrasonography, urodynamics and quality of life questionnaire over a 3 months period. Results:The objective cure rate in these 12 patients was 85% subjective complete cure rate was 66.67% (8 patients), 2 patients improved partially (16.7%), 2 patients did not improve (16.7%). Overall mean increase in the bulk of sphincter as measured by transvaginal ultrasonography 3 months post stem cell injection was 15.39% which forms about 1/7 of the sphincter tissue bulk. Conclusion:Autologous bone marrow derived MSC injection is a simple, safe and effective procedure for treating stress urinary incontinence. The short term results of the procedure show a success rate similar to that of the standard techniques; without their disadvantages in terms of complications especially voiding dysfunction. Further studies with long-term follow up are needed to assess the integrity of the results.

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Section: Discussionmentioning

confidence: 99%

The Impact of Autologous Bone Marrow Mesenchymal Stem Cells (MSCs) in the Treatment of Stress Urinary Incontinence: Short term Follow-up

ElSokkary¹

2016

JGynObsBul

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“…This treatment program was built on Goode et al’s research10 where a standard behavioral treatment was implemented based on the execution of Kegel exercises in a constant and controlled way. It was also based on research by Subak et al13 which studied urinary leakage episodes by the implementation of a Kegel exercise treatment in a constant and controlled way, but without an exhaustive control of the physical conditions of the urinary tract, as in the studies by Burgio et al and Richter et al9,14,15 Specifically, the aim of this study was to reduce almost 50% of the leakage episodes per week by the implementation of such a program and, once the treatment period had finished, performance at least twice a week by participants of the exercises as part of their routine.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a behavioral treatment for female urinary incontinence

Santacreu

Fernández-Ballesteros²

2011

CIA

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Urinary incontinence is a medical, psychological, social, economic, and hygienic problem. Although it is difficult to state its prevalence, all authors agree that it is related to age and gender. This study aimed to carry out a urinary incontinence behavioral treatment in order to reduce urine leakages in 14 participants recruited from a senior center. The program consists of daily training of the pelvic floor muscles with a weekly control by a supervisor during a 2-month period and follow-up of results 2 months after the last control session. Urinary incontinence episodes were reduced by 75.67% after program completion. It appears that pelvic floor muscles training, carried out under controlled and constant supervision, significantly reduces urinary leakage. Moreover, maintaining this improvement after treatment depends on the continuation of the exercises as well as on the urinary leakage frequency baseline and the urinary leakage frequency during the last treatment session.

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“…Some clinical trials of incontinence treatment now use the patient's satisfaction with outcomes or their perception of improvement as the primary outcome measure, [1,2]. The development of a validated instrument, the Patient Satisfaction Question (PSQ) has provided a measure of satisfaction with treatment in patients undergoing treatment for urinary incontinence, [3].…”

Section: Introductionmentioning

confidence: 99%

Correlates and predictors of patient satisfaction with drug therapy and combined drug therapy and behavioral training for urgency urinary incontinence in women

Goode

Burgio

Kraus³

et al. 2010

Int Urogynecol J

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Introduction and Hypothesis The goal was to identify correlates of patient satisfaction with drug and behavioral treatments for urge-predominant incontinence, which may help tailor treatments to improve satisfaction. Methods Planned secondary analysis of a multi-center, clinical trial randomizing 307 women to 10-weeks of tolterodine alone or combined with behavioral training. Satisfaction was measured using the Patient Satisfaction Question (PSQ). Potential correlates included baseline demographics, incontinence characteristics and prior treatments, history and physical parameters, expectations of treatment success, and outcome variables including the Global Perception of Improvement (GPI) and Urogenital Distress Inventory (UDI). Results After multivariable analysis, every ten-point increase in UDI change score increased odds of satisfaction by 11% (OR 1.11; 1.04-1.19). Odds of satisfaction increased among women reporting “much better” on the GPI (OR 13.8; 4.94-38.60). Conclusions Treatment satisfaction for women with urge-predominant incontinence was associated with patient-related outcomes reflecting impression of improvement and bother from incontinence-related symptoms.

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Non-surgical management of stress urinary incontinence: ambulatory treatments for leakage associated with stress (ATLAS) trial

Abstract: This trial will provide useful information to help counsel women with stress and mixed incontinence about the relative efficacy and satisfaction with pessary, behavioral therapy and both treatments combined.

Cited by 32 publications

References 31 publications

The Impact of Autologous Bone Marrow Mesenchymal Stem Cells (MSCs) in the Treatment of Stress Urinary Incontinence: Short term Follow-up

The Impact of Autologous Bone Marrow Mesenchymal Stem Cells (MSCs) in the Treatment of Stress Urinary Incontinence: Short term Follow-up

Evaluation of a behavioral treatment for female urinary incontinence

Correlates and predictors of patient satisfaction with drug therapy and combined drug therapy and behavioral training for urgency urinary incontinence in women

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