Nonsurgical Outpatient Therapies for the Management of Female Stress Urinary Incontinence: Long-Term Effectiveness and Durability

Davila, G. Willy

doi:10.1155/2011/176498

Cited by 35 publications

(17 citation statements)

References 73 publications

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“…As for surgery, suburethral slings are as effective as colposuspension, with lower perioperative morbidity, and are the gold standard in patients with SUI, displaying high and long-term cure rates [7,8]. However, there is a need for alternative therapeutic approaches in patients with significant comorbidities; in women who are unwilling to undergo surgery because of its associated risks, pain, and recovery; in patients with recurrent SUI; and in women in whom surgical options are limited (e.g., postoperatively or after irradiation) [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Bulking agents: an analysis of 500 cases and review of the literature

et al. 2012

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Introduction and hypothesis Stress urinary incontinence (SUI) is common, impacts women's quality of life, and generates high costs. Physiotherapy is the first-line therapy, and if it fails, suburethral slings are the gold standard in SUI surgery. Bulking agents injected periurethrally might be a beneficial alternative, but there is a paucity of data on bulking therapy. The aim of this study was to prospectively analyze the efficacy and safety of bulking agents in the setting of a tertiary referral center. Methods In the last 13 years, 514 elderly women with SUI were treated by injection therapy with either collagen (Contigen®), hyaluronic acid (Zuidex®), ethylene vinyl alcohol (Tegress®), or polyacrylamide hydrogel (Bulkamid®). Subjective and objective outcome was recorded at the 12-month postoperative appointment using the King's Health Questionnaire, visual analogue scale (VAS) describing their incontinence severity, standardized pad test, and urethral pressure profile.Results Demographic data were equally distributed in all four groups of agents used. Sixty-one patients were lost to follow-up (10.6 %). Statistically significant changes were found for maximum urethral closure pressure (MUCP), pad weight, and VAS before and after bulking for the four agents used. Pad test was negative in 73.2 % of patients after bulking therapy. Subjective assessment showed improvements in general health and role limitations. The overall complication rate was low for all agents. Conclusions This study shows improvement in incontinence after bulking therapy according to subjective and objective outcomes in an elderly population. In contrast to earlier reports, side effects due to injections were few and mild. We can advocate bulking therapy for treating SUI, as it is simple, safe, and shows both objective and subjective improvement and relief.

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Section: Introductionmentioning

confidence: 99%

Bulking agents: an analysis of 500 cases and review of the literature

et al. 2012

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“…Radiofrequency denaturation is a nonsurgical technique that involves the insertion of a device into the urethra under local anesthesia. Radiofrequency energy is then applied to the bladder neck and proximal urethra to denature and promote the remodeling of collagen in the surrounding tissue ( 28 ). Patient outcomes were variable with reported “cure rates” of 22%-67% ( 29 ).…”

Section: Stress Urinary Incontinencementioning

confidence: 99%

“…These IBAs include autologous fat, cross-linked collagen, graphite-coated zirconium beads, polytetrafluroethylene, silicon, dimethylsulfoxide and ethylene vinyl alcohol copolymers, hyaluronic acid, dextranomer microspheres, and calcium hydroxyapatite ( 34 , 35 , 36 ). Treatment with IBAs improves SUI symptoms by 18%-40% ( 28 ). The efficacy of IBAs is superior to that of pelvic floor physiotherapy but is inferior to that of surgical management ( 36 ).…”

Section: Stress Urinary Incontinencementioning

confidence: 99%

The Novel and Minimally Invasive Treatment Modalities for Female Pelvic Floor Muscle Dysfunction; Beyond the Traditional

Akın¹,

Young²,

Elmussareh³

et al. 2018

Balkan Med J

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Pelvic floor dysfunction is a clinical entity that is prevalent among female patients. Determining the exact underlying cause of pelvic floor dysfunction is difficult, and surgical intervention for this clinical entity may be challenging. Pelvic floor dysfunction can affect the quality of life of the patient by causing stress urinary incontinence, pelvic organ prolapse, or both. Well-defined surgical treatment options, minimally invasive approaches, and novel techniques for the treatment of pelvic floor dysfunction have been recently introduced. Here, we evaluated the management options available for patients with stress urinary incontinence and pelvic organ prolapse. We searched Medline and EMBASE databases for relevant articles by using the keywords “pelvic floor dysfunction,” “minimally invasive procedures,” “stress urinary incontinence,” “pelvic organ prolapse,” and “novel techniques”. Traditional treatment options for stress urinary incontinence and pelvic organ prolapse are beyond the scope of our review. Laparoscopic and robotic surgical treatments for pelvic floor dysfunction continue to evolve and develop. These minimally invasive techniques will soon replace open procedures. Alternative novel treatment modalities have also been developed from novel human-compatible materials and are emerging as successful treatments for stress urinary incontinence. The development of these various treatment options has implications for future surgical practice in the field of uro-gynecology.

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“…Agents such as autologous fat, collagen, or carbon beads are injected through a needle placed transurethrally or periurethrally [39]. Cure or improvement rates range from 40 to 60 percent, and this rate decreases by the time [40].…”

Section: Periurethral Injectionsmentioning

confidence: 99%