OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in Women

Amundsen, Cindy L.; Richter, Holly E.; Menefee, Shawn A.; Komesu, Yuko M.; Arya, Lily A.; Gregory, W. Thomas; Myers, Deborah L.; Zyczynski, Halina M.; Vasavada, Sandip P.; Nolen, Tracy L.; Wallace, Dennis; Meikle, Susan

doi:10.1001/jama.2016.14617

“…It has an efficacy similar to oral medication for urgency urinary incontinence but without the need for a daily medication 155,156 . The administration procedure is usually performed under a general anaesthetic· and is accordingly reserved as a third-line treatment.…”

Section: Managementmentioning

confidence: 99%

Urinary incontinence in women

Aoki

¹

,

Brown

²

,

Brubaker

³

et al. 2017

Nat Rev Dis Primers

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Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.

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“…It has an efficacy similar to oral medication for urgency urinary incontinence but without the need for a daily medication 155,156 . The administration procedure is usually performed under a general anaesthetic· and is accordingly reserved as a third-line treatment.…”

Section: Invasive Interventionsmentioning

confidence: 99%

Urinary incontinence in women

Ss

¹

,

Rm²

2017

Nat Rev Dis Primers

15

0

1

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Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.Correspondence to R.C. Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK. r.cartwright@imperial.ac.uk. Author contributions Competing interestsThe authors declare no competing interests. Publisher's noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. HHS Public AccessAuthor manuscript Nat Rev Dis Primers. Author manuscript; available in PMC 2018 April 01. Published in final edited form as:Nat Rev Dis Primers. ; 3: 17042. doi:10.1038/nrdp.2017.42. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptUrinary incontinence is the complaint of involuntary loss (leakage) of urine 1 . The condition occurs in both sexes, but is much more frequent in women. Although some overlap in pathophysiology is evident between sexes, incontinence in men is often a consequence of prostatic enlargement or from damage to continence mechanisms during surgery or radiotherapy for prostate cancer. By contrast, incontinence in women is typically related to dysfunction of the bladder or pelvic floor muscles, with such dysfunction often arising during pregnancy or childbirth, or at the time of menopause. This Primer focuses on female urinary incontinence because of its higher prevalence and unique pathophysiology.There are two main subtypes of urinary incontinence: stress incontinence and urgency incontinence. According to the International Urogynecological Association (IUGA) and the International Continence Society (ICS) standard definition, stress incontinence is the complaint of urine leakage in association with coughing, sneezing or physical exertion, whereas urgency incontinence is the comp...

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“…The procedure must be repeated over time (average duration in trials approximately 6 months). The efficacy appears to be at least similar to SNS [39] and superior to pharmacological therapy [40].…”

Section: Second Line: Pharmacologicalmentioning

confidence: 88%

Urinary Urgency in the Elderly

Potts¹,

Payne²

2018

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The last 2 decades have brought an explosion of research, new products, and general attention to the problem of urinary urgency, and yet patients continue to be plagued by this symptom – especially the elderly. What is it? What does it mean? How can we guide patients successfully through this challenge? This paper presents a review of current thinking about urgency relevant to the practicing clinician, including the epidemiology, pathophysiology, evaluation, and treatment of these patients.

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OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in Women

Cited by 193 publications

References 22 publications

Urinary incontinence in women

Urinary incontinence in women

Urinary incontinence in women

Urinary Urgency in the Elderly

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