Transurethral radiofrequency collagen denaturation for the treatment of women with urinary incontinence

Abstract

⊕⊕ Low a,d *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; MD: Mean difference; I-QOL: Incontinence Quality of Life; RCT: Randomised controlled trial; RR: Risk ratio; UI: Urinary incontinence. GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. a Downgraded for study limitations (-1): high risk of bias. b Downgraded for imprecision (-1): no events in small study. c Downgraded for imprecision (-1): confidence interval includes both no effect and appreciable benefit; low numbers of events. d Downgraded for imprecision (-1): confidence interval includes no effect and both appreciable benefit and appreciable harm; low numbers of events. 5 Transurethral radiofrequency collagen denaturation for the treatment of women with urinary incontinence (Review)

Surgery for urinary incontinence in women: Report from the 6th international consultation on incontinence

“…Radiofrequency ablation (RFA) using low‐level radiofrequency energy (65 to 75°C) creates localized collagen denaturation of the bladder neck and proximal urethra for the treatment of female SUI. The Cochrane review included only one small sham‐controlled, randomized trial of 173 women where 48% and 44% of subjects in the treatment and sham arms, respectively, demonstrated a ≥10 point I‐QOL score improvement at 12 months ( P = 0.7) . While several prospective trials have been performed since, this remains the only RCT and evidence is insufficient to show whether the procedure improves disease‐specific QoL [EL = 2/3].…”

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

“…After assessing Table 1. Search strategy full texts, 20 reviews [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] were found to fulfill our inclusion criteria and were included for qualitative synthesis.…”

Adjuvante Strahlentherapie nach radikaler Prostatektomie bei Prostatakarzinom

“…Dies spiegelt aus unserer Sicht den langsamen Krankheitsverlauf von Patienten mit Prostatakarzinomrezidiv wider, bei dem zwischen biochemischem Rezidiv und dem Auftreten von Metastasen ca. 8 Jahre und bis zum krebsbedingten Tod weitere 5 Jahre vergehen [3]. Ähnliche Effekte sind auch bei der ERSPC-Studie zu beobachten [9], bei der sich die Effekte des PSA-Screenings auf die prostatakrebsassoziierte Mortalität erst mit einer längeren Studiendauer von nunmehr 13 Jahren deutlich herauskristallisieren.…”

“…Bei etwa 30-50% der Patienten lassen sich jedoch im Prostatektomiepräparat bereits Charakteristika eines lokal fortgeschrittenen Karzinoms nachweisen, wie ein positiver chirurgischer Absetzungsrand, ein kapselüberschreitendes Wachstum oder eine Samenblaseninfiltration [2]. Diese Patienten unterliegen einem deutlich erhöhten Risiko für ein Rezidiv sowie einer Progression der Erkrankung [3]. In der Annahme, dass sich die residuelle Tumorerkrankung ausschließlich lokal im Bereich der ehemaligen Prostataloge befindet, wird in dieser Situation häufig eine postoperative Bestrahlung dieses Bereichs, eine sog.…”