Urinary incontinence in women
- 15 September 2014
- Vol. 349 (sep15 4), g4531
- https://doi.org/10.1136/bmj.g4531
Abstract
Urinary incontinence affects women of all ages. History, physical examination, and certain tests can guide specialists in diagnosing stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence. First line management includes lifestyle and behavior modification, as well as pelvic floor strength and bladder training. Drug therapy is helpful in the treatment of urgency incontinence that does not respond to conservative measures. In addition, sacral neuromodulation, intravesical onabotulinumtoxinA injections, and posterior tibial nerve stimulation can be used in select patient populations with drug refractory urgency incontinence. Midurethral synthetic slings, including retropubic and transobturator approaches, are safe and efficacious surgical options for stress urinary incontinence and have replaced more invasive bladder neck slings that use autologous or cadaveric fascia. Despite controversy surrounding vaginal mesh for prolapse, synthetic slings for the treatment of stress urinary incontinence are considered safe and minimally invasive.Keywords
This publication has 74 references indexed in Scilit:
- Caffeine and urinary incontinence in US womenInternational Urogynecology Journal, 2012
- A Randomized Trial of Urodynamic Testing before Stress-Incontinence SurgeryThe New England Journal of Medicine, 2012
- 5-Year Continence Rates, Satisfaction and Adverse Events of Burch Urethropexy and Fascial Sling Surgery for Urinary IncontinenceJournal of Urology, 2012
- Does Better Quality of Care for Falls and Urinary Incontinence Result in Better Participant-Reported Outcomes?Journal of the American Geriatrics Society, 2011
- National Trends in the Usage and Success of Sacral Nerve Test StimulationJournal of Urology, 2011
- Effect of Weight Loss on Urinary Incontinence in Overweight and Obese Women: Results at 12 and 18 MonthsJournal of Urology, 2010
- Outcomes of Intravesical Botulinum Toxin for Idiopathic Overactive Bladder Symptoms: A Systematic Review of the LiteratureJournal of Urology, 2010
- Retropubic versus Transobturator Midurethral Slings for Stress IncontinenceThe New England Journal of Medicine, 2010
- Continence Pessary Compared With Behavioral Therapy or Combined Therapy for Stress IncontinenceObstetrics & Gynecology, 2010
- Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta‐analysis of effectiveness and complicationsBJOG: An International Journal of Obstetrics and Gynaecology, 2007