Skip to main content
SpringerLink
Log in

Conservative Therapy of Urodynamic Stress Incontinence

  • Chapter
Urogynecology: Evidence-Based Clinical Practice

Conclusions

PFM training needs to be tailored to the individual woman. Stress incontinence is not life threatening, and patients know this. Do not recommend a therapy that the patient feels uncomfortable with, as her compliance will be poor. In order to provide the best results, discuss the options with the patient, and let her select that with which she thinks she can comply.

The caveat to this advice is that patients should also understand the risks of surgery, should they not respond to conservative therapy. If a woman understands that current continence surgery has a 5–6% risk of developing overactive bladder, and a 1–2% risk of voiding difficulty, then their interest in and compliance with conservative therapy may be enhanced. Urogynecologists must always remember that our first duty is “to do no harm,” and PFM training has no complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Berghmans LC, Hendriks HJ, Bo K et al (1998) Conservative treatment of genuine stress incontinence in women: A systematic review of randomized clinical trials Brit J Urol 82:181–191.

    PubMed  CAS  Google Scholar 

  2. Bo K, Hagen RH, Kvarstein B, Jorgensen J, Larson S (1990) Pelvic floor muscle exercise for treatment of female stress urinary incontinence. III: Effects of two different degrees of pelvic floor muscle exercises. Neurourol Urodyn 9:489–502.

    Google Scholar 

  3. Bo K, Talseth T (1995) Five year follow up of pelvic floor muscle exercise for treatment of stress urinary incontinence, Clinical and urodynamic assessment. Neurourol Urodyn 14:374–376.

    Google Scholar 

  4. Bo K, Talseth T, Holme I (1999) Single blind randomized controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ 318:487–493.

    PubMed  CAS  Google Scholar 

  5. Burns P, Pranikoff K, Nochajski M, Desotelle P, Harwood M (1990) Treatment of stress incontinence with pelvic floor exercises and biofeedback. J Am Geriatr Soc 38:341–344.

    PubMed  CAS  Google Scholar 

  6. Cammu H, Van Hylen M, Derde MP, Debruyne R, Amy JJ (1991) Pelvic physiotherapy in genuine stress incontinence. Urology 38:332–337.

    Article  PubMed  CAS  Google Scholar 

  7. Fantl JA, Cardozo L, McClish DK, and the Hormones and Urogenital Therapy Committee (1994) Estrogen therapy in the management of urinary incontinence in postmenopausal women: A meta-analysis. Obstet Gynecol 83:12–18.

    PubMed  CAS  Google Scholar 

  8. Goldberg RP, Galloway NT, Sand PK (2004) Extracorporeal electromagnetic stimulation therapy, In: Bourcier AP, McGuire EJ, Abrams P (eds) Pelvic floor disorders, Elsevier Saunders, Philadelphia, Chapter 30, pp 291–296.

    Google Scholar 

  9. Goode PS, Burgio KL, Locher JL et al (2003) Effect of behavioural training with or without pelvic floor electrical stimulation on stress in continence in women. A randomixed controlled trial. JAMA 290:345–352.

    Article  PubMed  Google Scholar 

  10. Grady D, Brown JS, Vittinghoff E (2001) HERS Research Group. Postmenopausal hormones and incontinence; the Heart and Estrogen/Progestin Replacement Study. Obstet Gynecol 97:116–120.

    Article  PubMed  CAS  Google Scholar 

  11. Hahn I, Milson J, Fall M, Eklund P (1993) Long term results of pelvic floor training in female stress urinary incontinence. Br J Urol 72:421–427.

    PubMed  CAS  Google Scholar 

  12. Hay-Smith EJ, Bo Berghmns LC, Hendriks HJ, de Bie RA, van Waalwijk van Doorn ES (2001) Pelvic floor muscle training for urinary incontinence in women. Cochrane Database Systematic Review 1:DC001407.

    Google Scholar 

  13. Henalla SM, Hutchins CJ, Robinson P, MacVicar J (1989) Nonoperative methods in the treatment of female genuine stress incontinence of urine. J Obstet Gynecol 9:222–225.

    Google Scholar 

  14. Jackson RA, Vittinghof E, Kanaya AM et al (2004) Urinary incontinence in elderly women: Findings from the Health Aging and Body Composition Study. Obstet Gynecol 104:301–307.

    PubMed  CAS  Google Scholar 

  15. Jolleys J (1989) Diagnosis and management of female urinary incontinence in general practice. J Roy Coll Gen Pract 39:277–279.

    CAS  Google Scholar 

  16. Lagro Janssen ALM, Debruyne FMJ, Smits AJA, Van Weel C (1992) The effects of treatment of urinary incontinence in general practice. Fam Pract 9:284–289.

    PubMed  CAS  Google Scholar 

  17. Miller J, Aston-Miller JA, DeLancey JOL (1996) The knack: Use of precisely timed pelvic muscle contraction can reduce leakage in SUI. Neurourol Urodyn 15:392–393.

    Google Scholar 

  18. Moehrer B et al (2003) Oestrogens for urinary incontinence (Review) Cochrane database. CD001405.DOI: 10.1002/14651858.CD.

    Google Scholar 

  19. Moore KH (2000) Conservative therapy for incontinence. In: Balliere’s Clinical Obstetrics and Gynaecology, ed. Cardozo, L. 14:251–289.

    Google Scholar 

  20. Moore KH, O’Sullivan RJ, Simons A, Prashar S, Anderson P, Louey M (2003) Randomized controlled trial of nurse continence advisor therapy versus standard urogynaecology regime for conservative incontinence treatment: Efficacy, costs and two year follow up. Brit J Obstet Gynaecol 110:649–657.

    CAS  Google Scholar 

  21. Morris A, Moore KH (2003) The contiform incontinence device-efficacy and patient acceptibility. Int J Urogynaecology 14:412–417.

    Article  CAS  Google Scholar 

  22. O’Brien J, Austin M, Sethi P, O’Boyle P (1991) Urinary incontinence: Prevalence, need for treatment, and effectiveness of intervention by nurse. Br Med J 303:1308–1312.

    Article  CAS  Google Scholar 

  23. Ramsay IN, Thou M (1990) A randomised double blind placebo controlled trial of pelvic floor exercises in the treatment of genuine stress incontinence. Neurourol Urodyn 9:398–399.

    Google Scholar 

  24. Schuessler B, Norton PA, Stanton SL, et al. Pelvic Floor Reeducation: Principles and Practice, second edition. Springer Verlag London Ltd, 2006 (in press).

    Google Scholar 

  25. Seim A, Siversen B, Eriksen BC, Hunskar S (1996) Treatment of urinary incontinence in women in general practice: An observational study. Br Med J 312:1459–1462.

    CAS  Google Scholar 

  26. Wells TJ, Brink MPH, Diokno AC, Wolfe R, Gillis GL (1991) Pelvic muscle exercise for stress urinary incontinence in elderly women. J Am Geriatr Soc 39:785–791.

    PubMed  CAS  Google Scholar 

  27. Wilson PD, Al Samarrai T, Deakein M, Kolbe E, Brown ADG (1987) An objective assessment of physiotherapy for female genuine stress incontinence. Br Obstet and Gynaecol 94:575–582.

    CAS  Google Scholar 

  28. Wilson PD, Hay Smith J, Nygaard J et al (2005) Adult conservative management. In: Abrams P, Cardoza L, Khoury S, Wein A (eds) Incontinence, Report of 3rd International Consultation on Incontinence. Health Publications Ltd, Plymouth, pp 855–964.

    Google Scholar 

Download references

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag London Limited

About this chapter

Cite this chapter

(2006). Conservative Therapy of Urodynamic Stress Incontinence. In: Urogynecology: Evidence-Based Clinical Practice. Springer, London. https://doi.org/10.1007/1-84628-165-2_6

Download citation

  • DOI: https://doi.org/10.1007/1-84628-165-2_6

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-164-8

  • Online ISBN: 978-1-84628-165-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation