Abstract
Purpose of Review
This review outlines current options for women suffering from both stress urinary incontinence (SUI) and underactive bladder (UAB). This is often a challenging patient population; however, many treatment options are available including behavioral, pharmacologic, and surgical. Therapies can be divided into those specifically targeting either the bladder or the bladder outlet.
Recent Findings
For patients with SUI and UAB, several clinical trials have helped to formulate current guidelines. Also, a number of novel techniques and therapeutic agents are currently under investigation. Current surgical treatments frequently employed for SUI include mid-urethral slings and urethral bulking agents. In contrast, the current treatments for UAB are limited to either sacral neuromodulation in women with Fowlers syndrome or in the majority, clean intermittent catheterization. Recent studies have investigated the use of adjustable urethral slings and novel modes of neuromodulation with varying degrees of success.
Summary
Choosing the best treatment plan for SUI combined with UAB involves a thorough understanding of a patient’s preferences and goals. Fortunately, women have many options that can significantly benefit their quality of life.
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Funding
This study is financially supported by NIH R21 AG062971—“A Novel Combination Drug Treatment for Detrusor Hyperactivity with Impaired Contractile Function (DHIC).”
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Katherine Shapiro and Pradeep Tyagi declare that they have no conflict of interest. Christopher Chermansky is a clinical site principal investigator for multicenter trials sponsored by Allergan for OAB and by Cook Myosite for female stress urinary incontinence.
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This article is part of the Topical Collection on Reconstructed Bladder Function & Dysfunction
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Shapiro, K.K., Tyagi, P. & Chermansky, C.J. Underactive Bladder and Bladder Outlet Procedures in Women. Curr Bladder Dysfunct Rep 15, 21–24 (2020). https://doi.org/10.1007/s11884-019-00572-1
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DOI: https://doi.org/10.1007/s11884-019-00572-1