Treatment Options for Stress Urinary Incontinence

Chapter
First Online:

Abstract

Urinary incontinence is a common and distressing condition which, although not life threatening, is known to have a significant effect on quality of life (QoL). The incidence of urinary incontinence increases with age and whilst stress urinary incontinence is more common in younger women many elderly women also complain of troublesome symptoms. With an increasingly elderly population urinary incontinence represents a significant burden on both primary and secondary healthcare and the incidence of stress incontinence is likely to increase with increasing activity levels in this age group. The term-stress urinary incontinence may be used to describe the symptom or sign of urinary leakage on coughing or exertion but should not be regarded as a diagnosis. A diagnosis of urodynamic stress incontinence (USI) may only be made after urodynamic investigation and this is defined as the involuntary leakage of urine during increased abdominal pressure in the absence of a detrusor contraction.

Keywords

Treatment Stress urinary incontinence Stress urinary incontinence Urodynamics Detrusor contraction Pelvic floor muscle training Colposuspension Laparoscopy Pubovaginal sling Retropubic mid-urethral tape procedures 
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri P, Rizk DE, Sand PK, Schaer GN. An international urogynaecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26.CrossRefPubMedGoogle Scholar
  2. 2.
    Hannestad YS, Rortveit G, Sandvik H, Hunskar S. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Clin Epidemiol. 2000;53:1150–7.Google Scholar
  3. 3.
    Rortveit G, Hannnestad YS, Daltveit AK, Hunskaar S. Age and type dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynaecol. 2001;98:1004–10.Google Scholar
  4. 4.
    Petros P, Ulmsten U. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynaecol Scand. 1990;153 Suppl:7–31.Google Scholar
  5. 5.
    Ingelman-Sundberg A. Urinary incontinence in women, excluding fistulas. Acta Obstet Gynaecol Scand. 1953;31:266–95.CrossRefGoogle Scholar
  6. 6.
    Westbury M, Asmussen M, Ulmsten U. Location of maximal intraurethral pressure related to urogenital diaphragm in the female subject as studied by simultaneous urethra-cystometry and voiding urethrocystography. Am J Obstet Gynaecol. 1982;144:408–12.CrossRefGoogle Scholar
  7. 7.
    Jorgensen L, Lose G, Thunedborg P. Diagnosis of mild stress incontinence in females: 24-hour pad weighing test versus the one-hour test. Neurourol Urodyn. 1987;6:165–6.Google Scholar
  8. 8.
    Lyons RA, Perry HM, Littlepage BNC. Evidence for the validity of the short form 36 questionnaire (SF-36) in an elderly population. Age Ageing. 1994;23:182–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997;104:1374–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Swithinbank L, Hashim H, Abrams P. The effect of fluid intake on urinary symptoms in women. J Urol. 2005;174(1):187–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, Richter HE, Myers D, Burgio KL, Gorin AA, Macer J, Kusek JW, Grady D. PRIDE investigators weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481–90.Google Scholar
  12. 12.
    Bo K. Pelvic Floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol. 2012;30(4):437–43.CrossRefPubMedGoogle Scholar
  13. 13.
    Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;7:CD009508Google Scholar
  14. 14.
    Herderschee R, Hay-Smith EJ, Herbison GP, Roovers JP, Heineman MJ. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;7:CD009252Google Scholar
  15. 15.
    Moore K, Dumoulin C, Bradley C, Burgio K, Chambers T, Hagen S, Hunter K, Imamura M, Thakar R, Williams K, Vale L. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 5th ed. Health Publication, Editions 21, Paris, France; 2013. pp. 1101–228.Google Scholar
  16. 16.
    Thor KB, Katofiasc MA. Effects of Duloxetine, a combined serotonin and norepineephrine reuptake inhibitor, on central neural control of lower urinary tract function in the chloralose-anesthetised female cat. Pharmacol Exp Ther. 1995;74:1014–24.Google Scholar
  17. 17.
    Millard R, Moore K, Yalcin I, Bump R. Duloxetine vs. placebo in the treatment of stress urinary incontinence: a global phase III study. Neurourol Urodynam. 2003;22:482–3.Google Scholar
  18. 18.
    Ghoniem GM, Van Leeuwen JS, Elser DM, Freeman RM, Zhao YD, Yalcin I, Bump RC, Duloxetine/Pelvic Floor Muscle Training Clinical Trail Group. A randomised controlled trial of duloxetine alone, pelvic floor muscle training alone, combined treatment and no active treatment in women with stress urinary incontinence. J Urol. 2005;173:1647–53.Google Scholar
  19. 19.
    Cardozo L, Drutz HP, Baygani SK, Bump RC. Pharmacological treatment of women awaiting surgery for stress urinary incontinence. Obstet Gynaecol. 2004;104:511–9.CrossRefGoogle Scholar
  20. 20.
    Marshall VF, Marchetti AA, Krantz KE. The correction of stress incontinence by simple vesicourethral suspension. Surg Gynaecol Obstet. 1949;88:509–18.Google Scholar
  21. 21.
    Burch J. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele and prolapse. Am J Obstet Gynaecol. 1961;81:281.CrossRefGoogle Scholar
  22. 22.
    Cardozo LD, Stanton SL, Williams JE. Detrusor instability following surgery for stress incontinence. Br J Urol. 1979;58:138–42.Google Scholar
  23. 23.
    Wiskind AK, Creighton SM, Stanton SL. The incidence of genital prolapse following the Burch colposuspension operation. Neurourol Urodyn. 1991;10:453–4.Google Scholar
  24. 24.
    Alcalay M, Monga A, Stanton SL. Burch colposuspension: 10–20 year follow-up. Br J Obstet Gynaecol. 1995;102:740–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Pereyra A. A simplified surgical procedure for the correction of stress incontinence in women. West J Surg. 1959;67:223.PubMedGoogle Scholar
  26. 26.
    Stamey T. Endoscopic suspension of the vesical neck for urinary incontinence. Surg Gynecol Obstet. 1973;136:547–54.PubMedGoogle Scholar
  27. 27.
    Raz S. Modified bladder neck suspension for female stress incontinence. Urology. 1981;17:82.CrossRefPubMedGoogle Scholar
  28. 28.
    Liu CY. Laparoscopic retropubic colposuspension (Burch procedure): a review of 58 cases. J Reprod Med. 1993;38:526–30.PubMedGoogle Scholar
  29. 29.
    Burton G. A randomised comparison of laparoscopic and open colposuspension. Neurourol Urodyn. 1994;13:497–8.Google Scholar
  30. 30.
    Carey MP, Goh JT, Rosamilia A, Cornish A, Gordon I, Hawthorne G, Maher CF, Dwyer PL, Moran P, Gilmour DT. Laparoscopic versus open Burch colposuspension: a randomised controlled trial. BJOG. 2006;113:999–1006.CrossRefPubMedGoogle Scholar
  31. 31.
    Kitchener HC, Dunn G, Lawton V, Reid F, Nelson L, Smith ARB on behalf of the COLPO study group. Laparoscopic versus open colposuspension- results of a prospective randomised controlled trial. BJOG 2006;113:1007–13.Google Scholar
  32. 32.
    Dumville JC, Manca A, Kitchener HC, Smith ARB, Nelson L, Torgerson DJ, on behalf of the COLPO study group. Cost effectiveness analysis of open colposuspension versus laparoscopic colposuspension in the treatment of urodynamic stress incontinence. BJOG. 2006;113:1014–22.CrossRefPubMedGoogle Scholar
  33. 33.
    Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthetic for treatment of female urinary incontinence. Int Urogynaecol J. 1996;7:81–6.Google Scholar
  34. 34.
    Nilsson CG, Palva K, Aarnio R, Morcos E, Falconer C. Seventeen year’s follow up of the tension free vaginal tape procedure for female stress urinary incontinence. Int Urogynaecol J. 2013;24:1265–9.CrossRefGoogle Scholar
  35. 35.
    Ward K, Hilton P. United Kingdom and Ireland Tension Free Vaginal Tape Trial Group Prospective multicentre randomised trial of tension free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ. 2002;325:67.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Ward K, Hilton P, United Kingdom and Ireland Tension Free Vaginal Tape Trial Group. Tension free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5 year follow up. BJOG 2008;115:226–33.Google Scholar
  37. 37.
    Staskin DR, Tyagi R. The SPARC sling system. Atlas Urol Clin. 2004;12:185–95.CrossRefGoogle Scholar
  38. 38.
    Deval B, Levardon M, Samain E, Rafii A, Cortesse A, Amarenco G, Ciofu C, Haab F. A French multicentre clinical trial of SPARC for stress urinary incontinence. Eur Urol. 2003;44:254–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Lord HE, Taylor JD, Finn JC, Tsokos N, Jeffery JT, Atherton MJ, Evans SF, Bremner AP, Elder GO, Holman CD. A randomised controlled equivalence trial of short term complications and efficacy of tension free vaginal tape and suprapubic urethral support sling for treating stress incontinence. BJU Int. 2006;98:367–76.CrossRefPubMedGoogle Scholar
  40. 40.
    Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol. 2001;11:1306–13.PubMedGoogle Scholar
  41. 41.
    Whiteside JL, Walters MD. Anatomy of the obturator region: relations to a transobturator sling. Int Urogynaecol J Pelvic Floor Dysfunct. 2004;15:223–6.Google Scholar
  42. 42.
    Madhuvrata P, Riad M, Ammembal MK, Agur W, Abdel-Fattah M. Systemaic review and meta-analysis of ‘inside-out versus ‘outside-in’ transobturator tapes in management of stress urinary incontinence in women. Eur J Obstet Gynaecol Reprod Biol. 2012;162:1–10.CrossRefGoogle Scholar
  43. 43.
    Abdel-Fattah M, Mostafa A, Familusi A, Ramsay I, N’dow J. Prospective randomised controlled trial of transobturator tapes in management of urodynamic stress incontinence in women: 3 year outcomes from the evaluation of Transobturator Tapes study. Eur Urol. 2012;62:843–51.CrossRefPubMedGoogle Scholar
  44. 44.
    Latthe PM, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG. 2007;114:522–31.CrossRefPubMedGoogle Scholar
  45. 45.
    Novara G, Artibani W, Barber MD, Chapple CR, Costantini E, Ficarra V, Hilton P, Nilsson CG, Waltregny. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. 2010;58:218–38.Google Scholar

*Recent Systematic Review of Continence Surgery

  1. 46.
    Abdel-Fattah M, Ford JA, Lim CP, Madhuvrata P. Single incision mini slings versus standard mid-urethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol. 2011;60:468–80.Google Scholar
  2. 47.
    Kirchin V, Page T, Keegan PE, Atiemo K, Cody JD, McClinton S. Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev. 2012;15:2:CD003881.Google Scholar
  3. 48.
    Ghoniem G, Bernhard P, Corcos J, Comiter C, Tomera K, Westney O, Herschorn S, Lucente V, Smith J, Wahle G, Mulcahy J. Multicentre randomised controlled trial to evaluate Macroplastique urethral bulking agent for the treatment of female stress urinary incontinence. Int Urogynaecol J. 2005;16(2):S129–30.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of UrogynaecologyKings College HospitalDenmark HillUK

Personalised recommendations