Skip to main content

Advertisement

Log in

Conservative strategies for the treatment of stress urinary incontinence

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

The conservative treatment of stress urinary incontinence for women has many facets. Each intervention may have value and patients may benefit from simple, reversible recommendations and techniques versus invasive surgery. Starting with a thorough history, lifestyle modifications may lead to decreased incontinence. Depending on the patient’s goals and clinical situation, they may benefit from a pessary or anti-incontinence device. Finally, the use of pelvic floor muscle exercises has been shown to benefit a significant number of patients. Regardless of the degree of stress urinary incontinence, conservative strategies should be considered a fundamental part of the treatment plan.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Noblett KL, Jensen JK, Ostergard DR: The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct 1997, 8:323–326.

    PubMed  CAS  Google Scholar 

  2. Møller LA, Lose G, Jorgensen T: Risk factors for lower urinary tract symptoms in women 40 to 60 years of age. Obstet Gynecol 2000, 96:446–451.

    Article  Google Scholar 

  3. Dallosso HM, McGrother CW, Matthews RJ, et al.: The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int 2003, 92:69–77.

    Article  PubMed  CAS  Google Scholar 

  4. Peyrat L, Haiilot O, Bruyere F, et al.: Prevalence and risk factors of urinary incontinence in young and middle-aged women. BJU Int 2002, 89:61–66.

    Article  PubMed  CAS  Google Scholar 

  5. Bump RC, Sugerman HJ, Fantl JA, McClish DK: Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol 1992, 167:392–399.

    PubMed  CAS  Google Scholar 

  6. Deitel M, Stone E, Kassam HA, et al.: Gynecologic-obstetric changes after loss of massive excess weight following bariatric surgery. J Am Coll Nutr 1988, 7:147–153.

    PubMed  CAS  Google Scholar 

  7. Dowd TT, Campbell JM, Jones JA: Fluid intake and urinary incontinence in older community-dwelling women. J Community Health Nurse 1996, 13:179–186.

    Article  CAS  Google Scholar 

  8. Bo K, Hay-Smith J, Nygaard I, et al.: Conservative treatment: women. In Incontinence, edn 2. Edited by Abrams P, Cardozo L, Khoury S, Wein A. Plymouth, UK: Health Publication Ltd.; 2002:571–624.

    Google Scholar 

  9. Tincello DG, Adams EJ, Boldersoon J, Richmond DH: A urinary control device for management of female stress incontinence. Obstet Gynecol 2000, 95:417–420.

    Article  PubMed  CAS  Google Scholar 

  10. Hahn I, Milson I: Treatment of female stress urinary incontinence with a new anatomically shaped vaginal device (Conveen Continence Guard). Br J Urol 1996, 77:711–715.

    PubMed  CAS  Google Scholar 

  11. Mouritsen L: Effect of vaginal devices on bladder beck mobility in stress incontinent women. Acta Obstet Gynecol Scand 2001, 80:428–431.

    PubMed  CAS  Google Scholar 

  12. Robert M, Mainprize TC: Long-term assessment of the incontinence ring pessary for the treatment of stress incontinence. Int Urogynecol J 2002, 13:326–329.

    Article  CAS  Google Scholar 

  13. Morris AR, Moore KH: The Contiform incontinence device: efficacy and patient acceptability. Int Urogynecol J 2003, 14:412–417.

    Article  CAS  Google Scholar 

  14. Donnelly MJ, Powell-Morgan S, Olsen AL, Nygaard IE: Vaginal pessaries for the management of stress and mixed urinary incontinence. Int Urogynecol J 2004, 15:302–307. Shows a moderately aggressive approach and patient acceptability of incontinence pessaries.

    Google Scholar 

  15. Kegel AH: Progressive resistance in the functional restoration of the perineal muscles. Am J Obstet Gynecol 1948, 56:238–249.

    Google Scholar 

  16. Bø K, Talseth T, Holme I: 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 1999, 318:487–493.

    PubMed  Google Scholar 

  17. Hay-Smith EJ, Bo Berghmans LC, Hendriks HJ, et al.: Pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 2001, 1:CD001 407.

    Google Scholar 

  18. Bump RC, Hurt WG, Fantl JA, Wyman JF: Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol 1991, 165:322–327. An older study, but extremely relevant because the clinician must not assume that patients know how to perform PFME.

    PubMed  CAS  Google Scholar 

  19. Nygaard IE, Kreder KJ, Lepic MM, et al.: Efficacy of pelvic floor muscle exercises in women with stress, urge, and mixed urinary incontinence. Am J Obstet Gynecol 1996, 174:120–125.

    Article  PubMed  CAS  Google Scholar 

  20. Elser DM, Wyman JF, McClish DK, et al.: The effect of bladder training, pelvic floor muscle training, or combination training on urodynamic parameters in women with urinary incontinence. Neurourol Urodynam 1999, 18:427–436.

    Article  CAS  Google Scholar 

  21. Meyer S, Hohlfeld P, Achtari C, De GrandiP: Pelvic floor education after vaginal delivery. Obstet Gynecol 2001, 97:673–677.

    Article  PubMed  CAS  Google Scholar 

  22. Jundt K, Peschers UM, Dimpfl T: Long-term efficacy of pelvic floor re-education with EMG-controlled biofeedback. Eur J Obstet Gynecol Reprod Biol 2002, 105:181–185.

    PubMed  Google Scholar 

  23. Aukee P, Immonen P, Laaksonen DE, et al.: The effect of home biofeedback training on stress incontinence. Acta Obstet Gynecol Scand 2004, 83:973–977.

    Article  PubMed  Google Scholar 

  24. Mørkved S, Bø K, Fjørtoft T: Effect of adding biofeedback to pelvic floor muscle training to treat urodynamic stress incontinence. Obstet Gynecol 2002, 100:730–739. Excellent study examining the lack of benefit of home biofeedback with PFMEs versus PFMEs alone for the treatment of SUI. The study design is exemplary and a model that should be used to answer the questions surrounding behavioral therapy for SUI.

    Article  PubMed  Google Scholar 

  25. Parkkinen A, Karjalainen E, Vartiainen M, Penttinen J: Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training. A 5-year follow-up study. Neurourol Urodynam 2004, 23:643–648.

    Article  CAS  Google Scholar 

  26. Goode PS, Burgio KL, Locher JL, et al.: Effect of behavioral training with or without pelvic floor electrical stimulation on stress incontinence in women. JAMA 2003, 290:345–352. This study demonstrates the benefit of clinical instruction of PFME for patients and the lack of benefit of ES if clinical training is used. The design and execution of the study allows results to be interpreted with confidence, although the follow-up is short.

    Article  PubMed  Google Scholar 

  27. Burgio K, Goode PS, Locher JL, et al.: Predictors of outcome in the behavioral treatment of urinary incontinence in women. Obstet Gynecol 2003, 102:940–947.

    Article  PubMed  Google Scholar 

  28. Herbison P, Plevnik S, Mantle J: Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev 2002, 1:CD002114.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dwyer, N.T., Kreder, K.J. Conservative strategies for the treatment of stress urinary incontinence. Curr Urol Rep 6, 371–375 (2005). https://doi.org/10.1007/s11934-005-0056-8

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-005-0056-8

Keywords

Navigation