Comparison of different treatment protocols in the treatment of idiopathic detrusor overactivity: a randomized controlled trial

Kaya, Serap; Akbayrak, Türkan; Beksaç, Sinan

doi:10.1177/0269215510385481

Cited by 41 publications

(21 citation statements)

References 42 publications

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“…Forty six patients were included. The stimulation group, combined or not with trospium was superior to trospium alone in quality of life (p = 0.017) and amount of urine leakage (p = 0.079) (47).…”

Section: Suprapubic Stimulationmentioning

confidence: 95%

Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

et al. 2013

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Background: Electrical stimulation is commonly recommended to treat urinary incontinence in women. It includes several techniques that can be used to improve stress, urge, and mixed symptoms. However, the magnitude of the alleged benefits is not completely established. Objectives: To determine the effects of electrical stimulation in women with symptoms or urodynamic diagnoses of stress, urge, and mixed incontinence. Search Strategy: Our review included articles published between January 1980 and January 2012. We used the search terms "urinary incontinence", "electrical stimulation", "intravaginal", "tibial nerve" and "neuromodulation" for studies including female patients. Selection Criteria: We evaluated randomized trials that included electrical stimulation in at least one arm of the trial, to treat women with urinary incontinence. Data Collection and Analysis: Two reviewers independently assessed the data from the trials, for inclusion or exclusion, and methodological analysis. Main Results: A total of 30 randomized clinical trials were included. Most of the trials involved intravaginal electrical stimulation. Intravaginal electrical stimulation showed effectiveness in treating urge urinary incontinence, but reported contradictory data regarding stress and mixed incontinence. Tibial-nerve stimulation showed promising results in randomized trials with a short follow-up period. Sacral-nerve stimulation yielded interesting results in refractory patients. Conclusions: Tibial-nerve and intravaginal stimulation have shown effectiveness in treating urge urinary incontinence. Sacral-nerve stimulation provided benefits in refractory cases. Presently available data provide no support for the use of intravaginal electrical stimulation to treat stress urinary incontinence in women. Further randomized trials are necessary to determine the magnitude of benefits, with long-term follow-up, and the effectiveness of other electrical-stimulation therapies.

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Section: Suprapubic Stimulationmentioning

confidence: 95%

Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

et al. 2013

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“…Such side-effects negatively affect patients’ compliance [5]. Surgical treatment is usually offered to refractory OAB cases and has a higher morbidity rate.…”

Section: Introductionmentioning

confidence: 99%

Effects of Bladder Training and Pelvic Floor Muscle Training in Female Patients with Overactive Bladder Syndrome: A Randomized Controlled Trial

2018

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Objective: The purpose of our study was to see the efficacy of 3 different modes of treatment for overactive bladder (OAB) in symptoms reduction and quality of life improvement. Methods: We conducted a 12-week single-blinded randomized controlled trial of women aged 22–65 years with clinical diagnosis of OAB. Arm A (n = 47) received bladder training, arm B (n = 50) received pelvic floor muscle training (PFMT), and arm C (n = 50) received PFMT with biofeedback. Bladder diary was used to assess the difference in urinary frequency, urgency, and leak accidents before and after treatment. Initial and final assessment was made using validated urogenital distress inventory short form 6 (UDI-SF6) and incontinence impact questionnaire short form 7 (IIQ-SF7). Results: UDI-SF6 scores showed significant improvement in all arms. There was a reduction in UDI-6 scores from 8.38 ± 4.3 to 4.77 ± 5.5 with a mean difference of 3.61 ± 7.4 in patients in arm A (p = 0.002), arm B (p = 0.01), and arm C (p = 0.016). All patients in arms A, B, and C reported significant improvement in quality of life as assessed by IIQ-SF7 scores with significant p values of 0.009, 0.051, and 0.001, respectively. Bladder diary results using paired t test showed the significant difference in day time urinary frequency in arm A after treatment, as well as the reduction in both leak accidents and urgency score in all 3 arms. Conclusions: All 3 arms of study showed significant results and can be used as the first line of management.

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“…We identified a total of 12 studies (all prospective in nature) examining bladder training in combination with medications (Table ) . The bladder training regimens ranged from tailored or generic self‐administered behavioral therapy to pelvic floor physiotherapy sessions with a trained professional, while the medications used in each study were anticholinergics.…”

Section: Resultsmentioning

confidence: 99%

“…We identified a total of 12 studies (all prospective in nature) examining bladder training in combination with medications ( Table 3). [21][22][23][24][25][26][27][28][29][30][31]37 The bladder training regimens ranged from tailored or generic self-administered behavioral therapy to pelvic floor physiotherapy sessions with a trained professional, while the medications used in each study were anticholinergics. Only 50% of the reviewed studies show improvements in urinary frequency, urgency, urge incontinence, or OAB-q scores when an anticholinergic is combined with bladder training, and the majority do not show superiority over monotherapy (usually medication) alone.…”

Section: Bladder Training Combination With Medicationsmentioning

confidence: 99%

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Kasman

Stave

Elliott

2019

Neurourology and Urodynamics

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Aims Overactive bladder (OAB) affects over 17% of the population and significantly effect the health‐related quality of life. The treatments for OAB include first line (lifestyle modification, pelvic floor muscle training), second line (anticholinergic or beta‐3 agonist medications), and third line therapies (intradetrusor botulinum toxin injection, sacral neurostimulation [SNM], or percutaneous tibial nerve stimulation [PTNS]). For those with urinary incontinence secondary to OAB, complete continence is the goal of therapy, though cure rates are only 5% to 40%. The use of combination therapies can be employed in refractory OAB, however, the efficacy of pooled modalities is relatively unknown. Our objective was to determine the volume of data supporting combination therapy in treating OAB. Methods We systematically reviewed PubMed, EMBASE, the Cochrane Library, and Google Scholar for articles published before October 2018. Each was independently reviewed by two reviewers and examined in detail if they met inclusion criteria. Results A total of 32 studies met inclusion criteria and were reviewed. Most large prospective studies evaluated combinations of medications with behavioral therapy or medications together. Combination therapy studies of third‐line treatments were rare and centered on medication with PTNS. No studies examined intradetrusor botulinum toxin injections in combination with another therapy and only one retrospective study briefly examined SNM therapy in combination with medication. Conclusion Combination therapy, with certain first, second, and third‐line OAB therapies, appears to be efficacious. There is a further need for carefully designed combination therapy studies, particularly those including third line modalities.

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Comparison of different treatment protocols in the treatment of idiopathic detrusor overactivity: a randomized controlled trial

Abstract: The physiotherapy protocol we introduced in the present study with or without anticholinergic therapy has a substantial positive impact on the treatment of female patients with idiopathic detrusor overactivity.

Cited by 41 publications

References 42 publications

Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

Effects of Bladder Training and Pelvic Floor Muscle Training in Female Patients with Overactive Bladder Syndrome: A Randomized Controlled Trial

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

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