Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence

Abstract

AimsThe objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. MethodsRevision and updates of the 4th ICI Report using systematic review covering years 2008-2012. ResultsEach section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a "grade of recommendation." The paper concludes with areas identified as requiring further research. ConclusionsFor UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre-and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation. Neurourol. Urodynam. 35:15-20, 2016.

Does pelvic floor muscle training improve female sexual function? A systematic review

“…Treatment of any aetiological factor may improve a woman's sexual function (SF). Pelvic floor muscle training (PFMT) is recommended as the first-line treatment for all types of UI and mild-moderate POP [9], and some studies have shown that successful treatment of UI or POP with PFMT also improves some aspects of a woman's sexual life and her SF [10][11][12][13][14][15], but this topic has not been systematically evaluated.…”

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

“…The literature on comparative effectiveness indicates that BT is either equivalent to or more effective than medications for reducing incontinence and OAB symptoms [11-20] but there is limited data for comparison of efficacy of BT and PFMT with or without biofeedback. Cochrane review published in 2014 supports the widespread recommendation that PFMT be included in first-line conservative management programs for women with stress and other types of urinary incontinence [21].…”

Pelvic organ prolapse: A primer for urologists

“…[23][24][25] These observations have led the 5th International Consultation on Incontinence to upgrade its recommendation for this modality. 26 In patients significantly bothered by their POP but who do not want surgery, and in those who are not medically fit or planning to become pregnant again, a pessary can be tried. These devices, usually made of silicone, come in a variety of shapes and sizes and are inserted in the vagina to reduce the prolapse by supporting the pelvic organs.…”