Guideline of guidelines: urinary incontinence

Abstract

The objective of the article is to review key guidelines on the management of urinary incontinence (UI) to guide clinical management in a practical way. Guidelines produced by the European Association of Urology (updated in 2014), the Canadian Urological Association (updated in 2012), the International Consultation on Incontinence (updated in 2012), and the National Collaborating Centre for Women's and Children's Health (updated in 2013) were examined and their recommendations compared. In addition, specialised guidelines produced by the collaboration between the American Urological Association and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction on overactive bladder and the use of urodynamics were reviewed. The Appraisal of Guidelines for Research and Evaluation II (AGREE) instrument was used to evaluate the quality of these guidelines. There is general agreement between the groups on the recommended initial evaluation and the use of conservative therapies for first‐line treatment, with a limited role for imaging or invasive testing in the uncomplicated patient. These groups have greater variability in their recommendations for invasive procedures; however, generally the mid‐urethral sling is recommended for uncomplicated stress UI, with different recommendations on the approach, as well as the comparability to other treatments, such as the autologous fascial sling. This ‘Guideline of Guidelines’ provides a summary of the salient similarities and differences between prominent groups on the management of UI.

Potential therapeutic role of punicalagin against mechanical-trauma-induced stress urinary incontinence via upregulation of Nrf2 and TGF-β1 signaling

“…Stress urinary incontinence (SUI) is a common social and hygiene problem affecting the quality of life (QoL) of 25~57% adult women worldwide and causing serious social economic load [1–5]. Although progress has been made in treating SUI in recent decades, pharmacological therapy is poorly understood.…”

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

“…According to most guidelines, after conservative measures, a midurethral sling (MUS) procedure is the treatment method of first choice [2] . For patients in whom sling surgery failed or for those who are unfit for surgery, options are limited.…”

Valsalva Leak Point Pressure Measurement in Women with Stress Urinary Incontinence: At what Bladder Volume?

“…SUI as defined by the international continence society (ICS Abrams 2003) [7] is the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing. It is the most prevalent form of urinary incontinence [8,9], with an estimation between 15% and 55% [10] in women complaining of lower urinary tract symptoms (LUTS). Meanwhile, Urodynamic study (UDS) [1] is simply the use of appropriate methods to study the function and the dysfunction of the urinary tract.…”