Nonsurgical Interventions for Incontinence: Where Is the Evidence?

Abstract

Urinary incontinence is a remarkably common urologic condition that results in significant clinical and economic sequelae. Although it is likely underestimated, the overall prevalence of urinary incontinence is projected to be between 15% and 38%. Evaluation frequently can be completed without invasive testing. Conservative therapy for incontinence often employs a multimodal approach that can include behavioral therapy, pelvic floor muscle training, external stimulation, medical devices, and pharmacologic treatment. Herein we present an overview of several conservative treatment options for stress and mixed urinary incontinence and review the available literature regarding these therapies. Despite substantial research into conservative incontinence treatment, few robust studies exist to guide practitioner interventions, and great opportunity exists for future evaluation to advance our knowledge regarding nonsurgical incontinence therapy.

Exosome biopotentiated hydrogel restores damaged skeletal muscle in a porcine model of stress urinary incontinence

“…Events such as vaginal delivery lead to a disruption of these coordinated events and result in continence compromise. Most surgical approaches to correct SUI have focused on re-establishing sub-urethral support with minimal attention paid to restoring urethral sphincter function 5,6 . Since its invention in the late 1990's, the minimally invasive mid-urethral sling, a procedure that utilizes a narrow strip of polypropylene mesh placed sub-urethral, has grown to account for ~90% of the yearly incontinence surgeries owing to its high success and low complications 7 .…”