Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: A short version Cochrane systematic review with meta-analysis

Dumoulin, Chantale; Hay‐Smith, Jean; Habée‐Séguin, Gabrielle Mac; Mercier, Joanie

doi:10.1002/nau.22700

Cited by 165 publications

(99 citation statements)

References 28 publications

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“…Behavioral treatments usually contain multiple components, such as urge control strategies, pelvic floor muscle training, and/or scheduled toileting [8]. Training commonly 2 Journal of Geriatrics involves biofeedback or vaginal palpation.…”

Section: Introductionmentioning

confidence: 99%

Treating Urge Incontinence in Older Women: A Cost-Effective Investment in Quality-Adjusted Life-Years (QALY)

Phillips

Tehrani

Langmuir

et al. 2015

Journal of Geriatrics

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Objectives. To conduct cost-effectiveness analyses of urge incontinence treatments for older women. Methods. Decision-analytic models assessed three treatment pathways: (1) limited behavioral therapy (LBT); (2) full behavioral therapy (FBT) with biofeedback; and (3) drug (DRUG), with allowances for crossover options following initial treatments. Model inputs were gathered from published data. Cost data were based on third party payer reimbursement. Outcomes were measured as the number of incontinence episodes avoided and quality-adjusted life years gained (QALYs). Results. At baseline values costs per QALY gained ranged from US$3696 to $10609. LBT was the least costly with the lowest benefit. Switching from LBT to FBT, with the greatest gain, was $415 per additional QALY. DRUG was the most expensive option. Sensitivity analyses showed that only small changes in key inputs were required for DRUG to generate greater gains than FBT. Medication costs had to fall substantially for DRUG to be cost competitive. Conclusion. All treatment strategies provide QALYs gains at a bargain price, compared to the standard of US$50,000 per QALY gained. No single treatment strategy dominated under all conditions. Clinicians should offer multiple treatment options to older women with urge incontinence.

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Section: Introductionmentioning

confidence: 99%

Treating Urge Incontinence in Older Women: A Cost-Effective Investment in Quality-Adjusted Life-Years (QALY)

Phillips

Tehrani

Langmuir

et al. 2015

Journal of Geriatrics

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“…11 The evidence for PFMT is limited for mixed incontinence; nevertheless, a recent systematic review found that women treated with PMFT (for at least three months) are significantly more likely to have improvement or complete resolution of their urinary incontinence, even with mixed incontinence. 17 It is important to note that PFMT is still an appropriate first-line therapy in women with urge predominant mixed incontinence, although it is more likely for the stress incontinence component to resolve. While systemic estrogen supplement is not associated with an improvement in incontinence (and perhaps even worsens symptoms), topical vaginal estrogen has been generally shown to decrease urinary urgency, frequency, and nocturia in postmenopausal women.…”

Section: Non-surgical Treatmentmentioning

confidence: 99%

The management of mixed urinary incontinence in women

Welk¹,

Baverstock²

2017

CUAJ

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Mixed urinary incontinence is a common diagnosis among women with urinary leakage and is often present in women who are unable to characterize their incontinence. Research and optimized clinical treatment of these patients is limited by the challenges in objectively defining and stratifying this population. The evaluation of these patients should follow the same general principles as any assessment of any women with incontinence; however, it is essential to define whether urge or stress incontinence is the predominant symptom. Urodynamics (UDS) may be helpful in this regard and may help predict surgical outcomes. Behavioural therapy, weight loss, and pelvic floor muscle therapy are usually appropriate initial management strategies. In postmenopausal women, vaginal estrogen can be considered, and in women with equal parts stress and urge incontinence or urge-predominant mixed incontinence, a trial of anticholinergics or beta-3 agonists is appropriate. In women with stress-predominant or equal parts stress and urge incontinence, stress incontinence surgery can be considered, with the caveat that outcomes are generally worse among women with more severe levels of urgency, success rates may not be as durable, and a significant proportion of women may need additional medical therapy.

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“…Ma to szczególne znaczenie w codziennej aktywności kobiet -zarówno zawodowej, jak i domowej. Według autorów widoczna jest potrzeba przygotowania obszernego programu treningu mięśni dna miednicy w profilaktyce nietrzymania moczu [36,37].…”

Section: ćWiczenia Mięśni Przepony Moczowo-płciowejunclassified

Selected methods of conservative treatment of stress urinary incontinence: current views. Part 1

Chmielewska¹,

Kwaśna²,

Piecha³

et al. 2012

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StreszczenieWspółczesne społeczeństwo boryka się z nietrzymaniem moczu, które stanowi ważny problem medyczny, psychologiczny i społeczny. O nietrzymaniu moczu w Polsce zaczęto mówić więcej na przestrzeniu ostatnich lat, choć problem nie jest nowy. Autorzy w niniejszej pracy podkreślają potrzebę sprecyzowania strategii profilaktyki i leczenia nietrzymania moczu. Przedstawiona praca to przegląd opublikowanych badań nad czynnikami predysponującymi do występowania nietrzymania moczu. Na podstawie dostępnego piśmiennictwa naukowego przeanalizowano również znaczenie profilaktyki u kobiet z zaburzeniami mikcji. Dotychczas przeprowadzono szereg badań dotyczących efektywności różnych form leczenia zachowawczego wysiłkowego nietrzymania moczu. Do najczęściej stosowanych metod fizjoterapeutycznych zalicza się m.in. ćwiczenia mięśni dna miednicy oraz metodę biofeedbacku. W opinii wielu autorów wymienione metody leczenia zachowawczego dają dobre efekty, lecz ze względu na różnorodność metodyczną prowadzonych form terapii nie można bezpośrednio porównać rezultatów tych obserwacji. Istnieje potrzeba sprecyzowania strategii leczenia nietrzymania moczu i zapobiegania temu schorzeniu.Słowa kluczowe: wysiłkowe nietrzymanie moczu, ćwiczenia mięśni dna miednicy, biofeedback, profilaktyka. SummaryModern society suffers from stress incontinence, which is an important medical, psychological and social problem. Stress incontinence has been discussed in Poland for the last years, but the problem is not new. The authors of this science paper emphasize the necessity for clarification of the strategy of prevention and treatment of urinary incontinence. This publication is a review of the published research concerning risk factors for the prevalence of stress incontinence. Based on the scientific literature, the importance of prevention of the urinary incontinence in women has also been analyzed. Until now, there have been numerous researches investigating the effectiveness of various forms of conservative treatment for stress urinary incontinence. The most common physiotherapy methods include exercises of the pelvic floor muscles and biofeedback. In the opinion of many authors, these methods of the conservative treatment have a beneficial effect but due to a variety of methodical approaches in the treatment you cannot directly compare the results of these observations. There is a necessity for clarification of the strategy of treatment and prevention of urinary incontinence.

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Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: A short version Cochrane systematic review with meta-analysis

Abstract: Background

Cited by 165 publications

References 28 publications

Treating Urge Incontinence in Older Women: A Cost-Effective Investment in Quality-Adjusted Life-Years (QALY)

Treating Urge Incontinence in Older Women: A Cost-Effective Investment in Quality-Adjusted Life-Years (QALY)

The management of mixed urinary incontinence in women

Selected methods of conservative treatment of stress urinary incontinence: current views. Part 1

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