Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

Labrie, J.; Lagro-Janssen, Antoine L. M.; Fischer, Kathelijn; Berghmans, Luc; Vaart, C. H. van der

doi:10.1007/s00192-014-2473-z

Cited by 13 publications

(10 citation statements)

References 21 publications

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“…Perhaps in the long-term, our outcomes benefit older patients with regard to more successful results. Younger women may be less accepting of incontinence and more likely to report being unsatisfied with the treatment, which corresponds well with the results of Labrie et al, who found that age ≤55 years is a predictor of surgery after physiotherapy [30]. Another explanation may be that older women have more time to perform the PFMT.…”

Section: Discussionsupporting

confidence: 80%

Non-face-to-face treatment of stress urinary incontinence: predictors of success after 1 year

et al. 2016

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Introduction and hypothesisThe objective was to determine predictors of long-term success in women with stress urinary incontinence (SUI) treated with a 3-month pelvic floor muscle training (PFMT) program delivered via the Internet or a brochure.MethodsWe included 169 women with SUI ≥1 time/week who completed the 1-year follow-up (n = 169, mean age 50.3, SD 10.1 years). Three outcome variables defined success after 1 year: Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF), and sufficient treatment. Using logistic regression, we analyzed data from the baseline, and from the 4-month and 1-year follow-ups, for potential predictors of success.ResultsOf the participants, 77 % (129 out of 169) were successful in ≥1 of the outcomes, 23 % (37 out of 160) were successful in all 3. Participants with successful short-term results were more likely to succeed in the corresponding outcome at 1 year than those without successful short-term results (adjusted odds ratios [ORs]: PGI 5.15, 95 % confidence interval [CI] 2.40–11.03), ICIQ-UI SF 6.85 (95 % CI 2.83–16.58), and sufficient treatment 3.78 (95 % CI 1.58–9.08). Increasing age predicted success in PGI-I and sufficient treatment (adjusted OR 1.06, 95 % CI 1.02–1.10, and 1.08, 95 % CI, 1.03–1.13 respectively). Compared with not training regularly, regular PFMT at 1 year predicted success for PGI and sufficient treatment (adjusted OR 2.32, 95 % CI 1.04–5.20, and 2.99, 95 % CI 1.23–7.27 respectively).ConclusionThe long-term success of a non-face-to-face treatment program for SUI with a focus on PFMT can be predicted by successful short-term results, increasing age, and the performance of regular PFMT after 1 year.

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Section: Discussionsupporting

confidence: 80%

Non-face-to-face treatment of stress urinary incontinence: predictors of success after 1 year

et al. 2016

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“…The association with younger age is in line with previous findings in women receiving drug treatment or combined treatment for UUI [25]. The association with older age is in line with what Lindh et al found for PFMT via the Internet [10] and with the findings of Labrie et al, with higher rates of crossover to surgery among younger women [26]. The incongruence in these findings is probably due to the different outcomes used, which also depend very much on the expectations of the women, and the non-linear relationship we found between age and improvement.…”

Section: Our Findings In Relation To Previous Datasupporting

confidence: 89%

“…However, this also depends on the outcome used, for example, Lindh et al found that women with higher ICIQ-UI SF scores were more likely to have ≥3 points reduction but less likely to be satisfied with treatment [10]. In line with this, Burgio et al report that women with higher incontinence episode frequency are less likely to be completely dry after behavioral training [12], and Labrie et al report that higher incontinence severity predicts crossover to surgery [26].…”

Section: Our Findings In Relation To Previous Datamentioning

confidence: 98%

Self-management of incontinence using a free mobile app: factors associated with improvement

2021

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Background Pelvic floor muscle training (PFMT) is first-line treatment for urinary incontinence (UI) in women. Self-management via a mobile app is a new cost-effective method for PFMT delivery. This study analyzes factors associated with improvement among app users. Methods A pragmatic observational study in a community setting. Upon downloading the app Tät®, users answered questions regarding their age, education, residence, and UI symptoms. After 3 months, users answered follow-up questions regarding symptoms and frequency of training and app usage, and the validated Patient Global Impression of Improvement (PGI-I) questionnaire. Only non-pregnant, non-postpartum adult women with UI who answered the PGI-I questionnaire were included. Multivariate logistic regression was used to analyze possible associations between these factors with any improvement and with great improvement according to the PGI-I. The models were adjusted for age. Results The study included 2,153 participants who had completed self-management, that is, 11.5% of eligible women who completed the baseline questionnaire. Of these participants, 65.6% reported improvement of UI. Any improvement was associated with age, frequency of PFMT, and app use, accounting for 27.9% of variability (Nagelkerke R2). Lower incontinence severity, frequency of PFMT, and app use were associated with great improvement. Conclusion Self-management of urinary incontinence is easily accessible to many women and improvement rates are comparable with other forms of PFMT. Demographic factors and incontinence severity showed no or incongruent association, whereas regular PFMT and app use predicted any and great improvement. App use showed an additional effect beyond frequency of training.

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“…Conservative treatment (such as pelvic floor exercises) and lifestyle modifications are now recommended as first line treatment for women with SUI and can temporarily or permanently delay surgical management . As a result, patients with a mild first presentation of SUI are likely to be treated nonsurgically initially, and only escalated to MUS once these measures have failed . Recent literature also confirms the increasing role of primary care in the management of early SUI in young women over immediate referral to a specialist gynaecologist, which could also explain the concurrent increase in SUI operations in older age groups, who have failed first line nonsurgical options.…”

Section: Discussionmentioning

confidence: 99%

Age-stratified trends in 20 years of stress incontinence surgery in Australia

Brown

King

2016

Aust N Z J Obstet Gynaecol

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Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

Abstract: In women with moderate to severe stress incontinence, individual prediction for surgery after initial physiotherapy is possible, thus enabling shared decision making for the choice between initial conservative or invasive management of stress urinary incontinence.

Cited by 13 publications

References 21 publications

Non-face-to-face treatment of stress urinary incontinence: predictors of success after 1 year

Non-face-to-face treatment of stress urinary incontinence: predictors of success after 1 year

Self-management of incontinence using a free mobile app: factors associated with improvement

Age-stratified trends in 20 years of stress incontinence surgery in Australia

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