Stress Urinary Incontinence: An Unsolved Clinical Challenge

Abstract

Stress urinary incontinence is still a frequent problem for women and men, which leads to pronounced impairment of the quality of life and withdrawal from the social environment. Modern diagnostics and therapy improved the situation for individuals affected. But there are still limits, including the correct diagnosis of incontinence and its pathophysiology, as well as the therapeutic algorithms. In most cases, patients are treated with a first-line regimen of drugs, possibly in combination with specific exercises and electrophysiological stimulation. When conservative options are exhausted, minimally invasive surgical therapies are indicated. However, standard surgeries, especially the application of implants, do not pursue any causal therapy. Non-absorbable meshes and ligaments have fallen into disrepute due to complications. In numerous countries, classic techniques such as colposuspension have been revived to avoid implants. Except for tapes in the treatment of stress urinary incontinence in women, the literature on randomized controlled studies is insufficient. This review provides an update on pharmacological and surgical treatment options for stress urinary incontinence; it highlights limitations and formulates wishes for the future from a clinical perspective.

Exploring the Challenges of Using Minimal Invasive Surgery to Treat Stress Urinary Incontinence: Insights from a Retrospective Case-Control Study

“…It is undoubtedly true that establishing a precise diagnosis of the condition and being well-versed in all available treatment options are both of fundamental importance in the management of stress urinary incontinence patients (SUI) [1]. Moreover, it is essential for physicians to continually recognize the significant social and quality of life impacts this condition can have on patients.…”

“…This condition, a prevalent public health issue, impacts one out of every three women, leading to a substantial decline in their quality of life. It creates a range of challenges, including social, psychological, occupational, physical and sexual difficulties, in those affected [1][2][3][4].…”

Production of Proliferation- and Differentiation-Competent Porcine Myoblasts for Preclinical Studies in a Porcine Large Animal Model of Muscular Insufficiency

“…For improvement of mild forms of insufficient sphincter muscle function, physical exercise of the lower pelvic floor, complemented by electrophysiological stimulation therapy was shown to improve the muscle strength and thus ameliorate or even cure SUI [6]. Non-surgical treatment of SUI includes also Life 2024, 14, 212 2 of 17 behavioral therapy measures and drug therapy approaches [7,8]. If such a regimen fails to satisfy the patient's needs, surgical treatment comes into play.…”

“…Here, options for female and male patients differ considerably. However, for both sexes, injections of bulking agents, the application of sex-adapted tapes or slings, as well as artificial sphincters were used [8]. Yet, such therapies inherit perioperative and also long-term risks and do not treat the underlying conditions.…”