Urinary incontinence: Difference between revisions
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==Treatment== | ==Treatment== | ||
===Exercises=== | ===Exercises=== | ||
[[Kegel exercise]]s to strengthen or retrain [[pelvic floor muscles]] and sphincter muscles can reduce stress leakage.<ref name="pmid17625461">{{cite journal |author=Choi H, Palmer MH, Park J |title=Meta-analysis of pelvic floor muscle training: randomized controlled trials in incontinent women |journal=Nursing research |volume=56 |issue=4 |pages=226-34 |year=2007 |pmid=17625461 |doi=10.1097/01.NNR.0000280610.93373.e1}}</ref> Patients younger than 60 years old benefit the most.<ref name="pmid17625461"/> The patient should do at least 24 daily contractions for at least 6 weeks. A [[systematic review]] concluded "pelvic floor muscle training would resolve 490 cases of stress urinary incontinence."<ref name="Tatyana">Tatyana A. Shamliyan et al., “Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women,” Ann Intern Med (February 11, 2008): http://www.annals.org/cgi/content/full/0000605-200803180-00211v1<ref> | [[Kegel exercise]]s to strengthen or retrain [[pelvic floor muscles]] and sphincter muscles can reduce stress leakage.<ref name="pmid17625461">{{cite journal |author=Choi H, Palmer MH, Park J |title=Meta-analysis of pelvic floor muscle training: randomized controlled trials in incontinent women |journal=Nursing research |volume=56 |issue=4 |pages=226-34 |year=2007 |pmid=17625461 |doi=10.1097/01.NNR.0000280610.93373.e1}}</ref> Patients younger than 60 years old benefit the most.<ref name="pmid17625461"/> The patient should do at least 24 daily contractions for at least 6 weeks.<ref name="pmid17625461"/> A [[systematic review]] concluded "pelvic floor muscle training would resolve 490 cases of stress urinary incontinence."<ref name="Tatyana">Tatyana A. Shamliyan et al., “Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women,” Ann Intern Med (February 11, 2008): http://www.annals.org/cgi/content/full/0000605-200803180-00211v1</ref> | ||
===Medications=== | ===Medications=== | ||
A [[randomized controlled trial]] found that [[trospium]] is effective.<ref name="pmid17632131">{{cite journal |author=Staskin D, Sand P, Zinner N, Dmochowski R |title=Once daily trospium chloride is effective and well tolerated for the treatment of overactive bladder: results from a multicenter phase III trial |journal=J. Urol. |volume=178 |issue=3 Pt 1 |pages=978–83; discussion 983–4 |year=2007 |pmid=17632131 |doi=10.1016/j.juro.2007.05.058}}</ref> | A [[randomized controlled trial]] found that [[trospium]] is effective.<ref name="pmid17632131">{{cite journal |author=Staskin D, Sand P, Zinner N, Dmochowski R |title=Once daily trospium chloride is effective and well tolerated for the treatment of overactive bladder: results from a multicenter phase III trial |journal=J. Urol. |volume=178 |issue=3 Pt 1 |pages=978–83; discussion 983–4 |year=2007 |pmid=17632131 |doi=10.1016/j.juro.2007.05.058}}</ref> | ||
[[Acetylcholine|Anticholinergic drugs]] such as [http://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=oxybutynin oxybutynin] and [http://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=tolterodine tolterodine] are effective according to a [[systematic review]].<ref name="Tatyana">Tatyana A. Shamliyan et al., “Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women,” Ann Intern Med (February 11, 2008): http://www.annals.org/cgi/content/full/0000605-200803180-00211v1<ref> | [[Acetylcholine|Anticholinergic drugs]] such as [http://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=oxybutynin oxybutynin] and [http://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=tolterodine tolterodine] are effective according to a [[systematic review]].<ref name="Tatyana">Tatyana A. Shamliyan et al., “Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women,” Ann Intern Med (February 11, 2008): http://www.annals.org/cgi/content/full/0000605-200803180-00211v1</ref> | ||
===Surgery=== | ===Surgery=== | ||
Revision as of 23:00, 13 February 2008
Urinary incontinence is defined as "Involuntary loss of urine, such as leaking of urine. It is a symptom of various underlying pathological processes."[1]
Classification
Urge incontinence
Stress incontinence
Causes
Incontinence is more common after a hysterectomy.[2]
Treatment
Exercises
Kegel exercises to strengthen or retrain pelvic floor muscles and sphincter muscles can reduce stress leakage.[3] Patients younger than 60 years old benefit the most.[3] The patient should do at least 24 daily contractions for at least 6 weeks.[3] A systematic review concluded "pelvic floor muscle training would resolve 490 cases of stress urinary incontinence."[4]
Medications
A randomized controlled trial found that trospium is effective.[5]
Anticholinergic drugs such as oxybutynin and tolterodine are effective according to a systematic review.[4]
Surgery
Among surgical options, a randomized controlled trial found greater benefit, but more complications from Fascial sling surgery as compared to Burch colposuspension.[6]
References
- ↑ Error on call to Template:cite web: Parameters url and title must be specified. Retrieved on 2007-10-26.
- ↑ Altman D, Granath F, Cnattingius S, Falconer C (2007). "Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study". Lancet 370 (9597): 1494–9. DOI:10.1016/S0140-6736(07)61635-3. PMID 17964350. Research Blogging.
- ↑ 3.0 3.1 3.2 Choi H, Palmer MH, Park J (2007). "Meta-analysis of pelvic floor muscle training: randomized controlled trials in incontinent women". Nursing research 56 (4): 226-34. DOI:10.1097/01.NNR.0000280610.93373.e1. PMID 17625461. Research Blogging.
- ↑ 4.0 4.1 Tatyana A. Shamliyan et al., “Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women,” Ann Intern Med (February 11, 2008): http://www.annals.org/cgi/content/full/0000605-200803180-00211v1
- ↑ Staskin D, Sand P, Zinner N, Dmochowski R (2007). "Once daily trospium chloride is effective and well tolerated for the treatment of overactive bladder: results from a multicenter phase III trial". J. Urol. 178 (3 Pt 1): 978–83; discussion 983–4. DOI:10.1016/j.juro.2007.05.058. PMID 17632131. Research Blogging.
- ↑ Albo ME, Richter HE, Brubaker L, et al (2007). "Burch colposuspension versus fascial sling to reduce urinary stress incontinence". N. Engl. J. Med. 356 (21): 2143–55. DOI:10.1056/NEJMoa070416. PMID 17517855. Research Blogging.