Efficacy of Conservative Treatments for Urinary Incontinence in Women
Study Details
Study Description
Brief Summary
To conduct a retrospective study to examine the effect of these conservative treatments to the symptoms and quality of life of patients with urinary incontinence. The investigators will use both subjective and objective assessment parameters, such as self-report symptoms, bladder diary, pad test and urodynamic study to access the improvement.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Urinary incontinence is a common problem among women. The main types include stress incontinence, urge incontinence, and overflow incontinence. Other underlying pathology, such as cancer or neurologic disease can also cause urinary incontinence. To limit the medical expenses and possible complications of surgical treatment, the current treatment guidelines recommend conservative treatment as the first choice. According to American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) guidelines, the first-line treatment for non-neurologic overactive bladder should be behavioral therapy, such as bladder training, water restriction, and pelvic floor muscle training, physiological feedback, pessary, etc. Bladder training aims to increase the time interval between voids, and to increase the bladder capacity by self-adjusted schedules. Pelvic floor muscle training strengthens the pelvic floor muscles to provide urethral support to prevent urine leakage and suppress urgency. There is strong evidence that pelvic floor muscle training is beneficial for stress urinary incontinence.
The second-line treatment is medication, including anticholinergic drugs and ß3 adrenoceptor-acting agents. Anticholinergic drugs can reduce bladder detrusor contraction, and ß3 adrenoceptor-acting agents can relax the detrusor and increase bladder capacity.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Bladder training (BT) Data obtained before and after the training. |
Procedure: BT
A program of BT (including exercise and muscle training)
|
| biofeedback-assisted pelvic floor muscle training (bPFMT) Data obtained before and after the training. |
Procedure: bPFMT
A bPFMT program at home
|
| intra-vaginal electric stimulation (iVES) Data obtained before and after the training. |
Procedure: iVES
An iVES program at home
|
| BT+bPFMT Data obtained before and after the training. |
Procedure: BT + bPFMT
Combination of BT and bPFMT
|
| BT+iVES Data obtained before and after the training. |
Procedure: BT + iVES
Combination of BT and iVES
|
| bPFMT+iVES Data obtained before and after the training. |
Procedure: bPFMT + iVES
Combination of bPFMT and iVES
|
Outcome Measures
Primary Outcome Measures
- Urodynamic study (intravesical pressure) [form the baseline to the post-treatment measurement (about 6 month post)]
intravesical pressure (cmH2O)
- Urodynamic study (abdominal pressure) [form the baseline to the post-treatment measurement (about 6 month post)]
abdominal pressure (cmH2O)
- Urodynamic study (detrusor pressure) [from the baseline to the post-treatment measurement (about 6 month post)]
detrusor pressure (cmH2O)
- Urodynamic study (Infused volume) [from the baseline to the post-treatment measurement (about 6 month post)]
infused volume (ml)
- Urodynamic study (voided volume) [from the baseline to the post-treatment measurement (about 6 month post)]
voided volume (ml)
- Pad test [from the baseline to the post-treatment measurement (about 6 month post)]
The weight of Pad (g) before and after testing
- Bladder diary (voiding frequency) [from the baseline to the post-treatment measurement (about 6 month post)]
the daily voiding frequency (times)
- Bladder diary (voiding volume) [from the baseline to the post-treatment measurement (about 6 month post)]
the daily voiding volume (ml)
- Questionaire (UDI-6) [from the baseline to the post-treatment measurement (about 6 month post)]
The urogenital distress inventory-6 (UDI-6)
- Questionaire (IIQ-7) [from the baseline to the post-treatment measurement (about 6 month post)]
incontinence impact questionnaire-7 (IIQ-7)
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Adult female patient diagnosed with urinary incontinence through clinical assessment
-
Diagnosed at Mackay Memorial Hospital and underwent non-surgical treatment and subsequent follow-up.
Exclusion Criteria:
-
Choosing invasive or surgical treatment options (such as bladder botulinum toxin injection, urethral sling surgery).
-
Unable to comply with regular follow-up for at least one year.
-
Pregnant women
-
Patients with a history of neuromuscular disorders.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Obstetrics and Gynecology | New Taipei City | Taiwan |
Sponsors and Collaborators
- Mackay Medical College
Investigators
- Study Chair: Hui-Hsuan Lau, M.D., Department of Ear, Nose, and Throat, MacKay Memorial Hospital, Taipei, Taiwan
Study Documents (Full-Text)
None provided.More Information
Publications
- Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017 Jul 6;3:17042. doi: 10.1038/nrdp.2017.42. Erratum In: Nat Rev Dis Primers. 2017 Nov 16;3:17097.
- Denisenko AA, Clark CB, D'Amico M, Murphy AM. Evaluation and management of female urinary incontinence. Can J Urol. 2021 Aug;28(S2):27-32.
- Lin HY, Tsai HW, Tsui KH, An YF, Lo CC, Lin ZH, Liou WS, Wang PH. The short-term outcome of laser in the management of female pelvic floor disorders: Focus on stress urine incontinence and sexual dysfunction. Taiwan J Obstet Gynecol. 2018 Dec;57(6):825-829. doi: 10.1016/j.tjog.2018.10.010.
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019 Dec;31(6):485-493. doi: 10.1097/GCO.0000000000000584.
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