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Urology 2018 Jul 12;117:9-17. Epub 2018 Jan 12.

Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH; Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH. Electronic address:

Minimally invasive stem cell therapy for stress urinary incontinence may provide an effective nonsurgical treatment for this common condition. Clinical trials of periurethral stem cell injection have been under way, and basic science research has demonstrated the efficacy of both local and systemic stem cell therapies. Results differ as to whether stem cells have a therapeutic effect by differentiating into permanent, functional tissues or exert benefits through a transient presence and the secretion of regenerative factors. Read More

Int Urogynecol J 2018 07 25;29(7):997-1004. Epub 2017 Jul 25.

School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.

Introduction And Hypothesis: We evaluated patients' perception and satisfaction with nonsurgical pulsed magnetic stimulation (PMS) for treatment of female stress urinary incontinence (SUI) in a randomized, double-blind, sham-controlled trial.

Methods: Women with SUI (n = 120) were randomized to either active or sham PMS for 8 weeks (twice/week). Patients answered seven questions on their perception and acceptability, each measured on a 5-point Likert scale. Read More

Eur Urol Focus 2016 Jun 4;2(2):158-171. Epub 2015 Oct 4.

Department of Urology, Addenbrooke's University Hospital, Cambridge, UK; Academic Urology Group, Department of Surgery and Oncology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK. Electronic address:

Context: In the absence of randomised controlled trials comparing the oncologic, toxicity, and functional outcomes of salvage radical prostatectomy (SRP), salvage high-intensity focused ultrasound (SHIFU), salvage brachytherapy (SBT), and salvage cryotherapy (SCT), controversy exists as to the optimal salvage modality in radiorecurrent prostate cancer.

Objective: We carried out a meta-regression analysis to determine whether there is a difference in oncologic, toxicity, and functional outcomes using data from original publications of salvage modalities in the postradiation setting.

Evidence Acquisition: We performed a systematic review of PubMed/Medline citations according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Read More

J Tissue Eng Regen Med 2018 Feb 2;12(2):e1108-e1121. Epub 2017 Aug 2.

Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation.

Stress urinary incontinence (SUI) significantly diminishes the quality of patients' lives. Currently available surgical and nonsurgical therapies remain far from ideal. At present, advances in cellular technologies have stirred growing interest in the use of autologous cell treatments aimed to regain urinary control. Read More

Female Pelvic Med Reconstr Surg 2017 Mar/Apr;23(2):108-113

From the Divisions of *Gynecologic Surgery and †Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.

Objectives: This study evaluated our experience after implementing a pelvic floor rehabilitation program including behavioral modification, biofeedback, and vaginal electrogalvanic stimulation (EGS).

Methods: This prospective cohort study evaluated outcomes of patients with pelvic floor dysfunction (urinary or defecatory dysfunction, pelvic pain/dyspareunia) who underwent pelvic floor rehabilitation. Patients received 4 to 7 sessions (1 every 2 weeks) including biofeedback and concluded with 30 minutes of vaginal EGS. Read More

Rev Urol 2015 ;17(3):129-39

Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

Urinary incontinence in women has a high prevalence and causes significant morbidity. Given that urinary incontinence is not generally a progressive disease, conservative therapies play an integral part in the management of these patients. We conducted a nonsystematic review of the literature to identify high-quality studies that evaluated the different components of conservative management of stress urinary incontinence, including behavioral therapy, bladder training, pelvic floor muscle training, lifestyle changes, mechanical devices, vaginal cones, and electrical stimulation. Read More

Female Pelvic Med Reconstr Surg 2016 Jan-Feb;22(1):7-10

From the *Division of Urogynecology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA; †Division of Urogynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; ‡Division of Urogynecology, Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Irvine, CA; §Division of Statistics, School of Public Health, University of Michigan, Ann Arbor, MI; and ∥Division of Urogynecology, Department of Obstetrics and Gynecology, Vanderbilt University, Nashville, TN.

Objective: The aim of the study was to determine whether surgeon case volume is associated with preoperative evaluation of pelvic organ prolapse before a hysterectomy for uterovaginal prolapse including a complete objective evaluation of prolapse (Baden-Walker or Pelvic Organ Prolapse Quantification), an offer of nonsurgical options for therapy (pessary), and a preoperative assessment of urinary incontinence

Methods: We performed a multicenter retrospective review of hysterectomies done for uterovaginal prolapse at 4 hospital systems between January 1, 2008 and December 31, 2011. The number of hysterectomies per surgeon for 4 years was evaluated to establish low-volume (≤10 cases), intermediate-volume (11-49 cases), and high-volume (≥50 cases) groups. Rates of preoperative standardized prolapse evaluations, offer of pessary, and evaluation of stress urinary incontinence were determined by chart review of 15% of the hysterectomy cases. Read More

Clin Geriatr Med 2015 Nov;31(4):471-85

Department of Urology, The Landon Center on Aging, School of Medicine, The University of Kansas, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA. Electronic address:

Urinary incontinence is a prevalent condition in elderly women with significant associated morbidity. Incontinence can by grouped into several types: stress incontinence, urgency incontinence, overflow incontinence, functional incontinence, and mixed urinary incontinence. Careful evaluation, including history and physical examination, is critical to making the correct diagnosis and guiding therapy. Read More

Trials 2015 Sep 8;16:400. Epub 2015 Sep 8.

Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.

Background: The position of invasive urodynamic testing (IUT) in diagnostic pathways for urinary incontinence is unclear, and systematic reviews have called for further trials evaluating clinical utility. The objective of this study was to inform the decision whether to proceed to a definitive randomised trial of IUT compared to clinical assessment with non-invasive tests, prior to surgery in women with stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI).

Methods: A mixed methods study comprising a pragmatic multicentre randomised pilot trial, a qualitative face-to face interview study with patients eligible for the trial, an exploratory economic evaluation including value of information study, a survey of clinicians' views about IUT, and qualitative telephone interviews with purposively sampled survey respondents. Read More

Urology 2015 Apr;85(4):932-6

Division of Urologic Surgery, Department of Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO.

Objective: To review our experience with nonmuscle flap repairs of enterourinary fistulae (EUF) and urinary cutaneous fistulae (UCF). EUF and UCF can be treated either with temporary urinary diversion allowing for healing by secondary intention or primary closure of the defect using an interposing omental, sliding, or muscle flap. Even after successful fistula repair, permanent urinary diversion can be required because of persistent urinary incontinence. Read More

Ann Intern Med 2014 Sep;161(6):I-34

Ann Intern Med 2014 Sep;161(6):429-40

Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the nonsurgical management of urinary incontinence (UI) in women.

Methods: This guideline is based on published English-language literature on nonsurgical management of UI in women from 1990 through December 2013 that was identified using MEDLINE, the Cochrane Library, Scirus, and Google Scholar. The outcomes evaluated for this guideline include continence, improvement in UI, quality of life, adverse effects, and discontinuation due to adverse effects. Read More

FP Essent 2014 Apr;419:28-34

University of Oklahoma Department of Family and Preventive Medicine, 900 NE 10th St, Oklahoma City, OK 73104,

Rectal prolapse, the protrusion of the layers of the rectal wall through the anal canal, may be partial (mucosal) or complete (full thickness). Although prolapse is most common among older women, it affects individuals of all ages, including children. Associated fecal incontinence and constipation are typical. Read More

Int Urogynecol J 2014 Jul 6;25(7):883-91. Epub 2014 Feb 6.

Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, G40BA, UK,

Introduction And Hypothesis: There is evidence that in nonsurgical populations, pelvic floor muscle training (PFMT) and lifestyle advice improves symptoms and stage of pelvic organ prolapse (POP). Some women, however, require surgery, after which de novo symptoms can develop or additional surgery is required due to recurrence. Robust evidence is required as to the benefit of perioperative PFMT in the postsurgery reduction of symptoms and POP recurrence. Read More

Female Pelvic Med Reconstr Surg 2013 Sep-Oct;19(5):260-5

Department of Obstetrics, Gynecology, and Women's Health, University of Missouri School of Medicine, Columbia, MO, USA.

Objective: The authors' intent was to determine the clinical efficacy of comprehensive pelvic floor rehabilitation among women with symptoms of pelvic floor dysfunction (PFD).

Methods: We performed a retrospective analysis of women referred to an academic female pelvic medicine and reconstructive surgery practice for PFD. Data were gathered from the records of 778 women referred for pelvic floor therapy for urinary, bowel, pelvic pain, and sexual symptoms over the course of 4 years. Read More

JAMA Intern Med 2013 Aug;173(15):1463-4

Department of Medicine, University of California, San Francisco.

Eur Urol 2014 May 30;65(5):907-14. Epub 2013 Apr 30.

Hospices Civils de Lyon, Department of Urology and Transplantation Surgery, Edouard Herriot Hospital, Lyon, France; Inserm, U1032, LabTau, Université de Lyon, Lyon, France.

Background: High-intensity focused ultrasound (HIFU) is a nonsurgical therapy for selected patients with localized prostate cancer (PCa).

Objective: The long-term oncologic and morbidity outcomes of primary HIFU therapy for localized PCa were evaluated in a prospective, single-arm, single-institution cohort study.

Design, Setting, And Participants: Participants were patients treated with HIFU for localized PCa from 1997 to 2009. Read More

Female Pelvic Med Reconstr Surg 2012 Mar-Apr;18(2):118-21

Departments of Obstetrics & Gynecology and Urology, Loyola University Chicago, IL, USA.

Objective: The objective of this study was to determine if differences exist in pelvic symptom distress and impact on women randomized to pessary versus behavioral therapy for treatment of stress urinary incontinence (SUI).

Methods: Change in symptom and condition-specific health-related quality-of-life (HRQOL) measures were compared between pessary and behavioral groups 3 months after randomization in the Ambulatory Treatments for Leakage Associated With Stress Incontinence trial. Four hundred forty-six women with symptoms of SUI were randomized to continence pessary, behavioral therapy (pelvic floor muscle training and continence strategies) or combination therapy. Read More

Rev Prat 2011 Sep;61(7):968-71

Centre mutualiste de Kerpape, 56275 Ploemeur Cedex.

Female urinary incontinence can be improved by nonsurgical pharmacologic as well as non-pharmacologic treatments. Hygiene and dietary rules apply to all forms of incontinence. If overweight, weight loss improves stress urinary incontinence. Read More

Adv Urol 2011 23;2011:176498. Epub 2011 Jun 23.

Section of Urogynecology, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.

Objective. To evaluate long-term effectiveness and safety of conservative and minimally invasive outpatient treatments for female stress urinary incontinence (SUI) through a review of the literature. Methods. Read More

BMC Pregnancy Childbirth 2010 Nov 10;10:73. Epub 2010 Nov 10.

Fistula Care Project, EngenderHealth, 440 9th Ave, New York, NY, USA.

Background: Maternal outcomes in most countries of the developed world are good. However, in many developing/resource-poor countries, maternal outcomes are bleaker: Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. Read More

Neurourol Urodyn 2010 Nov;29(8):1424-8

Illinois Urogynecology, Ltd, Oak Lawn, Illinois 60453-2345, USA.

Aims: To evaluate 18-month safety and durability of efficacy of nonsurgical transurethral collagen denaturation as treatment for stress urinary incontinence (SUI) in women.

Methods: Study comprised women with SUI due to bladder outlet hypermobility for at least 12 months who failed conservative treatment and had not undergone surgery or bulking agent treatment. This one-time procedure was performed in a physician's office or ambulatory treatment center. Read More

Curr Urol Rep 2010 Mar;11(2):109-13

Division of Urology, Children's Hospital of Philadelphia, Wood Center, 3rd Floor, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.

The nonsurgical management of patients with spina bifida is predicated on maintaining a compliant bladder of adequate size or correcting detrusor sphincter dyssynergy that can lead to progressive bladder damage and ultimately upper tract changes. Pharmacologic management, targeted at the detrusor and/or external sphincter, can be done. Neuromodulation using transcutaneous approaches with interferential electrostimulation, sacral (S2-S3) via digital transcutaneous electrical nerve stimulation, and percutaneous tibial nerve stimulation all have shown varied successes. Read More

Curr Urol Rep 2009 Sep;10(5):369-74

Department of Urology, Vanderbilt University Medical Center, Room A, 1302 Medical Center North, Nashville, TN 37232, USA.

Stress urinary incontinence (SUI) is a socially disabling disorder that affects a large population of women around the world. Surgical treatments for SUI typically seek to recapitulate the support of the endopelvic fascia and reduce urethral hypermobility or improve urethral compressive forces. Radio-frequency energy is a potent tool for such treatment, as it is in other medical specialties. Read More

J Minim Invasive Gynecol 2009 Jan-Feb;16(1):56-62. Epub 2008 Nov 13.

Illinois Urogynecology Ltd, Oak Lawn, Illinois, USA.

Study Objective: To assess efficacy of nonsurgical transurethral collagen denaturation (Renessa) in women with stress urinary incontinence (SUI) caused by bladder outlet hypermobility.

Design: Continuing, prospective, 36-month, open-label, single-arm clinical trial. Twelve-month results from intent-to-treat (ITT) analysis are reported. Read More

Curr Urol Rep 2008 Sep;9(5):373-9

Scott Department of Urology, Baylor College of Medicine, 6400 Fannin Street, Suite 2300, Houston, TX 77030, USA.

Transurethral collagen denaturation was approved by the US Food and Drug Administration in 2005 for the nonsurgical treatment of stress urinary incontinence in women. In this procedure, controlled, nonablative radiofrequency energy applied through a transurethral probe produces microscopic submucosal sites of collagen denaturation, resulting in reduced tissue compliance. Treatment is administered in about 30 minutes in an outpatient setting without incisions, general anesthesia, or use of cystoscopy or other visualization. Read More

BJOG 2008 Jul;115(8):1062-3; author reply 1063

BJOG 2008 Mar;115(4):435-44

Department of Obstetrics and Gynaecology, Birmingham Women's Hospital, Birmingham, UK.

Background: The guidance on SUI has not been rigorously assessed using GRADE system.

Objective: To determine if the quality and results of existing systematic reviews on conservative treatment of stress urinary incontinence (SUI) can underpin evidence-based recommendations for practice.

Study Design: Review of systematic reviews. Read More

Ann Intern Med 2008 Mar 11;148(6):459-73. Epub 2008 Feb 11.

Division of Health Policy and Management, University of Minnesota School of Public Health, D351 Mayo (MMC 197), 420 Delaware Street SE, Minneapolis, MN 55455, USA.

Background: Urinary incontinence in women is a common problem that adversely affects quality of life.

Purpose: To synthesize evidence of management of urinary incontinence in women.

Data Sources: MEDLINE, CINAHL, and the Cochrane Library. Read More

Womens Health (Lond) 2007 Nov;3(6):725-33

Illinois Urogynecology, Ltd, 5716 W 95th Street, Oak Lawn, IL 60453-2345, USA.

Stress urinary incontinence affects women of all ages, becoming more prevalent with increasing age. While many nonsurgical therapies are available for the treatment of stress urinary incontinence, options are limited for women who fail to respond to these therapies yet may not be candidates for, or wish to avoid, surgery. This limitation prompted efforts to develop less-invasive procedures for treating stress urinary incontinence patients, including bulking-agent injections and a new transurethral, radiofrequency collagen-denaturation system. Read More

Urology 2007 Sep;70(3):548-53

Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Objectives: To assess the rate and predictive factors of urinary retention after iodine 125 brachytherapy for localized prostate cancer.

Methods: Between 1998 and 2006, 655 patients with localized prostate cancer (T1-2, Gleason score 7 or less) were treated with brachytherapy at our institution. 42% received neoadjuvant hormonotherapy for prostate downsizing or when brachytherapy was combined with external beam radiation (10%). Read More

Int J Gynaecol Obstet 2007 Nov 4;99 Suppl 1:S57-64. Epub 2007 Sep 4.

Johns Hopkins Bayview Medical Center, Department of Obstetrics and Gynecology, Baltimore, Maryland, USA.

Objective: To provide a comprehensive review of the pathophysiology, evaluation, and treatment of gynatresia and urinary incontinence, 2 conditions that can arise following the repair of obstetric fistulas. The article discusses relevant issues with respect to urinary diversion in the treatment of obstetrical fistula and associated urinary incontinence.

Methods: A review was conducted of the existing literature and of the expert recommendations issued at the Gates Institute fistula meeting held in July 2005 at the Johns Hopkins Bloomberg School of Public Health. Read More

J Med Assoc Thai 2005 Oct;88 Suppl 2:S124-8

Department of Obstetrics & Gynaecology, Faculty of Medicine, Ramathibodi Hospital.

Urogynaecology is dedicated to the treatment of women with pelvic floor dysfunction such as urinary orfecal incontinence and prolapse (bulging or falling) of the vagina, bladder and/or the uterus. Pelvic organ prolapse simply means displacement from the normal position. On average, 11% of women will undergo surgery for this condition. Read More

Expert Rev Med Devices 2006 Nov;3(6):743-8

Novasys Medical Inc, Newark, CA 94560, USA.

Many women with stress urinary incontinence seek a nonsurgical, well-tolerated, effective and durable treatment that is associated with a rapid recovery and improvement in quality of life. However, the nonsurgical options available, such as pelvic floor exercises or behavioral therapy, are typically not effective; thus, many women with the condition remain untreated. A new nonsurgical treatment, transurethral radiofrequency collagen remodeling, offers many patient-desired treatment characteristics. Read More

Rev Urol 2004 ;6 Suppl 3:S29-47

Treatment options for stress urinary incontinence (SUI) in women are designed to prevent the involuntary loss of urine from the urethra during increases in intraabdominal pressure that occur during physical activity, coughing, or sneezing. Effective nonsurgical therapies include behavioral therapy (eg, bladder training, fluid and dietary modification) and drug therapy. Surgical therapy for this condition has existed for well over 100 years. Read More

Rev Urol 2002 ;4(1):1-11

The incidence of urinary incontinence and overactive bladder problems will continue to grow as the population ages. Future treatments are likely to include an implantable drug delivery system, gene therapy, and the intravesical use of the vallinoids capsaicin and resiniferatoxin (RTX). An understanding of the urothelium is essential for effective design of these therapies. Read More

J Minim Invasive Gynecol 2005 Sep-Oct;12(5):415-9

Tacoma Women's Specialists, Tacoma, Washington 98405, USA.

Study Objective: To demonstrate the feasibility, safety, and patient comfort associated with nonsurgical radiofrequency-energy (RF) tissue micro-remodeling in women with stress urinary incontinence (SUI) given oral and local anesthesia.

Design: Prospective, open-label pilot clinical trial (Canadian Task Force classification II-2).

Setting: Department of urology in a major academic teaching hospital in Mexico City, Mexico. Read More

Drugs 2004 ;64(14):1503-16

Western Clinical Research Inc., 23441 Madison Street, Suite 130, Torrance, CA 90505, USA.

Stress urinary incontinence (SUI) is the accidental leakage of urine associated with physical activities such as running, jumping or lifting, or with sneezing and coughing. Worldwide, SUI is a highly prevalent condition, both in young and elderly women, and is a condition fraught with social isolation, loss of self-esteem and significant financial burden. Most women with SUI assume that it is an inevitable part of aging and "suffer in silence", relying on absorbent pads or lifestyle changes to cope with their condition. Read More

Clin Obstet Gynecol 2004 Mar;47(1):70-82

Department of Physical Therapy, Rangos School of Health Sciences Duquesne University, Pittsburgh, Pennsylvania 15282, USA.

Int Urogynecol J Pelvic Floor Dysfunct 2004 Mar-Apr;15(2):106-10; discussion 110. Epub 2004 Feb 3.

Kvinno Centre, Suite 14 ASurgicentre, 38 Meadowvale Ave, 6151, South Perth, WA, Australia.

The normal pelvic floor functions as a balanced synergistic system composed of muscle, connective tissue (CT), and nerve components, with CT being the most vulnerable. The aim was to address a wide range of pelvic floor dysfunctions by strengthening all possible components of the system with minimal time loss, weaving every element of treatment seamlessly into a daily routine. The study group consisted of patients from a tertiary referral pelvic floor clinic who, after testing, opted for nonsurgical treatment of their problem. Read More

Clin Neurol Neurosurg 2004 Mar;106(2):82-7

Department of Neurosurgery, University Hospital, Klinikum Mannheim, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany.

Primary central nervous system lymphoma (PCNSL) is a rare and highly malignant tumor with increasing incidence. Survival has improved with the use of nonsurgical treatment modalities, of which methotrexate (MTX)-based intrathecal chemotherapy has been an important option. Here, we describe devastating complications in three patients with diffuse large B-cell lymphomas. Read More

Curr Womens Health Rep 2002 Aug;2(4):291-7

Division of Urogynecology, David Grant Medical Center, 101 Bodin Circle, Travis Air Force Base, CA 94535, USA.

Stress urinary incontinence is defined as the symptomatic loss of urine related to increases in intra-abdominal pressure. A variety of nonsurgical therapies with varying degrees of effectiveness and patient acceptance are available. If nonsurgical therapies fail, then multiple surgical options exist, including retropubic urethropexy, bulking agents, pubovaginal slings, and sling variants. Read More

Tech Urol 2001 Sep;7(3):246-8

Department of Surgery, Medical College of Pennsylvania, Philadelphia, USA.

Incontinence is a frequent complication of continent cutaneous urinary diversion that usually requires surgical intervention for correction. We report a novel nonsurgical therapy for reservoir incontinence in a woman who underwent anterior pelvic exenteration with formation of an Indiana pouch urinary diversion for treatment of adenocarcinoma of the urethra. When she subsequently developed urinary incontinence that was only partially responsive to anticholinergic therapy, stomal continence was restored by using a disposable urethral occlusion device. Read More

Drugs Aging 2001 ;18(3):213-23

Leicestershire MRC Incontinence Study, Department of Epidemiology and Public Health, University of Leicester, England.

Urinary incontinence is an area of clinical and social importance to older people and providers of care. This article provides an update on the 'symptom' of urinary incontinence and reviews the concept of lower urinary tract symptoms (LUTS). The challenges facing health services researchers working in this field are also discussed in terms of trying to quantify the size and extent of the underlying problem. Read More

Eur J Obstet Gynecol Reprod Biol 2001 Feb;94(2):264-9

Kvinno Centre, Suite 14A Surgicentre, 38 Ranelagh Creasant, South Perth, WA 6151, Australia.

A new approach to pelvic floor rehabilitation is presented. The aim was to strengthen the three directional muscle forces observed during effort along with their ligamentous insertions. A new anatomical classification guided diagnosis of anatomical defects in the anterior, middle and posterior compartments of the vagina. Read More

Eur Urol 2000 Mar;37(3):318-24

Department of Urology, Kouga Public Hospital, Shiga, Japan.

Objective: We examined the prognostic factors for longterm maintenance of continence following nonsurgical treatments in hospitalized patients with urinary incontinence.

Methods: 313 inpatients (average age: 64 years) in whom urinary incontinence had originally been managed with diapers (n = 158) or indwelling Foley catheters (n = 155) first received nonsurgical rehabilitative treatments. The patients who became continent with these treatments were then evaluated for being either continuously continent or recurrently incontinent during the 5-year follow-up period after discharge from hospital. Read More

Urol Nurs 1999 Jun;19(2):135-40

Continence Center, Lahey Clinic Medical Center, Burlington, MA, USA.

Stress urinary incontinence affects millions of women. Many treatment options are available, ranging from behavioral or nonsurgical therapies to surgical intervention. The clinical findings of a multicenter trial using the CapSure (Re/Stor) continence shield to evaluate the safety and efficacy of this device for treating women with stress urinary incontinence are reported here. Read More

J Gerontol A Biol Sci Med Sci 1999 Mar;54(3):M117-21

Department of Obstetrics and Gynecology, University of Wisconsin-Madison, USA.

Background: Although urinary incontinence affects up to 35% of community-dwelling elderly women, the long-term efficacy of conservative treatment in this population is unknown.

Methods: Between April 1991 and January 1994, 81 community-dwelling women over age 60 underwent nonsurgical incontinence treatment that included pelvic muscle exercises, bladder retraining, estrogen replacement, biofeedback, functional electrical stimulation, and pharmacologic therapy. Information about intercurrent medical problems, urogynecologic diagnoses, treatment recommendations, and provider-documented outcome were collected from medical records. Read More

Obstet Gynecol Clin North Am 1998 Dec;25(4):849-65, vii

Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA.

In the 50 years since pelvic muscle exercises were introduced for the nonsurgical management of pelvic floor dysfunction related to parturition, a variety of approaches have been introduced and the scope of indications has grown. This article describes the evaluation of patients with pelvic floor complaints, discusses additional techniques for performing pelvic muscle exercises including biofeedback and electrical stimulation, details a comprehensive educational program, and examines the literature on the use of pelvic muscle exercises for the treatment of stress and urge urinary incontinence. Read More