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Ther Adv Chronic Dis 2022 18;13:20406223211063059. Epub 2022 Mar 18.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.

Objective: To determine the effects of nonsurgical, minimally or noninvasive therapies on urge urinary incontinence (UUI) symptoms and quality of life (QoL) in individuals with neurogenic bladder (NGB).

Data Sources: Cochrane library, EMBASE, MEDLINE, PEDro, Scopus, and Web of Science databases were searched from inception to September 2021.

Review Methods: Randomized controlled trials that compared therapies such as intravaginal electrical stimulation (IVES), transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), transcutaneous tibial nerve stimulation (TTNS), pelvic floor muscle training (PFMT), and behavioural therapy (BT) to control were included. Read More

J Urol 2021 11 28;206(5):1184-1191. Epub 2021 Jun 28.

Department of Urology, Weill Cornell Medicine, New York, New York.

Purpose: Salvage radical prostatectomy is rare due to the risk of postoperative complications. We compare salvage Retzius-sparing robotic assisted radical prostatectomy (SRS-RARP) with salvage standard robotic assisted radical prostatectomy (SS-RARP).

Materials And Methods: A total of 72 patients across 9 centers were identified (40 SRS-RARP vs 32 SS-RARP). Read More

Biomed Microdevices 2020 03 17;22(2):26. Epub 2020 Mar 17.

Renovia Inc., Boston, MA, USA.

Urinary incontinence (UI) is experienced by an estimated 51% of women in the U.S. and often results from impaired function or weakening of the pelvic floor muscles. Read More

J Womens Health (Larchmt) 2020 03 29;29(3):383-389. Epub 2019 Aug 29.

Viveve, Inc., Englewood, Colorado.

The purpose of this prospective, investigator-initiated feasibility study is to evaluate the efficacy and safety of nonablative, cryogen-cooled, monopolar radiofrequency (CMRF) treatment for stress urinary incontinence (SUI). Subjects meeting all the inclusion and exclusion criteria were enrolled and divided into two groups. Subjects in Group 1 received a single SUI treatment, and subjects in Group 2 received two SUI treatments ∼6 weeks apart. Read More

J Urol 2019 10 6;202(4):725-731. Epub 2019 Sep 6.

Netherlands Cancer Institute, Amsterdam, Netherlands.

Purpose: Salvage radical prostatectomy has historically yielded a poor functional outcome and a high complication rate. However, recent reports of robotic salvage radical prostatectomy have demonstrated improved results. In this study we assessed salvage radical prostatectomy functional outcomes and complications when comparing robotic and open approaches. Read More

J Gen Intern Med 2019 08 6;34(8):1615-1625. Epub 2019 May 6.

Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM, USA.

Background: Urinary incontinence (UI) is a common malady in women. Numerous nonsurgical treatments are available, each associated with risk of adverse events (AEs).

Methods: We systematically reviewed nonsurgical interventions for urgency, stress, or mixed UI in women, focusing on AEs. Read More

Lasers Med Sci 2019 Sep 4;34(7):1509-1511. Epub 2019 Mar 4.

DIATROS, Clínica de Atención a la Mujer, C/ Aragó 403-405, 08013, Barcelona, Spain.

To alert patients and health care providers about the use of energy-based devices to perform a vaginal "rejuvenation," cosmetic vaginal procedures, or nonsurgical vaginal procedures to treat symptoms related to menopause, urinary incontinence, or sexual function, the US Food and Drug Administration (FDA) has issued a warning about the effectiveness and safety of such devices. We agree with the FDA that certain devices (laser, radiofrequency, etc.) have been marketed inappropriately for uses that are outside of their cleared or approved intended uses. Read More

Int Urogynecol J 2019 Mar 6;30(3):371-376. Epub 2018 Dec 6.

Department of Obstetrics and Gynecology, The American University of Beirut, Beirut, Lebanon.

This committee opinion reviews the laser-based vaginal devices for treatment of genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence. The United States Food and Drug Administration has issued a warning for unsubstantiated advertising and use of energy-based devices. Well-designed case-control studies are required to further investigate the potential benefits, harm, and efficacy of laser therapy in the treatment of genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence. Read More

Eur Urol 2018 04 3;73(4):596-609. Epub 2018 Feb 3.

Department of Urology, University Hospital Bern, Bern, Switzerland.

Context: The European Association of Urology guidelines on urinary incontinence (UI) have been updated in cyclical fashion with successive major chapters being revised each year. The sections on assessment, diagnosis, and nonsurgical treatment have been updated as of mid-2016.

Objective: We present a condensed version of the full guideline on assessment and nonsurgical management of UI, with the aim of improving accessibility and increasing their dissemination. Read More

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

Female Pelvic Med Reconstr Surg 2019 Jan/Feb;25(1):49-55

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.

Objective: The objective of this study was to perform a cost-utility analysis of nonsurgical treatments for stress urinary incontinence (SUI) in healthy adult women with a health system perspective over a 1-year time horizon.

Methods: A decision tree model was constructed to evaluate the following nonsurgical treatment options for SUI in a simulated healthy adult female cohort who had failed Kegel exercises: pelvic floor muscle therapy (PFMT), a disposable tampon device (Impressa), a self-fitting intravaginal incontinence device (Uresta), and a traditional incontinence pessary. Published data and consultation with health care providers were used to estimate efficacies and costs. 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 02 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

J Urol 2017 05 18;197(5):1302-1308. Epub 2016 Nov 18.

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

Purpose: Despite significant differences in success rates between surgical and nonsurgical treatments for female stress urinary incontinence, a few cross-sectional surveys showed that most patients still prefer the latter. We evaluated the efficacy of the under studied nonsurgical treatment using pulsed magnetic stimulation for female stress urinary incontinence.

Materials And Methods: This randomized, double-blind, sham controlled study was performed in 120 female subjects at least 21 years old with stress urinary incontinence. 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

Int Urogynecol J 2014 Apr 10;25(4):517-23. Epub 2013 Oct 10.

University of Chicago, Chicago, USA.

Introduction And Hypothesis: Stress urinary incontinence (SUI) is a common and growing problem among adult women and affects individuals and society through decreased quality of life (QoL), decreased work productivity, and increased health care costs. A new, nonsurgical treatment option has become available for women who have failed conservative therapy, but its cost effectiveness has not been evaluated. This study examined the cost effectiveness of transurethral radiofrequency microremodeling of the female bladder neck and proximal urethra compared with synthetic transobturator tape (TOT), retropubic transvaginal tape (TVT) sling, and Burch colposuspension surgeries for treating SUI. 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