Future directions of urinary incontinence research
Future research on urinary incontinence (UI) should focus on better phenotyping, early disease, risk factor identification, patient-centred research, incorporation of new technologies and prevention, suggests a recent study.
The National Institute of Diabetes and Digestive and Kidney Diseases in the US convened the Summit on Urinary Incontinence Clinical Research in Women in 2014. Participants coming from a broad range of clinical expertise reviewed findings from UI-related studies sponsored by the National Institutes of Health.
They also reviewed results from community-based epidemiological studies such as the Boston Area Community Health (BACH) Survey and from randomized clinical trials such as Program to Reduce Incontinence by Diet and Exercise (PRIDE), and studies conducted by the Pelvic Floor Disorders Network and the Urinary Incontinence Treatment Network.
The BACH Survey results provided fresh insights on precursors, incidence, prevalence and natural history of UI in a diverse group of women.
The Pelvic Floor Disorders Network study, on the other hand, found that anticholinergic medications and onabotulinumtoxinA are effective treatments for urge UI. In addition, Burch colposuspension and retropubic mid urethral polypropylene slings reduce stress UI following pelvic organ prolapse surgery in women with potential stress UI.
The Urinary Incontinence Treatment Network study observed that fascial slings outclass colposuspension, and that retropubic is on a par with transobturator mid urethral polypropylene sling for stress UI.
A preoperative urodynamic study was found to be noninferior to basic office examinations for surgical outcome in patients with stress UI. Female patients were not allowed to discontinue antimuscarinics for urge UI with the addition of behavioural intervention.
Finally, PRIDE indicated that losing weight could significantly reduce UI.