Clinical management of urinary incontinence in women.

نویسندگان

  • Lauren Hersh
  • Brooke Salzman
چکیده

Most cases of urinary incontinence in women fall under one of three major subtypes: urge, stress, or mixed. A stepped-care approach that advances from least invasive (behavioral modification) to more invasive (surgery) interventions is recommended. Bladder retraining and pelvic floor muscle exercises are first-line treatments for persons without cognitive impairment who present with urge incontinence. Neuromodulation devices, such as posterior tibial nerve stimulators, are an option for urge incontinence that does not respond to behavioral therapy. Pharmacologic therapy with anticholinergic medications is another option for treating urge incontinence if behavioral therapy is unsuccessful; however, because of adverse effects, these agents are not recommended in older adults. Other medication options for urge incontinence include mirabegron and onabotulinumtoxinA. Sacral nerve stimulators, which are surgically implanted, have also been shown to improve symptoms of urge incontinence. Pelvic floor muscle exercises are considered first-line treatment for stress incontinence. Noninvasive electrical and magnetic stimulation devices are also available. Alternatives for treating stress incontinence include vaginal inserts, such as pessaries, and urethral plugs. Limited or conflicting evidence exists for the use of medications for stress incontinence; no medications are approved by the U.S. Food and Drug Administration for this condition. Minimally invasive procedures, including radiofrequency denaturation of the urethra and injection of periurethral bulking agents, can be used if stress incontinence does not respond to less invasive treatments. Surgical interventions, such as sling and urethropexy procedures, should be reserved for stress incontinence that has not responded to other treatments.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Effects of pelvic floor muscle exercises on quality of life outcomes in women with stress urinary incontinence

 Absract  Background: Stress urinary incontinence is a common problem in the middleaged  women and can affect their quality of life. This study evaluated the effects of  pelvic floor muscle exercise on quality of life outcomes in women with stress urinary  incontinence .  Methods: After baseline evaluation, 50 women were assigned for this clinical trial .  Participants were instructed to do pel...

متن کامل

The effect of Estrogen and Imipramine therapy on the strees urinary incontinence (SUI) in menopaused women

Background: Women spend more than One – third of their life in postmenstrual period and more than 50% of them have urogenital problems in this period. The most common type of urinary incontinence in women is stress urinary incontinence and middle aged women are the most affected persons. Materials and methods: We treated 93 menopaused women during 3 months. There were three groups and each gro...

متن کامل

Comparison of Effect of Anterior Colporrhaphy and Transobturator Tape Surgeries on Urinary Incontinence and Sexual Performance in Women

Aims: Pelvic floor disorders such as urinary incontinence and pelvic and genital prolapse affect sexual function and quality of life. The aim of the present study was to compare the effect of anterior colporrhaphy and transobturator tape (TOT) surgeries on urinary incontinence and sexual function in women. Materials&Methods: This retrospective cohort clinical trial study was performed on 136 w...

متن کامل

The Effect of Education Based on Family-Centered Empowerment Model on the Self-Care Behaviors of the Women Suffering from Stress Urinary Incontinence

Introduction: Stress urinary incontinence (SUI) is a common health problem in women which is not revealed to the family most of the times. One of the ways for promoting the health level is taking into account the individuals’ level of self-care behaviors which was examined in this study. SO in this study, the impact of family-centered empowerment model on quality of life in women with stress ur...

متن کامل

بررسی تأثیر استفاده از دستگاه کیگل ماستر و ورزش کیگل بر بی‌اختیاری ادراری زنان در سنین باروری و مقایسه آنان

Background: Urinary incontinence is one of the most common complaints in women that can has serious influence on the quality of their lives. The purpose of the present study is to evaluate the effect of Kegel exercise with and without Kegelmaster device on the Stress Urinary Incontinence (SUI) in women and making a comparison between these two methods.Methods: A randomized clinical trial was pe...

متن کامل

Prevalence of Urinary Incontinence among Elderly Women in Yazd, Iran: A Population-Based Study

Introduction: Urinary incontinence (UI) is a common disorder among aging population especially women. Women are at more risk of UI than men, because of anatomic, social and cultural status and also because of pregnancy, delivery and menopause. Regarding lack of studies in the area in Yazd, the study aimed to find the prevalence and related factors to UI among aging women in Yazd city, Iran. ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • American family physician

دوره 87 9  شماره 

صفحات  -

تاریخ انتشار 2013