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Posted by on Apr 18, 2019 in Urinary incontinence | 0 comments

In a nutshell

This study examined which therapy, or combination of therapies, is most effective in treating urinary incontinence (UI) in women. This study concluded that behavioral therapy alone, or combined with another therapy, is more effective than medication alone in treating UI in women.  

Some background

Urinary incontinence (UI) is the unintentional loss of urine. It has a number of different causes. These include weak bladder muscles (stress UI), overactive bladder muscles (urgency UI) or a combination of these two factors (mixed). UI is a common condition among women. 

There are many treatment options for UI. These include medications, behavioral therapies, and neuromodulation (nerve stimulation). Medications include anticholinergics, hormones and alpha agonists. Neuromodulation involves treatment to block certain nerve signals to the bladder muscle. The end result is a reduction in the urge to urinate. Other therapies such as Botox (injected into the bladder) and bulking agents (injected close to the urethra) can also be used. 

It is not known which is the best treatment for UI in women.

Methods & findings

This study examined the results of 84 clinical trials. These trials looked at different treatments for UI. 

Behavioral therapies, anticholinergics, and nerve stimulation were the most common treatments. These were more effective than no treatment. 

In stress UI behavioral therapy was more effective than medications in curing or improving symptoms. Alpha-agonists were more effective than hormones in achieving improvement. Nerve stimulation was more effective than no treatment.

In urgency UI behavioral therapy was more effective than anticholinergics in curing or improving symptoms. Nerve stimulation and Botox were more effective than no treatment. Botox may have been more effective than nerve stimulation.

The bottom line

This study concluded that behavioral therapy with or without another therapy is more effective than medication alone in treating UI in women.

The fine print

This analysis examined different studies looking at many different therapies. It is difficult to directly compare the results of these studies.

Published By :

Annals of internal medicine

Date :

Mar 19, 2019

Original Title :

Pharmacologic and Nonpharmacologic Treatments for Urinary Incontinence in Women: A Systematic Review and Network Meta-analysis of Clinical Outcomes.

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