Management of urinary incontinence in women with overactive bladder in urologist daily practice

2021 ◽  
Vol 14 (2) ◽  
pp. 169-175
Author(s):  
Tomasz Wiatr ◽  
Piotr Chłosta
Keyword(s):  
Urinary Incontinence ◽  
Overactive Bladder ◽  
Older Women ◽  
Lifestyle Modification ◽  
Treatment Options ◽  
Daily Practice ◽  
Bladder Function ◽  
Patient Goals ◽  
Age Related ◽  
Bladder Management

Urinary incontinence urinary incontinence is common among women and contributes to decreased quality of life. Several effective treatment options are available for the most common types of urinary incontinence (stress, urge, and mixed), including lifestyle modification and behavioral technique, drug therapy, and minimally invasive procedures. Most women improve with treatment, and urinary incontinence is not an inevitable part of aging. To maximize the opportunity for successful treatment, it is essential to align the therapeutic approach with patient goals and expectations for care, including an assessment of patient-driven priorities regarding potential adverse effects, costs, and expected benefit of different treatment approaches. There are many unique challenges in treating an overactive bladder in older women, such as functional and cognitive impairment, multimorbidity, polypharmacy, and estrogen deficiency, all of which contribute to treating symptoms in older women. This review highlights the current understanding of age-related changes in bladder function and proposes specific clinical considerations for overactive bladder management specific to older women.

scholarly journals Management of overactive bladder review: the role of percutaneous tibial nerve stimulation

2017 ◽  
Vol 25 (4) ◽  
pp. 245-54
Author(s):  
Elita Wibisono ◽  
Harrina E. Rahardjo
Keyword(s):  
Overactive Bladder ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Botulinum Toxin Injection ◽  
Treatment Options ◽  
Bladder Function ◽  
World Population ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation

Overactive bladder (OAB) is a common condition that is experienced by around 455 million people (11% of the world population) and associated with significant impact in patients’ quality of life. The first line treatments of OAB are conservative treatment and anti-muscarinic medication. For the refractory OAB patients, the treatment options available are surgical therapy, electrical stimulation, and botulinum toxin injection. Among them, percutaneous tibial nerve stimulation (PTNS) is a minimally invasive option that aims to stimulate sacral nerve plexus, a group of nerve that is responsible for regulation of bladder function. After its approval by food and drug administration (FDA) in 2007, PTNS revealed considerable promise in OAB management. In this review, several non-comparative and comparative studies comparing PTNS with sham procedure, anti-muscarinic therapy, and multimodal therapy combining PTNS and anti-muscarinic had supportive data to this consideration.

scholarly journals Patient–Provider Discussions About Urinary Incontinence Among Older Women

2020 ◽  
Author(s):  
Giulia I Lane ◽  
Kaitlin Hagan ◽  
Elisabeth Erekson ◽  
Vatche A Minassian ◽  
Francine Grodstein ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Older Women ◽  
Health Care Access ◽  
Health Professionals ◽  
Treatment Options ◽  
Prospective Cohort Studies ◽  
Care Access ◽  
Health Studies ◽  
Adjusted Logistic Regression

Abstract Background Urinary incontinence (UI) is prevalent in women and has been associated with decreased quality of life and institutionalization. Despite this, and the fact that several treatment options exist, few women discuss UI with clinicians. The aim of this study was to examine the proportion of middle aged and older women with urinary incontinence who have discussed UI with clinicians, focusing on female health professionals as a way to examine this question outside of issues of health care access. Methods Data are from the Nurses Health Studies (NHS), two ongoing observational, prospective, cohort studies. The surveys collected detailed information about UI, including frequency, amount and type. Women were also asked if they had discussed UI with a clinician. We used multivariable-adjusted logistic regression to estimate odds ratios (OR) of participants reporting discussion about UI. Results 94,692 women with UI aged 49–91 years old were included in this study. Of these, 34% reported that they had discussed their incontinence with a clinician. Women with daily UI had 4.4 times greater odds of discussing it with clinicians when compared to those with monthly UI (OR = 4.36, 95% confidence interval [CI] 4.06–4.69). When controlling for severity of symptoms, the oldest women, greater than eighty years, were 20% less likely to have discussed UI with their clinician, compared to the youngest women (OR = 0.81, 95% CI 0.73–0.89). Conclusions A minority of women with UI, even among health professionals, discuss their symptoms with clinicians. Oldest women were the least likely to discuss their UI with a provider.

Urinary incontinence in older women: a review of conservative therapeutic interventions

2014 ◽  
Vol 24 (1) ◽  
pp. 93-104 ◽  
Author(s):  
Gemma Wright
Keyword(s):  
Urinary Incontinence ◽  
Electrical Stimulation ◽  
Older Women ◽  
Complementary Therapies ◽  
Pelvic Floor Muscle ◽  
Treatment Options ◽  
Evidence Base ◽  
Therapeutic Interventions ◽  
Adjunctive Treatment ◽  
Positive Outcomes

SummaryUrinary incontinence is a highly prevalent yet largely ignored condition that affects older women. Conservative treatment options are widely under-used and containment methods more widely prescribed. This study sought to review the efficacy of conservative approaches and identify which should be recommended. It was found that there is a strong evidence base in support of pelvic floor muscle and behavioural training with biofeedback as a useful adjunctive treatment. The use of therapeutic electrical stimulation was difficult to evaluate due to the different combinations of treatment available and a paucity of evidence of its use with older women. Lifestyle intervention and complementary therapies both demonstrated some positive outcomes. In conclusion it was felt that there is a place for conservative treatments in the management of urinary incontinence rather than relying on containment products. A combination of different treatment approaches is felt to be the most beneficial.

Association of overactive bladder and stress urinary incontinence in rats with pudendal nerve ligation injury

2008 ◽  
Vol 294 (5) ◽  
pp. R1510-R1516 ◽  
Author(s):  
Akira Furuta ◽  
Masafumi Kita ◽  
Yasuyuki Suzuki ◽  
Shin Egawa ◽  
Michael B. Chancellor ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Overactive Bladder ◽  
Pudendal Nerve ◽  
Bladder Function ◽  
Urinary Continence ◽  
Detrusor Muscle ◽  
Pathophysiological Mechanism ◽  
Afferent Pathways ◽  
Contractile Responses

Approximately one-third of patients with stress urinary incontinence (SUI) also suffer from urgency incontinence, which is one of the major symptoms of overactive bladder (OAB) syndrome. Pudendal nerve injury has been recognized as a possible cause for both SUI and OAB. Therefore, we investigated the effects of pudendal nerve ligation (PNL) on bladder function and urinary continence in female Sprague-Dawley rats. Conscious cystometry with or without capsaicin pretreatment (125 mg/kg sc), leak point pressures (LPPs), contractile responses of bladder muscle strips to carbachol or phenylephrine, and levels of nerve growth factor (NGF) protein and mRNA in the bladder were compared in sham and PNL rats 4 wk after the injury. Urinary frequency detected by a reduction in intercontraction intervals and voided volume was observed in PNL rats compared with sham rats, but it was not seen in PNL rats with capsaicin pretreatment that desensitizes C-fiber-afferent pathways. LPPs in PNL rats were significantly decreased compared with sham rats. The contractile responses of detrusor muscle strips to phenylephrine, but not to carbachol, were significantly increased in PNL rats. The levels of NGF protein and mRNA in the bladder of PNL rats were significantly increased compared with sham rats. These results suggest that pudendal nerve neuropathy induced by PNL may be one of the potential risk factors for OAB, as well as SUI. Somato-visceral cross sensitization between somatic (pudendal) and visceral (bladder) sensory pathways that increases NGF expression and α1-adrenoceptor-mediated contractility in the bladder may be involved in this pathophysiological mechanism.

Treatment options for the overactive bladder syndrome

Therapy ◽  
2005 ◽  
Vol 2 (6) ◽  
pp. 921-936
Author(s):  
Hashim Hashim ◽  
Paul Abrams
Keyword(s):  
Overactive Bladder ◽  
Treatment Options ◽  
Overactive Bladder Syndrome

The Incidence of Overactive Bladder (OAB) in KIA Poly Patients at Pauh Health Center in Padang City Using Overactive Bladder Symptoms Score (OABSS)

2019 ◽  
Vol 3 (2) ◽  
pp. 55-62
Author(s):  
Bobby Indra Utama ◽  
Widayat Widayat ◽  
Berriandi Arwan
Keyword(s):  
Urinary Incontinence ◽  
Overactive Bladder ◽  
Health Center ◽  
Sampling Technique ◽  
Reproductive Age ◽  
Exclusion Criteria ◽  
Symptom Scores ◽  
Bladder Symptom ◽  
Bladder Symptoms ◽  
Tract Infections

Objective : This study looked at the incidence of overactive bladder (OAB) in KIA poly patients at Pauh Health Center in Padang City using Overactive Bladder Symptomps Score (OABSS).Method : This research is descriptive. The sampling technique was purposive sampling by considering inclusion and exclusion criteria. The inclusion criteria were women of ideal reproductive age (20-35 years) who had given birth spontaneously, were not pregnant, did not suffer from neurological disorders, diabetes, post bladder surgery and or urinary tract infections and were not treated with Overactive Bladder (OAB), while the exclusion criteria are not willing to take part in the study. The study was carried out at the KIA Poly of Pauh City Health Center in Padang during January 2019. The variable in this study was Overactive Bladder (OAB).Result : In this study, 97.22% of respondents experienced complaints of overactive bladder (OAB), (97.14%) experienced an urgent complaint, and only a small percentage (2.86%) of respondents experienced urinary incontinence. The results of this study indicate that respondents who did not experience complaints of overactive bladder (OAB) were respondents with the smallest parity (parity 1).Conclusion : Most respondents experienced complaints of overactive bladder (OAB) and urgency, and only a small proportion of respondents experienced urinary incontinence. The results of this study indicate that respondents who did not experience complaints of overactive bladder (OAB) were respondents with the smallest parity (parity 1).Keywords : overactive bladder (OAB), Urgensi,inkontinensia urin, Overactive Bladder Symptom Scores (OABSS).

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