Urinary incontinence in women - the overview of pharmacological and surgical methods
DOI:
https://doi.org/10.12775/JEHS.2022.12.08.007Keywords
urinary incontinence, treatment, women, pharmacology, surgeryAbstract
Introduction and purpose of the work:
Urinary incontinence (UI) is a common problem among women and the incidence increases with age. It is estimated that about 50% of women will be affected by this problem. There are 5 types of urinary incontinence: exercise, pressure, mixed, overflow and functional. Stress UI is the most common cause among young women, while stress UI is the second most common cause among older women. The widespread use of this phenomenon makes it a significant economic burden.
State of knowledge (brief description):
Due to the different types of UI and its many causes, treating this disorder becomes a significant challenge. It is important to use combination therapy, starting with pelvic floor muscle strengthening exercise, lifestyle modification, weight loss, and smoking cessation, followed by drug therapy and surgery as necessary.
Summary:
Currently, many drugs are used in the treatment of urinary incontinence, with different mechanisms of action, which allow the treatment of various types of UI, but pharmacotherapy often does not bring the expected benefits. Surgical treatment appears to be a promising form of treatment, but more research is needed on the long-term effects.
References
Goforth J, Langaker M. Urinary Incontinence in Women. North Carolina Medical Journal, vol. 77, no. 6, pp. 423–425, Nov. 2016, doi: 10.18043/ncm.77.6.423.
Hu JS, Pierre EF. Urinary Incontinence in Women: Evaluation and Management. Am Fam Physician, vol. 100, no. 6, pp. 339–348, 2019.
John G, Bardini C, Combescure C, Dällenbach P. Urinary Incontinence as a Predictor of Death: A Systematic Review and Meta-Analysis. PLOS ONE, vol. 11, no. 7, p. e0158992, Jul. 2016, doi: 10.1371/journal.pone.0158992.
Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician, vol. 87, no. 8, pp. 543–50, Apr. 2013.
Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers, vol. 3, p. 17042, Jul. 2017, doi: 10.1038/nrdp.2017.42.
Irwin GM. Urinary Incontinence. Prim Care, vol. 46, no. 2, pp. 233–242, Jun. 2019, doi: 10.1016/j.pop.2019.02.004.
Anderson RU, Mobley D, Blank B, Saltzstein D, Susset J, Brown JS. Once daily controlled versus immediate release oxybutynin chloride for urge urinary incontinence. OROS Oxybutynin Study Group. Journal of Urology, vol. 161, no. 6, pp. 1809–1812, Jun. 1999, doi: 10.1016/S0022-5347(05)68810-6.
Abrams P et al. Muscarinic receptors: their distribution and function in body systems, and the implications for treating overactive bladder. British Journal of Pharmacology, vol. 148, no. 5, pp. 565–578, Jul. 2006, doi: 10.1038/sj.bjp.0706780.
Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D. The Effects of Antimuscarinic Treatments in Overactive Bladder: An Update of a Systematic Review and Meta-Analysis. European Urology, vol. 54, no. 3, pp. 543–562, Sep. 2008, doi: 10.1016/j.eururo.2008.06.047.
Yamanishi, Kaga K, Fuse M, Shibata C, Kamai T, Uchiyama T. The role of muscarinic receptor subtypes on carbachol-induced contraction of normal human detrusor and overactive detrusor associated with benign prostatic hyperplasia. Journal of Pharmacological Sciences, vol. 128, no. 2, pp. 65–70, Jun. 2015, doi: 10.1016/j.jphs.2015.05.005.
Herbison P, McKenzie JE. Which anticholinergic is best for people with overactive bladders? A network meta‐analysis. Neurourology and Urodynamics, vol. 38, no. 2, pp. 525–534, Feb. 2019, doi: 10.1002/nau.23893.
BuserN, Ivic S, Kessler TM, Kessels AGH Bachmann LM. Efficacy and Adverse Events of Antimuscarinics for Treating Overactive Bladder: Network Meta-analyses. European Urology, vol. 62, no. 6, pp. 1040–1060, Dec. 2012, doi: 10.1016/j.eururo.2012.08.060.
Lightner DJ, Gomelsky A, Souter L, Vasavada SP. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment 2019. Journal of Urology, vol. 202, no. 3, pp. 558–563, Sep. 2019, doi: 10.1097/JU.0000000000000309.
Wu JP, Peng L, Zeng X, Li H, Shen H, Luo DY. Is imidafenacin an alternative to current antimuscarinic drugs for patients with overactive bladder syndrome?. International Urogynecology Journal, vol. 32, no. 5, pp. 1117–1127, May 2021, doi: 10.1007/s00192-020-04329-x.
Sacco E et al. Discovery history and clinical development of mirabegron for the treatment of overactive bladder and urinary incontinence. Expert Opinion on Drug Discovery, vol. 9, no. 4, pp. 433–448, Apr. 2014, doi: 10.1517/17460441.2014.892923.
Maman K et al. Comparative Efficacy and Safety of Medical Treatments for the Management of Overactive Bladder: A Systematic Literature Review and Mixed Treatment Comparison. European Urology, vol. 65, no. 4, pp. 755–765, Apr. 2014, doi: 10.1016/j.eururo.2013.11.010.
Ko KJ, Choo M, Chang Y, Kim JC, Lee K. A multicenter prospective study for overactive bladder patient treatment satisfaction with mirabegron after being unsatisfied with antimuscarinic therapy (FAVOR study). Neurourology and Urodynamics, vol. 39, no. 8, pp. 2417–2424, Nov. 2020, doi: 10.1002/nau.24505.
Sacco E, Bientinesi R. Mirabegron: a review of recent data and its prospects in the management of overactive bladder. Therapeutic Advances in Urology, vol. 4, no. 6, pp. 315–324, Dec. 2012, doi: 10.1177/1756287212457114.
Chapple CR, Cardozo L, Nitti VW, Siddiqui E, Michel MC. Mirabegron in overactive bladder: A review of efficacy, safety, and tolerability. Neurourology and Urodynamics, vol. 33, no. 1, pp. 17–30, Jan. 2014, doi: 10.1002/nau.22505.
Soda T, Tashiro Y, Koike S, Ikeuchi R, Okada T. Overactive bladder medication: Persistence, drug switching, and reinitiation. Neurourology and Urodynamics, vol. 39, no. 8, pp. 2527–2534, Nov. 2020, doi: 10.1002/nau.24527.
Edmondson SD et al. Discovery of Vibegron: A Potent and Selective β 3 Adrenergic Receptor Agonist for the Treatment of Overactive Bladder. Journal of Medicinal Chemistry, vol. 59, no. 2, pp. 609–623, Jan. 2016, doi: 10.1021/acs.jmedchem.5b01372.
Staskin D, Frankel J, Varano S, Shortino D, Jankowich R, Mudd PN. International Phase III, Randomized, Double-Blind, Placebo and Active Controlled Study to Evaluate the Safety and Efficacy of Vibegron in Patients with Symptoms of Overactive Bladder: EMPOWUR. Journal of Urology, vol. 204, no. 2, pp. 316–324, Aug. 2020, doi: 10.1097/JU.0000000000000807.
Kennelly MJ, Rhodes T, Girman CJ, Thomas E, Shortino D, Mudd PN. Efficacy of Vibegron and Mirabegron for Overactive Bladder: A Systematic Literature Review and Indirect Treatment Comparison. Advances in Therapy, vol. 38, no. 11, pp. 5452–5464, Nov. 2021, doi: 10.1007/s12325-021-01902-8.
Ohlstein EH, von Keitz A, Michel MC. A Multicenter, Double-blind, Randomized, Placebo-controlled Trial of the β3-Adrenoceptor Agonist Solabegron for Overactive Bladder. European Urology, vol. 62, no. 5, pp. 834–840, Nov. 2012, doi: 10.1016/j.eururo.2012.05.053.
Tzoumas N, Farrah TE, Dhaun N, Webb DJ. Established and emerging therapeutic uses of PDE type 5 inhibitors in cardiovascular disease. British Journal of Pharmacology, vol. 177, no. 24, pp. 5467–5488, Dec. 2020, doi: 10.1111/bph.14920.
Lee WC, Leu S, Wu KLH, Tain YL, Chuang YC, Chan JYH. Tadalafil ameliorates bladder overactivity by restoring insulin-activated detrusor relaxation via the bladder mucosal IRS/PI3K/AKT/eNOS pathway in fructose-fed rats. Scientific Reports, vol. 11, no. 1, p. 8202, Dec. 2021, doi: 10.1038/s41598-021-87505-3.
Chen H et al. Efficacy of Daily Low-dose Tadalafil for Treating Overactive Bladder: Results of a Randomized, Double-blind, Placebo-controlled Trial. Urology, vol. 100, pp. 59–64, Feb. 2017, doi: 10.1016/j.urology.2016.11.008.
Jost W, Marsalek P. Duloxetine: mechanism of action at the lower urinary tract and Onuf’s nucleus. Clinical Autonomic Research, vol. 14, no. 4, Aug. 2004, doi: 10.1007/s10286-004-0197-8.
Li J, Yang L, Pu C, Tang Y, Yun H, Han P. The role of duloxetine in stress urinary incontinence: a systematic review and meta-analysis. International Urology and Nephrology, vol. 45, no. 3, pp. 679–686, Jun. 2013, doi: 10.1007/s11255-013-0410-6.
Hunskaar S, Welle‐Nilsen LK. The market lifecycle of duloxetine for urinary incontinence in Norway. Acta Obstetricia et Gynecologica Scandinavica, vol. 89, no. 2, pp. 217–222, Feb. 2010, doi: 10.3109/00016340903508650.
van Kerrebroeck P, Marcelissen TAT. Sacral neuromodulation for lower urinary tract dysfunction. World Journal of Urology, vol. 30, no. 4, pp. 445–450, Aug. 2012, doi: 10.1007/s00345-011-0780-2.
Feloney MP, Stauss K, Leslie SW. Sacral Neuromodulation. 2022.
Wald A. Diagnosis and Management of Fecal Incontinence. Current Gastroenterology Reports, vol. 20, no. 3, p. 9, Mar. 2018, doi: 10.1007/s11894-018-0614-0.
McCrery R et al. Treatment of Urinary Urgency Incontinence Using a Rechargeable SNM System: 6-Month Results of the ARTISAN-SNM Study. Journal of Urology, vol. 203, no. 1, pp. 185–192, Jan. 2020, doi: 10.1097/JU.0000000000000458.
Niu HL, Ma YH, Zhang CJ. Comparison of OnabotulinumtoxinA versus sacral neuromodulation for refractory urinary urge incontinence: A systematic review and meta-analysis of randomized controlled trials. International Journal of Surgery, vol. 60, pp. 141–148, Dec. 2018, doi: 10.1016/j.ijsu.2018.10.041.
Khunda A, McCormick C, Ballard P. Sacral neuromodulation and sexual function: a systematic review and meta-analysis of the literature. International Urogynecology Journal, vol. 30, no. 3, pp. 339–352, Mar. 2019, doi: 10.1007/s00192-018-3841-x.
Rehman H, Bezerra CA, Bruschini H, Cody JD, Aluko P. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database of Systematic Reviews, Jul. 2017, doi: 10.1002/14651858.CD001754.pub4.
Nilsson CG, Palva K, Rezapour M, Falconer C. Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. International Urogynecology Journal, vol. 19, no. 8, pp. 1043–1047, Aug. 2008, doi: 10.1007/s00192-008-0666-z.
Karim NB, Lo TS, Nawawib EA, Wu PY, “Review on midurethral sling procedures for stress urinary incontinence,” Gynecology and Minimally Invasive Therapy, vol. 4, no. 2, pp. 33–36, May 2015, doi: 10.1016/j.gmit.2015.04.003.
Lee HJ, Won YB, Park YJ, Kong MK, Bai SW. Postoperative urinary symptoms after transobturator tape in normal-weight compared with overweight and obese woman. Obstetrics & Gynecology Science, vol. 61, no. 3, p. 374, 2018, doi: 10.5468/ogs.2018.61.3.374.
Mayekar RV, Bhosale AA, Kandhari KV, Nandanwar YS, Shaikh SS. A study of transobturator tape in stress urinary incontinence. Urology Annals, vol. 9, no. 1, p. 9, 2017, doi: 10.4103/0974-7796.198867.
Sik BA, Copur H, Aba YA. The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years' follow-up. Pakistan Journal of Medical Sciences, vol. 35, no. 2, Mar. 2019, doi: 10.12669/pjms.35.2.603.
Zullo MA, Schiavi MC, Luffarelli P, Prata G, Di Pinto A. Oliva C. TVT-O vs TVT-Abbrevo for stress urinary incontinence treatment in women: a randomized trial. International Urogynecology Journal, vol. 31, no. 4, pp. 703–710, Apr. 2020, doi: 10.1007/s00192-019-04077-7.
Dogan O, Kaya AE, Pulatoglu C, Basbug A, Yassa M. A randomized comparison of a single-incision needless (Contasure-needleless®) mini-sling versus an inside-out transobturator (Contasure-KIM®) mid-urethral sling in women with stress urinary incontinence: 24-month follow-up results. International Urogynecology Journal, vol. 29, no. 9, pp. 1387–1395, Sep. 2018, doi: 10.1007/s00192-018-3624-4.
Emami M, Momtazan A, Maghsoudi R,Ameli M, Kashi A, Amirpoor M, Karimi S. Transobturator tape and mini-sling methods in stress urinary incontinence: Results of a randomized clinical trial. Urologia Journal, vol. 86, no. 3, pp. 152–155, Aug. 2019, doi: 10.1177/0391560319845255.
Nakamura R, Yao M, Maeda Y, Fujisaki A, Sekiguchi Y. Outpatient mid-urethral tissue fixation system sling for urodynamic stress urinary incontinence: 3-year surgical and quality of life results. International Urogynecology Journal, vol. 28, no. 11, pp. 1733–1738, Nov. 2017, doi: 10.1007/s00192-017-3341-4.
Sekiguchi Y, Kinjyo M, Inoue H, Sakata H, Kubota Y. Outpatient mid urethral tissue fixation system sling for urodynamic stress urinary incontinence: 1-year results. Journal of Urology, vol. 182, no. 6, pp. 2810–2813, Dec. 2009, doi: 10.1016/j.juro.2009.08.045.
Inoue H, Nakamura R, Sekiguchi Y, Kohata Y, Fukuda T, Oonuma K, Uzawa Y, Watanabe R. Tissue Fixation System ligament repair cures major pelvic organ prolapse in ageing women with minimal complications - a 10-year Japanese experience in 960 women. Central European Journal of Urology, 2021, doi: 10.5173/ceju.2021.0208.
Hota LS, Hanaway K, Hacker MR, Disciullo A, Elkadry E, Dramitinos P, Shapiro A, Ferzandi T, Rosenblatt PL. TVT-Secur (Hammock) Versus TVT-Obturator: A Randomized Trial of Suburethral Sling Operative Procedures. Female Pelvic Medicine & Reconstructive Surgery, vol. 18, no. 1, pp. 41–45, Jan. 2012, doi: 10.1097/SPV.0b013e31823bdbcf.
Shin YS, Cha JS, Cheon MW, Kim YG, Ki M. Efficacy and Safety of the TVT-SECUR® and Impact on Quality of Life in Women with Stress Urinary Incontinence: A 2-Year Follow-Up. Korean Journal of Urology, vol. 52, no. 5, p. 335, 2011, doi: 10.4111/kju.2011.52.5.335.
Hamer MA, Larsson PG, Teleman P, Bergqvist CE, Persson J. One-year results of a prospective randomized, evaluator-blinded, multicenter study comparing TVT and TVT Secur. International Urogynecology Journal, vol. 24, no. 2, pp. 223–229, Feb. 2013, doi: 10.1007/s00192-012-1840-x.
Serdinsek T, Martan A, Svabik K,But I, Kolek P, Masata J. Is the fixation of single incision TVT-S tape as good as that of transobturator tape? An ultrasound study of randomized trial results. International Urogynecology Journal, vol. 32, no. 1, pp. 141–148, Jan. 2021, doi: 10.1007/s00192-020-04390-6.
Yokoyama O, Honda M, Yamanishi T, Sekiguchi Y, Fujii K, Nakayama T, Mogi T. OnabotulinumtoxinA (botulinum toxin type A) for the treatment of Japanese patients with overactive bladder and urinary incontinence: Results of single-dose treatment from a phase III, randomized, double-blind, placebo-controlled trial (interim analysis). International Journal of Urology, vol. 27, no. 3, pp. 227–234, Mar. 2020, doi: 10.1111/iju.14176.
Ramos HL, Castellanos LY, Esparza IP, Jaramillo A, Rodríguez A, Bencardino CM. Management of Overactive Bladder With OnabotulinumtoxinA: Systematic Review and Meta-analysis. Urology, vol. 100, pp. 53–58, Feb. 2017, doi: 10.1016/j.urology.2016.10.026.
Veit‐Rubin N, Dubuisson J, Ford A, Mourad S, Digesu A. Burch colposuspension. Neurourology and Urodynamics, vol. 38, no. 2, pp. 553–562, Feb. 2019, doi: 10.1002/nau.23905.
Burch JC. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. American Journal of Obstetrics and Gynecology, vol. 81, no. 2, pp. 281–290, Feb. 1961, doi: 10.1016/S0002-9378(16)36367-0.
Tanagho EA. Colpocystourethropexy: The Way we do it. Journal of Urology, vol. 116, no. 6, pp. 751–753, Dec. 1976, doi: 10.1016/S0022-5347(17)58997-1.
Cowan W, Morgan HR. A simplified retropubic urethropexy in the treatment of primary and recurrent urinary stress incontinence in the female. American Journal of Obstetrics and Gynecology, vol. 133, no. 3, pp. 295–298, Feb. 1979, doi: 10.1016/0002-9378(79)90682-3.
Lapitan MCM, Cody JD, Mashayekhi A. Open retropubic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews, Jul. 2017, doi: 10.1002/14651858.CD002912.pub7.
Fusco F et al. Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence. European Urology, vol. 72, no. 4, pp. 567–591, Oct. 2017, doi: 10.1016/j.eururo.2017.04.026.
Sokol ER. Urinary Incontinence. in General Gynecology, Elsevier, 2007, pp. 583–607. doi: 10.1016/B978-032303247-6.10024-3.
Librach SL .Urinary Incontinence. in Palliative Care, Elsevier, 2007, pp. 155–164. doi: 10.1016/B978-141602597-9.10011-0.
Shamliyan T, Wyman JF, Ramakrishnan R, Sainfort F, Kane RL. Benefits and Harms of Pharmacologic Treatment for Urinary Incontinence in Women. Annals of Internal Medicine, vol. 156, no. 12, p. 861, Jun. 2012, doi: 10.7326/0003-4819-156-12-201206190-00436.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Karolina Mikut, Aleksandra Wijata, Anna Gorajek, Kornelia Kędziora-Kornatowska
![Creative Commons License](http://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 453
Number of citations: 0