Tag Archive | "stress urinary incontinence"

One-Third of Women Experience Stress Urinary Incontinence

About one in three women experience stress urinary incontinence (SUI), an involuntary loss of urine due to forces on the bladder caused by physical movement of the body.  Even though SUI can interfere with quality of life, it often goes untreated because of the personal nature of the symptoms.  Any women feel embarrassed about their bodies and are reluctant to discuss or report urinary leakage.

For these reasons, the American Urological Association (AUA) Foundation issued a new Monograph, titled “Stress Urinary Incontinence: Monograph from the AUA Foundation,” a few months ago to encourage women and their healthcare providers to openly discuss SUI and to empower women to make lifestyle changes to decrease their risk of this condition and understand that they are not alone if they experience SUI.  The monograph provides information about SUI, including symptoms, risk factors, prevalence and common myths associated with the condition.  It highlights the fact that overweight and obese women are more prone to SUI, and evidence shows that weight loss may improve urinary incontinence in obese women.  The monograph also provides ways to prevent or control the symptoms of SUI, including lifestyle changes, urinary control devices or surgery.  Women can manage SUI by using mini pads, sanitary pads, or incontinence pads.

AUA Foundation Executive Director Sandra Vassos, MPH, reported that the prevalence of SUI costs society an estimated $8 billion annually.  Symptoms of SUI vary widely from light to heavy leakage, which may occur during rigorous activity or natural reflexes, such as playing sports or coughing.  In more severe cases, leakage may occur due to low impact movements, such as standing up, walking or bending over. Because these symptoms often lead to feelings of isolation, they may interfere with women’s day-to-day activities, impact their relationships, and prevent them from opening up about their condition. For these reasons, many women with SUI may miss important opportunities to learn more about SUI and manage its symptoms.

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Stem Cell Injections Better than Collagen Injections in Treating Stress Urinary Incontinence

A new study from Austria has found that injections of stem cells and other cells obtained from a woman’s own body can treat stress urinary incontinence with dramatically better results than conventional collagen injections.

These results mimic those from U.S. research that is underway and might also be long-lasting.

The study appears in The Lancet. The Austrian researchers, led by Hannes Strasser, MD, from the Medical University of Innsbruck, compared the effects of the stem cell injections with conventional injections of collagen in 63 women with stress urinary incontinence.

The team first performed a small muscle biopsy on the upper arms of the 42 women assigned to get stem cell injections.  In the laboratory, the women received myoblasts, a type of muscle stem cell, and fibroblasts, cells which form the structural framework for many body tissues.  According to Strasser, both types of cells have been shown to be effective in reconstructing the lower urinary tract in animal studies.

Then, Strasser’s team injected the cells back into the women’s sphincter and surrounding area using the ultrasound.

Traditional collagen injections, which do not generally have a high success rate for incontinence, were given to the other 21 women. Collagen treatments work by bulking up the area to compress the urethra, helping to hold urine.

After 12 months, 38 of the 42 women given the stem cell and other cell injections were completely continent. The other four showed either slight or substantial improvement. Only two of the 21 who got collagen injections were continent; seven others showed either slight or substantial improvement.

From ultrasound exams after the injections, it could be seen that the thickness of the sphincter had increased 59 percent in the women given cell injections but just nine percent in the collagen-treated group.  Muscle contractibility increased much more in the cell group.  Increases in the sphincter thickness and muscle contractibility are thought to help improve symptoms.  The women who were treated with the injections of cells reported higher quality of life than the women treated with collagen.  No one in the study reported any adverse side effects.

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Single-Incision Mini-Slings (SIMS) Don’t Perform Well in Stress Urinary Incontinence

Results from the review of Dr. Mohamed Abdel-Fattah of the University of Aberdeen and his colleagues on single-incision mini-slings (SIMS) compared to standard midurethral slings (SMUS) in their short and medium term efficacy shows SIMS don’t perform as well in women with stress urinary incontinence.

The researchers conducted a literature search and a meta-analysis of data from nine randomized trials involving 758 women followed for an average of 9.5 months.

Although SIMS were associated with significantly shorter operative time, lower day 1 pain scores and less postoperative groin pain, there was no significant difference in the quality of life scores between the groups.  But at 6 to 12 months, the patient reported cure rate (risk ratio, 0.83) was significantly lower with SIMS vs SMUS as was the objective cure rate (risk ratio, 0.85).

The SIMS group also had a significantly more repeat continence surgery (risk ratio, 6.72) and de novo urgency incontinence (risk ratio, 2.08).

Dr. Abdel-Fattah said “The results from this review will have a significant impact on surgical practice of urologists and urogynecologists.  We We have shown that the evidence from the current medical literature does not support the use of SIMS in surgical treatment of women with stress urinary incontinence especially that the standards have been set high with the standard mid-urethral slings,”

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The PelvicToner ™ for Stress Urinary Incontinence

After successful clinical trials, a new product called the PelvicToner™ has been approved for the treatment of Stress Urinary Incontinence (SUI).

The PelvicToner offers a more effective and speedier treatment option to the millions of women who suffer from SUI.  The device is also the first major advance in the NHS primary care treatment of SUI for over 60 years.

The PelvicToner is a simple, portable exercise device that works by strengthening the walls of the pelvic floor through mild resistance training.  This tightens the muscles around the neck of the bladder and prevents urine from leaking out when you cough, sneeze, laugh or make a sudden movement.

The NHS decided that the PelvicToner is effective and cost-beneficial after its highly successful clinical trials in 2010.  The device has been available for patients since January 2011 and is expected to gain popularity throughout the year.  It is the only product available in the category of Pelvic Toning Devices.

The results of the PelvicToner clinical trials were published in the British Journal of Urology International.  The trial shows that the PelvicToner is as effective as supervised Pelvic Floor Exercises (PFEs), which are the standard exercises offered to patients suffering from SUI.  The added benefit is that the device helps women confidently identify their pelvic floor and exercise more effectively by squeezing against a mild resistance.  Over 80% of PelvicToner users reported significant improvement within just a couple of weeks.

The cost-benefit of this new device is astounding.  With over 4 million women in the UK alone who suffer from SUI, millions of dollars will be saved by simply prescribing the PelvicToner.  Enabling women to use the device in their own home also frees up resources for specialist physiotherapists and surgeons, who will now be able to focus on the neediest cases.

The author of the BJUI article and the research leader, Professor Marcus Drake of the Bristol Urology Institute, says, “Continence service provision is patchy and this sort of product empowers women, gives them better privacy and the prospect of not wasting their time.  In our study the PelvicToner aided women to identify their pelvic floor confidently.  It increases patient choice and may promote subsequent compliance and sustained efficacy.”

Until now, specialists have had to rely on the unsupervised version of PFEs, which are often just a sheet explaining how to do the exercises.  Clinical estimates suggest that a third of women cannot even identify their pelvic floor and how to squeeze it.  Simply giving them just an instruction sheet does not solve the problem.

Many specialists also note that the general level of training is poor when it comes to supervised PFEs.  Even under supervision, women are not expected to see significant improvements for three months of performing the exercises.  This just leads to frustration, low motivation, and very poor compliance.  The PelvicToner, however, claims rapid improvement.  The users demonstrate eagerness to exercise on a regular basis to maintain a strong and healthy pelvic floor.

“This recognition is a major boost for the PelvicToner and the women who are happy to consult their GP for advice.  But there are still millions of women who are too embarrassed to even consult with their doctor because of the taboo that surrounds stress incontinence.  These women can now help themselves and purchase with confidence knowing that the PelvicToner is cheap, simple to use and of proven effectiveness,” comments Barry Fowler, MD, of the manufacturer SPM Ltd.

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