INTRODUCTION: Stress incontinence, involving involuntary leaking of urine on effort, exertion, sneezing, or coughing, affects 17-45% of adult women. Risk factors include pregnancy (especially with vaginal delivery), smoking, and obesity. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-surgical treatments and surgical treatments for women with stress incontinence? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 97 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: adrenoceptor agonists, anterior vaginal repair, laparoscopic colposuspension, needle suspension, oestrogen supplements, pelvic floor electrical stimulation, pelvic floor muscle exercises, retropubic colposuspension, selective serotonin reuptake inhibitors (duloxetine), suburethral slings, tension-free vaginal tape, transobturator foramen procedures, and vaginal cones.
INTRODUCTION:Stress incontinence, involving involuntary leaking of urine on effort, exertion, sneezing, or coughing, affects 17-45% of adult women. Risk factors include pregnancy (especially with vaginal delivery), smoking, and obesity. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-surgical treatments and surgical treatments for women with stress incontinence? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 97 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: adrenoceptor agonists, anterior vaginal repair, laparoscopic colposuspension, needle suspension, oestrogen supplements, pelvic floor electrical stimulation, pelvic floor muscle exercises, retropubic colposuspension, selective serotonin reuptake inhibitors (duloxetine), suburethral slings, tension-free vaginal tape, transobturator foramen procedures, and vaginal cones.
Authors: Garnet L Anderson; Marian Limacher; Annlouise R Assaf; Tamsen Bassford; Shirley A A Beresford; Henry Black; Denise Bonds; Robert Brunner; Robert Brzyski; Bette Caan; Rowan Chlebowski; David Curb; Margery Gass; Jennifer Hays; Gerardo Heiss; Susan Hendrix; Barbara V Howard; Judith Hsia; Allan Hubbell; Rebecca Jackson; Karen C Johnson; Howard Judd; Jane Morley Kotchen; Lewis Kuller; Andrea Z LaCroix; Dorothy Lane; Robert D Langer; Norman Lasser; Cora E Lewis; JoAnn Manson; Karen Margolis; Judith Ockene; Mary Jo O'Sullivan; Lawrence Phillips; Ross L Prentice; Cheryl Ritenbaugh; John Robbins; Jacques E Rossouw; Gloria Sarto; Marcia L Stefanick; Linda Van Horn; Jean Wactawski-Wende; Robert Wallace; Sylvia Wassertheil-Smoller Journal: JAMA Date: 2004-04-14 Impact factor: 56.272