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Conservative management for urinary incontinence.

K H Moore1

  • 1Pelvic Floor Unit, St George Hospital, University of New South Wales, Kogarah, Australia.

Bailliere'S Best Practice & Research. Clinical Obstetrics & Gynaecology
|July 18, 2000
PubMed
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Conservative therapies for genuine stress incontinence, including pelvic floor exercises, are effective. Further research is needed for biofeedback, vaginal cones, and electrostimulation, while bladder training remains key for urgency. Novel devices offer options for mixed incontinence.

Area of Science:

  • Urology
  • Gynaecology
  • Pelvic Health

Background:

  • Growing awareness among gynaecologists regarding conservative treatments for genuine stress incontinence.
  • Need for evidence-based therapeutic options for women experiencing urinary incontinence.

Purpose of the Study:

  • To review the evidence for conservative therapies for genuine stress incontinence and detrusor instability.
  • To identify areas requiring further research in female urinary incontinence management.

Main Methods:

  • Review of randomized controlled trials and existing literature on conservative incontinence therapies.
  • Analysis of the efficacy of pelvic floor exercises, biofeedback, vaginal cones, electrostimulation, bladder training, and new devices.

Main Results:

Related Experiment Videos

  • Supervised pelvic floor exercises have strong objective evidence of efficacy.
  • Efficacy of biofeedback, vaginal cones, and electrostimulation is variable, necessitating further investigation.
  • Bladder training is the established primary therapy for detrusor instability/sensory urgency.
  • Transcutaneous electrical nerve stimulation (TENS) shows promise for urge incontinence.
  • New vaginal and urethral devices offer additional options for mixed stress and urge incontinence.

Conclusions:

  • Pelvic floor exercises and bladder training are effective conservative treatments for specific types of urinary incontinence.
  • Further research is crucial to optimize the use of biofeedback, vaginal cones, and electrostimulation.
  • Emerging treatments and devices provide new avenues for managing complex cases of female urinary incontinence.