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Related Concept Videos

Urinary Bladder01:23

Urinary Bladder

The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
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Perineal Layer
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A Novel Surgical Technique in a Sheep Model for Suburethral Graft Implantation
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Weighted vaginal cones for urinary incontinence.

G Peter Herbison1, Nicola Dean

  • 1Department of Preventive&SocialMedicine,Dunedin School ofMedicine, University ofOtago,Dunedin, New Zealand.peter.herbison@otago.ac.nz.

The Cochrane Database of Systematic Reviews
|July 10, 2013
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Summary

Weighted vaginal cones show promise for treating stress urinary incontinence (SUI) compared to no treatment. Effectiveness appears similar to pelvic floor muscle training (PFMT) and electrostimulation, but more research is needed.

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Area of Science:

  • Urology
  • Gynecology
  • Pelvic Floor Health

Background:

  • Pelvic floor muscle training (PFMT) is a primary conservative treatment for stress urinary incontinence (SUI).
  • Weighted vaginal cones offer a method for women to engage in PFMT by inserting cones and contracting muscles to retain them.

Purpose of the Study:

  • To evaluate the effectiveness of vaginal cones in managing female SUI.
  • To compare vaginal cones against no treatment, other conservative therapies (PFMT, electrostimulation), combined therapies, and non-conservative methods.
  • To explore secondary outcomes including learning curve, self-taught efficacy, correlation between cone weight retention and improvement, and identification of suitable patient subgroups.

Main Methods:

  • Systematic review of randomized and quasi-randomized controlled trials.
  • Searched multiple databases including Cochrane Incontinence Group Specialised Trials Register, MEDLINE, and EMBASE up to March 2013.
  • Independent assessment of study inclusion and quality by two reviewers; data extraction and cross-checking.

Main Results:

  • Included 23 trials with 1806 women; many trials were small and of variable quality.
  • Vaginal cones demonstrated superiority over no active treatment for SUI cure (RR 0.84, 95% CI 0.76 to 0.94).
  • Limited evidence showed similar subjective cure rates between cones and PFMT (RR 1.01, 95% CI 0.91 to 1.13) or electrostimulation (RR 1.26, 95% CI 0.85 to 1.87), with wide confidence intervals.

Conclusions:

  • Weighted vaginal cones show potential as an effective treatment for SUI, outperforming no active treatment.
  • Effectiveness appears comparable to PFMT and electrostimulation, though further high-quality trials are necessary.
  • Vaginal cones can be considered a viable treatment option if acceptable to patients.