Nonsurgical treatments for urinary incontinence in women summary of primary findings and conclusions

摘要

Source of Review This review was commissioned by the Agency for Healthcare Research and Quality(AHRQ) and conducted by the University of Minnesota Evidence-Based Practice Center for theAHRQComparative Effectiveness Review series.1 Background Urinary incontinence affects more than a quarter ofwomenand can have adverse effects on women's physical, psychological, and social well-being. Clinicians rely to varying extents on patientreported measures and clinical tests to diagnose incontinence and guide treatment in the ambulatory setting. Available nonsurgical treatments include pharmacological therapies such as antimuscarinic, serotonin-noradrenalin reuptake inhibitor, and estrogenbased medications, as well as nonpharmacological treatments such as lifestyle changes, pelvic floor muscle training, bladder training, electrical stimulation, magnetic stimulation, and intravaginal or intraurethral devices. Objectives The objectives of this review were to (1) determine what constitutes an adequate diagnostic evaluation on which to base nonsurgical treatment of urinary incontinence in women in the ambulatory care setting and (2) determine the benefits and harms of available pharmacological and nonpharmacological treatments for incontinence in women.