Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Female Mixed Urinary Incontinence

Female Mixed Urinary Incontinence ImportanceMixed urinary incontinence, a condition of both stress and urge urinary incontinence, is prevalent in 20% to 36% of women and is challenging to diagnosis and treat because urinary symptoms are variable and guidelines for treatment are not clear. ObjectiveTo review the diagnosis and management of mixed urinary incontinence in women, with a focus on current available evidence. Evidence ReviewMEDLINE was searched from January 1, 1992, to December 31, 2013. Additional citations were obtained from references of the selected articles and reviews. Articles that discussed the prevalence, diagnosis, results, and treatment of mixed urinary incontinence were selected for review. Evidence was graded using Oxford Centre for Evidence-Based Medicine levels of evidence for treatment recommendations. FindingsThe MEDLINE search resulted in 785 articles. After selection and obtainment of additional citations, a total of 73 articles were reviewed. There is high-quality (level 1) evidence for treating urinary incontinence with weight loss, for treating stress urinary incontinence by performing anti-incontinence procedures of both traditional and mid-urethral slings and retropubic urethropexies, and for managing urge urinary incontinence with anticholinergic medications. However, direct high-quality evidence for treatment of women with mixed urinary incontinence is lacking, as are clear diagnostic criteria and management guidelines. Conclusion and RelevanceHigh-quality, level 1 evidence for urinary incontinence therapy can guide clinicians in the treatment of the components of mixed urinary incontinence. Because high-quality evidence is lacking regarding the treatment of mixed urinary incontinence, treatment generally begins with conservative management emphasizing the most bothersome component. Randomized trials in women with mixed urinary incontinence populations are needed. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Female Mixed Urinary Incontinence

JAMA , Volume 311 (19) – May 21, 2014

Loading next page...
 
/lp/american-medical-association/female-mixed-urinary-incontinence-C501wnHVzr
Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2014.4299
pmid
24846038
Publisher site
See Article on Publisher Site

Abstract

ImportanceMixed urinary incontinence, a condition of both stress and urge urinary incontinence, is prevalent in 20% to 36% of women and is challenging to diagnosis and treat because urinary symptoms are variable and guidelines for treatment are not clear. ObjectiveTo review the diagnosis and management of mixed urinary incontinence in women, with a focus on current available evidence. Evidence ReviewMEDLINE was searched from January 1, 1992, to December 31, 2013. Additional citations were obtained from references of the selected articles and reviews. Articles that discussed the prevalence, diagnosis, results, and treatment of mixed urinary incontinence were selected for review. Evidence was graded using Oxford Centre for Evidence-Based Medicine levels of evidence for treatment recommendations. FindingsThe MEDLINE search resulted in 785 articles. After selection and obtainment of additional citations, a total of 73 articles were reviewed. There is high-quality (level 1) evidence for treating urinary incontinence with weight loss, for treating stress urinary incontinence by performing anti-incontinence procedures of both traditional and mid-urethral slings and retropubic urethropexies, and for managing urge urinary incontinence with anticholinergic medications. However, direct high-quality evidence for treatment of women with mixed urinary incontinence is lacking, as are clear diagnostic criteria and management guidelines. Conclusion and RelevanceHigh-quality, level 1 evidence for urinary incontinence therapy can guide clinicians in the treatment of the components of mixed urinary incontinence. Because high-quality evidence is lacking regarding the treatment of mixed urinary incontinence, treatment generally begins with conservative management emphasizing the most bothersome component. Randomized trials in women with mixed urinary incontinence populations are needed.

Journal

JAMAAmerican Medical Association

Published: May 21, 2014

References