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Future Directions of Research and Care for Urinary Incontinence: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases Summit on Urinary Incontinence Clinical Research in Women.

Publication ,  Journal Article
Chai, TC; Asfaw, TS; Baker, JE; Clarkson, B; Coleman, P; Hoffstetter, S; Konkel, K; Lavender, M; Nair, S; Norton, J; Subak, L; Visco, A ...
Published in: J Urol
July 2017

PURPOSE: Female urinary incontinence is prevalent, costly and morbid. Participants in a NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) sponsored summit reviewed findings from NIH (National Institutes of Health) funded clinical research on urinary incontinence in women and discussed the future of urinary incontinence research. MATERIALS AND METHODS: The NIDDK convened the Summit on Urinary Incontinence Clinical Research in Women on March 14, 2014. Participants representing a broad range of clinical expertise reviewed completed NIH sponsored urinary incontinence related studies, including results from community based epidemiological studies such as the BACH (Boston Area Community Health) Survey and from randomized clinical trials such as PRIDE (Program to Reduce Incontinence by Diet and Exercise), and studies conducted by the Pelvic Floor Disorders Network and the Urinary Incontinence Treatment Network. RESULTS: BACH Survey results improved our understanding of precursors, incidence, prevalence and natural history of urinary incontinence in a diverse group of women. The Pelvic Floor Disorders Network study found that anticholinergic medications and onabotulinumtoxinA are efficacious for treating urge urinary incontinence, and Burch colposuspension and retropubic mid urethral polypropylene slings are efficacious for decreasing stress urinary incontinence following pelvic organ prolapse surgery in women with potential stress urinary incontinence. The Urinary Incontinence Treatment Network study found that fascial slings were better than colposuspension, and that retropubic and transobturator mid urethral polypropylene slings were equivalent for stress urinary incontinence. In patients with stress urinary incontinence a preoperative urodynamic study was noninferior to basic office examinations for surgical outcome. The addition of behavioral intervention did not allow female patients to discontinue antimuscarinics for urge urinary incontinence. PRIDE showed that modest weight reductions significantly decreased urinary incontinence. CONCLUSIONS: Strategies for future research on urinary incontinence should include a focus on early disease, risk factor identification, better phenotyping, incorporation of new technologies, patient centered research and prevention.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2017

Volume

198

Issue

1

Start / End Page

22 / 29

Location

United States

Related Subject Headings

  • Weight Loss
  • Urology & Nephrology
  • Urologic Surgical Procedures
  • Urodynamics
  • Urinary Incontinence
  • United States
  • Treatment Outcome
  • Prevalence
  • Pelvic Organ Prolapse
  • National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)
 

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Chai, T. C., Asfaw, T. S., Baker, J. E., Clarkson, B., Coleman, P., Hoffstetter, S., … Bavendam, T. (2017). Future Directions of Research and Care for Urinary Incontinence: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases Summit on Urinary Incontinence Clinical Research in Women. J Urol, 198(1), 22–29. https://doi.org/10.1016/j.juro.2016.10.133
Chai, Toby C., Tirsit S. Asfaw, Jan E. Baker, Becky Clarkson, Pamela Coleman, Susan Hoffstetter, Kimberly Konkel, et al. “Future Directions of Research and Care for Urinary Incontinence: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases Summit on Urinary Incontinence Clinical Research in Women.J Urol 198, no. 1 (July 2017): 22–29. https://doi.org/10.1016/j.juro.2016.10.133.
Chai TC, Asfaw TS, Baker JE, Clarkson B, Coleman P, Hoffstetter S, Konkel K, Lavender M, Nair S, Norton J, Subak L, Visco A, Star RA, Bavendam T. Future Directions of Research and Care for Urinary Incontinence: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases Summit on Urinary Incontinence Clinical Research in Women. J Urol. 2017 Jul;198(1):22–29.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2017

Volume

198

Issue

1

Start / End Page

22 / 29

Location

United States

Related Subject Headings

  • Weight Loss
  • Urology & Nephrology
  • Urologic Surgical Procedures
  • Urodynamics
  • Urinary Incontinence
  • United States
  • Treatment Outcome
  • Prevalence
  • Pelvic Organ Prolapse
  • National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)