TY - JOUR
T1 - Management of urinary incontinence in postmenopausal women
T2 - An EMAS clinical guide
AU - Russo, Eleonora
AU - Caretto, Marta
AU - Giannini, Andrea
AU - Bitzer, Johannes
AU - Cano, Antonio
AU - Ceausu, Iuliana
AU - Chedraui, Peter
AU - Durmusoglu, Fatih
AU - Erkkola, Risto
AU - Goulis, Dimitrios G.
AU - Kiesel, Ludwig
AU - Lambrinoudaki, Irene
AU - Hirschberg, Angelica Lindén
AU - Lopes, Patrice
AU - Pines, Amos
AU - Rees, Margaret
AU - van Trotsenburg, Mick
AU - Simoncini, Tommaso
N1 - Publisher Copyright:
© 2020
PY - 2021/1
Y1 - 2021/1
N2 - Introduction: The prevalence of urinary incontinence and of other lower urinary tract symptoms increases after the menopause and affects between 38 % and 55 % of women aged over 60 years. While urinary incontinence has a profound impact on quality of life, few affected women seek care. Aim: The aim of this clinical guide is to provide an evidence-based approach to the management of urinary incontinence in postmenopausal women. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: Healthcare professionals should consider urinary incontinence a clinical priority and develop appropriate diagnostic skills. They should be able to identify and manage any relevant modifiable factors that could alleviate the condition. A wide range of treatment options is available. First-line management includes lifestyle and behavioral modification, pelvic floor exercises and bladder training. Estrogens and other pharmacological interventions are helpful in the treatment of urgency incontinence that does not respond to conservative measures. Third-line therapies (e.g. sacral neuromodulation, intravesical onabotulinum toxin-A injections and posterior tibial nerve stimulation) are useful in selected patients with refractory urge incontinence. Surgery should be considered in postmenopausal women with stress incontinence. Midurethral slings, including retropubic and transobturator approaches, are safe and effective and should be offered.
AB - Introduction: The prevalence of urinary incontinence and of other lower urinary tract symptoms increases after the menopause and affects between 38 % and 55 % of women aged over 60 years. While urinary incontinence has a profound impact on quality of life, few affected women seek care. Aim: The aim of this clinical guide is to provide an evidence-based approach to the management of urinary incontinence in postmenopausal women. Materials and methods: Literature review and consensus of expert opinion. Summary recommendations: Healthcare professionals should consider urinary incontinence a clinical priority and develop appropriate diagnostic skills. They should be able to identify and manage any relevant modifiable factors that could alleviate the condition. A wide range of treatment options is available. First-line management includes lifestyle and behavioral modification, pelvic floor exercises and bladder training. Estrogens and other pharmacological interventions are helpful in the treatment of urgency incontinence that does not respond to conservative measures. Third-line therapies (e.g. sacral neuromodulation, intravesical onabotulinum toxin-A injections and posterior tibial nerve stimulation) are useful in selected patients with refractory urge incontinence. Surgery should be considered in postmenopausal women with stress incontinence. Midurethral slings, including retropubic and transobturator approaches, are safe and effective and should be offered.
KW - Aging
KW - Estrogens
KW - Menopause
KW - Midurethral slings
KW - Urinary incontinence
UR - http://www.scopus.com/inward/record.url?scp=85092650270&partnerID=8YFLogxK
U2 - 10.1016/j.maturitas.2020.09.005
DO - 10.1016/j.maturitas.2020.09.005
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C2 - 33008675
AN - SCOPUS:85092650270
SN - 0378-5122
VL - 143
SP - 223
EP - 230
JO - Maturitas
JF - Maturitas
ER -