OBJECTIVE:To review key guidelines on the management of urinary incontinence in order to guide clinical management in a practical way.
MATERIALS AND METHODS: Guidelines produced by the European Association of Urology (updated in 2014), the Canadian Urological Association (updated in 2012), the International Consultation on Incontinence (updated in 2012), and the National Collaborating Centre for Women's and Children's Health (updated in 2013) were examined and their recommendations compared. In addition, specialized guidelines produced by the collaboration between the American Urological Association and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction on overactive bladder and the use of urodynamics were reviewed. The Appraisal of Guidelines for Research & Evaluation II (AGREE) Instrument was used to evaluate the quality of these guidelines.
RESULTS: There is general agreement between the groups on the recommended initial workup and the use of conservative therapies for first line treatment, with limited role for imaging or invasive testing in the uncomplicated patient. These groups have greater variability in their recommendations for invasive procedures, however generally the mid-urethral sling is recommended for uncomplicated stress urinary incontinence, with different recommendations on the approach as well as the comparability to other treatments, such as the autologous fascial sling.
CONCLUSION: This Guideline of Guidelines provides a summary of the salient similarities and differences between prominent groups on the management of urinary incontinence.
Written by:
Syan R, Brucker BM. Are you the author?
Department of Urology, New York University Langone Medical Center, New York, New York, USA; Department of Obstetrics & Gynecology, New York University Langone Medical Center, New York, New York, USA.
Reference: BJU Int. 2015 Jun 1. Epub ahead of print.
doi: 10.1111/bju.13187
PubMed Abstract
PMID: 26033093