Urinary Incontinence

Involuntary loss of URINE, such as leaking of urine. It is a symptom of various underlying pathological processes. Major types of incontinence include URINARY URGE INCONTINENCE and URINARY STRESS INCONTINENCE.

Also Known As:

Networked: 5820 relevant articles (521 outcomes, 752 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Overactive Urinary Bladder (Overactive Bladder)
2.	Stress Urinary Incontinence
3.	Erectile Dysfunction
4.	Pain (Aches)
5.	Prostatic Neoplasms (Prostate Cancer)

Experts

1.	Richter, Holly E: 45 articles (10/2022 - 09/2003)
2.	Wein, Alan J: 27 articles (01/2020 - 09/2002)
3.	Herschorn, Sender: 23 articles (01/2022 - 05/2006)
4.	Brubaker, Linda: 20 articles (01/2022 - 07/2004)
5.	Burgio, Kathryn L: 20 articles (01/2022 - 08/2002)
6.	Kuo, Hann-Chorng: 20 articles (01/2022 - 11/2008)
7.	Griebling, Tomas L: 20 articles (01/2020 - 08/2009)
8.	Guan, Zhonghong: 20 articles (05/2011 - 05/2006)
9.	Chancellor, Michael B: 19 articles (01/2021 - 01/2002)
10.	Newman, Diane K: 18 articles (07/2022 - 01/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Urinary Incontinence:

1.	Type A Botulinum Toxins (Botox)FDA Link 03/01/2020 - "In the onabotulinumtoxinA group, there was a significantly greater decrease from baseline in the mean number of daily urinary incontinence episodes compared with the placebo group (2.16; P < 0.001), and significantly greater improvement for all secondary end-points (P < 0.05). " 10/04/2016 - "Among women with refractory urgency urinary incontinence, treatment with onabotulinumtoxinA compared with sacral neuromodulation resulted in a small daily improvement in episodes that although statistically significant is of uncertain clinical importance. " 10/04/2016 - "To assess whether onabotulinumtoxinA is superior to sacral neuromodulation in controlling refractory episodes of urgency urinary incontinence. " 02/29/2016 - "The urinary incontinence episodes, maximum cystometric capacity, and maximum detrusor pressure were improved greater by botulinum toxin A compared to placebo. " 01/01/2013 - "Intravesical botulinum toxin type A injection is effective in treatment of urinary incontinence due to detrusor overactivity in men and women, as well as in children. "
2.	Estrogens (Estrogen)FDA Link 05/01/1998 - "To analyze by meta-analysis the results of randomized controlled clinical trials on the efficacy of estrogen treatment in menopausal patients with urinary incontinence. " 01/01/2023 - "In addition, 43% of participants in the estrogen group and 31% of participants in the placebo group showed improvement in urgency urinary incontinence (P=.41), and 41% of participants in the estrogen group and 26% of participants in the placebo group showed improvement in urinary frequency (P=.18). " 06/01/1998 - "Urinary incontinence is thought to be benefited by treatment with estrogen, although controversy exists. " 11/01/1996 - "Efficacy of estrogen supplementation in the treatment of urinary incontinence. " 03/01/2012 - "The aim of this study was to examine the relationship between self-reported estrogen use and newly incident urinary incontinence (UI) among community-dwelling postmenopausal women. "
3.	pentalenolactone F methyl esterIBA 01/01/2022 - "PFME versus no PFME had a beneficial effect on urinary incontinence remission at 3 months, 3-6 months, and more than 6 months post-surgery, with risk differences ranging from 12 to 25%. " 01/01/2020 - "We hypothesised that a single pelvic floor muscle exercise (PFME) session immediately postpartum would be effective in preventing urinary incontinence (UI) in a 3-month postpartum period with good adherence rates. " 01/01/2019 - "Pelvic floor muscle exercise (PFME) is recommended as a first-line treatment for urinary incontinence. " 10/22/2022 - "Antenatal pelvic floor muscle exercises (PFME) in women without prior urinary incontinence (UI) are effective in reducing postnatal UI; however, UK midwives often do not provide advice and information to women on undertaking PFME, with evidence that among women who do receive advice, many do not perform PFME. " 01/01/2011 - "PFME applied in pregnancy is effective in the treatment and prevention of urinary incontinence during pregnancy, and this effect may persist to postpartum period."
4.	Cholinergic Antagonists (Anticholinergics)IBA 12/01/2012 - "It is important to conduct urodynamic study before starting anticholinergic treatment of females with urinary incontinence to identify therapeutic data of poor prognosis, such as SUI and lower urinary tract obstruction, thus optimizing the therapeutic efficacy of anticholinergics." 10/14/2023 - "Impact of microbiota and host immunologic response on the efficacy of anticholinergic treatment for urgency urinary incontinence." 06/01/1982 - "The effect of anticholinergic drugs in the treatment of urinary incontinence in elderly patients with uninhibited bladder contractions might to some extent be due to an improvement in the patients' understanding and acceptance of the bladder disorders." 04/01/2018 - "The aims of this study were to investigate patterns of prescribing anticholinergic drugs among women with urinary incontinence (UI) and to identify factors associated with prescription of these drugs. " 08/01/2012 - "Patients not on anticholinergic treatment for OAB and experiencing urinary incontinence (≥1 episode/week) and micturition frequency (≥8 episodes/day) or urgency (≥1 episode/week) were enrolled in this 4-week, open-label study. "
5.	Tolterodine Tartrate (Detrol)FDA Link 01/01/2006 - "In addition, TDOXY was similar to tolterodine, and it produced a significant improvement in the number of urinary incontinence episodes, complete continence, and urodynamic and quality of life parameters compared with placebo. " 01/01/2012 - "Parameter estimates included utilities of improved urinary incontinence (0.92) and continued urinary incontinence (0.73), reduction in quality of life from side effects (5%), cost of percutaneous tibial nerve stimulation per session ($203) and cost of tolterodine ER per month ($150). " 10/01/2013 - "A total of six randomized clinical trials and 11 other studies of tolterodine in children with urinary incontinence were included in the present systematic review. " 02/18/2009 - "Previous studies demonstrate that tolterodine extended release (ER) significantly improves urgency urinary incontinence (UUI) episodes. " 04/01/2007 - "A post hoc analysis was conducted using 3-day bladder diary data from a 12-week, multicenter, prospective, open-label study of tolterodine ER (4 mg qd) in patients (aged > or = 18 years) with urinary frequency (> or = 8 micturitions/24 h) and urgency (strong and sudden desire to urinate) with or without urgency urinary incontinence (UUI). "
6.	fesoterodineFDA Link 01/01/2014 - "At week 12 the fesoterodine group had significantly greater improvements in urgency urinary incontinence episodes per 24 hours (-2.84 vs -2.20, p = 0.002) and most other diary variables and quality of life, as well as a higher diary dry rate (50.8% vs 36.0%, p = 0.002). " 01/01/2019 - "The experts concluded that the physician should not leave urgency undeclared or untreated; that the patient should be involved in the choice of treatment; and that fesoterodine, which offers flexible dosing and has proven, consistent positive results on urgency episodes and urgency urinary incontinence, with very low/no risk of impairment of cognitive function, appears to be one of the good choices in the treatment of this symptom." 01/01/2014 - "Flexible dose fesoterodine significantly improved urgency urinary incontinence episodes and other outcomes vs placebo, and was generally well tolerated." 12/01/2010 - "Greater improvement in urgency urinary incontinence was seen with fesoterodine 8 mg versus 4 mg. For those aged ≥65 to <75 years, fesoterodine 4 and 8 mg significantly improved all diary variables, except for the mean voided volume and micturition frequency, respectively, [corrected] versus placebo. " 01/01/2010 - "Treatment differences in micturitions and frequency-urgency sum were significant by week 2 and in urgency urinary incontinence and urgency episodes by week 6. Significantly greater percentages of subjects taking fesoterodine had improved Patient Perception of Bladder Condition and Urgency Perception Scale scores at weeks 2, 6, and 12 (P <.05). "
7.	Solifenacin SuccinateFDA Link 05/01/2016 - "This study shows that solifenacin treatment is effective for treating urinary incontinence but may lead to changes in bowel patterns and affects overall quality of life (QoL). " 01/01/2019 - "Among the included studies only solifenacin succinate double-blind, randomized, placebo-controlled study was assessed as low risk of bias, and treatment led to an improvement in urinary incontinence. " 05/01/2015 - "In this pilot trial, solifenacin succinate treatment led to an improvement in urinary incontinence, despite persistence in other OAB symptoms." 06/01/2006 - "Short- and long-term efficacy of solifenacin treatment in patients with symptoms of mixed urinary incontinence." 10/01/2020 - "Moreover, two studies tested the effect of solifenacin on urinary incontinence. "
8.	mirabegronIBA 01/01/2021 - "We found that mirabegron treatment resulted in a significant improvement in bladder compliance [mean difference (MD) = 19.53, 95% confidence interval (CI): 14.19 to 24.87, P < 0.00001], urinary incontinence episodes (MD = -0.78, 95% CI: -0.89 to -0.67, P < 0.00001) and Incontinence Quality of Life (I-QOL) (MD = 8.02, 95% CI: 3.20 to 12.84, P = 0.001). " 01/01/2015 - "After mirabegron, urinary incontinence was improved in all patients. " 01/01/2021 - "This 12-week study included patients who were starting mirabegron treatment for the OAB symptoms of urinary urgency, daytime frequency, and urgency urinary incontinence. " 01/01/2016 - "A meta-analysis of four placebo-controlled trials including about 3500 patients suggested that mirabegron was poorly effective: on average, treatment prevented one episode of urinary incontinence every 2 days." 04/27/2023 - "Mirabegron treatment was associated with a lower number of urinations and occurrences of urinary incontinence per day. "
9.	CollagenIBA 06/01/1997 - "Periurethral collagen injection may be effective for urinary incontinence in patients who have adequate capacity with good compliance and low Valsalva leak point pressure. " 05/01/2001 - "With long-term followup collagen injection is rarely effective for treating urinary incontinence in children with neurogenic sphincter deficiency." 02/01/1996 - "Endoluminal ultrasonography is helpful in ensuring the accurate submucosal location of collagen injection and in avoiding dispersion of the material and should enhance therapeutic efficacy in the treatment of urinary incontinence." 04/01/1995 - "In our experience, endoscopic collagen injection is effective in the treatment of both urinary incontinence and VUR in paediatric patients. " 10/01/1998 - "Injection of transurethral collagen appears to be a safe and effective method for treating urinary incontinence. "
10.	oxybutynin (Tavor)FDA LinkGeneric 10/01/2005 - "Individualized dosing with ER oxybutynin was associated with highly effective and well tolerated control of urinary incontinence with more than 40% of patients achieving total dryness." 11/27/2023 - "Oxybutynin, an agent for treating urinary incontinence, is recently claimed with protective effects on bladder ultrastructure. " 01/01/2015 - "Efficacy and safety of oxybutynin topical gel 3% in patients with urgency and/or mixed urinary incontinence: a randomized, double-blind, placebo-controlled study." 01/01/2007 - "Safety and tolerability of extended-release oxybutynin once daily in urinary incontinence: combined results from two phase 4 controlled clinical trials." 01/01/2020 - "It is uncertain whether surgery compared with oxybutynin leads to more women being dry (83% vs 0%; OR 195.89, 95% confidence interval (CI) 9.91 to 3871.03) or having less urgency urinary incontinence (13% vs 43%; RR 0.29, 95% CI 0.09 to 0.94) because the quality of this evidence is very low. "

Therapies and Procedures

1.	Therapeutics 10/01/2019 - "Most patients responded well to a standard course of induction topical therapy followed by maintenance therapy, but some, including three patients with ongoing urinary incontinence and three postpubertal patients, continued to have active disease. " 08/01/2004 - "Pharmacologic therapy clearly is beneficial for most types of urinary incontinence. " 01/01/1998 - "For therapy of the recurrent urinary incontinence the abdominal Burch colposuspension showed the best results with cure rates of 50% and cure or improvement in 75%. " 01/01/2017 - "Urinary incontinence resolved completely within five months of hormonal therapy. " 02/01/2015 - "Consideration of the psychosomatics is important in the therapy for female urinary incontinence from three points of view: 1) the efficacy of treatment is better suited to the patient, 2) the treatment costs are lower, 3) the professional satisfaction of the responsible physician increases. "
2.	Prostatectomy (Retropubic Prostatectomy) 01/01/2021 - "To develop and validate a model to predict 12-month continence status after robot-assisted radical prostatectomy (RARP) from preoperative and 3-month postoperative data; this model could help in informing patients on their individualised risk of urinary incontinence (UI) after RP in order to choose the best treatment option. " 01/01/2022 - "Virtue could be considered an interesting option for postradical prostatectomy urinary incontinence with positive results over time even in patients with high BMI. " 11/25/2020 - "In treating the clinically localized PC, the radical prostatectomy is regarded as a gold standard, but it is associated with syndromes as urinary incontinence (UI), which can have a significant impact on patients' quality of life. " 10/01/2017 - "The majority of patients undergoing the AdVance sling procedure for post-prostatectomy urinary incontinence saw a significant reduction in pad use, and were overall satisfied in both radiated and non-radiated groups at short and long term follow up. " 01/01/2017 - "In conclusion, although AUS implants are recommended as the gold-standard treatment of severe urinary incontinence after prostatectomy, the observed high rates of malfunction and grade III adverse events are a matter of concern warranting further assessment on the safety and efficacy of these devices."
3.	Suburethral Slings (Tension-Free Vaginal Tape) 01/01/2018 - "Male sling for urinary incontinence is usually accompanied by very good results, with a small number of complications,but, when appear, they may be redundant. " 01/01/2022 - "Surgical management is complex; after a good preoperative evaluation, a two-step management strategy including minimally invasive mid-urethral sling removal and treatment of recurrent urinary incontinence leads to good results with 77% of patients cured. " 09/01/2020 - "A midurethral sling successfully relieved mixed urinary incontinence in this case, but it might be necessary to loosen the laparoscopic sacrocolopopexy mesh in some other cases." 01/01/2020 - "Intraoperative trans-obturator tape adjustment using the Credé maneuver to identify the leaking pattern significantly improved the success rate in women with mixed urinary incontinence, and Credé maneuver-directed adjustment significantly improved the cure rate." 02/01/2013 - "Both retropubic and transobturator midurethral slings are effective for patients with mixed urinary incontinence, but the overall cure rate is lower than for patients with pure SUI. "
4.	Artificial Urinary Sphincter 05/01/2019 - "As slings are the most frequent first-line treatment for management of female urinary incontinence, an artificial urinary sphincter may be indicated in cases of failure and sphincter deficiency. " 02/16/1992 - "We find implantation of the artificial urinary sphincter very effective treatment for urinary incontinence." 06/01/2000 - "Persistent urinary incontinence after failed surgical repair can be successfully treated with the artificial urinary sphincter. " 05/01/1984 - "With the refinements in the Sphincter 800, better patient selection and improved surgical techniques, the artificial urinary sphincter now offers a viable treatment alternative in the management of urinary incontinence arising from sphincteric incompetence." 12/01/1995 - "The aim of this study is to evaluate the therapeutic efficacy of artificial urinary sphincter AMS 800 implants for male patients with urinary incontinence. "
5.	Psychology Biofeedback (Biofeedback) 07/06/2011 - "Women who received biofeedback were significantly more likely to report that their urinary incontinence was cured or improved compared to those who received PFMT alone (risk ratio 0.75 , 95% confidence interval 0.66 to 0.86). " 03/01/2007 - "However, the prognosis of urinary incontinence following surgery is good and can be improved by pelvic floor muscle exercises in combination with biofeedback systems. " 04/01/2000 - "Pelvic floor muscle exercises can be effective in maintaining and improving urinary incontinence and associated bladder symptoms following a successful course of biofeedback and electrical stimulation." 08/01/1988 - "Research questions addressed by this study were: 1) Is the treatment of chronic urinary incontinence (UI) in elderly, nondemented ambulatory patients using bladder-sphincter biofeedback as effective when performed by an internist/geriatrician and a nurse practitioner as that reported by behavioral scientists?; and 2) how does bladder-sphincter biofeedback compare to a program of behavioral training that does not utilize biofeedback? " 12/12/2007 - "(4) Pelvic floor muscle training and biofeedback are effective in preventing and reversing fecal and urinary incontinence in women for the first year after giving birth, and these approaches may also prevent or reduce urinary incontinence in older women and in men undergoing prostate surgery. "