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Stress urinary incontinence is a common disease among older people, especially women. The symptoms are leakage of urine when the person coughs, laughs or exercises. It affects social, psychological, physical and financial aspects of life. Acupuncture is used widely in Asian countries for this condition and frequency of use is increasing worldwide. From the viewpoint of traditional Chinese medicine, acupuncture could improve the symptoms of stress urinary incontinence by reinforcing qi (the vital substance constituting human body) and promoting recovery of the bladder's function. This review included only one small trial with 60 women. There was not enough evidence to assess the effects of acupuncture for stress urinary incontinence compared with drug treatment, and high‐quality randomised controlled trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 1, 2013

Stress urinary incontinence (SUI) is loss of urine when a person coughs or exercises. Damage to the pelvic floor muscles and injuries to the nerves during childbirth may lead to SUI. Simple treatments, such as exercising the muscles in the pelvic floor or drugs (medication), may be tried at first. If these methods have not worked, surgery is often performed. This usually involves placing a tape made from polypropylene (a synthetic material, like nylon, that is used in some surgical stitches and other medical devices) underneath the neck of the bladder. This operation is very successful but not all women will be cured after a first tape surgery, and there is currently no agreement among experts on how to treat women with persistent or recurrent problems. This review set out to find evidence for different treatments, but it did not identify any studies which provided answers. High quality randomised clinical trials are urgently needed to answer this question.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 28, 2013

Stress urinary incontinence is involuntary urine leakage on coughing or exertion. The trials reviewed compared duloxetine against dummy placebo tablets and also pelvic floor muscle training in women with predominantly stress urinary incontinence. Duloxetine reduced the frequency of episodes of incontinence and improved quality of life scores. However, it had little impact on the numbers cured and commonly had side effects, especially nausea. More studies comparing a serotonin and noradrenaline reuptake inhibitor with placebo and surgery are required, especially if conducted independently of pharmaceutical companies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 20, 2005

Stress urinary incontinence (involuntary leakage of urine on effort or exertion; or on sneezing, coughing or laughing) is the commonest form of incontinence in women and leads to a reduction in their quality of life. Women with stress urinary incontinence can also have problems with sexual intercourse, as leakage of urine can occur. A significant amount of the woman's and her family's income can be spent on managing the symptoms. One in three women over the age of 18 years will be affected by stress urinary incontinence at some point in her lifetime.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 31, 2017

We investigated whether electrical stimulation was better than no treatment at all or better than other available treatments for curing or improving stress urinary incontinence (SUI) symptoms in women. We also investigated whether SUI was cured or improved by adding electrical stimulation to other treatments, compared to other treatments and to different types of electrical stimulation. Finally, we investigated whether electrical stimulation represented value for money.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2018

Urinary incontinence is the leakage of urine, and when caused by coughing or exercising it is called stress incontinence. It may be caused by damage to muscles either holding up the bladder or holding the bladder neck closed. Adrenergic agonist drugs may help the bladder neck muscle to contract more strongly. This review of 22 trials involving 673 women and seven different adrenergic drugs found weak evidence that adrenergic agonists may help stress urinary incontinence. Side effects do occur but are usually minor. Rarely, more serious adverse effects such as high blood pressure can occur. More evidence is needed to compare adrenergic drugs with other drugs for stress incontinence and also with pelvic floor muscle exercises.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 20, 2005

Stress incontinence is the involuntary leakage of urine with a physical activity such as coughing or sneezing. Urgency leakage occurs with a strong need to urinate, but the person cannot make it to the toilet in time. A combination of stress and urgency leakage is called mixed incontinence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 14, 2014

Women of all ages are affected by urinary incontinence. A common treatment is pelvic floor muscle exercises (also called pelvic floor muscle training) where the pelvic floor muscles are squeezed and lifted then relaxed several times in a row, up to three times a day. The exercises can help strengthen the muscles, improve muscle endurance (so the muscle tires less easily), and improve coordination (so the muscle squeezes hardest when the risk of leaking is greatest, e.g. with a cough or sneeze).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 6, 2011

Stress urinary incontinence is loss of urine when coughing, laughing, sneezing or exercising. Damage to the muscles that hold up the bladder may cause it. About a third of adult women may have urine leakage, and about a third of these may have problems bad enough to require surgery. A significant amount of a woman's and their family's income can be spent on management of stress urinary incontinence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 25, 2017

Leaking urine when coughing, sneezing, or exercising (stress urinary incontinence) is a common problem for women. This is especially so after giving birth, when about one woman in three will leak urine. Training of the pelvic floor muscles is the most common form of treatment for this problem. One way that women can train these muscles is by inserting cone‐shaped weights into the vagina, and then contracting the pelvic floor muscles to stop the weights from slipping out again.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 8, 2013

Urinary leakage (incontinence) after surgery to remove the prostate (prostatectomy) for benign or malignant disease is a well‐known and often feared outcome. Although a small amount of incontinence may not cause a problem, larger degrees of incontinence can have a major impact on a man's quality of life. Improvement in urinary leakage may occur six to 12 months after the prostatic surgery, but for men with persistent bothersome leakage despite conservative therapy such as pelvic floor exercises, surgery may be offered.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 27, 2014

Some men leak urine (urinary incontinence) when they cough or exercise (stress urinary incontinence) or when they have a sudden, compelling urge to pass urine (urgency urinary incontinence). Men may also need to pass urine more often than usual (frequency) or get up more than once at night to pass urine (nocturia). In men this may be due to an enlarged prostate gland or develop after surgery to removal the prostate. Men can contract their pelvic floor muscles to reduce or stop these symptoms. Electrical stimulation with non‐implanted devices involves stimulation of these muscles with a painless electric current using surface electrodes on the skin or a probe placed into the anus. The aim is to make the pelvic floor muscles contract so that they become stronger and so better able to prevent leakage, or to make the muscle at the base of the bladder (the sphincter) contract more strongly to stop urine escaping. Electrical stimulation might also lessen the contractions of the bladder muscle to ease the sense of urgency and allow the bladder to hold more urine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 6, 2013

Urinary incontinence is the leakage of urine when coughing or exercising (stress urinary incontinence) or after a strong uncontrollable urge to urinate (urgency urinary incontinence). In women who have gone through the menopause, low oestrogen levels may contribute to urinary incontinence. The review found 34 trials including more than 19,000 women of whom over 9000 received oestrogen. The review found that significantly more women who received local (vaginal) oestrogen for incontinence reported that their symptoms improved compared to placebo. There was no evidence about whether the benefits of local oestrogen continue after stopping treatment but this seems unlikely as women would revert to having naturally low oestrogen levels. Trials investigating systemic (oral) administration, on the other hand, found that women reported worsening of their urinary symptoms. The evidence comes mainly from two very large trials including 17,642 incontinent women. These trials were investigating other effects of hormone replacement therapy as well as incontinence, such as prevention of heart attacks in women with coronary heart disease, bone fractures, breast and colorectal cancer. In addition, in one large trial women who did not have incontinence at first were more likely to develop incontinence. There may be risks from long‐term use of systemic oestrogen, such as heart disease, stroke and cancer of the breast and uterus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 17, 2012

Stress incontinence is losing urine when coughing, laughing, sneezing or exercising. A significant amount of a woman's and their family's income can be spent on managing the symptoms. Usually muscles and tissue form a cushion supporting the base of the bladder and closing the urethra (the passage through which urine leaves the body). If they do not, artificial cushioning can be created by injecting bulking agents into the area around the urethra. The review of 14 trials, which included 2004 women, found some limited evidence that this can relieve stress incontinence in women. Other treatments such as surgery might be better. Using the women's own fat tissue as the agent injected can cause serious complications. In terms of costs, a brief review of economic studies suggested that collagen injection was less costly than surgery when used as first treatment or after initial surgery failure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 25, 2017

Involuntary leakage of urine (urinary incontinence) affects women of all ages, particularly older women who live in residential care, such as nursing homes. Some women leak urine during exercise or when they cough or sneeze (stress urinary incontinence). This may occur as a result of weakness of the pelvic floor muscles, which may be a result of factors such as damage during childbirth. Other women leak urine before going to the toilet when there is a sudden and compelling need to pass urine (urgency urinary incontinence). This may be caused by involuntary contraction of the bladder muscle. Mixed urinary incontinence is the combination of both stress and urgency urinary incontinence. Pelvic floor muscle training is a supervised treatment that involves muscle‐clenching exercises to strengthen the pelvic floor muscles. It is a common treatment used by women to stop urine leakage. Other treatments are also available, which can be used either alone, or in combination with pelvic floor muscle training.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 3, 2015

Stress urinary incontinence is losing urine when coughing, laughing, sneezing or exercising. It can be caused by changes to muscles and ligaments holding up the bladder. Mixed urinary incontinence is also losing urine when there is an urge to void as well as when coughing and laughing. Muscle‐strengthening exercises can help, and there are surgical procedures to improve support or correct problems. A significant amount of a woman's and their family's income can be spent on management of stress urinary incontinence. Open retropubic colposuspension is an operation which involves lifting the tissues around the junction between the bladder and the urethra.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 25, 2017

Traditional sling operations are used to treat women with stress urinary incontinence. This is loss of urine when coughing, laughing, sneezing or exercising due to damage to the muscles that hold up the bladder, and injuries to the nerves that may occur during childbirth. A significant amount of the woman's and her family's income can be spent on managing the symptoms. Sometimes stress incontinence occurs together with 'urge incontinence' ‐ known as 'mixed incontinence'. The sling operation aims to hold up the bladder with a strip of material which may be biological or synthetic. The results showed that there is not enough information on which to judge whether traditional sling operations are better or worse than any other treatments. Long‐term results are awaited. In terms of costs, a brief review of economic studies, which considered the overall costs and effects, suggested that traditional slings are less costly when compared with collagen injection but expensive when compared with minimally invasive slings. In this review there were few trials, of high quality, comparing slings with other forms of surgery and only one study comparing sling operations with non‐surgical treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 26, 2017

Urinary incontinence is the inability to prevent urine leakage. Stress urinary incontinence is loss of urine when a person coughs or exercises. A significant amount of a woman's or her families income can be spent on management of stress urinary incontinence. Damage to the muscles that hold up the bladder, and injuries to the nerves during childbirth, may be causes. When non‐surgical methods, such as exercising the muscles in the pelvic floor (the base of the abdomen), have not worked, surgery is sometimes used to lift and support the bladder. Anterior vaginal repair aims to achieve this, operating through the vaginal wall. The review of 10 trials in 1012 women found some evidence that surgery through the abdomen may be better than vaginal repair. However, there was not enough information about side‐effects, or in comparison with other physical or surgical methods of treating urine leakage.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 31, 2017

Urinary incontinence is involuntary loss of urine. The common types are stress and urge incontinence. Mechanical devices are made of plastic or other materials. They are placed within the urethra or vagina in order to stop or control the leakage of urine. This review of trials found that using mechanical devices might be better than no treatment but the evidence is weak. There was not enough evidence to recommend any specific type of device or to show whether mechanical devices are better than other forms of treatment such as pelvic floor muscle training.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 17, 2014

Involuntary urine leakage (or incontinence) is a widespread condition experienced by about a quarter of women. Exercise for the pelvic floor muscles is often the first treatment women are offered. Improving the strength, endurance and co‐ordination of the pelvic floor muscles can help decrease the urine leakage. This review included 21 studies in 1490 women and looked at whether one way of teaching, supervising or performing these exercises was better than another. Women who had regular and repeated contact with the person who taught them to do the exercises and monitored their progress were more likely to report they were improved after treatment. Further research is needed because there were problems interpreting the studies, which meant we could not draw any firm conclusions about many of the other possible ways of teaching, supervising or performing these exercises.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 7, 2011

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