Brown University Leads NIH Study on Surgery for Urinary Incontinence

In a study published in the Journal of the American Medical Association, surgery for stress urinary incontinence also improved symptoms of urgency incontinence in women who suffer from both types. The findings counter the current treatment guidelines that suggest the surgery may worsen urgency incontinence in women with both forms.

The Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM) was a randomized clinical trial with 480 women with mixed urinary incontinence. All participants underwent mid-urethral sling surgery and were randomized to surgery alone, or surgery with behavior and pelvic floor muscle therapy. Participants were followed for one year and responded to the urogenital distress inventory (UDI). They also responded to surveys on quality of life and perceptions of surgical success.

Researchers found that both groups of participants experienced significant improvement in their incontinence symptoms after surgery. Since the post-treatment UDI scores did not differ significantly (40.3 for surgery only verses 33.8 for surgery combined with therapy), researchers suggest that adding behavioral and pelvic floor muscle therapy to treatment may not result in better clinical outcomes. However, participants’ self-report outcomes indicated that those with combined surgery and therapy experienced fewer instances of incontinence a year after surgery and were less likely to receive additional treatment. Researchers are calling for additional research to identify which patients with mixed urinary incontinence are at risk for continued symptoms after surgery and to identify effective treatments for them.

Read the full article from NIH here.