Incontinence surgery bests physical therapy in trial - 21 News Now, More Local News for Youngstown, Ohio -

Incontinence surgery bests physical therapy in trial

Updated: Sep 19, 2013 09:22 AM
  • More NewsMore>>

  • Remembering Idora Park over the years

    Remembering Idora Park over the years

    Wednesday, April 23 2014 11:44 PM EDT2014-04-24 03:44:21 GMT
    This Saturday will mark the 30th anniversary of the devastating fire that led to the closing of the Idora Amusement Park. Glenn Stevens took a look back at Idora Park's history and the memories it made for generations. More >>
    This Saturday will mark the 30th anniversary of the devastating fire that led to the closing of the Idora Amusement Park. Glenn Stevens took a look back at Idora Park's history and the memories it made for generations. More >>
  • Trumbull County Sheriff Tom Altiere talks about hostage situation

    Trumbull County Sheriff Tom Altiere talks about hostage situation

    Wednesday, April 23 2014 11:29 PM EDT2014-04-24 03:29:48 GMT
    Following the five hour hostage situation at the Trumbull County jail that ended with the safe release of a corrections guard taken hostage by 3 inmates, Trumbull County Sheriff Tom Altiere spoke to 21 News.More >>
    Following the five hour hostage situation at the Trumbull County jail that ended with the safe release of a corrections guard taken hostage by 3 inmates, Trumbull County Sheriff Tom Altiere spoke to 21 News.More >>
  • GM ships kits to repair ignition in recalled cars

    GM ships kits to repair ignition in recalled cars

    Wednesday, April 23 2014 11:27 PM EDT2014-04-24 03:27:38 GMT
    General Motors says it has shipped thousands of kits consisting of ignition switches, ignition cylinders and key sets for older model small cars subject to a safety recall.According to a notice posted Wednesday on the General Motors corporate website, letters were mailed last week to about 1.4 million owners of 2003-2007 models telling them to contact a GM dealer to make an appointment for repairs, which GM says should take about 90 minutes. Wait times may be longer depending on the busyness ...More >>
    General Motors says it has shipped thousands of kits consisting of ignition switches, ignition cylinders and key sets for older model small cars subject to a safety recall.According to a notice posted Wednesday on the General Motors corporate website, letters were mailed last week to about 1.4 million owners of 2003-2007 models telling them to contact a GM dealer to make an appointment for repairs, which GM says should take about 90 minutes. Wait times may be longer depending on the busyness ...More >>
By Serena Gordon
HealthDay Reporter

WEDNESDAY, Sept. 18 (HealthDay News) -- Stress urinary incontinence is a common problem among women, and new research suggests that surgery might be a better first-line treatment than pelvic muscle strengthening.

In what is billed as a first comparison of the two therapies, Dutch researchers found that almost 91 percent of women who had a type of surgery called midurethral-sling surgery reported improvement compared to 64 percent of women who had physical therapy for pelvic floor muscle training to correct the problem.

"The prevalence of stress urinary incontinence -- leakage on physical exercise, laughing, coughing -- is high, and the impact on daily life can be substantial," said study lead author Dr. Julien Labrie, a gynecology resident at the University Medical Center Utrecht, in the Netherlands.

"Regardless of the severity of the incontinence, pelvic floor muscle training is the first-line treatment in most international guidelines," Labrie said. "With rapidly increasing evidence that [midurethral-sling surgery] is safe with lasting efficacy, we believed it was time to compare surgery with pelvic muscle floor training as a first-line treatment for women with moderate to severe stress urinary incontinence."

Results of the study are published in the Sept. 19 issue of the New England Journal of Medicine.

Stress incontinence is a problem that affects many women as they age, and it has a negative affect on quality of life, according to the National Association for Continence.

The treatment options include pelvic muscle floor training, which involves exercises known as kegels that help strengthen the pelvic muscles. The hope is that the stronger muscles can effectively close the urethra, holding back urine. The rates of subjective success vary greatly for pelvic muscle floor training -- from 53 percent to 97 percent, according to background information in the study.

There also are several surgical options. One is the midurethral-sling surgery, which is a minimally invasive procedure that involves inserting a hammock-like device underneath the urethra to give it additional support and compression to help it stay closed. Subjective cure rates for this procedure vary from 75 percent to 94 percent, the study reported.

To see how these options compared, the researchers recruited 230 women for pelvic muscle floor training (physiotherapy) and another 230 for surgery. The researchers allowed the women in either group to switch if they were unhappy with their treatment.

Nearly half of the women in the physiotherapy group switched to the surgical group, while 11 percent of the women in the surgery group crossed over to physiotherapy during the study.

After a year, the researchers found that subjective improvement was reported by 90.8 percent of the women in the surgery group and 64.4 percent in the physiotherapy group. The rates of subjective cure were somewhat lower -- 85.2 percent for those in the surgical group and 53.4 percent for the physiotherapy group.

Risks of surgery include perforation, the need for reoperation, postoperative bleeding, blood loss and new urinary urge incontinence, according to the study.

"We feel surgery and physiotherapy should both be offered as first-line treatment options," Labrie said. "The woman herself should be involved in deciding what, in her individual case, should be the treatment."

Labrie noted, however, that the trial did not include women with mild incontinence, so the results shouldn't be applied to women who have mild stress incontinence.

Dr. Benjamin Brucker, an assistant professor of female pelvic medicine and reconstructive surgery at the NYU Langone Medical Center in New York City, called the study "very well designed."

The data on surgical complications was reassuring because the complications were relatively minor, he said.

But where does all this leave women who have urinary incontinence? What option should they choose?

"Each woman is unique," Brucker said. "What works best for one woman isn't what would work best for every other woman."

"On an individual level, this study shows that if you want to be conservative, you don't lose anything by having physiotherapy first," he said. "But it also shows that depending on your embarrassment and emotional health scores, if you're a woman who says, 'I just want to put this behind me,' you're not doing yourself a disservice by having surgery first."

More information

Learn more about stress incontinence and treatment options from the National Association for Continence.

Copyright © 2013 HealthDay. All rights reserved.

*DISCLAIMER*: The information contained in or provided through this site section is intended for general consumer understanding and education only and is not intended to be and is not a substitute for professional advice. Use of this site section and any information contained on or provided through this site section is at your own risk and any information contained on or provided through this site section is provided on an "as is" basis without any representations or warranties.
  • More From wfmj.comMore>>

  • Restaurant plans new statue of Joe Paterno

    Restaurant plans new statue of Joe Paterno

    Wednesday, April 23 2014 12:57 PM EDT2014-04-23 16:57:56 GMT
     (AP) - Fans of the late Penn State University football coach Joe Paterno are planning to commission a new bronze statue of him, and place it across from the school. Organizers say the statue will feature Paterno sitting on a bench reading. It's expected to cost about $300,000 and would hopefully be done in 2015 by Philadelphia sculptor Zenos Frudakis. Penn State spokeswoman Lisa Powers says the school isn't involved in the plan. But a restaurant owner in downtown State Col...More >>
     (AP) - Fans of the late Penn State University football coach Joe Paterno are planning to commission a new bronze statue of him, and place it across from the school. Organizers say the statue will feature Paterno sitting on a bench reading. It's expected to cost about $300,000 and would hopefully be done in 2015 by Philadelphia sculptor Zenos Frudakis. Penn State spokeswoman Lisa Powers says the school isn't involved in the plan. But a restaurant owner in downtown State Col...More >>
  • Woman allegedly sold heroin from hospital bed

    Woman allegedly sold heroin from hospital bed

    Wednesday, April 23 2014 11:01 AM EDT2014-04-23 15:01:45 GMT
    A woman in western Pennsylvania is accused of selling heroin from a hospital intensive care unit and a hospital room.More >>
    A woman in western Pennsylvania is accused of selling heroin from a hospital intensive care unit and a hospital room.More >>
  • Jet stowaway undetected for hours before departure

    Jet stowaway undetected for hours before departure

    Tuesday, April 22 2014 11:44 PM EDT2014-04-23 03:44:25 GMT
    Surveillance cameras at San Jose International Airport successfully captured the teenager on the tarmac, climbing up the landing gear of a jet. But in the end, the cameras failed because no one noticed the security...More >>
    A 15-year-old stowaway who survived a flight over the Pacific in a jet's wheel well spent seven hours undetected in what is supposed to be a highly secure area of San Jose International Airport before the flight...More >>
  • Hot ClicksHot ClicksMore>>

  • Can an app save the planet?

    Can an app save the planet?

    This startup's Earth Day launch has a massive goal: Cut carbon emissions globally. It has its work cut out for it.
    More >>
    This startup's Earth Day launch has a massive goal: Cut carbon emissions globally. It has its work cut out for it.
    More >>
  • 'Captain America' holds onto top box office spot

    'Captain America' holds onto top box office spot

    Monday, April 21 2014 10:47 PM EDT2014-04-22 02:47:39 GMT
    LOS ANGELES (AP) - Captain America really is unbeatable - at least at the box office"Captain America: The Winter Soldier" has been the top draw at theaters for three consecutive weeks, vanquishing would-be foes including the new thriller starring Johnny Depp.According to Monday's final box office figures, the Marvel sequel added $25.6 million in ticket sales over the weekend. "The Winter Soldier" has made more than $200 million domestically since logging the best April opening in history."Hea...More >>
    LOS ANGELES (AP) - Captain America really is unbeatable - at least at the box office"Captain America: The Winter Soldier" has been the top draw at theaters for three consecutive weeks, vanquishing would-be foes including the new thriller starring Johnny Depp.According to Monday's final box office figures, the Marvel sequel added $25.6 million in ticket sales over the weekend. "The Winter Soldier" has made more than $200 million domestically since logging the best April opening in history."Hea...More >>
  • Netflix poised to raise prices after strong 1Q

    Netflix poised to raise prices after strong 1Q

    Monday, April 21 2014 10:37 PM EDT2014-04-22 02:37:26 GMT
    SAN FRANCISCO (AP) - Netflix is preparing a sequel unlikely to be a hit with its subscribers. The Internet video service is about to raise its prices for the first time in three years to help pay for more Internet video programming such as its popular political drama "House of Cards."The increase, to take place sometime before July, will hike prices by $1 or $2 per month for new customers. The company's nearly 36 million current subscribers will continue to pay $8 per month for at least the n...More >>
    SAN FRANCISCO (AP) - Netflix is preparing a sequel unlikely to be a hit with its subscribers. The Internet video service is about to raise its prices for the first time in three years to help pay for more Internet video programming such as its popular political drama "House of Cards."The increase, to take place sometime before July, will hike prices by $1 or $2 per month for new customers. The company's nearly 36 million current subscribers will continue to pay $8 per month for at least the n...More >>
Powered by WorldNow
All content © Copyright 2000 - 2014 Worldnow and WFMJ. All Rights Reserved. For more information on this site, please read our Privacy Policy and Terms