Davila G Willy
Section of Urogynecology, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
Adv Urol. 2011;2011:176498. doi: 10.1155/2011/176498. Epub 2011 Jun 23.
Objective. To evaluate long-term effectiveness and safety of conservative and minimally invasive outpatient treatments for female stress urinary incontinence (SUI) through a review of the literature. Methods. PubMed was searched for reports on prospective clinical trials with at least 12-month follow-up of minimally invasive treatments, pelvic floor rehabilitation, or pharmacotherapy in women with SUI. Each report was examined for long-term rates of effectiveness and safety. Results. Thirty-two clinical trial reports were included. Prospective long-term studies of pelvic floor rehabilitation were limited but indicated significant improvements with treatment adherence for at least 12 months. Poor initial tolerability with duloxetine resulted in substantial discontinuation. Most patients receiving transurethral radiofrequency collagen denaturation or urethral bulking agents reported significant long-term improvements, generally good tolerability, and safety. Conclusions. Conservative therapy is an appropriate initial approach for female SUI, but if therapy fails, radiofrequency collagen denaturation or bulking agents may be an attractive intermediate management step or alternative to surgery.
目的。通过文献综述评估女性压力性尿失禁（SUI）保守及微创门诊治疗的长期有效性和安全性。方法。检索PubMed，查找关于对女性SUI进行微创治疗、盆底康复或药物治疗且至少随访12个月的前瞻性临床试验报告。检查每份报告的长期有效性和安全性数据。结果。纳入32份临床试验报告。盆底康复的前瞻性长期研究有限，但表明坚持治疗至少12个月有显著改善。度洛西汀初始耐受性差导致大量停药。大多数接受经尿道射频胶原变性或尿道填充剂治疗的患者报告长期有显著改善，耐受性总体良好且安全。结论。保守治疗是女性SUI的合适初始方法，但如果治疗失败，射频胶原变性或填充剂可能是有吸引力的中间管理步骤或手术替代方案。
