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Surgery for urinary incontinence in women 65 years and older: a systematic review
Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Department of Obstetrics and Gynecology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-9062-8840
Swedish Council on Health Technology Assessment (SBU), Stockholm, Sweden.
Center for Primary Health Care Research, Lund University, Malmö, Sweden.
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2015 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 26, no 8, p. 1095-1102Article in journal (Refereed) Published
Abstract [en]

Introduction and hypothesis: Urinary incontinence (UI) is common among the elderly, but the literature is sparse on the surgical treatment of UI among the elderly. This systematic review aims to assess the effectiveness of surgical interventions as treatment for urinary incontinence in the elderly population ≥65 years of age.

Methods: Randomized controlled trials (RCT) and prospective nonrandomized studies (NRS) were included. The databases PubMed (NLM), EMBASE (Elsevier), Cochrane Library (Wiley), and Cinahl (EBSCO) were searched for the period 1966 up to October 2013. The population had to be ≥65 years of age and had to have undergone urethral sling procedures, periurethral injection of bulking agents, artificial urinary sphincter surgery, bladder injection treatment with onabotulinumtoxin A or sacral neuromodulation treatment. Eligible outcomes were episodes of incontinence/urine leakage, adverse events, and quality of life.

The studies included had to be at a moderate or low risk of bias. Mean difference (MD) or standard mean difference (SMD)as well as risk difference (RD) and the 95 % CI were calculated.

Results: Five studies-all on the suburethral sling procedure in women- that fulfilled the inclusion criteria were identified. The proportion of patients reporting persistent SUI after surgery ranged from 5.2 to 17.6 %. One study evaluating quality of life (QoL) showed a significant improvement after surgery. The complication rates varied between 1 and 26 %, mainly bladder perforation, bladder emptying disturbances, and de novo urge.

Conclusion: The suburethral sling procedure improves continence as well as QoL among elderly women with SUI; however, evidence is limited.

Place, publisher, year, edition, pages
Springer, 2015. Vol. 26, no 8, p. 1095-1102
Keywords [en]
Elderly; Surgery; Systematic review; Urinary incontinence
National Category
Urology and Nephrology Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:oru:diva-39470DOI: 10.1007/s00192-014-2573-9ISI: 000361229500002PubMedID: 25477140Scopus ID: 2-s2.0-84938954854OAI: oai:DiVA.org:oru-39470DiVA, id: diva2:770295
Note

Funding Agency:

Swedish Council on Technology Assessment in Health Care (SBU)

Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2018-06-26Bibliographically approved

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Franzén, Karin MAndersson, Gunnel

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Franzén, Karin MAndersson, Gunnel
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School of Medicine, Örebro University, SwedenÖrebro University HospitalSchool of Health and Medical Sciences, Örebro University, Sweden
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International Urogynecology Journal
Urology and NephrologyObstetrics, Gynecology and Reproductive Medicine

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