The course of urinary incontinence in different periods of a woman’s life

Ilyina I.Yu., Chikisheva A.A., Dobrokhotova Yu.E.

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
The paper deals with female urinary incontinence that is a serious social and medical problem with a substantial negative impact on the physical, social, economic, and psychological well-being of women. Urinary incontinence is quite common in patients, although not all seek medical care for this problem despite the fact that there are many effective treatment options today. The paper describes different urinary incontinence types that can occur in different periods of a woman’s life. It depicts diagnostic features and possible treatment options according to the type of urinary incontinence, the degree of its severity, and the efficiency of one or other therapeutic methods. It should be noted that many of the studies described in the paper indicate that the use of antimuscarinic agents, trospium chloride in particular, in the treatment of overactive bladder, as well as in the elderly, is safe and effective in improving the well-being and quality of life of patients.
Conclusion. The optimal therapeutic approach to treating overactive bladder symptoms should include drug and behavioral therapies in addition to lifestyle advice.

Keywords

urinary incontinence
overactive bladder
stress urinary incontinence
imperative urinary incontinence
antimuscarinic agents
trospium chloride

References

  1. Aoki Y., Brown H.W., Brubaker L, Cornu J.N., Daly J.O., Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017 Jul 6; 3:17042. https://dx.doi.org/10.1038/nrdp.2017.42.
  2. Schreiber Pedersen L., Lose G., Hоybye M.T., Elsner S., Waldmann A., Rudnicki M. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta Obstet Gynecol Scand. 2017 Aug; 96(8):939-48. https://dx.doi.org/10.1111/aogs.13149. Epub 2017 May 20.
  3. Goforth J., Langaker M. Urinary Incontinence in Women. N C Med J. 2016 Nov-Dec; 77(6):423-425. https://dx.doi.org/10.18043/ncm.77.6.423.
  4. Клинические рекомендации. Недержание мочи у женщин. 2016. [Clinical recommendations. Urinary incontinence in women. 2016. (in Russian)].
  5. Lukacz E.S., Santiago-Lastra Y., Albo M.E., Brubaker L. Urinary Incontinence in Women: A Review. JAMA. 2017 Oct 24; 318(16):1592-1604. https://dx.doi.org/10.1001/jama.2017.12137.
  6. Glazener C.M., Cooper K., Mashayekhi A. Anterior vaginal repair for urinary incontinence in women. Cochrane Database Syst Rev. 2017 Jul 31; 7(7): CD001755. https://dx.doi.org/10.1002/14651858.CD001755.pub2.
  7. Woodley S.J., Lawrenson P., Boyle R., Cody J.D., Mоrkved S, Kernohan A. et al. Cochrane Database Syst Rev. 2020 May 6;5(5):CD007471. https://dx.doi.org/10.1002/14651858.CD007471.pub4.Cochrane Database Syst Rev. 2020. PMID: 32378735.
  8. Sangsawang B., Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. 2013 Jun; 24(6): 901-12. https://dx.doi.org/10.1007/s00192-013-2061-7. Epub 2013 Feb 23.
  9. Yan W., Li X., Sun S., Xiang Y., Zhou Y., Zeng X. et al. Risk factors for female pelvic organ prolapse and urinary incontinence. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018 Dec 28; 43(12): 1345-50. https://dx.doi.org/10.11817/j.issn.1672-7347.2018.12.010.
  10. Franiс D., Fistoniс I. Laser Therapy in the Treatment of Female Urinary Incontinence and Genitourinary Syndrome of Menopause: An Update. Biomed Res Int. 2019 Jun 4; 2019: 1576359. https://dx.doi.org/10.1155/2019/1576359. eCollection 2019.
  11. Аhlund S., Rothstein E., Rаdestad I., Zwedberg S., Lindgren H. Urinary incontinence after uncomplicated spontaneous vaginal birth in primiparous women during the first year after birth. Int Urogynecol J. 2020 Jul; 31(7): 1409-16. https://dx.doi.org/10.1007/s00192-019-03975-0. Epub 2019 May 28.
  12. Handa V.L., Pierce C.B., Munoz A., Blomquist J.L. Longitudinal changes in overactive bladder and stress incontinence among parous women. Neurourol Urodyn. 2015 Apr; 34(4): 356-61. https://dx.doi.org/10.1002/nau.22583. Epub 2014 Mar 14.
  13. Доброхотова Ю.Э., Нагиева Т.С., Ильина И.Ю. Алгоритм ведения пациенток с дисфункцией тазового дна в послеродовом периоде. Акушерство и гинекология. 2020; S6: 28-31. [Dobrokhotova Yu.E., Nagieva T.S., Ilyina I.Yu. Algorithm for managing patients with pelvic floor dysfunction in the postpartum period. Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; S6: 28-31. (in Russian)].
  14. Blomquist J.L., Munoz A., Carroll M., Handa V.L. Association of Delivery Mode With Pelvic Floor Disorders After Childbirth. JAMA. 2018 Dec 18; 320(23): 2438-47. https://dx.doi.org/10.1001/jama.2018.18315.
  15. Harnett M.D., Shipley J., MacLean L., Schwiderski U., Sandage B.W. Study of the population pharmacokinetic characteristics of once-daily trospium chloride 60 mg extended-release capsules in patients with overactive bladder and in healthy subjects. Clin Drug Investig. 2013 Feb; 33(2): 133-41. https://dx.doi.org/10.1007/s40261-012-0039-8.
  16. Natalin R., Lorenzetti F., Dambros M. Management of OAB in those over age 65. Curr Urol Rep. 2013 Oct;14(5):379-85. https://dx.doi.org/10.1007/s11934-013-0338-5.
  17. Ильина И.Ю., Доброхотова Ю.Э., Маликова В.О., Чикишева А.А. Особенности мочеиспускания у гинекологических больных. Гинекология. 2013; 15(5): 48-50. [Ilyina I.Yu., Dobrokhotova Yu.E., Malikova V.O., Chikisheva A.A. Features of urination in gynecological patients. Gynecology. 2013; 15(5): 48-50. (in Russian)].
  18. Ящук А.Г., Казихинуров А.А., Мусин И.И., Зайнуллина Р.М., Нафтулович Р.А., Попова Е.М. Современная догоспитальная диагностика недержания мочи у женщин репродуктивного возраста. Медицинский вестник Башкортостана. 2017; 12, 3 (69): 145-8. [Yashhuk A.G., Kazixinurov A.A., Musin I.I., Zajnullina R.M., Naftulovich R.A., Popova E.M. Modern prehospital diagnosis of urinary incontinence in women of reproductive age. Medical Bulletin of Bashkortostan. 2017; 12, 3 (69): 145-8. (in Russian)].
  19. Rosier P.F., Schaefer W., Lose G., Goldman H.B, Guralnick M., Eustice S. et al. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn. 2017 Jun; 36(5): 1243-60. https://dx.doi.org/10.1002/nau.23124. Epub 2016 Dec 5.
  20. Silva J.C., Soler Z.A., DominguesWysocki A. Associated factors to urinary incontinence in women undergoing urodynamic testing. Esc Enferm USP. 2017 Apr 3; 51: e03209. https://dx.doi.org/10.1590/S1980-220X2016140903209.
  21. Аполихина И.А., Болотова Н.В., Райгородский Ю.М. Реабилитация в гинекологии с помощью аппаратной физиотерапии. Руководство для врачей. М.; 2019. [Apolixina I.A., Bolotova N.V., Rajgorodskij Yu.M. Rehabilitation in gynecology with the aid of physiotherapy. A guide for physicians. Moscow. 2019. (in Russian)].
  22. Woodley S.J., Boyle R., Cody J.D., Mоrkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017 Dec 22;12(12): CD007471. https://dx.doi.org/10.1002/14651858.CD007471.pub3.
  23. Moossdorff-Steinhauser H.F., Bols E.M., Spaanderman M.E., Dirksen C.D., Weemhoff M. Long-term effects of motherfit group therapy in pre- (MOTHERFIT1) and post-partum women (MOTHERFIT2) with stress urinary incontinence compared to care-as-usual: study protocol of two multi-centred, randomised controlled trials. Trials. 2019 Apr 25; 20(1): 237. https://dx.doi.org/10.1186/s13063-019-3331-6.
  24. Murgas S., Adolf D. Evaluation of real-world persistence of propiverine and trospium chloride in treatment of overactive bladder in Germany. Res Rep Urol. 2019 Jan 17; 11:9-13. https://dx.doi.org/10.2147/RRU.S185278. eCollection 2019.
  25. Sacomani C.A., Almeida F.G., Silvinato A., Bernardo W.M. Overactive bladder – pharmacological treatment. Rev Assoc Med Bras (1992). 2019 May 2; 65(4): 487-92. https://dx.doi.org/10.1590/1806-9282.65.4.487.
  26. Kitta T. Editorial Comment to Long-term safety and efficacy of antimuscarinic add-on therapy in patients with overactive bladder who had a suboptimal response to mirabegron monotherapy: A multicenter, randomized study in Japan (MILAI II study). Int J Urol. 2019 Mar; 26(3):352. https://dx.doi.org/10.1111/iju.13862. Epub 2018 Dec 13.
  27. Pratt T.S., Suskind A.M. Management of Overactive Bladder in Older Women. Curr Urol Rep. 2018 Sep 10; 19(11):92. https://dx.doi.org/10.1007/s11934-018-0845-5.Curr Urol Rep. 2018. PMID: 30203368.
  28. Suskind A.M., Kowalik C., Quanstrom K., Boscardin J., Zhao S., Reynolds W.S. et al. The impact of frailty on treatment for overactive bladder in older adults. Neurourol Urodyn. 2019 Sep; 38(7): 1915-23. doi: 10.1002/nau.24093. Epub 2019 Jul 8.
  29. Wang J., Zhou Z., Cui Y., Li Y., Yuan H., Gao Z., Zhu Z., Wu J. Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder. Neurourol Urodyn. 2019 Jan; 38(1): 22-30. https://dx.doi.org/10.1002/nau.23863. Epub 2018 Oct 23. PMID: 30350884.
  30. Gratzke C., van Maanen R., Chapple C., Abrams P., Herschorn S., Robinson D. et al. Long-term Safety and Efficacy of Mirabegron and Solifenacin in Combination Compared with Monotherapy in Patients with Overactive Bladder: A Randomised, Multicentre Phase 3 Study (SYNERGY II). Eur Urol. 2018 Oct; 74(4): 501-9. https://dx.doi.org/10.1016/j.eururo.2018.05.005. Epub 2018 Jun 1.
  31. Ivchenko A., Bоdeker R.H., Neumeister C., Wiedemann A. Anticholinergic burden and comorbidities in patients attending treatment with trospium chloride for overactive bladder in a real-life setting: results of a prospective non-interventional study. BMC Urol. 2018 Sep 14; 18(1):80. https://dx.doi.org/10.1186/s12894-018-0394-8.
  32. Notz H.J., Hautumm B., Werdier D., Groves R., Odenthal K.P. Trospium chloride once daily for overactive bladder syndrome: results of a multicenter observational study. Urologe A. 2013 Jan; 52(1): 65-70. https://dx.doi.org/10.1007/s00120-012-2989-0.
  33. Kranz J., Petzinger E., Geyer J. Brain penetration of the OAB drug trospium chloride is not increased in aged mice. World J Urol. 2013 Feb; 31(1): 219-24. https://dx.doi.org/10.1007/s00345-011-0803-z. Epub 2011 Nov 27.
  34. Turkoglu A.R., Parmak Yener N., Coban S., Guzelsoy M., Emul A., Demirbas M. et al. Effect of trospium chloride therapy on intraocular pressure and tear secretion in overactive bladder patients. Cutan Ocul Toxicol. 2017 Dec; 36(4): 331-5. https://dx.doi.org/10.1080/15569527.2017.1289219. Epub 2017 May 4.
  35. Oefelein M.G., Tong W., Kerr S., Bhasi K., Patel R.K., Yu D. Effect of concomitant administration of trospium chloride extended release on the steady-state pharmacokinetics of metformin in healthy adults. Clin Drug Investig. 2013 Feb; 33(2): 123-31. https://dx.doi.org/10.1007/s40261-012-0049-6.
  36. Gamе X., Peyronnet B., Cornu J.N. Fesoterodine: Pharmacological properties and clinical implications. Eur J Pharmacol. 2018 Aug 15; 833:155-157. doi: 10.1016/j.ejphar.2018.05.036. Epub 2018 May 24. PMID: 29803689 Review.
  37. Alcаntara-Montero A. Combined treatment of solifenacin and mirabegron, an alternative in patients with overactive bladder (BESIDE study). Actas Urol Esp. 2016 Nov; 40(9): 593-4. https://dx.doi.org/10.1016/j.acuro.2016.03.005. Epub 2016 Apr 25.
  38. Yamaguchi O., Kakizaki H., Homma Y., Igawa Y., Takeda M., Nishizawa O. et al. Long-term safety and efficacy of antimuscarinic add-on therapy in patients with overactive bladder who had a suboptimal response to mirabegron monotherapy: A multicenter, randomized study in Japan (MILAI II study). Int J Urol. 2019 Mar; 26(3): 342-52. https://dx.doi.org/10.1111/iju.13868. Epub 2018 Dec 13.
  39. Chapple C.R., Nazir J., Hakimi Z., Bowditch S., Fatoye F., Guelfucci F. et al. Persistence and Adherence with Mirabegron versus Antimuscarinic Agents in Patients with Overactive Bladder: A Retrospective Observational Study in UK Clinical Practice. Eur Urol. 2017 Sep; 72(3): 389-99. https://dx.doi.org/ 10.1016/j.eururo.2017.01.037. Epub 2017 Feb 11.
  40. Yang G., Xu Y., Qu G., Zhang Y. Refractory overactive bladder patients who chose sacral neuromodulation therapy after failed OnabotulinumtoxinA treatment: A systematic review and meta-analysis. PLoS One. 2020 Mar 30; 15(3): e0230355. https://dx.doi.org/10.1371/journal.pone.0230355. eCollection 2020.
  41. Hashim H., Beusterien K., Bridges J.F., Amos K., Cardozo L. Patient preferences for treating refractory overactive bladder in the UK. Int Urol Nephrol. 2015 Oct; 47(10): 1619-27. https://dx.doi.org/10.1007/s11255-015-1100-3. Epub 2015 Sep 7.
  42. Zahner P.M., Giusto L.L., Goldman H.B. What Is the Role of Additional Pharmacotherapy and Neuromodulation in Patients with Marginal Benefit from Botulinum Toxin Injection? Curr Urol Rep. 2018 Sep 8; 19(11): 91. https://dx.doi.org/10.1007/s11934-018-0842-8.
  43. Musco S., Serati M., Lombardi G., Lumi E., Parisi A.I., Del Popolo G. et al. Percutaneous Tibial Nerve Stimulation Improves Female Sexual Function in Women With Overactive Bladder Syndrome. J Sex Med. 2016 Feb; 13(2): 238-42. https://dx.doi.org/10.1016/j.jsxm.2015.12.025. Epub 2016 Jan 20.
  44. Клинические рекомендации. Менопаузальная гормонотерапия и сохранение здоровья женщин в зрелом возрасте. М.; 2015. [Clinical recommendations. Menopausal hormone therapy and the preservation of women’s health in adulthood. Moscow. 2015. (in Russian)].
  45. Alperin M., Burnett L., Lukacz E., Brubaker L. The mysteries of menopause and urogynecologic health: clinical and scientific gaps. Menopause. 2019 Jan; 26(1): 103-11. https://dx.doi.org/10.1097/GME.0000000000001209.
  46. Weber M.A., Lim V., Oryszczyn J., Te West N., Souget J., Jeffery S. et al. The Effect of Vaginal Oestriol Cream on Subjective and Objective Symptoms of Stress Urinary Incontinence and Vaginal Atrophy: An International Multi-Centre Pilot Study. Gynecol Obstet Invest. 2017; 82(1):15-21. https://dx.doi.org/10.1159/000445074. Epub 2016 Mar 19.
  47. Rahn D.D., Carberry C., Sanses T.V., Mamik M.M., Ward R.M., Society of Gynecologic Surgeons Systematic Review Group. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014 Dec;124(6):1147-56. https://dx.doi.org/10.1097/AOG.0000000000000526.

Received 01.10.2020

Accepted 15.10.2020

About the Authors

Irina Yu. Ilyina, N.I. Pirogov RNRMU HPE SEI, Therapeutical Faculty, Obstetrics and Gynecology Department. Tel: +7(495)722-63-99. E-mail: iliyina@mail.ru.
ORCID: 0000-0001-8155-8775. 117513, Russia, Moscow, Ostrovitianov str., 1/9.
Ayshe A. Chikisheva, N.I. Pirogov RNRMU HPE SEI, Therapeutical Faculty, Obstetrics and Gynecology Department. Tel: +7(495)722-63-99. E-mail: aishe007@mail.ru.
ORCID: 0000-0003-4934-4501. 117513, Russia, Moscow, Ostrovitianov str., 1/9.
Yulia E. Dobrokhotova, N.I. Pirogov RNRMU HPE SEI, Therapeutical Faculty, Obstetrics and Gynecology Department.
Tel: +7(495)722-63-99. E-mail: pr.dobrohotova@mail.ru. ORCID: 0000-0002-7830-2290. 117513, Russia, Moscow, Ostrovitianov str., 1/9.

For citation: Ilyina I.Yu., Chikisheva A.A., Dobrokhotova Yu.E. The course of urinary incontinence in different periods of a woman’s life.
Akusherstvo i Ginekologiya/ Obstetrics and Gynecology. 2020; 10: 195-202 (in Russian)
https://dx.doi.org/10.18565/aig.2020.10.195-202

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