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Management of Urinary Incontinence With Underactive Bladder: A Review

김준철|조강준
대한배뇨장애요실금학회 (Korean Continence Society)|2020.06|International Neurourology Journal|제24권 제2호|pp. 111-117|DOI 10.5213/inj.2040076.038

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참고문헌

키워드

Urinary incontinenceUrinary bladderTherapeuticsunderactive

초록

Urinary incontinence is caused by storage function failure, while underactive bladder (UAB) is caused by a decline in detrusor contractility and voiding dysfunction. As the treatment mechanisms for incontinence and UAB are contrary to each other, it is difficult to treat both incontinence and UAB, and the patient’s quality of life can be further degraded. Conventional midurethral sling (MUS), such as transobturator tape or retropubic MUS, introduces a risk of postoperative voiding dysfunction in stress urinary incontinence with UAB. However, there have been several reports about the efficacy and safety of conventional MUS. Adjustable sling procedures, such as transobturator adjustable tape or the Remeex system, have better outcomes than conventional MUS because they control tension both during and after surgery. When voiding dysfunction occurs after incontinence treatment with UAB, voiding symptoms can be improved by various therapeutic modalities. Clean intermittent catheterization is recommended for patients with significant increased postvoid residual volumes or urinary retention. Although pharmacotherapy such as with alpha-blockers or parasympathomimetics can be considered for UAB, there is insufficient evidence of their effect on incontinence with UAB. Future therapies, such as stem cell therapy or gene therapy, may be used to treat incontinence with UAB. The possibility of management urgency urinary incontinence that related to detrusor hyperactivity with impaired contractility using sacral neuromodulation has been suggested. Further research is needed to establish evidence for the efficacy and safety of treatments for incontinence with UAB and improve patient quality of life.

Abstract

Urinary incontinence is caused by storage function failure, while underactive bladder (UAB) is caused by a decline in detrusor contractility and voiding dysfunction. As the treatment mechanisms for incontinence and UAB are contrary to each other, it is difficult to treat both incontinence and UAB, and the patient’s quality of life can be further degraded. Conventional midurethral sling (MUS), such as transobturator tape or retropubic MUS, introduces a risk of postoperative voiding dysfunction in stress urinary incontinence with UAB. However, there have been several reports about the efficacy and safety of conventional MUS. Adjustable sling procedures, such as transobturator adjustable tape or the Remeex system, have better outcomes than conventional MUS because they control tension both during and after surgery. When voiding dysfunction occurs after incontinence treatment with UAB, voiding symptoms can be improved by various therapeutic modalities. Clean intermittent catheterization is recommended for patients with significant increased postvoid residual volumes or urinary retention. Although pharmacotherapy such as with alpha-blockers or parasympathomimetics can be considered for UAB, there is insufficient evidence of their effect on incontinence with UAB. Future therapies, such as stem cell therapy or gene therapy, may be used to treat incontinence with UAB. The possibility of management urgency urinary incontinence that related to detrusor hyperactivity with impaired contractility using sacral neuromodulation has been suggested. Further research is needed to establish evidence for the efficacy and safety of treatments for incontinence with UAB and improve patient quality of life.

참고문헌 (43)

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관련 논문AI추천

Assessing the Readjustable Sling Procedure (Remeex System) for Female Stress Urinary Incontinence With Detrusor Underactivity고광진, 서윤석, 성현환, 유규하, 이규성, 이문재대한배뇨장애요실금학회 · International Neurourology Journal2017 · 제21권 제2호Underactive Bladder: Clinical Features, Urodynamic Parameters, and TreatmentJohan Gani, Nathan Hoag대한배뇨장애요실금학회 · International Neurourology Journal2015 · 제19권 제3호Effects of Transobturator Adjustable Tape Sling Procedure on the Therapeutic Outcome in Patients with Stress Urinary Incontinence and Detrusor Underactivity서주태, 양승애, 조대기대한배뇨장애요실금학회 · International Neurourology Journal2010 · 제14권 제1호Predictors of Voiding Dysfunction after Mid-urethral Sling Surgery for Stress Urinary Incontinence김진욱, 문두건, 배재현, 신정호, 오미미, 이정구대한배뇨장애요실금학회 · International Neurourology Journal2012 · 제16권 제1호The Influence of Preoperative Bladder Outlet Obstruction on Continence and Satisfaction in Patients with Stress Urinary Incontinence after Midurethral Sling김수진, 김준철, 조혁진, 최항원, 황태곤대한배뇨장애요실금학회 · International Neurourology Journal2010 · 제14권 제4호Outcomes of Intradetrusor Onabotulinum Toxin A Therapy in Overactive Bladder Refractory to Sacral NeuromodulationHamilton Trinh, Humphrey Atiemo, Mireya Diaz, Vicki Irish대한배뇨장애요실금학회 · International Neurourology Journal2019 · 제23권 제3호

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