Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Surgery vs physiotherapy for stress urinary incontinence

This week's publication of the New England Journal of Medicine compares surgery with physiotherapy for stress urinary incontinence.

News image

Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence.

Midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful.

Data are lacking from randomized trials comparing these 2 options as initial therapy.

Dr Julien Labrie and colleagues performed a multicenter, randomized trial to compare physiotherapy and midurethral-sling surgery in women with stress urinary incontinence.

Crossover between groups was allowed.

Rates of subjective cure were 85% in the surgery group
New England Journal of Medicine

The researcher's primary outcome was subjective improvement, measured by means of the Patient Global Impression of Improvement at 12 months.

The team randomly assigned 230 women to the surgery group, and 230 women to the physiotherapy group.

A total of 49% of women in the physiotherapy group, and 11% of women in the surgery group crossed over to the alternative treatment.

In an intention-to-treat analysis, subjective improvement was reported by 91% of women in the surgery group, and 64% of women in the physiotherapy group.

The research team found that the rates of subjective cure were 85% in the surgery group, and 53% in the physiotherapy group.

Rates of objective cure were 76% and 59%, respectively.

The team showed that women who crossed over to the surgery group had outcomes similar to those of women initially assigned to surgery, and that both these groups had outcomes superior to those of women who did not cross over to surgery.

Dr Labrie's team concludes, "For women with stress urinary incontinence, initial midurethral-sling surgery, as compared with initial physiotherapy, results in higher rates of subjective improvement and subjective and objective cure at 1 year."

N Engl J Med 2013; 369: 1124-1133
26 September 2013

Go to top of page Email this page Email this page to a colleague

 23 July 2014

Advanced search
 23 July 2014 
C-section and IBD risk
 23 July 2014 
Sofosbuvir and ribavirin for Hep C
 23 July 2014 
Early corticosteroids after the diagnosis of ulcerative colitis
 22 July 2014 
Alcohol and colorectal adenoma risk
 22 July 2014 
Cognitive behavioral therapy in IBS
 22 July 2014 
Thromboembolism in IBD
 21 July 2014 
Mortality in IBD
 21 July 2014 
Stents to prevent post-ERCP pancreatitis
 21 July 2014 
Psychometric validation of IBS symptom severity
 18 July 2014 
ERCP with overtube-assisted enteroscopy
 18 July 2014 
Treatment of enteropancreatic neuroendocrine tumors
 18 July 2014 
Ulcer complications and dyspeptic symptoms
 17 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 17 July 2014 
Treatment of H. pylori
 17 July 2014 
Ultrasound for diagnosis of gastric varices
 16 July 2014 
Mortality after colectomy in IBD
 16 July 2014 
Esophageal cancer missed at endoscopy
 16 July 2014 
Screening for Hepatitis B
 15 July 2014 
Diagnosing diverticulitis
 15 July 2014 
Variation in management decisions for colorectal cancer
 15 July 2014 
Muscle cramps in cirrhosis
 14 July 2014 
Predicting the course of ulcerative colitis
 14 July 2014 
Choice in colorectal cancer screening tests
 14 July 2014 
Adhesions in abdominal surgery
 11 July 2014 
Temporal evolution of antidrug antibodies in IBD
 11 July 2014 
Atopy and functional gastrointestinal disorders
 11 July 2014 
Fecal microbiota transplant for C. diff
 10 July 2014 
Acid-suppressive medications and cancer risk in Barrett's
 10 July 2014 
Personalized medicine in the management of IBD
 10 July 2014 
Pregnancy outcome in anti-TNF treated women with IBD
 09 July 2014 
Quality of care provided to patients with varices
 09 July 2014 
Eosinophilic esophagitis and celiac disease
 09 July 2014 
Diagnosis and management of adult celiac disease
 08 July 2014 
Screening for Hep B
 08 July 2014 
NSAID-induced small intestinal injury
 08 July 2014 
Drug-induced liver injury
 07 July 2014 
Pediatric celiac disease risk factors
 07 July 2014 
Obesity and complications after lapaproscopic colorectal surgery
 07 July 2014 
Everolimus and advanced hepatocellular carcinoma
 04 July 2014 
Day-case vs inpatient laparoscopic fundoplication
 04 July 2014 
Alcohol assessment in liver transplant
 04 July 2014 
Clinical competence in colorectal cancer surgery
 03 July 2014 
Predicting acute liver failure in drug-induced liver injury
 03 July 2014 
Cognitive dysfunction impairs quality of life after liver transplant
 03 July 2014 
NOTES for colon resections
 02 July 2014 
Routine colonoscopy for uncomplicated diverticulitis
 02 July 2014 
Risk of stroke in ulcerative colitis
 02 July 2014 
Hemodialysis during liver transplant
 01 July 2014 
Outcomes for pregnant women with primary biliary cirrhosis
 01 July 2014 
Liver-prognosis assessment in Hep C
 01 July 2014 
Mortality from biliary diseases requiring ERCP
 30 June 2014 
Combination therapy for eradication of Helicobacter pylori
 30 June 2014 
Drug-induced liver injury
 30 June 2014 
Surrogate for adenoma detection rate
 27 June 2014 
Infliximab and luminal pediatric Crohn's
 27 June 2014 
Colonoscopy surveillance intervals
 27 June 2014 
Endoscopy protocol for serrated polyposis syndrome
 26 June 2014 
Cognitive impairment in celiac disease
 26 June 2014 

Congenital malformations in offspring of parents with celiac disease

 26 June 2014 
Risk of colorectal adenomas and glucose metabolism

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us