SUFU 2018: What Has the Urinary Incontinence Treatment Network Taught Us?

Austin, TX (UroToday.com) Over the course of its existence, Urinary Incontinence Treatment Network (UITN) trials have been performed over 9 clinical sites and a digestive disease center. It has developed and conducted 4 major randomized controlled trials over 10 years, with its data archived in the NIDDK repository.  Regarding surgical treatment of stress predominant urinary incontinence in women, we now have level 1 evidence for short and medium-term efficacy and safety of burch vs sling and retropubic vs transobturator tape (TOT) midurethral mesh slings.  It has also produced level 1 evidence about value of preoperative urodynamics. 

SUFU 2018: The Effects of Augmentation Cystoplasty and Botulinum Toxin Use on Patient Reported Bladder Function

Austin, TX (UroToday.com) Dr. Jeremy Myers and colleagues presented a study of 846 spinal cord injury (SCI) patients who perform clean intermittent catheterization (CIC) for bladder management, identified from the Neurogenic Bladder Research Group (NBRG) registry. The study sought to examine the effects of augmentation cystoplasty and botulinum toxin use on patient reported bladder function and interventions, such as intravesical botox injections and augmentation cystoplasty, to determine if these interventions can improve satisfaction among individuals with spinal cord injury performing intermittent catheterization, an attempt to decrease rates of CIC discontinuation.

SUFU 2018: Is Prophylactic Stress Incontinence Surgery Necessary at the Time of Pelvic Organ Prolapse Repair?

Austin, TX (UroToday.com) Dr. Syan and colleagues presented a retrospective study of 1,504 women who had undergone index pelvic organ prolapse (POP) repair without concomitant SUI surgery, then necessitating subsequent SUI repair.  The cohort was obtained from the Office of Statewide Health Planning and Development in California, from 2005 to 2011, with at least 1 year of follow up.  Mean follow up was 4.1 years.  Using multivariate analysis, patient and surgical characteristics were examined for associations with future SUI procedures after index POP repair.

SUFU 2018: Surgically Induced Weight Loss Results in a Rapid and Consistent Improvement of Female Pelvic Floor Symptoms

Austin, TX (UroToday.com) Dr. Groutz and colleagues presented a prospective study on 101 women with a mean BMI of 41.6 kg/m2 undergoing bariatric surgery at a single institution, in order to assess the short and medium term effect of weight loss on urinary incontinence, POP, and colorectal-anal symptoms.  They completed 3 validated questionnaires (ICIQ-UI, BFLUTS-SF, and PFDI-20) to evaluate pelvic floor symptoms at baseline, 3-6 months, and 12-24 months postoperatively.

SUFU 2018: Vibegron, Significantly Reduces Average Daily Micturitions, Urge Incontinence and Urgency Episodes - Overactive Bladder

Austin, TX (UroToday.com) Dr. Mitcheson presented an international, phase 2b, randomized, double-blind, dose-ranging, placebo and active comparator-controlled study in 1395 patients taking Vibegron, a new novel once daily oral beta-3 agonist for overactive bladder.  The drug was evaluated both alone and when taken with tolterodine.  The authors looked at average daily voids, urge incontinence episodes and urgency episodes at week 8, using a 7-day voiding diary.

SUFU 2018: Randomized Controlled Trial of Group-Administered Behavioral Treatment in Reducing Urinary Incontinence in Adult Women

Austin, TX (UroToday.com) Dr. Diane Newman and colleagues presented a randomized controlled trial of 463 women ages 55 and older, to determine the effectiveness of Group Behavioral Therapy (GBT) versus no treatment in adult women with no prior treatments, with stress, urgency, or mixed urinary incontinence.  The patients were randomized to a GBT group and a no treatment group.  The authors looked at the results of the ICIQ UI-SF scores, as well as a 3-day voiding diary, paper towel test, 24-hr pad weight, Brink test, Incontinence Quality of Life Questionnaire (I-QOL) and Patient Global Impression of Improvement (PGI-I).  The women undergoing GBT attended a one time 2 hour bladder health class, both groups received a behavioral education brochure.  The follow ups were every 3 months for 1 year, with clinic visits at months 3 and 12, with mailed questionnaires at months 6 and 9.

SUFU 2018: Sacrocolpopexy: Tips and Tricks

Austin, TX (UroToday.com) Sacrocolpopexy background: Apical recurrence with abdominal sacrocolpopexy (ASC)( 9% at 2 years, 22% at 7 years) Cochrane review supports ASC vs. native tissue vaginal repairs.  Balance with increased risk of SE.  Lap and robotic technology is improving (outcome data emerging, promising, SE possible, convalescence improved.