Surgery may help women with two types of incontinence

By Tauren Dyson

Sept. 17 (UPI) -- A surgical procedure can improve symptoms of both stress urinary incontinence and urgency urinary incontinence, a new study says.

The research contradicts current recommendations that say surgery may actually aggravate the UUI, according to findings published Tuesday in the Journal of the American Medical Association.


Stress urinary incontinence is urinating after a cough, sneeze or other moments of exertion. Urgency urinary incontinence is having a spontaneous urge to urinate. Together, these are known as mixed urinary incontinence.

According to the National Institutes of Health, between one-third to one-half of women in the United States with urinary incontinence also has mixed urinary incontinence.

"Women with mixed urinary incontinence may have more bothersome symptoms than women with either stress or urgency urinary incontinence alone," Donna Mazloomdoost, a researcher at National Institute of Child Health and Human Development and study author, said in a news release. "The findings show promise in treating a condition that can be hard to manage under existing practices."

The randomized clinical trial included 480 women throughout the United States who underwent mid-urethral sling surgery to treat varying degrees of urinary incontinence. For the treatment, the women had a thin strip mesh inserted under their urethra to help stop urine leakage during coughing, sneezing or other forms of exertion.


Some patients received just therapy while others got the surgery plus behavioral and pelvic floor muscle therapy. This therapy included six sessions with a health professional.

A questionnaire asked patients to rank urinary symptoms from 0 to 300 points based on severity, as well as their quality of life and comfort with surgery results.

The group that only received surgery scored an average of 176.8 prior to surgery and 40.3 afterward. That's compared to the surgery and therapy group which scored 178 before surgery and 33 after. This suggests the therapy may not lead to better health results for patients.

The study did show the surgery led to fewer moments of incontinence and less follow-up treatment for the condition.

"Current practice guidelines may be unnecessarily delaying surgery for women with mixed urinary incontinence," said Vivian W. Sung, a researcher at Brown University and study lead author. "We hope these findings will improve how patients are counseled and treated."

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