Efficacy of Conservative Treatments for Urinary Incontinence in Women

Study Overview
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Brief Summary
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To conduct a retrospective study to examine the effect of these conservative treatments to the symptoms and quality of life of patients with urinary incontinence. The investigators will use both subjective and objective assessment parameters, such as self-report symptoms, bladder diary, pad test and urodynamic study to access the improvement.

Detailed Description
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Urinary incontinence is a common problem among women. The main types include stress incontinence, urge incontinence, and overflow incontinence. Other underlying pathology, such as cancer or neurologic disease can also cause urinary incontinence. To limit the medical expenses and possible complications of surgical treatment, the current treatment guidelines recommend conservative treatment as the first choice. According to American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) guidelines, the first-line treatment for non-neurologic overactive bladder should be behavioral therapy, such as bladder training, water restriction, and pelvic floor muscle training, physiological feedback, pessary, etc. Bladder training aims to increase the time interval between voids, and to increase the bladder capacity by self-adjusted schedules. Pelvic floor muscle training strengthens the pelvic floor muscles to provide urethral support to prevent urine leakage and suppress urgency. There is strong evidence that pelvic floor muscle training is beneficial for stress urinary incontinence. The second-line treatment is medication, including anticholinergic drugs and ß3 adrenoceptor-acting agents. Anticholinergic drugs can reduce bladder detrusor contraction, and ß3 adrenoceptor-acting agents can relax the detrusor and increase bladder capacity.

Official Title
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Evaluation of Efficacy of Conservative Treatments in Women With Urinary Incontinence

Conditions
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Urinary Incontinence

Intervention / Treatment
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* Procedure: BT
* Procedure: bPFMT
* Procedure: iVES
* Procedure: BT + bPFMT
* Procedure: BT + iVES
* Procedure: bPFMT + iVES


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult female patient diagnosed with urinary incontinence through clinical assessment Diagnosed at Mackay Memorial Hospital and underwent non-surgical treatment and subsequent follow-up. Exclusion Criteria: Choosing invasive or surgical treatment options (such as bladder botulinum toxin injection, urethral sling surgery). Unable to comply with regular follow-up for at least one year. Pregnant women Patients with a history of neuromuscular disorders.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Bladder training (BT)<br>Data obtained before and after the training. | Procedure: BT<br>* A program of BT (including exercise and muscle training)<br>|
| biofeedback-assisted pelvic floor muscle training (bPFMT)<br>Data obtained before and after the training. | Procedure: bPFMT<br>* A bPFMT program at home<br>|
| intra-vaginal electric stimulation (iVES)<br>Data obtained before and after the training. | Procedure: iVES<br>* An iVES program at home<br>|
| BT+bPFMT<br>Data obtained before and after the training. | Procedure: BT + bPFMT<br>* Combination of BT and bPFMT<br>|
| BT+iVES<br>Data obtained before and after the training. | Procedure: BT + iVES<br>* Combination of BT and iVES<br>|
| bPFMT+iVES<br>Data obtained before and after the training. | Procedure: bPFMT + iVES<br>* Combination of bPFMT and iVES<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Urodynamic study (intravesical pressure) | intravesical pressure (cmH2O) | form the baseline to the post-treatment measurement (about 6 month post) | 
| Urodynamic study (abdominal pressure) | abdominal pressure (cmH2O) | form the baseline to the post-treatment measurement (about 6 month post) | 
| Urodynamic study (detrusor pressure) | detrusor pressure (cmH2O) | from the baseline to the post-treatment measurement (about 6 month post) | 
| Urodynamic study (Infused volume) | infused volume (ml) | from the baseline to the post-treatment measurement (about 6 month post) | 
| Urodynamic study (voided volume) | voided volume (ml) | from the baseline to the post-treatment measurement (about 6 month post) | 
| Pad test | The weight of Pad (g) before and after testing | from the baseline to the post-treatment measurement (about 6 month post) | 
| Bladder diary (voiding frequency) | the daily voiding frequency (times) | from the baseline to the post-treatment measurement (about 6 month post) | 
| Bladder diary (voiding volume) | the daily voiding volume (ml) | from the baseline to the post-treatment measurement (about 6 month post) | 
| Questionaire (UDI-6) | The urogenital distress inventory-6 (UDI-6) | from the baseline to the post-treatment measurement (about 6 month post) | 
| Questionaire (IIQ-7) | incontinence impact questionnaire-7 (IIQ-7) | from the baseline to the post-treatment measurement (about 6 month post) |