Surgery is more effective than physiotherapist-led pelvic floor exercises in women with moderate-to-severe stress urinary incontinence, according to authors of a new study in the New England Journal of Medicine.
Researchers randomised 460 women aged 35 and older suffering from moderate-to-severe stress urinary incontinence to :
- pelvic floor therapy by certified pelvic floor physiotherapists or
- mid-urethral tape surgery – the insertion of an artificial tape to support the mid urethra during physical activity.
At 12 month follow-up a subjective improvement occurred in 91% of the women who had had surgery, compared to 65% of the women who had started pelvic floor physiotherapy. In the surgery group 85% of the women were completely cured compared to 85% in the pelvic floor therapy group.
The study comes just two weeks after new NICE guidance on female urinary incontinence which recommends pelvic floor therapy – together with lifestyle advice including smoking, fluid intake, weight loss and caffeine – as first-line therapy in women with stress urinary incontinence.
- Guideline debrief: female urinary incontinence – worth a suggested 2 CPD hours – is the ideal way to get up to speed with the new NICE guideline
“Excellent- makes managing an extremely distressing and commonly presenting problem more logical and evidence based” Dr Hilary Kevan