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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 34132

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Special Issue Editors

Prof. Dr. Emilio Sacco

E-Mail Website1 Website2
Guest Editor

1. Urology at Dept. of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Largo Vito 1, 00168 Rome, RM, Italy
2. Functional Urology Unit at Urology Dept., Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, RM, Italy
Interests: urologic surgery; robotic surgery; reconstructive surgery; pelvic floor dysfunctions; urinary incontinence; bladder cancer; prostate cancer; urinary tract infections; kidney cancer
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Dr. Vincenzo Li Marzi

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Guest Editor

Department of Urology, Unit of Urological Minimally Invasive Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
Interests: urologic surgery; neuro-urology; pelvic floor dysfunctions; urinary incontinence; bladder cancer; prostate cancer; urinary tract infections; kidney transplantation

Dr. Riccardo Bientinesi

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Guest Editor

Urology Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
Interests: urologic oncology; functional urology; robotic surgery; urinary incontinence; neurourology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Urinary incontinence is a very prevalent condition in the worldwide population, associated with a detrimental impact on patients’ quality of life and high costs for society.

It has been reported that more than half of all women aged 60 years or more suffer from stress urinary incontinence. In male patients, despite the great developments in surgical technique, urinary incontinence is still one of the major complaints after radical prostatectomy. Overactive bladder syndrome, both idiopatic and neurogenic, is another very bothersome chronic condition associated with urgency incontinence, affecting both genders and deteriorating all aspects of patients’ life. Being age-related, the prevalence of this syndrome is expected to significantly increase.

The diagnostic work-up includes history taking, physical evaluation, questionnaires, and more specialized evaluations, such as urodynamics, endoscopy, and imaging techniques. A search for novel diagnostic tools is ongoing for a more detailed assessment of the lower urinary tract, sphincter function, and pelvic floor.

The therapy has evolved significantly and encompasses several options, ranging from conservative management to various surgical procedures. The availability of many therapeutic modalities has increased the complexity of the decision-making process, requiring continuous updating by healthcare professionals and patient involvement. Despite the wide range of available treatments, there is still no “perfect treatment” for urinary incontinence. Furthermore, female mid-urethral slings have been abandoned in some countries due to bothersome complications in a significant portion of patients. Therefore, there is an urgent need for other minimally invasive options and non-invasive therapies for patients unfit for surgery.

This Special Issue aims to collect high-quality contributions on the latest and most innovative advances in physiopathology, diagnosis, management, and prevention of urinary incontinence. All researchers are invited to contribute original works and reviews (animal research, case reports, and short reviews are not accepted).

Prof. Dr. Emilio Sacco
Dr. Vincenzo Li Marzi
Dr. Riccardo Bientinesi
Guest Editors

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Keywords

post-prostatectomy incontinence
female stress incontinence
overactive bladder
geriatric incontinence
neurogenic incontinence
diagnosis
prevention
rehabilitation
incontinence aids
pharmacological therapy
surgery
neuromodulation
botulinum toxin

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Related Special Issue

Latest Advances in Urinary Incontinence: Part II in Journal of Clinical Medicine (2 articles)

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Editorial

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3 pages, 199 KiB

Open AccessEditorial

Special Issue: “Latest Advances on Urinary Incontinence”

by Riccardo Bientinesi, Filippo Gavi, Vincenzo Li Marzi and Emilio Sacco

J. Clin. Med. 2023, 12(22), 7075; https://doi.org/10.3390/jcm12227075 - 14 Nov 2023

Viewed by 921

Abstract

Urinary incontinence (UI) has a great impact on patients’ quality of life [...] Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

Research

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9 pages, 700 KiB

Open AccessArticle

Comparison Study between Artificial Urinary Sphincter and Adjustable Male Sling: A Propensity-Score-Matched Analysis

by Paolo Geretto, Enrico Ammirati, Marco Falcone, Alberto Manassero, Marco Agnello, Marcello Della Corte, Paolo Gontero and Alessandro Giammò

J. Clin. Med. 2023, 12(17), 5489; https://doi.org/10.3390/jcm12175489 - 24 Aug 2023

Cited by 6 | Viewed by 1235

Abstract

Aims: This study aimed to compare the outcomes of the AUS and an adjustable male sling (ATOMS^TM). Methods: It was a retrospective observational cohort study with two arms. Propensity score matching (PSM) was performed in order to limit selection bias and, consequently, a comparison between groups in terms of functional outcomes (24 h pad test and perception of improvement questionnaires), complications (overall complications, high-grade complications, reinterventions and explantations) and device survival was performed. Results: 49 patients in both arms were included. The baseline characteristics were similar between the groups. The mean follow up was 43 ± 35 months. Dryness was achieved in 22 patients (44.9%) in the AUS group and 11 (22.5%) in the sling group (p = 0.03). A total of 40 patients declared themselves well improved in the sling group (81%), while 35 (71%) declared the same in the AUS group (p = 0.78). The AUS was associated with more high-grade complications, reinterventions and explantations than the ATOMS^TM. Survival at 60 months was 82 ± 9% in the sling group and 67 ± 7% in the AUS group (p = 0.03). Conclusions: While the AUS may be characterized by a higher dry rate, it has an increased risk of high-grade complications and reinterventions. It is proposed that the ATOMS prosthesis can be successfully used for patients who require a less invasive procedure that maintains good functional outcomes. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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10 pages, 528 KiB

Open AccessArticle

Urinary and Double Incontinence in Cognitively Impaired Patients: Impacts on Those Affected and Their Professional Caregivers

by Anke Kirsten Jaekel, Theresa Maria Rings, Franziska Schmitz, Franziska Knappe, Alix Tschirhart, Franziska Isabelle Winterhagen, Ruth Klara Maria Kirschner-Hermanns and Stephanie C. Knüpfer

J. Clin. Med. 2023, 12(10), 3352; https://doi.org/10.3390/jcm12103352 - 9 May 2023

Cited by 3 | Viewed by 1382

Abstract

Urinary or double incontinence in frail elderly people is common and leads to a reduction in quality of life and an increased burden on the patients’ caregivers. Up to now, no special instrument has been available to assess the impact of incontinence on cognitively impaired patients and their professional caregivers. Thus, the outcomes of incontinence-specific medical and nursing interventions for cognitively impaired individuals are not measurable. Our aim was to investigate the impacts of urinary and double incontinence on both the affected patients and their caregivers using the newly developed “International Consultation on Incontinence Questionnaire Cognitively Impaired Elderly” (ICIQ-Cog) tool. The severity of incontinence was measured by incontinence episodes per night/per 24 h, the type of incontinence, the type of incontinence devices used, and the proportion of incontinence care out of total care; all these measures were correlated to the ICIQ-Cog. Incontinence episodes per night and the proportion of incontinence care out of total care showed significant correlations with the patient- and caregiver-related ICIQ-Cog scores. Both items have negative effects on patient quality of life and caregiver burden. Improving nocturnal incontinence and reducing the need for incontinence care overall can decrease the incontinence-specific bother of affected patients and their professional caregivers. The ICIQ-Cog can be used to verify the impacts of medical and nursing interventions. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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15 pages, 3309 KiB

Open AccessEditor’s ChoiceArticle

Transalbugineal Artificial Urinary Sphincter: A Refined Implantation Technique to Improve Surgical Outcomes

by Emilio Sacco, Filippo Marino, Carlo Gandi, Riccardo Bientinesi, Angelo Totaro, Stefano Moretto, Filippo Gavi, Marco Campetella and Marco Racioppi

J. Clin. Med. 2023, 12(8), 3021; https://doi.org/10.3390/jcm12083021 - 21 Apr 2023

Cited by 8 | Viewed by 1648

Abstract

The artificial urinary sphincter (AUS) implantation is an effective treatment of post-prostatectomy urinary incontinence (PPI). Still, it may result in troublesome complications such as intraoperative urethral lesion and postoperative erosion. Based on the multilayered structure of the tunica albuginea of the corpora cavernosa, we evaluated an alternative transalbugineal surgical technique of AUS cuff placement with the aim to decrease perioperative morbidity while preserving the integrity of the corpora cavernosa. A retrospective study was conducted in a tertiary referral center from September 2012 to October 2021, including 47 consecutive patients undergoing AUS (AMS800^®) transalbugineal implantation. At a median (IQR) follow-up of 60 (24–84) months, no intraoperative urethral injury and only one noniatrogenic erosion occurred. The actuarial 12 mo and 5 yr overall erosion-free rates were 95.74% (95% CI: 84.04–98.92) and 91.76% (95% CI: 75.23–97.43), respectively. In preoperatively potent patients, the IIEF-5 score remained unchanged. The social continence (0–1 pads per day) rate was 82.98% (CI 95%: 68.83–91.10) at 12 mos and 76.81% (CI 95%: 60.56–87.04) at 5 yrs follow-up. Our technically refined approach to AUS implantation may help to avoid intraoperative urethral lesions and lower the risk of subsequent erosion without compromising sexual function in potent patients. Prospective and adequately powered studies are necessary to achieve more compelling evidence. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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10 pages, 264 KiB

Open AccessArticle

Hysteropexy and Anterior Vaginal Native Tissue Repair in Women with Anterior and Central Compartment Prolapse: A Long Term Follow-Up

by Maurizio Serati, Stefano Salvatore, Marco Torella, Chiara Scancarello, Andrea De Rosa, Alessandro Ferdinando Ruffolo, Giorgio Caccia, Fabio Ghezzi, Andrea Papadia, Yoav Baruch and Andrea Braga

J. Clin. Med. 2023, 12(7), 2548; https://doi.org/10.3390/jcm12072548 - 28 Mar 2023

Cited by 4 | Viewed by 1792

Abstract

Although it is known that hysterectomy (HY) alone cannot resolve apical prolapse, vaginal hysterectomy (VH) remains the most common surgical procedure for this issue. In recent years, various procedures for uterine conservation have been proposed to avoid the surgical risks of HY. Furthermore, most women with symptomatic pelvic organ prolapse (POP) prefer uterine conservation in the absence of considerable benefit in uterine removal. In 2017, we proposed a new technique for hysteropexy and anterior vaginal native tissue repair (NTR) in women with cystocele and apical prolapse. The objective of this study is to assess the efficacy and safety of this new procedure after at least 5 years of follow-up. We included only patients with stage II or greater prolapse of the anterior vaginal wall and a concomitant stage II uterine prolapse in accordance with Pelvic Organ Prolapse Quantification (POP-Q) system. A Patient Global Impression of Improvement (PGI-I) score ≤ 2 in addition with the absence of POP symptoms was defined as subjective success. A descensus with a maximum point of less than −1 in any compartment was considered objective cure. A total of 102 patients who fulfilled the inclusion criteria were enrolled. At 60 months follow-up, 90 out of 102 patients (88%) were subjectively cured, whereas 88 out of the 102 (86%) patients were objectively cured. Subjective and objective cure rates persisted during the entire study period. Uni- and multivariate analysis of possible predictive factors associated with recurrence of prolapse showed that only a preoperative point C > 0 cm and BMI ≥ 25 kg/m² were risk factors for failure. In conclusion, our study showed that hysteropexy with anterior vaginal native tissue repair may be an effective and safe option for the treatment of anterior vaginal prolapse and concomitant stage II uterine prolapse by at least 5 years of follow-up. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

13 pages, 490 KiB

Open AccessArticle

Impact of Urinary Incontinence on Physical Function and Respiratory Muscle Strength in Incontinent Women: A Comparative Study between Urinary Incontinent and Apparently Healthy Women

by Sirine Abidi, Amine Ghram, Sameh Ghroubi, Said Ahmaidi, Mohamed Habib Elleuch, Olivier Girard, Theodoros Papasavvas, Jari Laukkanen, Helmi Ben Saad, Beat Knechtle, Katja Weiss and Mehdi Chlif

J. Clin. Med. 2022, 11(24), 7344; https://doi.org/10.3390/jcm11247344 - 10 Dec 2022

Cited by 7 | Viewed by 3088

Abstract

Patients with stress urinary incontinence (SUI) may be afraid to increase intra-abdominal pressure to avoid incontinence. This could lead to weak expiratory muscles. The aim of this study was to investigate the association between respiratory muscle strength, physical function, and SUI in patients with SUI. A cross-sectional study was conducted in the Physical Medicine and Functional Rehabilitation Department. Thirty-one incontinent women (IG) and twenty-nine women in a control group (CG) were enrolled in this study. Anthropometric data, respiratory muscle strength (maximal inspiratory pressure; maximal expiratory pressure), SUI (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; Pad test), and physical function (waist circumference; timed-up-and-go test; abdominal muscle strength) were assessed. Body fat, body mass index, body weight, and waist circumference were higher in IG than CG (p < 0.01), while postural gait and abdominal muscles were lower (p < 0.001). Respiratory muscle strength displayed moderate correlations with SUI severity, especially for maximal expiratory pressure (p < 0.01). Maximal expiratory pressure was moderately associated with physical function. Deterioration in respiratory muscle strength is a characteristic of women with SUI. In this population, pelvic floor muscle training may be prescribed to improve continence. By feeling more confident about increasing intra-abdominal pressure, women with SUI would strengthen their expiratory muscles and eventually improve their physical function. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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7 pages, 263 KiB

Open AccessArticle

Efficacy and Complications of the Re-Adjustable Male Sling System for Stress Urinary Incontinence after Radical Prostatectomy

by Liang-Wei Chiu, Wen-Chi Chen, Po-Fan Hsieh, Yung-Hsiang Chen and Chi-Ping Huang

J. Clin. Med. 2022, 11(22), 6764; https://doi.org/10.3390/jcm11226764 - 15 Nov 2022

Cited by 1 | Viewed by 1607

Abstract

The aim of this study was to investigate the outcomes of re-adjustable male slings in pa-tients with postoperative stress urinary incontinence (SUI) following radical prostatectomy (RP). We retrospectively analyzed 18 patients with SUI following RP for prostate cancer, who were treated with re-adjustable male slings from January 2016 to December 2021. The clinical outcomes were evaluated based on daily pad usage and urodynamic studies, both preoperatively and post-operatively. The degree of SUI was categorized as either mild, moderate, or severe. Success was defined as no more pad use or significantly decreased pad use. Complications were classified ac-cording to the Clavien–Dindo system. The mean age of patients was 70.4 ± 5.9 years, and 61.1% of cases were diagnosed as locally advanced prostate cancer. Mild, moderate, and severe SUI were reported as 33.3%, 50.0%, and 16.7%, respectively. The average daily pad use after RP was 3.3 pads and there was a significant reduction in the number of daily pads used after the re-adjustable male sling procedure (3.3 vs. 1.3; p = 0.002). Overall, the operation was considered successful in 11 pa-tients (61.1%), 1 case showed improvement (5.6%), and it was considered unsuccessful in 6 patients (33.3%). Impressively, in the severe incontinence subgroup (three patients), one (33.3%) had im-provement and one (33.3%) had success. Transient perineal discomfort after the operation was the most common complaint. However, two patients had severe complications with bowel injury during sling implantation (Clavien–Dindo grade III). The re-adjustable male sling system was an efficient surgical treatment option for post-RP SUI, even in a locally advanced disease dominant population. One should pay attention to the complication of bowel perforation during surgery. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

7 pages, 796 KiB

Open AccessArticle

Efficacy of 3 Tesla Functional Magnetic Stimulation for the Treatment of Female Urinary Incontinence

by Andrea Braga, Fabiana Castronovo, Giorgio Caccia, Andrea Papadia, Luca Regusci, Marco Torella, Stefano Salvatore, Chiara Scancarello, Fabio Ghezzi and Maurizio Serati

J. Clin. Med. 2022, 11(10), 2805; https://doi.org/10.3390/jcm11102805 - 16 May 2022

Cited by 14 | Viewed by 2879

Abstract

Functional magnetic stimulation (FMS) is a new technique for the conservative treatment of Urinary incontinence (UI), based on magnetic induction. It induces controlled depolarization of the nerves, resulting in pelvic muscle contraction and sacral S2-S4 roots neuromodulation. The aim of this study was to assess the efficacy of the new 3 Tesla FMS chair, both in patients with pure stress urinary incontinence (SUI) and in women with pure overactive bladder (OAB) symptoms. A prospective observational study was conducted in our urogynaecologic unit. All the patients involved were consecutive women with pure SUI or pure OAB symptoms treated by a 3 Tesla electromagnetic chair. The primary outcome was a subjective outcome evaluation by the PGI-I Scale and a patient-satisfaction scale. The secondary outcome was the change score of the UDI-6, IIQ-7, ICIQ-SF and OAB-q SF questionnaires from baseline to final visit. At 2 months follow-up, 28 out of 60 patients (47%) with SUI symptoms and 20 out of 40 patients (50%) with OAB symptoms declared themselves cured. Considering cured and improved patients, the subjective cure rates were 68.3% (41/60) and 70% (28/40) for patients with SUI and OAB symptoms, respectively. The results of this study showed that the 3 Tesla electromagnetic chair may be an effective option for the treatment of UI. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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Review

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18 pages, 749 KiB

Open AccessReview

Latest Evidence on Post-Prostatectomy Urinary Incontinence

by Mauro Gacci, Cosimo De Nunzio, Vasileios Sakalis, Malte Rieken, Jean-Nicolas Cornu and Stavros Gravas

J. Clin. Med. 2023, 12(3), 1190; https://doi.org/10.3390/jcm12031190 - 2 Feb 2023

Cited by 20 | Viewed by 6922

Abstract

A radical prostatectomy is frequently used as the first-line treatment for men with prostate cancer. Persistent urinary incontinence after surgery is one of the most severe adverse events. We report the results of a comprehensive literature search focused on post-prostatectomy urinary incontinence (PPI), performed by a panel of experts on non-neurogenic lower urinary tract symptoms. The data on the prevalence and timing of PPI are very heterogeneous. The etiology of PPI can be multifactorial and mainly dependent on patient characteristics, lower urinary tract function or surgical issues. The medical history with a physical examination, the use of validated questionnaires with a voiding diary and pad tests are determinants in identifying the contributing factors and choosing the right treatment. Lifestyle intervention and urinary containment are the most frequently used strategies for the conservative management of PPI, while antimuscarinics, beta-3 agonists and duloxetine (off-label) are drugs indicated to manage PPI with a concomitant overactive bladder. Surgical therapies for the management of post-prostatectomy SUI include non-adjustable trans-obturator slings in men with mild-to-moderate incontinence and an artificial urinary sphincter in men with moderate-to-severe incontinence. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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8 pages, 416 KiB

Open AccessReview

Neurologic Urinary Incontinence, Lower Urinary Tract Symptoms and Sexual Dysfunctions in Multiple Sclerosis: Expert Opinions Based on the Review of Current Evidences

by Riccardo Bientinesi, Filippo Gavi, Simone Coluzzi, Viviana Nociti, Monia Marturano and Emilio Sacco

J. Clin. Med. 2022, 11(21), 6572; https://doi.org/10.3390/jcm11216572 - 5 Nov 2022

Cited by 13 | Viewed by 2831

Abstract

Objective: To resume each specialist’s role in the management of neurologic urinary tract symptoms (nLUTS) and sexual dysfunctions (SD) in patients suffering from multiple sclerosis (MS). Material and Methods: We asked a neurologist, a urologist and a gynecologist, experts on neuro-urology and sexual dysfunction at our hospital, to resume their role in the management of nLUTS and SD in MS patients based on the review of current evidence. PubMed was used to review literature with a focus on nLUTS and SD in MS patients. Conclusions: The difference in symptomatology in MS patients is very wide. The more the CNS is involved, the more the variations and severity of nLUTS is present. SD have numerous causes and should always be assessed. Urologists play the director’s role in evaluating and treating these patients. Neurologist should play an important role, they must evaluate the potential mutual interactions between disease manifestations of MS and their treatments. Additionally, gynecologists play an important information sharing role in the management of patients with multiple sclerosis. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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14 pages, 954 KiB

Open AccessReview

Physical Agent-Based Treatments for Overactive Bladder: A Review

by Nurida Khasanah, Hung-Yen Chin and Chih-Wei Peng

J. Clin. Med. 2022, 11(17), 5150; https://doi.org/10.3390/jcm11175150 - 31 Aug 2022

Cited by 4 | Viewed by 4017

Abstract

Almost one-fifth of the people in the world experience a decrease in quality of life due to overactive bladder (OAB) syndrome. The main bothersome symptoms are urgency accompanied by urinary frequency and nocturia. This chronic, disabling condition is first managed by reducing fluid intake and pelvic floor muscle training, supplemented with antimuscarinic drugs, if necessary. However, refractory cases often still occur. In more severe cases, invasive surgical interventions can be considered; yet, the success rate is still inconsistent, and there is a high complication rate. This condition is frustrating for patients and challenging for the medical staff involved. Although its pathophysiology has not been fully elucidated, peripheral autonomic somatic and sensory afferent receptors are considered to be involved in this condition. Hence, currently, physical agent-based treatments such as neuromodulation have taken a significant place in the third-line therapy of OAB. The efficacy and safety profiles of electrical and magnetic stimulation continue to evolve. Physical-based agents provide an appealing option owing to their effectiveness and minimal side effects. In addition, more physical therapies using light and shock energy are currently being investigated. Thus, a comprehensive understanding of these modalities is an extremely important aspect to provide the most suitable modalities for patients. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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Other

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5 pages, 180 KiB

Open AccessOpinion

The Maximal Urethral Pressure at Rest and during Normal Bladder Filling Is Only Determined by the Activity of the Urethral Smooth Musculature in the Female

by Pieter L. Venema, Guus Kramer, Gommert A. van Koeveringe and John P. F. A. Heesakkers

J. Clin. Med. 2023, 12(7), 2575; https://doi.org/10.3390/jcm12072575 - 29 Mar 2023

Cited by 5 | Viewed by 1114

Abstract

The aim of this opinion paper is to determine the entities that define the maximal urethral pressure (MUP) during rest and during bladder filling that is needed to guarantee continence in females. For the development of this opinion, the literature was searched for via the Pubmed database and historic sources. Animal studies indicate that the maximal urethral pressure is determined by the smooth muscle activity in the mid-urethra. Additionally, during increased smooth muscle tone development, the largest sympathetic responses are found in the middle part of the urethra. This could be confirmed in human studies that are unable to find striated EMG activity in this area. Moreover, the external urethral striated sphincter is situated at the distal urethra, which is not the area with the highest pressure. The external urethral sphincter only provides additional urethral pressure in situations of exertion and physical activity. From a physics point of view, the phasic pressure of the external striated sphincter at the distal urethra cannot be added to the tonic pressure generated by the smooth muscle in the mid-urethra. The assertion that mid-urethral pressure is the result of different pressure forces around the urethra, including that of the external striated sphincter, is not supported by basic research evidence combined with physical calculation and should therefore be considered a misconception in the field of functional urology. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

8 pages, 450 KiB

Open AccessSystematic Review

Patients’ Preferences and Expectations in Overactive Bladder: A Systematic Review

by Antonio Cicione, Riccardo Lombardo, Vincenzo Umbaca, Giorgia Tema, Giacomo Gallo, Jordi Stira, Carmen Gravina, Beatrice Turchi, Antonio Franco, Elisa Mancini, Antonio Nacchia, Rocco Damiano, Andrea Tubaro and Cosimo De Nunzio

J. Clin. Med. 2023, 12(2), 396; https://doi.org/10.3390/jcm12020396 - 4 Jan 2023

Cited by 2 | Viewed by 2205

Abstract

The aim of our study is to review the current available knowledge regarding preferences and expectations of patients with overactive bladder (OAB). The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines were followed for this manuscript’s preparation. Three online databases were searched: PubMed/Medline, Embase, and Scopus, while a combination of the following keywords was used: detrusor overactivity, overactive bladder, urinary incontinence, perspectives, expectations, and preferences. Overall, 1349 studies were retrieved and screened while only 10 studies appeared to be relevant for the scope of this review. Most of the studies were related to preferences about OAB medications (i.e., antimuscarinics); four of them reported patients’ inclinations to alternative treatments in the case of medication therapy failure (i.e., neuromodulation, Botox). No data were found about diagnosis or other aspects of disease management (i.e., surgery, follow-up). Based on these findings, from the patient’s point of view, the ideal medication should be cheap, without risk of cognitive function impairment, and able to reduce daytime urinary frequency and incontinence episodes. Full article

(This article belongs to the Special Issue Latest Advances in Urinary Incontinence)

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