Novel therapies in management of stress urinary incontinence

Abstract

Female urinary incontinence (UI) is a common problem affecting 40% of women, but it is usually understated. It not only is a medical problem but has a larger impact on a women’s social and psychological life. It is often not reported by women especially Indian women as they tend to accept it as a part of aging or a consequence of childbirth. In this review, we would be focusing on female stress UI (SUI) and newer therapies that can help improve the symptoms and lifestyle of such women. Pregnancy, childbirth, menopause, obesity, advanced age, and race and ethnicity are some common risk factors for SUI. The underlying mechanism includes pudendal nerve denervation, loss of ligamentous support of the urethral complex leading to dysfunction of the levator ani muscles, endopelvic fascia, and muscular urethra causing UI. Many treatment options are available for treating UI, such as lifestyle changes, pelvic floor muscle training (PFMT), bladder training, and electromagnetic stimulation of the pelvic floor muscles, and the surgical procedures—Burch colposuspension and bladder‐neck slings and their various modifications. Traditionally, surgery forms the mainstay of management but now focus is towards minimally invasive and non-surgical techniques which could improve the quality of life in such patients. Newer therapies for SUI Management includes the drug-duloxetine, laser therapy and stem cell therapy.