title: New treatments for incontinence.
abstract: Urinary incontinence (UI) is a common, yet underdetected and under-reported, health problem that can significantly affect quality of life. UI may also have serious medical and economic ramifications for untreated or undertreated patients, including perineal dermatitis, worsening of pressure ulcers, urinary tract infections, and falls. To prevent incontinence, the urethral sphincter must maintain adequate closure to resist the flow of urine from the bladder at all times until voluntary voiding is initiated and the bladder must accommodate increasing volumes of urine at a low pressure. UI can be categorized as a result of urethral underactivity (stress UI), bladder overactivity (urge UI), a combination of the 2 (mixed incontinence), or urethral overactivity/bladder underactivity (overflow incontinence). The main goal of therapy for the management of UI is to reduce the number of UI episodes, prevent complications, and, if possible, restore continence. This review highlights the existing treatment of stress, urge, mixed, and overflow UI in adult men and women and discusses many of the novel treatments including potential future or emerging therapies.
authors.affiliation: Department of Urology, Lahey Hospital and Medical Center, Burlington, MA; Department of Urology, Medical University of South Carolina, Charleston, SC.
authors.forename: Lara S
authors.initials: LS
authors.lastname: MacLachlan
authors.affiliation: Department of Urology, Lahey Hospital and Medical Center, Burlington, MA; Department of Urology, Medical University of South Carolina, Charleston, SC. Electronic address: rovnere@musc.edu.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Rovner
mesh_terms: D058667:Adrenergic beta-3 Receptor Agonists / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D057928:Intermittent Urethral Catheterization; D008160:Lumbosacral Plexus; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D009465:Neuromuscular Agents / Q000627:therapeutic use; D026741:Physical Therapy Modalities; D053825:Suburethral Slings; D013979:Tibial Nerve; D023822:Tissue Engineering; D014546:Urinary Catheterization; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000628:therapy; D014550:Urinary Incontinence, Stress / Q000628:therapy*; D053202:Urinary Incontinence, Urge / Q000628:therapy*
chemical_list: D058667:Adrenergic beta-3 Receptor Agonists; D018727:Muscarinic Antagonists; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Mixed incontinence; Overflow incontinence; Stress urinary incontinence; Urge urinary incontinence; Urinary incontinence