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    Review Examines Treatments for Urinary Incontinence

    Pelvic muscle and bladder training, anticholinergic drugs boost women's continence rates

    THURSDAY, Feb. 14 (HealthDay News) -- Pelvic floor muscle and bladder training offer women a good chance of resolving urinary incontinence, as do anticholinergic drugs, but many other treatments showed inconsistent effects in a systematic review published online Feb. 12 in the Annals of Internal Medicine.

    Tatyana A. Shamliyan, M.D., of the University of Minnesota School of Public Health in Minneapolis, and colleagues included 96 randomized controlled trials and three systematic reviews published from 1990 through May 2007 in their review of non-surgical interventions to treat urinary incontinence in women.

    Moderate levels of evidence showed that pelvic floor muscle and bladder training consistently improved continence rates, with improvement seen across four trials. The anticholinergic drugs oxybutynin and tolterodine led to increased continence rates compared to placebo. Electrical stimulation didn't resolve incontinence, however, and oral hormone treatment was associated with increased rates of incontinence over placebo.

    "Despite substantial heterogeneity among studies, attributable benefit for public health can be estimated from individual randomized controlled trials. Intensive lifestyle changes would avoid 54 cases of stress urinary incontinence per 1,000 treated women. Pelvic floor muscle training would resolve 490 cases of stress urinary incontinence, 80 cases of any urinary incontinence, and 167 cases of stress or urge urinary incontinence per 1,000 treated women. Magnetic stimulation therapy would resolve 390 cases of urge urinary incontinence and the administration of tolterodine (extended-release, 4 mg), 202 cases of urge urinary incontinence per 1,000 treated women," the authors write.

    A study co-author reports consultancies with Eli Lilly and Pfizer.

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