Research recommendation(s) from an individual piece of guidance
|Guidance||Urinary incontinence in women: management|
|Date issued||September 2013|
Research recommendations coming out of this guidance
- Pelvic floor muscle training:- How effective are different pelvic floor muscle training regimens in the management of women with overactive bladder (OAB) symptoms and to whom should it be offered?
- Neurostimulation:- What is the comparative effectiveness and cost-effectiveness of transcutaneous stimulation of the sacral nerve roots, and transcutaneous and percutaneous posterior tibial nerve stimulation for the treatment of OAB?
- Botulinum toxin A:- What is the long-term effectiveness, optimal dose and optimal frequency of repeat therapy of botulinum toxin A in women with OAB based on detrusor overactivity including risk of adverse events such as urinary infection and intermittent catheterisation?
- Sequence of invasive OAB procedures:- What is the effectiveness and optimum sequence of treatment with botulinum toxin A and percutaneous sacral nerve stimulation for the treatment of OAB after failed conservative (including drug) management?
Predictors of tape failure:- What are the effects of the following predictors on tape failure?
- Age per decade
- Lower maximum urethral closure pressure
- Secondary surgery versus primary surgery
- Higher maximal flow rate
- Concurrent pelvic organ prolapse surgery
- Nocturia versus no nocturia
- Urgency versus no urgency
- Pad weight (per 10 g)
Previous urinary incontinence surgery versus no surgery
Q-tip maximum straining less than 30 degrees, yes versus no
Urge score (per 10 points)
Urgency symptoms versus no urgency symptoms
More than 20 procedures for each surgeon versus first 10 procedures for each surgeon
General anaesthesia versus local anaesthesia
BMI over 35 versus 30 or less
Maximum urethral closure pressure of 31 or more versus 30 or less
Primary surgery versus secondary surgery
Preoperative anticholinergic medication use versus no use