https://doi.org/10.4081/aiua.2023.11718
Treatment of urge incontinence in postmenopausal women: A systematic review
Published: October 4, 2023
Abstract Views: 2323
PDF: 1455
Supplementary Material: 51
Supplementary Material: 51
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Background: Urinary incontinence and other urinary symptoms tend to be frequent at menopause because of hormonal modifications and aging. Urinary symptoms are associated with the genitourinary syndrome of menopause which is characterized by physical changes of the vulva, vagina and lower urinary tract. The treatment strategies for postmenopausal urinary incontinence are various and may include estrogens, anticholinergics, and pelvic floor muscle training. A comparison of these treatments is difficult due to the heterogeneity of adopted protocols. We systematically reviewed the evidence from randomized controlled trials (RCTs) focusing on treatment of postmenopausal women with urge incontinence. Methods: We conducted a systematic review and meta-analysis by searching PubMed and EMBASE databases for randomized controlled trials (RCTs) reporting results of treatments for postmenopausal urinary urge incontinence. Odds ratios for improvement of urinary incontinence were calculated using random effect Mantel-Haenszel statistics. Results: Out of 248 records retrieved, 35 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared with placebo, systemic estrogens were associated with decreased odds of improving urinary incontinence in postmenopausal women (OR = 0.74, 95% CI: 0.61-0.91, 7 series, 17132 participants, Z = 2.89, P = 0.004, I2 = 72%). In most studies, no significant improvement in urinary symptoms was observed in patients treated with local estrogens, although they showed to be helpful in improving vaginal symptoms. Vitamin D, phytoestrogens and estrogen modulators were not effective in improving symptoms of incontinence and other symptoms of genitourinary menopause syndrome or yielded contradictory results. A randomized controlled trial demonstrated that oxybutynin was significantly better than placebo at improving postmenopausal urgency and urge incontinence. The combination of anticholinergics with local estrogens has not been shown to be more effective than anticholinergics alone in improving urinary incontinence symptoms in postmenopausal women. Physical therapy showed an overall positive outcome on postmenopausal urinary incontinence symptoms, although such evidence should be further validated in the frame of quality RCTs. Conclusions: The evidence for effective treatment of postmenopausal urinary incontinence is still lacking. Welldesigned large studies having subjective and objective improvement primary endpoints in postmenopausal urinary incontinence are needed. At present, a combination of different treatments tailored to the characteristics of the individual patient can be suggested.
Diokno A, Brock B, Brown M, Herzog A. Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly. J Urol 1986;136:1022–5.
DOI: https://doi.org/10.1016/S0022-5347(17)45194-9
Brown JS, Seeley D, Fong J, Black D, Ensrud K, Grady D. Urinary incontinence in older women: Who is at risk? Obstet Gynecol 1996;87:715–21.
DOI: https://doi.org/10.1016/0029-7844(96)00013-0
Iosif C, Batra S, Ek A, Astedt B. Estrogen receptors in the human female lower urinary tract. Am J Obstet Gynecol 1981;141:817–20.
DOI: https://doi.org/10.1016/0002-9378(81)90710-9
Chen YC, Chen GD, Hu SW, Lin TL, Lin LY (2003) Is the occurrence of storage and voiding dysfunction affected by menopausal transition or associated with the normal aging process? Menopause 10(3):203–208
DOI: https://doi.org/10.1097/00042192-200310030-00005
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097.
DOI: https://doi.org/10.1371/journal.pmed.1000097
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71.
DOI: https://doi.org/10.1136/bmj.n71
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng H-Y, Corbett MS, Eldridge SM, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898.PRISMA
DOI: https://doi.org/10.1136/bmj.l4898
Cardozo L, Rekers H, Tapp A, Barnick C, Shepherd A, Schussler B, Kerr-Wilson R, van Geelan J, Barlebo H, Walter S. Oestriol in the treatment of postmenopausal urgency: a multicentre study. Maturitas. 1993 Dec;18(1):47-53. doi: 10.1016/0378-5122(93)90028-g. PMID: 8107615.
DOI: https://doi.org/10.1016/0378-5122(93)90028-G
Fantl JA, Bump RC, Robinson D, McClish DK, Wyman JF. Efficacy of estrogen supplementation in the treatment of urinary incontinence. The Continence Program for Women Research Group. Obstet Gynecol. 1996 Nov;88(5):745-9. doi: 10.1016/0029-7844(96)00281-5. PMID: 8885906.
DOI: https://doi.org/10.1016/0029-7844(96)00281-5
Grady D, Brown JS, Vittinghoff E, Applegate W, Varner E, Snyder T; HERS Research Group. Postmenopausal hormones and incontinence: the Heart and Estrogen/Progestin Replacement Study. Obstet Gynecol. 2001 Jan;97(1):116-20. doi: 10.1016/s0029-7844(00)01115-7. PMID: 11152919.
DOI: https://doi.org/10.1097/00006250-200101000-00023
Steinauer JE, Waetjen LE, Vittinghoff E, Subak LL, Hulley SB, Grady D, Lin F, Brown JS. Postmenopausal hormone therapy: does it cause incontinence? Obstet Gynecol. 2005 Nov;106(5 Pt 1):940-5. doi: 10.1097/01.AOG.0000180394.08406.15. PMID: 16260510; PMCID: PMC1557396.
DOI: https://doi.org/10.1097/01.AOG.0000180394.08406.15
Hendrix SL, Cochrane BB, Nygaard IE, Handa VL, Barnabei VM, Iglesia C, Aragaki A, Naughton MJ, Wallace RB, McNeeley SG. Effects of estrogen with and without progestin on urinary incontinence. JAMA. 2005 Feb 23;293(8):935-48.
DOI: https://doi.org/10.1001/jama.293.8.935
Sherman AM, Shumaker SA, Sharp P, Reboussin DM, Kancler C, Walkup M, Herrington DM. No effect of HRT on health-related quality of life in postmenopausal women with heart disease. Minerva Ginecol. 2003 Dec;55(6):511-7. PMID: 14676740.
Waetjen LE, Brown JS, Vittinghoff E, Ensrud KE, Pinkerton J, Wallace R, Macer JL, Grady D. The effect of ultralow-dose transdermal estradiol on urinary incontinence in postmenopausal women. Obstet Gynecol. 2005 Nov;106(5 Pt 1):946-52. doi: 10.1097/01.AOG.0000182576.48290.6d. PMID: 16260511; PMCID: PMC1557395.
DOI: https://doi.org/10.1097/01.AOG.0000182576.48290.6d
Rufford J, Hextall A, Cardozo L, Khullar V. A double-blind placebo-controlled trial on the effects of 25 mg estradiol implants on the urge syndrome in postmenopausal women. Int Urogynecol J Pelvic Floor Dysfunct. 2003 Jun;14(2):78-83. doi: 10.1007/s00192-003-1054-3. Epub 2003 Apr 23. PMID:12851747.
DOI: https://doi.org/10.1007/s00192-003-1054-3
Vestergaard P, Hermann AP, Stilgren L, Tofteng CL, Sørensen OH, Eiken P, Nielsen SP, Mosekilde L. Effects of 5 years of hormonal replacement therapy on menopausal symptoms and blood pressure-a randomised controlled study. Maturitas. 2003 Oct 20;46(2):123-32. doi: 10.1016/s0378-5122(03)00181-6. PMID: 14559383.
DOI: https://doi.org/10.1016/S0378-5122(03)00181-6
Cardozo LD, Wise BG, Benness CJ. Vaginal oestradiol for the treatment of lower urinary tract symptoms in postmenopausal women--a double-blind placebo-controlled study. J Obstet Gynaecol. 2001 Jul;21(4):383-5. doi: 10.1080/01443610120059941. PMID: 12521832
DOI: https://doi.org/10.1080/01443610120059941
Dessole S, Rubattu G, Ambrosini G, Gallo O, Capobianco G, Cherchi PL, Marci R, Cosmi E. Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women. Menopause. 2004 Jan-Feb;11(1):49-56. doi: 10.1097/01.GME.0000077620.13164.62. PMID: 14716182.
DOI: https://doi.org/10.1097/01.GME.0000077620.13164.62
Speroff L. Efficacy and tolerability of a novel estradiol vaginal ring for relief of menopausal symptoms. Obstet Gynecol. 2003 Oct;102(4):823-34. doi: 10.1016/s0029-7844(03)00764-6. PMID: 14551014.
DOI: https://doi.org/10.1016/S0029-7844(03)00764-6
Melis GB, Paoletti AM, Murgia C, Piras B, Pilia I, Romagnino S, Tuveri F Vaginal estriol and benzidamine in the treatment of urogenital disorders during the postmenopause. Giornale Italiano di Ostetricia e Ginecologia 1997; 19:303-312.
Lose G, Englev E. Oestradiol-releasing vaginal ring versus oestriol vaginal pessaries in the treatment of bothersome lower urinary tract symptoms. BJOG. 2000 Aug;107(8):1029-34. doi: 10.1111/j.1471-0528.2000.tb10408.x. PMID: 10955437.
DOI: https://doi.org/10.1111/j.1471-0528.2000.tb10408.x
Nelken RS, Ozel BZ, Leegant AR, Felix JC, Mishell DR Jr. Randomized trial of estradiol vaginal ring versus oral oxybutynin for the treatment of overactive bladder. Menopause. 2011 Sep;18(9):962-6. doi: 10.1097/gme.0b013e3182104977. PMID: 21532512.
DOI: https://doi.org/10.1097/gme.0b013e3182104977
Tapp AJ, Cardozo LD, Versi E, Cooper D. The treatment of detrusor instability in post-menopausal women with oxybutynin chloride: a double blind placebo controlled study. Br J Obstet Gynaecol. 1990 Jun;97(6):521-6. doi: 10.1111/j.1471-0528.1990.tb02523.x. PMID: 2198921.
DOI: https://doi.org/10.1111/j.1471-0528.1990.tb02523.x
Chughtai B, Forde JC, Buck J, Asfaw T, Lee R, Te AE, Kaplan SA. The concomitant use of fesoterodine and topical vaginal estrogen in the management of overactive bladder and sexual dysfunction in postmenopausal women. Post Reprod Health. 2016 Mar;22(1):34-40
DOI: https://doi.org/10.1177/2053369116633017
Jiang F, Zhu L, Xu T, Gong MY, Huang YL, Li HF, Wang JJ, Tong XW, Cheng XX, Bai WP, Li X, Xu XX, Xu HC. Efficacy and safety of solifenacin succinate tablets versus solifenacin succinate tablets with local estrogen for the treatment of overactive bladder in postmenopausal women--a multicenter, randomized, open-label, controlled comparison study. Menopause. 2016 Apr;23(4):451-7. doi: 10.1097/GME.0000000000000574. PMID: 26757270.
DOI: https://doi.org/10.1097/GME.0000000000000574
Martin L, Hidalgo R, Schachar J, Ossin D, Hurtado E, Davila GW. Anticholinergic medication and local estrogen for overactive bladder: A randomized placebo controlled trial International Urogynecology Journal 2018; 29 (Supplement 1): S112
Tseng LH, Wang AC, Chang YL, Soong YK, Lloyd LK, Ko YJ. Randomized comparison of tolterodine with vaginal estrogen cream versus tolterodine alone for the treatment of postmenopausal women with overactive bladder syndrome. Neurourol Urodyn. 2009;28(1):47-51. doi: 10.1002/nau.20583. PMID: 19089890.
DOI: https://doi.org/10.1002/nau.20583
Bumbu A, Bianca P, Tit DM, Bungau S, Bumbu G. The effects of soy isoflavones and hormonal replacing therapy on the incidence and evolution of postmenopausal female urinary incontinence. Farmacia 2016;64(3):419-422
Manonai J, Songchitsomboon S, Chanda K, Hong JH, Komindr S. The effect of a soy-rich diet on urogenital atrophy: a randomized, cross-over trial. Maturitas. 2006 May 20;54(2):135-40. doi: 10.1016/j.maturitas.2005.09.011. Epub 2005 Nov 16. PMID: 16297576.
DOI: https://doi.org/10.1016/j.maturitas.2005.09.011
Markland AD, Tangpricha V, Mark Beasley T, Vaughan CP, Richter HE, Burgio KL, Goode PS. Comparing Vitamin D Supplementation Versus Placebo for Urgency Urinary Incontinence: A Pilot Study. J Am Geriatr Soc. 2019 Mar;67(3):570-575. doi: 10.1111/jgs.15711. Epub 2018 Dec 21. PMID: 30578542; PMCID: PMC6403014.
DOI: https://doi.org/10.1111/jgs.15711
Oberg J, Verelst M, Jorde R, Cashman K, Grimnes G. High dose vitamin D may improve lower urinary tract symptoms in postmenopausal women. J Steroid Biochem Mol Biol. 2017 Oct;173:28-32. doi: 10.1016/j.jsbmb.2017.03.013. Epub 2017 Mar PMID: 28323043
DOI: https://doi.org/10.1016/j.jsbmb.2017.03.013
Waetjen LE, Brown JS, Modelska K, Blackwell T, Vittinghoff E, Cummings SR; MORE Study Group. Effect of raloxifene on urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2004 Feb;103(2):261-6. doi: 10.1097/01.AOG.0000109429.67671.d1. PMID: 14754693.
DOI: https://doi.org/10.1097/01.AOG.0000109429.67671.d1
Green SA, Alon A, Ianus J, McNaughton KS, Tozzi CA, Reiss TF. Efficacy and safety of a neurokinin-1 receptor antagonist in postmenopausal women with overactive bladder with urge urinary incontinence. J Urol. 2006 Dec;176(6 Pt 1):2535-40; discussion 2540. doi: 10.1016/j.juro.2006.08.018. PMID: 17085151.
DOI: https://doi.org/10.1016/j.juro.2006.08.018
Alves FK, Riccetto C, Adami DB, Marques J, Pereira LC, Palma P, Botelho S. A pelvic floor muscle training program in postmenopausal women: A randomized controlled trial. Maturitas. 2015 Jun;81(2):300-5. doi:10.1016/j.maturitas.2015.03.006. Epub 2015 Mar 14. PMID: 25862491
DOI: https://doi.org/10.1016/j.maturitas.2015.03.006
Diokno AC, Sampselle CM, Herzog AR, Raghunathan TE, Hines S, Messer K, Karl C, Leite MC. Prevention of urinary incontinence by behavioral modification program: a randomized, controlled trial among older women in the community. J Urol. 2004 Mar;171(3):1165-71. doi: 10.1097/01.ju.0000111503.73803.c2. PMID:14767293.
DOI: https://doi.org/10.1097/01.ju.0000111503.73803.c2
Sran M, Mercier J, Wilson P, Lieblich P, Dumoulin C. Physical therapy for urinary incontinence in postmenopausal women with osteoporosis or low bone density: a randomized controlled trial. Menopause. 2016 Mar;23(3):286-93. doi: 10.1097/GME.0000000000000594. PMID: 26886884.
DOI: https://doi.org/10.1097/GME.0000000000000594
Fuentes-Aparicio L, Rejano-Campo M, López-Bueno L, Marie Donnelly G, Balasch-Bernat M. The effect of an abdominopelvic exercise program alone VS in addition to postural instructions on pelvic floor muscle function in climacteric women with stress urinary incontinence. A randomized controlled trial. Physiother Theory Pract. 2023 Apr;39(4):738-749.
DOI: https://doi.org/10.1080/09593985.2022.2028323
Wu C, Newman D, Schwartz TA, Zou B, Miller J, Palmer MH. Effects of
unsupervised behavioral and pelvic floor muscle training programs on nocturia, urinary urgency, and urinary frequency in postmenopausal women: Secondary analysis of a randomized, two-arm, parallel design, superiority trial (TULIP study). Maturitas. 2021 Apr;146:42-48. doi: 10.1016/j.maturitas.2021.01.008. Epub 2021 Feb 4. PMID: 33722363.
DOI: https://doi.org/10.1016/j.maturitas.2021.01.008
Spruijt J, Vierhout M, Verstraeten R, Janssens J, Burger C. Vaginal electrical stimulation of the pelvic floor: a randomized feasibility study in urinary incontinent elderly women. Acta Obstet Gynecol Scand. 2003 Nov;82(11):1043-8. doi: 10.1034/j.1600-0412.2003.00130.x. PMID: 14616279.
DOI: https://doi.org/10.1034/j.1600-0412.2003.00130.x
Eftekhar T, Ghorbani L, Ghanbari Z, Razavi J, Dolatshad F. Comparison of the Effect of Radiofrequency and Laser Treatment on Mixed Urinary Incontinence and Vulvovaginal Atrophy in Iranian Menopausal Women: A Randomized Controlled Trial. International Journal of Women’s Health and Reproduction Sciences 2021; 9: 61–68
DOI: https://doi.org/10.15296/ijwhr.2021.11
Aguiar LB, Politano CA, Costa-Paiva L, Juliato CRT. Efficacy of Fractional CO2 Laser, Promestriene, and Vaginal Lubricant in the Treatment of Urinary Symptoms in Postmenopausal Women: A Randomized Clinical Trial. Lasers Surg Med. 2020 Oct;52(8):713-720. doi: 10.1002/lsm.23220. Epub 2020 Jan 28.PMID: 31990089.
DOI: https://doi.org/10.1002/lsm.23220
Lin KL, Lu JH, Chueh KS, Juan TJ, Wu BN, Chuang SM, Lee YC, Shen MC, Long CY, Juan YS. Low-Intensity Extracorporeal Shock Wave Therapy Promotes Bladder Regeneration and Improves Overactive Bladder Induced by Ovarian Hormone Deficiency from Rat Animal Model to Human Clinical Trial. Int J Mol Sci. 2021 Aug 27;22(17):9296. doi: 10.3390/ijms22179296. PMID: 34502202; PMCID:PMC8431217.
DOI: https://doi.org/10.3390/ijms22179296
Biehl C, Plotsker O, Mirkin S. A systematic review of the efficacy and safety of vaginal estrogen products for the treatment of genitourinary syndrome of menopause. Menopause. 2019 Apr;26(4):431-453.
DOI: https://doi.org/10.1097/GME.0000000000001221
Cody JD, Richardson K, Moehrer B, Hextall A, Glazener CM. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001405.
DOI: https://doi.org/10.1002/14651858.CD001405.pub2
Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall A. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2012 Oct 17;10(10):CD001405.
DOI: https://doi.org/10.1002/14651858.CD001405.pub3
Miodrag A, Castleden CM, Vallance TR. Sex hormones and the female urinary tract. Drugs. 1988 Oct;36(4):491-504
DOI: https://doi.org/10.2165/00003495-198836040-00006
Harding CK, Lapitan MC, Arlandis S, Bø K, Cobussen-Boekhorst H, Costantini E, Groen J, Nambiar AK, Omar MI, Peyronnet B, Phé V, van der Vaart CH. EAU Guidelines on Management of Non-Neurogenic Female Lower Urinary Tract Symptoms EAU Guidelines. Edn. presented at the EAU Annual Congress Milan March 2023. EAU Guidelines Office, Arnhem, The Netherlands http://uroweb.org/guidelines/compilations-of-all-guidelines/
Glazier MG, Bowman MA. A review of the evidence for the use of phytoestrogens as a replacement for traditional estrogen replacement therapy. Arch Intern Med. 2001 May 14;161(9):1161-72.
DOI: https://doi.org/10.1001/archinte.161.9.1161
Crescioli C, Morelli A, Adorini L, et al. Human bladder as a novel target for vitamin D receptor ligands. J Clin Endocrinol Metab. 2005;90:962-972.
DOI: https://doi.org/10.1210/jc.2004-1496
Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM, Leicestershire MRC Incontinence Study Group. Nutrient composition of the diet and the development of overactive bladder: a longitudinal study in women. NeurourolUrodyn. 2004;23:204-210.
DOI: https://doi.org/10.1002/nau.20028
Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Trinchieri A, Buchholz N. Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials. Arch Ital Urol Androl. 2022 Dec 28;94(4):492-506.
DOI: https://doi.org/10.4081/aiua.2022.4.492
Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, Yu O, Crane PK, Larson EB. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015 Mar;175(3):401-7.
DOI: https://doi.org/10.1001/jamainternmed.2014.7663
Risacher SL, McDonald BC, Tallman EF, West JD, Farlow MR, Unverzagt FW, Gao S, Boustani M, Crane PK, Petersen RC, Jack CR Jr, Jagust WJ, Aisen PS, Weiner MW, Saykin AJ; Alzheimer’s Disease Neuroimaging Initiative. Association Between Anticholinergic Medication Use and Cognition, Brain Metabolism, and Brain Atrophy in Cognitively Normal Older Adults. JAMA Neurol. 2016 Jun 1;73(6):721-32.
DOI: https://doi.org/10.1001/jamaneurol.2016.0580
Sink KM, Thomas J 3rd, Xu H, Craig B, Kritchevsky S, Sands LP. Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc. 2008 May;56(5):847-53.
DOI: https://doi.org/10.1111/j.1532-5415.2008.01681.x
Tannenbaum C, Paquette A, Hilmer S, Holroyd-Leduc J, Carnahan R. A systematic review of amnestic and non-amnestic mild cognitive impairment induced by anticholinergic, antihistamine, GABAergic and opioid drugs. Drugs Aging. 2012 Aug 1;29(8):639-58.
DOI: https://doi.org/10.2165/11633250-000000000-00000
Wagg A, Nitti VW, Kelleher C, Castro-Diaz D, Siddiqui E, Berner T. Oral pharmacotherapy for overactive bladder in older patients: mirabegron as a potential alternative to antimuscarinics. Curr Med Res Opin. 2016;32(4):621-38.
DOI: https://doi.org/10.1185/03007995.2016.1149806
Kennelly MJ, Rhodes T, Girman CJ, Thomas E, Shortino D, Mudd PN Jr. Efficacy of Vibegron and Mirabegron for Overactive Bladder: A Systematic Literature Review and Indirect Treatment Comparison. Adv Ther. 2021 Nov;38(11):5452-5464.
DOI: https://doi.org/10.1007/s12325-021-01902-8
Kinjo M, Masuda K, Nakamura Y, Miyakawa J, Tambo M, Fukuhara H. Comparison of Mirabegron and Vibegron in Women With Treatment-Naive Overactive Bladder: A Randomized Controlled Study. Urology. 2023 May;175:67-73.
DOI: https://doi.org/10.1016/j.urology.2023.02.003
Stenzelius, K., et al. The effect of conservative treatment of urinary incontinence among older and frail older people: a systematic review. Age Ageing, 2015. 44: 736.
DOI: https://doi.org/10.1093/ageing/afv070
Wagg, A., Chen, LK, Johnson, T, et al.. Committee 11, Incontinence in frail older persons, in Incontinence, P. Abrams, et al., Editor. 2017.
Alsulihem A, Corcos J. The use of vaginal lasers in the treatment of urinary incontinence and overactive bladder, systematic review. Int Urogynecol J. 2021 Mar;32(3):553-572.
DOI: https://doi.org/10.1007/s00192-020-04548-2
How to Cite
Bapir, R., Bhatti, K. H., Eliwa, A., García-Perdomo, H. A., Gherabi, N., Hennessey, D., Magri, V., Mourmouris, P., Ouattara, A., Perletti, G., Philipraj, J., Stamatiou, K., Tolani, M. A., Tzelves, L., Trinchieri, A., & Buchholz, N. (2023). Treatment of urge incontinence in postmenopausal women: A systematic review. Archivio Italiano Di Urologia E Andrologia, 95(3). https://doi.org/10.4081/aiua.2023.11718
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.