Bottom Line: Adding behavioral and physical therapy before and after surgery for women with stress and urgency urinary incontinence resulted in a small improvement in symptoms compared to women who just had surgery but that difference in symptoms may not be clinically important. There have been a lack of studies examining treatments for women with both stress and urgency urinary incontinence also called mixed urinary incontinence. This randomized clinical trial included 480 women with symptoms of mixed urinary incontinence and compared the effect among women of having sessions of behavioral and pelvic floor muscle therapy before and after midurethral sling surgery for incontinence or surgery alone. The authors report that after 12 months, compared to women who just had surgery, women in the combined therapy and surgery group had a small improvement in symptoms of mixed urinary incontinence but that difference didn't meet the threshold set for clinical importance. A limitation of the study was a lack of well-established thresholds when this study was designed for determining minimal clinically important differences for women with mixed urinary incontinence.
Authors: Vivian W. Sung, M.D., M.P.H., Alpert Medical School of Brown University, Providence, Rhode Island, and coauthors
(doi:10.1001/jama.2019.12467)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Media advisory: To contact corresponding author Vivian W. Sung, M.D., M.P.H., email Kevin Stacey at kevin_stacey@brown.edu. The full study and editorial are linked to this news release.
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JAMA