PMID- 31062225
OWN - NLM
STAT- MEDLINE
DCOM- 20201104
LR  - 20201104
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 34
IP  - 8
DP  - 2019 Aug
TI  - Adverse Events Associated with Nonsurgical Treatments for Urinary Incontinence in 
      Women: a Systematic Review.
PG  - 1615-1625
LID - 10.1007/s11606-019-05028-0 [doi]
AB  - BACKGROUND: Urinary incontinence (UI) is a common malady in women. Numerous 
      nonsurgical treatments are available, each associated with risk of adverse events 
      (AEs). METHODS: We systematically reviewed nonsurgical interventions for urgency, 
      stress, or mixed UI in women, focusing on AEs. We searched MEDLINE(R), Cochrane 
      Central Trials Registry, Cochrane Database of Systematic Reviews, and Embase(R) 
      through December 4, 2017. We included comparative studies and single-group 
      studies with at least 50 women. Abstracts were screened independently in 
      duplicate. One researcher extracted study characteristics and results with 
      verification by another independent researcher. When at least four studies of a 
      given intervention reported the same AE, we conducted random effects model 
      meta-analyses of proportions. We also assessed the strength of evidence. RESULTS: 
      There is low strength of evidence that AEs are rare with behavioral therapies and 
      neuromodulation, and that periurethral bulking agents may result in erosion and 
      increase the risk of voiding dysfunction. High strength of evidence finds that 
      anticholinergics and alpha agonists are associated with high rates of dry mouth 
      and constitutional effects such as fatigue and gastrointestinal complaints. 
      Onabotulinum toxin A (BTX) is also associated with increased risk of urinary 
      tract infections (UTIs) and voiding dysfunction (moderate strength of evidence). 
      DISCUSSION: Behavioral therapies and neuromodulation have low risk of AEs. 
      Anticholinergics and alpha agonists have high rates of dry mouth and 
      constitutional effects. BTX is associated with UTIs and voiding dysfunction. 
      Periurethral bulking agents are associated with erosion and voiding dysfunction. 
      These AEs should be considered when selecting appropriate UI treatment options. 
      AE reporting is inconsistent and AE rates across studies tended to vary widely. 
      Trials should report AEs more consistently.
FAU - Balk, Ethan M
AU  - Balk EM
AD  - Brown Evidence-based Practice Center, Center for Evidence Synthesis in Health, 
      Brown School of Public Health, Brown University, Providence, RI, USA. 
      ethan_balk@brown.edu.
FAU - Adam, Gaelen P
AU  - Adam GP
AD  - Brown Evidence-based Practice Center, Center for Evidence Synthesis in Health, 
      Brown School of Public Health, Brown University, Providence, RI, USA.
FAU - Corsi, Katherine
AU  - Corsi K
AD  - Rhode Island Hospital, College of Pharmacy, University of Rhode Island, 
      Providence, RI, USA.
FAU - Mogul, Amanda
AU  - Mogul A
AD  - Binghamton University School of Pharmacy and Pharmaceutical Sciences, Binghamton, 
      NY, USA.
FAU - Trikalinos, Thomas A
AU  - Trikalinos TA
AD  - Brown Evidence-based Practice Center, Center for Evidence Synthesis in Health, 
      Brown School of Public Health, Brown University, Providence, RI, USA.
FAU - Jeppson, Peter C
AU  - Jeppson PC
AD  - Division of Urogynecology, Department of Obstetrics and Gynecology, University of 
      New Mexico School of Medicine, Albuquerque, NM, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Systematic Review
DEP - 20190506
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
SB  - IM
MH  - Conservative Treatment/*adverse effects/methods
MH  - Female
MH  - Humans
MH  - Urinary Incontinence/*therapy
PMC - PMC6667523
OTO - NOTNLM
OT  - adverse events
OT  - meta-analysis
OT  - quality of life
OT  - systematic review
OT  - urinary incontinence
COIS- The authors declare that they do not have a conflict of interest.
EDAT- 2019/05/08 06:00
MHDA- 2020/11/05 06:00
PMCR- 2020/08/01
CRDT- 2019/05/08 06:00
PHST- 2019/01/22 00:00 [received]
PHST- 2019/03/28 00:00 [accepted]
PHST- 2019/02/06 00:00 [revised]
PHST- 2019/05/08 06:00 [pubmed]
PHST- 2020/11/05 06:00 [medline]
PHST- 2019/05/08 06:00 [entrez]
PHST- 2020/08/01 00:00 [pmc-release]
AID - 10.1007/s11606-019-05028-0 [pii]
AID - 5028 [pii]
AID - 10.1007/s11606-019-05028-0 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2019 Aug;34(8):1615-1625. doi: 10.1007/s11606-019-05028-0. Epub 
      2019 May 6.