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Stress urinary incontinence in women:
pelvic muscle training is the first option

The initial treatment for stress urinary incontinence in women is pelvic floor exercises. Surgery should be considered on a case- by-case basis, generally as a last resort. Drug treatment is not appropriate.

Stress urinary incontinence (SUI) in women is a common ailment which sometimes causes acute embarrassment. Pelvic floor exercises carry no significant risk, and should be the front-line treatment. Two-thirds to three-quarters of women find it improves their condition.

If surgical intervention is required, the classic method is retropubic colposuspension, with around 90% of women regaining continence one year after surgery. There are other simpler and more practical techniques such as suburethral slings or the transobturator approach, on which there is scant long-term data.

All drug treatments for SUI in women have a negative benefit-harm balance. Duloxetine, the first drug available on the French market for moderate to severe SUI in women, has no tangible clinical benefit and can cause a number of sometimes serious adverse effects.

©Prescrire July 2005

Source: "Les traitements de l’incontinence urinaire d’effort chez la femme : pas de place pour les médicaments" Rev Prescrire 2005 ; 25 (263) : 514-519. "Duloxétine (Yentrène°) dans l’incontinence urinaire d’effort : trop de risques pour trop peu de bénéfices" Rev Prescrire 2005 ; 25 (263) : 491-494.

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