Vol 94, No 4 (2023)
Guidelines / Expert consensus
Published online: 2022-02-18

open access

Page views 3046
Article views/downloads 916
Get Citation

Connect on Social Media

Connect on Social Media

The Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guideline for the diagnostic assessment of stress urinary incontinence in women

Edyta Wlazlak1, Magdalena E. Grzybowska2, Tomasz Rechberger3, Wlodzimierz Baranowski4, Artur Rogowski5, Pawel Miotla3, Klaudia Stangel-Wojcikiewicz6, Magda Krzycka1, Tomasz Kluz7, Elzbieta Narojczyk-Swiesciak8, Bartlomiej Burzynski9, Grzegorz Surkont1
Pubmed: 35315030
Ginekol Pol 2023;94(4):330-336.

Abstract

Objectives: The aim of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) was to develop an updated Guideline for the diagnostic assessment of stress urinary incontinence (SUI) in women.
Material and methods: Earlier PSGO guidelines and the literature about the diagnostic assessment of SUI, including current international guidelines, were reviewed.
Results: As in the earlier guidelines, the diagnostic process was subdivided into the initial and the specialized diagnostics. Patients who required specialized diagnostic testing were identified. Functional diagnostic tests, performed by physiotherapists, were included. Attention was paid to new diagnostic possibilities.
Conclusions: Initial diagnostic assessment is sufficient to devise the optimal treatment plan in a number of patients. It also allows to identify which patients will require specialized diagnostics, whose scope is individually tailored to the patient needs and depends on symptom complexity, surgical history, treatment plan, experience of the physician, availability of the equipment, and cost-effectiveness ratio.

Article available in PDF format

View PDF Download PDF file

References

  1. Haylen BT, de Ridder D, Freeman RM, et al. International Urogynecological Association, International Continence Society. An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29(1): 4–20.
  2. Diaz DC, Robinson D. et al.. Initial Assessment of Urinary Incontinence in Adult Male and Female Patients. In: Abrams P, Cardozo L, Wagg A, Wein A. ed. Incontinence. 6th Edition 2017. ICUD ICS, Tokyo 2016: 497–540.
  3. Wróbel AF, Kluz T, Surkont G, et al. Novel biomarkers of overactive bladder syndrome. Ginekol Pol. 2017; 88(10): 568–573.
  4. Wróbel A, Kluz T, Surkont G, et al. Perspectives for the pharmacological treatment of overactive bladder syndrome. Ginekol Pol. 2017; 88(9): 504–508.
  5. Wróbel A, Miziak B, Bańczerowska-Górska M, et al. The influence of nebivolol on the activity of BRL 37344 - the β3-adrenergic receptor agonist, in the animal model of detrusor overactivity. Neurourol Urodyn. 2019; 38(5): 1229–1240.
  6. Surkont G, Wlaźlak E, Dunicz-Sokolowska A, et al. The efficacy of SUI treatment with Burch colposuspension evaluated with use of ITT analysis. Ginekol Pol. 2007; 78(5): 378–380.
  7. Khullar V. Imaging, Neurophysiological Testing and Other Tests In: Abrams P, Cardozo L, Wagg A, Wein A (eds) Incontinence, 6th edition. In: Incontinence. 6th Edition 2017. ICUD ICS, Tokyo 2016: 671–804.
  8. American Urogynecologic Society and American College of Obstetricians and Gynecologists. Committee opinion: evaluation of uncomplicated stress urinary incontinence in women before surgical treatment. Female Pelvic Med Reconstr Surg. 2014; 20(5): 248–251.
  9. Nambiar AK, Bosch R, Cruz F, et al. Asociación Europea de Urología, European Association of Urology. EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur Urol. 2012; 62(6): 1130–1142.
  10. Syan R, Brucker BM, et al. Guideline of guidelines: urinary incontinence. BJU Int. 2016; 117(1): 20–33.
  11. Radziszewski P, Baranowski W, Nowak-Markwitz E, et al. Wytyczne Zespołu Ekspertów odnośnie postępowania diagnostyczno- terapeutycznego u kobiet z nietrzymaniem moczu i pęcherzem nadreaktywnym. Ginekol Pol. 2010; 81(10): 789–793.
  12. Spaczyński M. Rekomendacje Polskiego Towarzystwa Ginekologicznego w sprawie diagnostyki i leczenia nietrzymania moczu u kobiet. Gin Prakt. 2005; 86(5): 45–53.
  13. Rosier PWM. et al.. Urodynamic Testings. In: Abrams P, Cardozo L, Wagg A, Wein A. ed. Incontinence. 6th Edition 2017. Urodynamic Testing Incontinence, Tokyo 2016: 599–670.
  14. van Leijsen SA, Kluivers KB, Mol BW, et al. Dutch Urogynecology Consortium*. Value of urodynamics before stress urinary incontinence surgery: a randomized controlled trial. Obstet Gynecol. 2013; 121(5): 999–1008.
  15. Wlaźlak E, Surkont G, Shek KaL, et al. Can we predict urinary stress incontinence by using demographic, clinical, imaging and urodynamic data? Eur J Obstet Gynecol Reprod Biol. 2015; 193: 114–117.
  16. Guralnick ML, Fritel X, Tarcan T, et al. ICS Educational Module: Cough stress test in the evaluation of female urinary incontinence: Introducing the ICS-Uniform Cough Stress Test. Neurourol Urodyn. 2018; 37(5): 1849–1855.
  17. Bernards ATM, Berghmans BCM, Slieker-Ten Hove MC, et al. Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update. Int Urogynecol J. 2014; 25(2): 171–179.
  18. Nambiar AK, Bosch R, Cruz F, et al. Asociación Europea de Urología, European Association of Urology. EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur Urol. 2012; 62(6): 1130–1142.
  19. Asimakopoulos AD, De Nunzio C, Kocjancic E, et al. Measurement of post-void residual urine. Neurourol Urodyn. 2016; 35(1): 55–57.
  20. Wood LN, Anger JT. Urinary incontinence in women. BMJ. 2014; 349: g4531.
  21. Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician. 2013; 87(8): 543–550.
  22. Irwin GM. Urinary Incontinence. Prim Care. 2019; 46(2): 233–242.
  23. Vo A, Kielb SJ. Female Voiding Dysfunction and Urinary Incontinence. Med Clin North Am. 2018; 102(2): 313–324.
  24. Kenton KS, Smilen SW. Committee on Practice Bulletins—Gynecology and the American Urogynecologic Society. Urinary Incontinence in Women — Practice Bulletin. Female Pelvic Medicine & Reconstructive Surgery. 2015; 126(5): 66–81.
  25. Jamard E, Blouet M, Thubert T, et al. Utility of 2D-ultrasound in pelvic floor muscle contraction and bladder neck mobility assessment in women with urinary incontinence. J Gynecol Obstet Hum Reprod. 2020; 49(1): 101629.
  26. Yin Y, Xia Z, Feng X, et al. Three-Dimensional transperineal ultrasonography for diagnosis of female occult stress urinary incontinence. Med Sci Monit. 2019; 25: 8078–8083.
  27. Rzymski P, Burzyński B, Knapik M, et al. How to balance the treatment of stress urinary incontinence among female athletes? Arch Med Sci. 2021; 17(2): 314–322.
  28. Grzybowska ME, Wydra D. 24/7 usage of continence pads and quality of life impairment in women with urinary incontinence. Int J Clin Pract. 2019; 73(8).
  29. Grzybowska ME, Wydra D, Smutek J. Analysis of the usage of continence pads and help-seeking behavior of women with stress urinary incontinence in Poland. BMC Womens Health. 2015; 15: 80.
  30. Farrell SA, Bent A, Amir-Khalkhali B, et al. Women's ability to assess their urinary incontinence type using the QUID as an educational tool. Int Urogynecol J. 2013; 24(5): 759–762.
  31. Hess R, Huang AJ, Richter HE, et al. Long-term efficacy and safety of questionnaire-based initiation of urgency urinary incontinence treatment. Am J Obstet Gynecol. 2013; 209(3): 244.e1–244.e9.
  32. Takahashi S, Takei M, Asakura H, et al. Clinical guideline for female lower urinary tract symptoms. Low Urin Tract Symptoms. 2016; 8(1): 5–29.
  33. Grzybowska ME, Griffith JW, Kenton K, et al. Validation of the polish version of the pelvic floor distress inventory. Int Urogynecol J. 2019; 30(1): 101–105.
  34. Grzybowska ME, Piaskowska-Cala J, Wydra DG. Polish translation and validation of the pelvic organ prolapse/urinary incontinence sexual questionnaire, iuga-revised (PISQ-IR). Int Urogynecol J. 2019; 30(1): 55–64.
  35. Grzybowska ME, Piaskowska-Cala J, Wydra DG, et al. Validation of the polish version of the pelvic organ prolapse/urinary incontinence sexual questionnaire. Int Urogynecol J. 2016; 27(5): 781–786.
  36. Mody L, Juthani-Mehta M. Urinary tract infections in older women: a clinical review. JAMA. 2014; 311(8): 844–854.
  37. Mothes AR, Runnebaum M, Runnebaum IB. An innovative dual-phase protocol for pulsed ablative vaginal Erbium:YAG laser treatment of urogynecological symptoms. Eur J Obstet Gynecol Reprod Biol. 2018; 229: 167–171.
  38. Dietz HP, Shek KL. The quantification of levator muscle resting tone by digital assessment. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(11): 1489–1493.
  39. Dietz HP, Shek KL. The quantification of levator muscle resting tone by digital assessment. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(11): 1489–1493.
  40. Lemos N, Korte JE, Iskander M, et al. Center-by-center results of a multicenter prospective trial to determine the inter-observer correlation of the simplified POP-Q in describing pelvic organ prolapse. Int Urogynecol J. 2012; 23(5): 579–584.
  41. Stangel-Wojcikiewicz K, Piatkowski M, Radwan-Praglowska J, et al. Microwave-assisted synthesis and characterization of novel chitosan-based biomaterials for pelvic organ prolapse treatment. J Physiol Pharmacol. 2019; 70(3).
  42. Thorp JM, Jones LH, Wells E, et al. Assessment of pelvic floor function: a series of simple tests in nulliparous women. Int Urogynecol J Pelvic Floor Dysfunct. 1996; 7(2): 94–97.
  43. Shek KaL, Chantarasorn V, Dietz HP. The urethral motion profile before and after suburethral sling placement. J Urol. 2010; 183(4): 1450–1454.
  44. Wlaźlak E, Viereck V, Kociszewski J, et al. Role of intrinsic sphincter deficiency with and without urethral hypomobility on the outcome of tape insertion. Neurourol Urodyn. 2017; 36(7): 1910–1916.
  45. Wlaźlak E, Kluz T, Kociszewski J, et al. The analysis of repeatability and reproducibility of bladder neck mobility measurements obtained during pelvic floor sonography performed introitally with 2D transvaginal probe. Ginekol Pol. 2017; 88(7): 360–365.
  46. Surkont G, Wlaźlak E, Petri E, et al. Standardized modified colposuspension — mid-term results of prospective studies in one centre. Ann Agric Environ Med. 2015; 22(2): 293–296.
  47. Wlaźlak E, Kluz T, Surkont G, et al. Urethral funneling visualized during pelvic floor sonography — analysis of occurrence among urogynecological patients. Ginekol Pol. 2018; 89(2): 55–61.
  48. Al Afraa T, Mahfouz W, Campeau L, et al. Normal lower urinary tract assessment in women: I. Uroflowmetry and post-void residual, pad tests, and bladder diaries. Int Urogynecol J. 2012; 23(6): 681–685.
  49. Kociszewski J, Surkont G, Wlaźlak E, et al. Differences in female urethral length based on ultrasound measurement results. Annual Meeting of the International Urogynecological Association. Como, Włochy, 2009.
  50. Pomian A, Majkusiak W, Kociszewski J, et al. Demographic features of female urethra length. Neurourol Urodyn. 2018; 37(5): 1751–1756.
  51. Viereck V, Kuszka A, Rautenberg O, et al. Do different vaginal tapes need different suburethral incisions? The one-half rule. Neurourol Urodyn. 2015; 34(8): 741–746.
  52. Kociszewski J, Rautenberg O, Kuszka A, et al. Can we place tension-free vaginal tape where it should be? The one-third rule. Ultrasound Obstet Gynecol. 2012; 39(2): 210–214.
  53. Surkont G, Wlaźlak E, Suzin J. Long-term risk of complications after mid-urethral sling IVS implantation. Ann Agric Environ Med. 2015; 22(1): 163–166.
  54. Kluz T, Wlaźlak E, Surkont G. Transvaginal six-arm mesh OPUR in women with apical pelvic organ prolapse — analysis of short-term results, pelvic floor ultrasound evaluation. Ginekol Pol. 2017; 88(6): 302–306.
  55. Kociszewski J, Kolben S, Barski D, et al. Complications following tension-free vaginal tapes: accurate diagnosis and complications management. Biomed Res Int. 2015; 2015: 538391.
  56. Fabian G, Barcz E, Zwierzchowska A, et al. Complications of sub-urethral sling procedures. Ginekol Pol. 2014; 85(7): 536–540.
  57. Tunn R, Albrich S, Beilecke K, et al. Interdisciplinary S2k guideline: sonography in urogynecology: short version — AWMF registry number: 015/055. Geburtshilfe Frauenheilkd. 2014; 74(12): 1093–1098.
  58. Ku JH, Jeong IG, Lim DJ, et al. Voiding diary for the evaluation of urinary incontinence and lower urinary tract symptoms: prospective assessment of patient compliance and burden. Neurourol Urodyn. 2004; 23(4): 331–335.
  59. Scotti RJ, Ostergard DR, Guillaume AA, et al. Predictive value of urethroscopy as compared to urodynamics in the diagnosis of genuine stress incontinence. J Reprod Med. 1990; 35(8): 772–776.
  60. Govier FE, Pritchett TR, Kornman JD. Correlation of the cystoscopic appearance and functional integrity of the female urethral sphincteric mechanism. Urology. 1994; 44(2): 250–253.
  61. Davis R, Jones JS, Barocas DA, et al. American Urological Association. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol. 2012; 188(6 Suppl): 2473–2481.
  62. Chade DC, Shariat SF, Godoy G, et al. Clinical outcomes of primary bladder carcinoma in situ in a contemporary series. J Urol. 2010; 184(1): 74–80.
  63. Kim JK, Kim YJ, Choo MS, et al. The urethra and its supporting structures in women with stress urinary incontinence: MR imaging using an endovaginal coil. AJR Am J Roentgenol. 2003; 180(4): 1037–1044.
  64. Law YM, Fielding JR. MRI of pelvic floor dysfunction: review. AJR Am J Roentgenol. 2008; 191(6 Suppl): 45–53.
  65. Artibani W, Cerruto MA. The role of imaging in urinary incontinence. BJU Int. 2005; 95(5): 699–703.