Evidence-Based Complementary and Alternative Therapies in Urinary Incontinence

Abstract

Urinary incontinence; is an important and common health problem that causes medical, psychosocial and hygienic problems and may adversely affect the quality of life of individuals. About 200 million people in the world are experiencing urinary incontinence complaints. Health professionals are constantly seeking better interventions in the treatment of urinary incontinence symptoms, which have a significant impact on quality of life. Complementary and Alternative Medicine, such as behavior change, lifestyle changes, bladder training, Pelvic Floor Muscle Exercises, vaginal cones, biofeedback, yoga, acupressure, acupuncture may prevent or reduce bladder dysfunction. Our review was prepared to analyze the evidence-based complementary and alternative medicine interventions used in urinary incontinence. During the preparation process of the review, relevant articles published in Cochrane and PubMed were scanned and their level of evidence was examined according to the evidence level classification accepted by the Joanna Briggs Institute. As a result of the data obtained, there is no reliable, sufficient evidence on whether complementary and alternative medicine methods are useful, and should be a research priority.

Keywords

• urinary incontinence,evidence-based practices,complementary and alternative therapies,nursing

Üriner İnkontinansta Kanıt Temelli Tamamlayıcı ve Alternatif Tedaviler

Abstract

Üriner inkontinans; medikal, psikososyal ve hijyenik sorunlara neden olan, bireylerin yaşam kalitesini olumsuz etkileyebilen, önemli ve yaygın bir sağlık sorunudur. Dünyada ortalama 200 milyon insan üriner inkontinans şikâyeti yaşamaktadır. Yaşam kalitesi üzerinde önemli bir etkiye sahip olan üriner inkontinans semptomlarının tedavisinde sağlık profesyonelleri sürekli olarak daha iyi müdahaleler aramaktadırlar. Tamamlayıcı ve Alternatif Tedavi yöntemlerinden olan davranış değişikliği, yaşam tarzı değişiklikleri, mesane eğitimi, Pelvik Taban Kas Egzersizleri, vajinal konlar, biofeedback, yoga, akupressure, akupunktur gibi uygulamalar mesane fonksiyon bozukluğunu önleyebilir veya azaltabilir. Derlememiz, üriner inkontinansta kullanılan kanıt temelli tamamlayıcı ve alternatif tedavi uygulamalarını incelemek amacıyla hazırlanmıştır. Derlemenin hazırlanma sürecinde, Cochrane ve PubMed’de yayınlanmış konuyla ilgili makaleler taranmış ve elde edilen makalelerin kanıt düzeyi Joanna Briggs Enstitüsünün kabul ettiği kanıt düzeyi sınıflandırmasına göre incelenmiştir. Elde edilen veriler sonucunda, tamamlayıcı ve alternatif tedavi yöntemlerinin yararlı olup olmadığı konusunda güvenilir, yeterli kanıt bulunamamıştır ve araştırma önceliği olması gerekmektedir. 

Keywords

• üriner inkontinans,kanıta dayalı uygulamalar,tanımlayıcı ve alternatif tedaviler,hemşirelik

References

1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub‐committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-178. doi:10.1002/nau.10052
2. Abrams P, Cardozo L, Khoury S, Wein A. Incontinence 3rd international consultation. Health, Paris. 2005;1:1589-1630.
3. Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in US women. Obstet Gynecol. 2014;123(1):141-148. doi:10.1097/AOG.0000000 000000057
4. O'halloran T, Bell RJ, Robinson PJ, Davis SR. Urinary incontinence in young nulligravid women: a cross-sectional analysis. Ann Intern Med. 2012;157(2):87-93. doi:10.7326/ 0003-4819-157-2-201207170-00005
5. Tennstedt SL, Link CL, Steers WD, McKinlay JB. Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults: the Boston Area Community Health (BACH) Survey. Am J Epidemiol. 2008;167(4):390-399. doi:10.1093/aje/kwm356
6. Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. Jama. 2008;300(11):1311-1316. doi:10.1001/jama.300.11.1311
7. Lukacz E, Brubaker L, Schmader K. Evaluation of women with urinary incontinence. In: UptoDate, L. Brubaker KS, & K. Eckler, eds. UpToDate, Waltham, MA. (Accessed on May 01, 2019).
8. Anger JT, Saigal CS, Litwin MS, Project UDoA. The prevalence of urinary incontinence among community dwelling adult women: results from the National Health and Nutrition Examination Survey. J Urol. 2006;175(2):601-604. doi:10.1016/S0022-5347(05)00242-9

9. McGrother C, Donaldson M, Shaw C, et al. Storage symptoms of the bladder: prevalence, incidence and need for services in the UK. BJU Int. 2004;93(6):763-769. doi:10.1111/j.1464-410X.2003.04721.x
10. Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG. 2003;110(3):247-254. doi:10.1046/j.1471-0528.2003.02327.x
11. Kadioğlu M, Beji NK. Üriner İnkontinans tedavisinde önerilen yaşam biçimi uygulamalarına güncel yaklaşım. HSP. 2016;3(3):201-207. doi:10.17681/hsp.52539
12. Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary incontinence in women: A review urinary incontinence in women urinary incontinence in women. In: JAMA. 2017;318(16):1592-1604. doi:10.1001/jama.2017.121 37
13. Forem J. Healing with pressure point therapy: Simple, effective techniques for massaging away more than 100 annoying ailments. Penguin; 1999.
14. Su L, Wu K, Lee L, Wang H, Liu C. Effects of far infrared acupoint stimulation on autonomic activity and quality of life in hemodialysis patients. AJCM. 2009;37(02):215-226. doi:10.1142/S0192415X09006783
15. Dumoulin C, Hay‐Smith J, Habée‐Séguin GM, Mercier J. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a short version Cochrane systematic review with meta‐analysis. Neurourol Urodyn. 2015;34(4):300-308. doi:10.1002/nau.22 700
16. Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev. 2004(1). doi:10.1002/14651858.CD001308.pub2
17. Bayraktar E. Exercise. Turk J Integr Med. 2015;3(2):102-103.
18. Olness K. Hypnosis and biofeedback with children and adolescents; clinical, research, and educational aspects. Introduction. Journal of developmental and behavioral pediatrics: JDBP. 1996;17(5):299.
19. Kemper KJ. Complementary and alternative medicine in pediatrics. İçinde: UpToDate, Jan E, Mary M, editörler. UpToDate, Waltham, MA. 2019.
20. World Health Organization. WHO global report on traditional and complementary medicine 2019. https://www.who.i nt/traditional-complementary-integrative-medicine/WhoGlob alReportOnTraditionalAndComplementaryMedicine2019.pdf?ua=1 . 2019'da basıldı. 1 Mayıs 2019'da erişildi.
21. Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği. İçinde: T.C.Resmi Gazete, Sağlık Bakanlığı, editörler. Ankara: Başbakanlık Basımevi; 2014.
22. Kocaman G. Hemşirelikte kanıta dayalı uygulama. HEMAR-G. 2003;2(4):61-69.
23. Diokno AC, Newman DK, Low LK, ve ark. Effect of group-administered behavioral treatment on urinary incontinence in older women: a randomized clinical trial. JAMA Intern Med. 2018;178(10):1333-1341. doi: 10.1001/jamainternmed.2018.3766
24. Demirci N, Coşar F. Üriner inkontinans tedavisinde davranışsal tedavi yöntemleri. SDÜ Tip Fak. Derg. 2009;16(3):35-40.
25. Varlı M, Doğan Aras S, Atlı T. Yaşlıda üriner inkontinans ve tedavisi. Akademik Geriatri Dergisi. 2009;1(1):45-58.
26. Özcan M, Kapucu S. Üriner inkontinansı olan geriatrik hastalara hemşirelik yaklaşımı. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2014;1(2):101-109.
27. Wyman J, Burgio K, Newman D. Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. Int J Clin Pract. 2009;63(8):1177-1191. doi:10.1111/j.1742-1241.2009.02078.x
28. Borrie MJ, Bawden M, Speechley M, Kloseck M. Interventions led by nurse continence advisers in the management of urinary incontinence: A randomized controlled trial. CMAJ. 2002;166(10):1267-1273.
29. Imamura M, Williams K, Wells M, McGrother C. Lifestyle interventions for the treatment of urinary incontinence in adults. Cochrane Database Syst Rev. 2015;(12): CD003505. doi:10.1002/14651858.CD003505.pub5
30. Dallosso H, Matthews R, McGrother C, Donaldson M. Diet as a risk factor for the development of stress urinary incontinence: a longitudinal study in women. Eur J Clin Nutr. 2004;58(6): 920–926. doi:10.1038/sj.ejcn.1601913
31. Dallosso HM, Matthews RJ, McGrother CW, Donaldson MM, Shaw C, Group LMIS. The association of diet and other lifestyle factors with the onset of overactive bladder: A longitudinal study in men. Public Health Nutr. 2004;7(7):885-891. doi:10.1079/PHN2004627
32. Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM. Nutrient composition of the diet and the development of overactive bladder: A longitudinal study in women. Neurourol Urodyn. 2004;23(3):204-210. doi:10.1002/nau.20028
33. Dallosso H, McGrother C, Matthews R, Donaldson M, Group LMIS. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: A longitudinal study in women. BJU Int. 2003;92(1):69-77. doi:10.1046/j.1464-410X.2003.04271.x
34. Asplund R, Åberg H. Nocturia in relation to body mass index, smoking and some other life-style factors in women. Climacteric. 2004;7(3):267-273. doi: 10.1080/13697130400001398
35. Bradley CS, Kennedy CM, Nygaard IE. Pelvic floor symptoms and lifestyle factors in older women. J Womens Health (Larchmt). 2005;14(2):128-136. doi:10.1089/jwh.20 05.14.128
36. Subak L, Johnson C, Whitcomb E, Boban D, Saxton J, Brown J. Does weight loss improve incontinence in moderately obese women? Int Urogynecol J. 2002;13(1):40-43. doi:10.10007/s0 01920200008
37. Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med . 2009;360(5):481-490. doi:10.1056/NEJMoa0806375
38. Brown JS, Wing R, Barrett-Connor E, et al. Lifestyle intervention is associated with lower prevalence of urinary incontinence: the Diabetes Prevention Program. Diabetes care. 2006;29(2):385-390. doi:10.2337/diacare.29.02.06.dc 05-1781
39. Wing RR, West DS, Grady D, et al. Effect of weight loss on urinary incontinence in overweight and obese women: Results at 12 and 18 months. J. Urol. 2010;184(3):1005-1010. doi:10.1016/j.juro.2010.05.031
40. Phelan S, Kanaya AM, Subak LL, et al. Weight loss prevents urinary incontinence in women with type 2 diabetes: Results from the Look AHEAD trial. J. Urol. 2012;187(3):939-944. doi:10.1016/j.juro.2011.10.139
41. Burgio KL. Behavioral treatment of urinary incontinence, voiding dysfunction, and overactive bladder. Obstet Gynecol Clin N Am. 2009;36(3):475-491. doi:10.1016/j.ogc.2009. 08.005
42. Newman DK, Willson MM. Review of intermittent catheterization and current best practices. Urol Nurs. 2011;31(1).
43. Willis‐Gray M, Wu JM, Markland A. Urinary incontinence and hydration: A population‐based analysis. Neurourol Urodyn. 2018;37(1):200-205. doi:10.1002/nau.23274
44. Callan L, Thompson DL, Netsch D. Does increasing or decreasing the daily intake of water/fluid by adults affect overactive bladder symptoms? Wound Ostomy Continence Nurs. 2015;42(6):614-620. doi: 10.1097/WON.000000000000 0183
45. Nuotio M, Jylhä M, Koivisto A-M, Tammela T. Association of smoking with urgency in older people. Eur Urol. 2001;40(2):206-212. doi: 10.1159/000049774
46. Bryant CM, Dowell CJ, Fairbrother G. Caffeine reduction education to improve urinary symptoms. BJN. 2002;11(8):560-565. doi: 10.12968/bjon.2002.11.8.10165
47. Møller LA, Lose G, Jørgensen T. Risk factors for lower urinary tract symptoms in women 40 to 60 years of age. Obstet Gynecol. 2000;96(3):446-451. doi:10.1016/S0029-7844(00)00915-7
48. Zhang W, Song Y, He X, ve ark. Prevalence and risk factors of lower urinary tract symptoms in Fuzhou Chinese women. Eur. Urol. 2005;48(2):309-313. doi: 10.1016/j.eururo.2005.0 3.003
49. Wood LN, Anger JT. Urinary incontinence in women. Bmj. 2014;349: doi: 10.1136/bmj.g4531.
50. Tähtinen RM, Auvinen A, Cartwright R, Johnson TM, Tammela TL, Tikkinen KA. Smoking and bladder symptoms in women. Obstet Gynecol. 2011;118(3):643-648. doi:10.1097/AOG.0b013e318227b7ac
51. Nygaard IE. Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female Olympians. Obstet Gynecol. 1997;90(5):718-722. doi:10.1016/S0029-7844(97)00436-5
52. Eliasson K, Nordlander I, Larson B, Hammarström M, Mattsson E. Influence of physical activity on urinary leakage in primiparous women. Scand J Med Sci Sports. 2005;15(2):87-94. doi: 10.1111/j.1600-0838.2004.407.x
53. Nygaard I, DeLancey J, Arnsdorf L, Murphy E. Exercise and incontinence. Obstet Gynecol. 1990;75(5):848-851. https://europepmc.org/article/med/2325968
54. Bø K, Borgen JS. Prevalence of stress and urge urinary incontinence in elite athletes and controls. Med Sci Sports Exerc. 2001;33(11):1797-1802. https://journals.lww.com /acsm-msse/Fulltext/2001/11000/Prevalence_of_stress_and_u rge_urinary_incontinence.1.aspx
55. Bø K, Maehlum S, Oseid S, Larsen S. Prevalence of stress urinary incontinence among physically active and sedentary female students. Scand J Sports Sci. 1989;11(3):113-116.
56. Shamliyan T, Wyman J, Kane RL. Nonsurgical treatments for urinary incontinence in adult women: diagnosis and comparative effectiveness. Comparative Effectiveness. (Comparative Effectiveness Reviews, No. 36.). Rockville (MD): Agency for Healthcare Research and Quality (US); 2012.
57. Roe B, Ostaszkiewicz J, Milne J, Wallace S. Systematic reviews of bladder training and voiding programmes in adults: A synopsis of findings from data analysis and outcomes using metastudy techniques. J Adv Nurs. 2007;57(1):15-31. doi:10.1111/j.1365-2648.2006.04097.x
58. Ostaszkiewicz J, Chestney T, Roe B. Habit retraining for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2004;(2): CD002801. doi:10.1002/1465 1858.CD002801.pub2
59. Ostaszkiewicz J, Johnston L, Roe B. Timed voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2004;(1):CD002802. doi:10.100 2/14651858.CD002802.pub2.
60. Nygaard I. Idiopathic urgency urinary incontinence. N Engl J Med . 2010;363(12):1156-1162. doi:10.1056/NEJMcp100384 9
61. Dumoulin C, Cacciari LP, Hay‐Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018; 10:CD005654. doi:10.100 2/14651858.CD005654.pub4
62. Obstetricians ACo, Gynecologists. Urinary incontinence in women. Obstet Gynecol. 2005;105(6):1533-1545. doi:10.1097/00006250-200506000-00069
63. Dumoulin C, Hay‐Smith EJC, Mac Habée‐Séguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014;(5): CD005654. doi: 10.1002/14651858.CD005654.pub3
64. Hay‐Smith J, Mørkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2008;(4): CD007471. doi: 10.1002/14651858.CD007471
65. Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay‐Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;(12): CD007471. doi:10.1002/14651858.CD007471.pub3
66. Hay‐Smith EJC, Herderschee R, Dumoulin C, Herbison GP. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;(12): CD009508. doi:10.1002/14651858.CD009508
67. Seo JT, Yoon H, Kim YH. A randomized prospective study comparing new vaginal cone and FES-Biofeedback. Yonsei Med J. 2004;45(5):879-884. doi: 10.3349/ymj.2004.45.5.879
68. Lopez-Liria R, Varverde-Martinez MLA, Padilla-Gongora D, Rocamora-Perez P. Effectiveness of physiotherapy treatment for urinary incontinence in women: A systematic review. J Womens Health (Larchmt). 2019;28(4):490-501. doi:10.1089/jwh.2018.7140
69. Herbison GP, Dean N. Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev. 2013;(7):CD002114. doi:10.1002/14651858.CD002114.pub2
70. Stewart F, Berghmans B, Bø K, Glazener CM. Electrical stimulation with non‐implanted devices for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;(12):CD012390. doi:10.1002/14651858.CD012390.pub 2
71. Hagen S, McClurg D, Bugge C, ve ark. Effectiveness and cost-effectiveness of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence: protocol for the OPAL randomised trial. BMJ open. 2019;9(2):e024153. doi:10.1136/bmjopen-2018-024153
72. Herderschee R, Hay‐Smith EJC, Herbison GP, Roovers JP, Heineman MJ. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;(7):CD009252. doi:10.1002/14651858.CD009252
73. Herderschee R, Hay‐Smith EJ, Herbison GP, Roovers JP, Heineman MJ. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women: shortened version of a Cochrane systematic review. Neurourol Urodyn. 2013;32(4):325-329. doi:10.1002/nau.22329
74. Huang AJ, Jenny HE, Chesney MA, Schembri M, Subak LL. A group-based yoga therapy intervention for urinary incontinence in women: A pilot randomized trial. Female Pelvic Med Reconstr Surg. 2014;20(3):147-154. doi:10.1097/ SPV.0000000000000072
75. Tenfelde S, Tell D, Garfield L, Mathews H, Janusek L. Yoga for women with urgency urinary incontinence: A pilot study. Female Pelvic Med Reconstr Surg. 2019;00:00–00. doi:10. 1097/spv.0000000000000723
76. Wieland LS, Shrestha N, Lassi ZS, Panda S, Chiaramonte D, Skoetz N. Yoga for treating urinary incontinence in women. Cochrane Database Syst Rev. 2019;(2): CD012668 doi:10.1002/14651858.CD012668.pub2
77. Wang Y, Zhishun L, Peng W, Zhao J, Liu B. Acupuncture for stress urinary incontinence in adults. Cochrane Database Syst Rev. 2013(7):CD009408. doi:10.1002/14651858.CD009408.p ub2
78. Langevin HM, Churchill DL, Cipolla MJ. Mechanical signaling through connective tissue: A mechanism for the therapeutic effect of acupuncture. FASEB J. 2001;15(12): 2275-2282. doi:10.1096/fj.01-0015hyp
79. Hino K, Honjo H, Nakao M, Kitakoji H. The effects of sacral acupuncture on acetic acid-induced bladder irritation in conscious rats. Urology. 2010;75(3):730-734. doi:10.1016/j.u rology.2009.04.025
80. Jiao R, Liu Y, Liu B, Liu Z. Risk factors related to acupuncture response in postmenopausal women with stress urinary incontinence: Secondary analysis of a randomized controlled trial. Medicine. 2019;98(16): e15220. doi:10.1097/MD.0000000000015220.
81. Mucuk S, Ceyhan Ö. Kanıta dayalı rehberleriyle tamamlayıcı ve destekleyici uygulamalar. Ankara: Akademisyen Kitabevi; 2015.
82. Chang KK, Wong TK, Wong TH, Leung AW, Chung JW. Effect of acupressure in treating urodynamic stress incontinence: A randomized controlled trial. AJCM. 2011;39(06):1139-1159. doi:10.1142/S0192415X11009469