Universität zu Köln

Ludwig, Sebastian, Becker, Ingrid ORCID: 0000-0001-5829-3553, Mallmann, Peter and Jaeger, Wolfram (2019). Comparison of Solifenacin and Bilateral Apical Fixation in the Treatment of Mixed and Urgency Urinary Incontinence in Women: URGE 1 Study, A Randomized Clinical Trial. In Vivo, 33 (6). S. 1949 - 1958. ATHENS: INT INST ANTICANCER RESEARCH. ISSN 1791-7549

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Abstract

Background: The aetiology of urgency urinary incontinence is a matter of debate. Current treatment options are based on the hypothesis of a neurological disorder of bladder innervation. However, it has also been hypothesised that one main cause is the reduced function of the bladder-holding apparatus, that is, insufficient suspension of the vesico-urethral junction. This study compared the effects of surgical apical vaginal elevation with those of solifenacin on urgency urinary incontinence in women. Patients and Methods: Women with mixed and urgency urinary incontinence were randomised to either an established pharmacological arm (10 mg/day solifenacin) or the surgical arm (bilateral uterosacral ligament replacement, cervicosacropexy, CESA; or vaginosacropexy, VASA. Clinical and objective outcomes were assessed at 4 months after each type of intervention. Results: The study was terminated early; 55 patients were operated on and 41 patients received pharmacological treatment. After surgical treatment, 23 patients (42%, 95% confidence intervaI=29-55%) became continent compared to four patients (10%, 95% confidence intervaI=1-19%) during solifenacin treatment. Conclusion: Compared to pharmacological treatment, the surgical repair of the apical vaginal end restored urinary continence in significantly more patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ludwig, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Mallmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaeger, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-129551
DOI:	10.21873/invivo.11690
Journal or Publication Title:	In Vivo
Volume:	33
Number:	6
Page Range:	S. 1949 - 1958
Date:	2019
Publisher:	INT INST ANTICANCER RESEARCH
Place of Publication:	ATHENS
ISSN:	1791-7549
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PELVIC ORGAN PROLAPSE; VAGINAL VAULT SUSPENSION; FASCIA DEFECT REPAIR; PREDICTIVE-VALUE; RESOLUTION; EFFICACY; OUTCOMES; SURGERY; PLACEBO; SAFETY Multiple languages Medicine, Research & Experimental Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12955