Beaumont Researchers Study Treatments for Female Incontinence & Overactive Bladder

Beaumont Hospitals urologists recently had two urology studies published in prestigious journals- the New England Journal of Medicine and the Journal of Urology. These findings will be presented at the American Urological Association annual meeting May 29-June 3 in San Francisco.

Larry Sirls, M.D.

Urologist Larry Sirls, M.D., headed Beaumont’s participation in a trial funded by the National Institutes of Health to study the effectiveness of two surgical procedures for female stress incontinence. Beaumont Hospital, Royal Oak was one of nine centers nationwide to participate.

Stress urinary incontinence - the cause of urine leakage with coughing, sneezing or physical activity - affects about 13 million Americans, most of them women.

According to study findings published in the New England Journal of Medicine, both surgical procedures were equally effective. Each option, however, carries its own unique side effects. The techniques, known as mid-urethral slings, are used to treat stress incontinence or urine loss.

Researchers recruited 597 patients from across the U.S. and focused on women 21 years or older who were scheduled for surgery for stress incontinence. Some women were assigned a technique called the retropubic procedure or a second surgical option known as the transobturator procedure. The study showed that both procedures have success rates of between 78 and 81 percent. They also caused side effects- urination problems for the retropubic procedure sometimes requiring further surgery and upper leg weakness with the transobturator procedure. Most side effects from both procedures resolved in a matter of weeks.

According to Dr. Sirls the retropubic procedure, considered the standard care, had slightly more complications than the newer transobturator technique.

“This study will have an international impact. Doctors from around the world will use these findings to inform their patients of the risks and benefits of these two minimally invasive surgical options,” explains Dr. Sirls. “This large trial proves that patients and their surgeons are willing to team together to answer important questions on surgical treatments for common problems.”

Kenneth Peters, M.D.

In another trial lead by Kenneth Peters, M.D., chairman, Urology, Beaumont, Royal Oak, researchers studied the effectiveness of tibial nerve stimulation to treat overactive bladder syndrome, also known as OAB.

The study was conducted by urologists, urogynecologists and nurse practitioners at 23 clinical centers across the United States. Dr. Peters was the principal investigator for the multi-center trial and Beaumont was the lead site.

Overactive bladder syndrome affects about 34 million Americans or 17 percent of the U.S. population. As baby boomers age, the incidence of this condition is increasing. OAB can reduce the quality of life, leading to social isolation. People with OAB usually refrain from travel, entertaining and tend to be less social. It can also lead to falls and fractures.

The findings published in the Journal of Urology provided strong evidence that percutaneous tibial nerve stimulation is safe and effective at treating OAB. Researchers recruited 220 adults. It is the first neuromodulation study to use a validated sham component.

Percutaneous tibial nerve stimulation does not require surgical implantation of a power supply, leads or electrodes or the use of antibiotics.

“This is the first study proving that stimulation of the tibial nerve improves bladder function. Since this is a minimally invasive office procedure, it should be considered a first-line treatment for patients that suffer from overactive bladder,” says Dr. Peters. “These findings will impact the future treatment of OAB, improving the quality of life for many.”