Tighten My Vagina

Main Category: Urology / Nephrology
Also Included In: Women’s Health / Gynecology;  Psychology / Psychiatry
Article Date: 11 Apr 2012 – 1:00 PDT

email to a friend   printer friendly   opinions  

<!– rate article

Patient / Public:

Healthcare Prof:

Women with UI suffer physical, psychological, and social consequences of not being in full control of their bladders.

Women with mild UI may occasionally leak urine when they cough or sneeze, while women with more severe UI may have extreme, sudden urges to urinate that can result in embarrassing accidents. Standard treatment for women with urgency UI includes lifestyle changes, pelvic floor muscle training, and bladder training. In addition, several drugs have been approved for adults with overactive bladder with or without urgency UI.

Researchers systematically reviewed 94 published randomized controlled trials to determine the safety and efficacy of drugs available in the U.S. for urinary incontinence. The researches focused on continence and quality of life as primary outcomes. Fifty percent or more reduction in daily UI episodes was defined as a clear, clinically important response to treatment.

Adverse effects and treatment discontinuation due to side-effects also were examined. The researchers found that drugs were more effective than placebo in achieving continence and improving UI, but the improvements were small and treatment discontinuation due to bothersome adverse effect was frequent.

Few studies were available to compare one drug to another. Among individual drug comparisons, festerodine was more effective than tolterodine in achieving continence and improving UI. Discontinuation due to adverse effects occurred more often with fesoterodine or oxybutynin than with tolterodine. The lowest rates of treatment discontinuation with 5 mg of solifenacin.

The researchers conclude that treatment decisions should be based on side-effects profile and patient preferences.

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd
Bexhill-on-Sea, United Kingdom
MediLexicon International Ltd © 2004-2012 All rights reserved.

Source: http://www.medicalnewstoday.com/releases/243922.php

Incontinence Drugs: Benefits and Harms Compared

April 9, 2012 — Drugs that treat incontinence caused by an overactive bladder offer modest benefits to some women, and they often come with significant side effects, a new review of research shows.

The government-funded review compared the benefits and side effects of several drugs: darifenacin (Enablex), fesoterodine (Toviaz), oxybutynin (Ditropan, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol), and trospium (Sanctura).

Each drug is different. But they all work by relaxing the bladder muscle, reducing spasms that can cause urgency and leakage.

The new review is based on data from 94 studies that compared at least one of the medications to a placebo pill.

As a group, the drugs all helped women achieve continence more frequently than placebo pills. The researchers estimate that for every 1,000 women who were treated with the drugs, less than 200, or 20%, achieved continence on the medications.

But side effects were also common.

“One of the things we report is that 50% of the women in the study stopped treatment with the drugs within one year,” says researcher Robert L. Kane, MD, a professor of long-term care and aging at the University of Minnesota?s School of Public Health in Minneapolis. “Basically, it’s because of side effects.”

The most commonly reported side effect of the drugs was dry mouth. Other common side effects included constipation, dry skin, dry eyes, and upset stomach.

People were most likely to quit the drug oxybutynin because of side effects.

Side effects were least often reported by people taking the drug solifenacin. In long-term follow-up, one drug, tolterodine was strongly linked to a greater risk of hallucinations.

And older people who used incontinence medications in combination with other drugs, like antihistamines, were more likely to experience abnormal heart rhythms problems and sudden death.

Those side effects are not new, however. They had been noted in previous studies.

OAB: Helping a Confused Bladder

Weighing Benefits and Risks

The review does not make recommendations about the use of these drugs.

“It turns out that it’s as important to sit down with your doctor and look at the side effect pattern of the pills as it is the direct effects,” Kane says, “because for the most part, a number of them basically have about the same effectiveness, but they have different patterns of side effects.”

The new study is published in the Annals of Internal Medicine. It was funded by the federal Agency for Healthcare Research and Quality.

“This is a very important and well-done study,” says Patricia Goode, MD, a professor of medicine in the Center for Aging at the University of Alabama at Birmingham.

Goode says in an email that studies comparing the benefits and drawbacks of similar drugs are rare, “so this type of study, providing all of the best effectiveness data in one place, will be very useful.”

But she says the research may also be a little misleading since it masks the small degrees of improvement many women see on the drugs.

“Improvement alone can improve quality of life — for example, going from diapers to pads, or no�longer having accidents that overflow pads and cause embarrassment,” she says. “Both frequency and volume decreases are important.”

But she says that for women who are able, Kegel exercises and lifestyle changes that include drinking less caffeine and watching fluid intake are likely to have bigger impacts on the condition.

“They have very virtually no side effects and can be very effective,” she says.

Source: http://www.webmd.com/urinary-incontinence-oab/news/20120409/incontinence-drugs-benefits-and-harms-compared?src=RSS_PUBLIC

Incontinence Drugs: Benefits and Harms Compared

April 9, 2012 — Drugs that treat incontinence caused by an overactive bladder offer modest benefits to some women, and they often come with significant side effects, a new review of research shows.

The government-funded review compared the benefits and side effects of several drugs: darifenacin (Enablex), fesoterodine (Toviaz), oxybutynin (Ditropan, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol), and trospium (Sanctura).

Each drug is different. But they all work by relaxing the bladder muscle, reducing spasms that can cause urgency and leakage.

The new review is based on data from 94 studies that compared at least one of the medications to a placebo pill.

As a group, the drugs all helped women achieve continence more frequently than placebo pills. The researchers estimate that for every 1,000 women who were treated with the drugs, less than 200, or 20%, achieved continence on the medications.

But side effects were also common.

“One of the things we report is that 50% of the women in the study stopped treatment with the drugs within one year,” says researcher Robert L. Kane, MD, a professor of long-term care and aging at the University of Minnesota?s School of Public Health in Minneapolis. “Basically, it’s because of side effects.”

The most commonly reported side effect of the drugs was dry mouth. Other common side effects included constipation, dry skin, dry eyes, and upset stomach.

People were most likely to quit the drug oxybutynin because of side effects.

Side effects were least often reported by people taking the drug solifenacin. In long-term follow-up, one drug, tolterodine was strongly linked to a greater risk of hallucinations.

And older people who used incontinence medications in combination with other drugs, like antihistamines, were more likely to experience abnormal heart rhythms problems and sudden death.

Those side effects are not new, however. They had been noted in previous studies.

OAB: Helping a Confused Bladder

Weighing Benefits and Risks

The review does not make recommendations about the use of these drugs.

“It turns out that it’s as important to sit down with your doctor and look at the side effect pattern of the pills as it is the direct effects,” Kane says, “because for the most part, a number of them basically have about the same effectiveness, but they have different patterns of side effects.”

The new study is published in the Annals of Internal Medicine. It was funded by the federal Agency for Healthcare Research and Quality.

“This is a very important and well-done study,” says Patricia Goode, MD, a professor of medicine in the Center for Aging at the University of Alabama at Birmingham.

Goode says in an email that studies comparing the benefits and drawbacks of similar drugs are rare, “so this type of study, providing all of the best effectiveness data in one place, will be very useful.”

But she says the research may also be a little misleading since it masks the small degrees of improvement many women see on the drugs.

“Improvement alone can improve quality of life — for example, going from diapers to pads, or no�longer having accidents that overflow pads and cause embarrassment,” she says. “Both frequency and volume decreases are important.”

But she says that for women who are able, Kegel exercises and lifestyle changes that include drinking less caffeine and watching fluid intake are likely to have bigger impacts on the condition.

“They have very virtually no side effects and can be very effective,” she says.

But a new Depend campaign aimed at baby boomers takes a decidedly different approach, featuring younger celebrities who are not incontinent but agree to model the products as a stunt to benefit charity. The campaign is to introduce brieflike products, Silhouette for Women and Real Fit for Men.

A commercial that will be shown on Monday opens on a football field where a pitchman holding the product approaches the National Football League players DeMarcus Ware, Clay Matthews and Wes Welker.

“Now I know you don’t need one,” he says, “but will you try one on for charity to prove just how great the fit is?”

After they reluctantly comply, the players run drills as the camera lingers on their form-fitting football pants, the absorbent undergarments undetectable.

Another commercial features the actress Lisa Rinna (“Days of Our Lives” on NBC), who agrees to model the product under a clingy dress at a red-carpet event.

Both commercials promote a new Web site, The Great American Try On, where consumers can request samples.

In online videos, the celebrities discuss the charities Depend supported on their behalf. In Ms. Rinna’s case, $225,000 was given to Dress for Success, which provides professional attire and career advice to women in need. For the football players, $150,000 was donated to the V Foundation, which finances research for cancers, including prostate cancer, which the players point out often leads to bladder dysfunction.

The campaign is by Ogilvy Mather Worldwide in New York, part of WPP, with the digital agency Organic, based in San Francisco.

•

Marketed as premium lines, Real Fit and Silhouette will cost about $1.08 each, compared to 72 cents for the standard Depend. In a first for the brand, the product is shown in profile on barelegged models. In the men’s commercial, a model wiggles into a pair of snug jeans; in the women’s, a model pulls a slinky dress over her head, and the garment cascades over the product.

The demonstrations are split-screen, with the opposing half featuring what is called a bargain product that appears lumpy under clothing.

Mark Cammarota, the marketing director for Depend, said the demonstration videos resonated with consumer research panels, particularly with women.

“When the dress drop comes down, that was really the money shot,” Mr. Cammarota said. “That five seconds of video in our testing was a really big drive to purchase.”

Less enthralled were executives at two networks, which the brand declined to name, who raised objections to earlier ads where models turned more toward the camera and were more exposed.

To address that concern, “there were some tweaks we needed to make,” said Victoria Azarian, a group creative director at Ogilvy Mather who oversees the Depend account.

“If you can show a Victoria Secret model in her underwear, why can’t you show this?” Ms. Azarian said. “It’s just like underwear.”

Featuring younger models who are not incontinent may appeal to boomers who are increasingly in need of incontinence products but who are defiant about aging.

“We tried to stay away from typical lifestyle imagery like older people golfing or gardening, because boomers don’t buy into that stereotype,” Ms. Azarian said. “It’s not like once you reach a certain age,” you are limited to wearing “a housecoat,” she said.

While younger celebrities with healthy bladders cannot vouch for how well the products control wetness or odor, they do demonstrate inconspicuousness.

“When we show Lisa Rinna or the football guys, those are the real torture tests,” Ms. Azarian said. “If you can play football in these, and if you can’t see them even under an incredibly tight dress, then you’re showing everyone that this is a step change.”

Depend spent $13.1 million on advertising in 2011, compared with $10.2 million in 2010, according the Kantar Media unit of WPP.

The American market for disposable incontinence garments has grown steadily in recent years. The research firm Euromonitor International estimates annual sales of $1.32 billion in 2011, compared with $557 million in 1997, an increase of 137 percent.

Depend is the dominant brand, with a 30.8 percent share of the market, according to the SymphonyIRI Group.

•

Ian Bell, global head of tissue and hygiene research at Euromonitor, said incontinence brands were “trying to normalize the products” so consumers felt comfortable not only wearing them but also adding them to grocery carts.

He was heartened to see celebrities in the new Depend campaign.

“These celebrities aren’t worried that their images will be tarnished by representing these products, and that may give consumers who are most in need of these products the confidence to buy them and to use them,” said Mr. Bell.

Nancy Muller, executive director of the National Association for Continence, a nonprofit educational and advocacy group, lauded the ingenuity of the new, less bulky Depend line, but not the campaign.

“The ads run the risk of making light of the condition, and they aren’t really believable,” said Ms. Muller, who also objected to the scenes of the product on barelegged models.

“Everyone knows how these products are put on,” she said. “Cialis ads don’t show a cutaway of a man having an erection after he’s had the drug. There’s a more credible and more effective way of communicating that message.”

This article has been revised to reflect the following correction:

Correction: March 28, 2012

An earlier version of this article, using information provided by Depend, included outdated figures about charitable contributions to Dress for Success and the V Foundation. Dress for Success has been given $225,000, not $150,000. The V Foundation has been given $150,000, not $75,000.

Source: http://feeds.nytimes.com/click.phdo?i=d988cceae36376d079539721a020a939

Main Category: Urology / Nephrology
Also Included In: Women’s Health / Gynecology;  Pregnancy / Obstetrics
Article Date: 27 Mar 2012 – 1:00 PDT

email to a friend   printer friendly   opinions  

<!– rate article

Patient / Public:

Healthcare Prof:

Women are nearly three times more likely to experience urinary incontinence for more than 10 years following a vaginal delivery rather than a caesarean section, finds new research at the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Urinary incontinence (UI) is a common condition affecting adult women of all ages and can have a negative influence on quality of life. This new study from the University of Gothenburg in Sweden looked at the prevalence and risk factors for UI 20 years after vaginal delivery (VD) or caesarean section (CS). The study included women who had only one child and assessed their prevalence of UI for less than five years, between 5-10 years and for more than 10 years.

Over six thousand women involved

The SWEPOP (Swedish pregnancy, obesity and pelvic floor) study was conducted in 2008 and data were obtained from the Medical Birth Register (MBR) for deliveries between 1985 and 1988. A questionnaire was sent to women and 6, 148 completed it answering questions on height, weight, urinary or anal incontinence, genital prolapse, menstrual status, hysterectomy, the menopause and hormone treatment.

Prevalence of incontinence tripled

Overall, the prevalence of UI was considerably higher after a vaginal delivery (40.3%) compared to women who delivered by caesarean section (28.8%). The study also found that the prevalence of UI for more than 10 years almost tripled after VD (10.1%) compared to women who had a CS (3.9%).

Overweight also a risk factor

In addition, the paper looks at the impact of BMI on UI. The risk increase of UI in obese women more than doubled in comparison to women with a normal BMI after VD and more than tripled after CS.

Many risk factors

Maria Gyhagen, Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg, Sweden and co-author of the paper said: “In conclusion, the risk of developing urinary incontinence was higher 20 years after a vaginal delivery compared to a caesarean section.

“There are many factors affecting urinary incontinence but obesity and ageing as well as obstetric trauma during childbirth are known to be three of the most important risk factors.”

Affects daily life

BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added: “Urinary incontinence affects many women and can have a big impact on day to day life.

“However, women need to look at all the information when deciding on mode of delivery as despite vaginal delivery and BMI being linked to urinary incontinence, caesarean section involves its own risks.”

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd
Bexhill-on-Sea, United Kingdom
MediLexicon International Ltd © 2004-2012 All rights reserved.

Source: http://www.medicalnewstoday.com/releases/243388.php