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Current Clinical Advances in Urinary Incontinence

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 25 November 2026 | Viewed by 3924

Special Issue Editors


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Guest Editor
1. Division of Gynecology and Obstetrics, University Clinical Center Ljubljana, 1000 Ljubljana, Slovenia;
2. Department of Gynecology and Obstetrics, Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
Interests: urinary incontinence; prolapse; pelvic floor dysfunction; reconstructive surgery; laser treatment

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Guest Editor
1. Division of Gynecology and Obstetrics, University Clinical Center Ljubljana, 1000 Ljubljana, Slovenia;
2. Department of Gynecology and Obstetrics, Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
Interests: urinary incontinence; pelvic floor dysfuntion; surgery; energy based devices; conservative treatment

E-Mail Website
Guest Editor
1. Division of Gynecology and Obstetrics, University Clinical Center Ljubljana, 1000 Ljubljana, Slovenia;
2. Department of Gynecology and Obstetrics, Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
Interests: urinary incontinence; pelvic organ prolapse; pelvic floor dysfuntion; pelvic reconstructive and gynecological surgery; tissue engineering

Special Issue Information

Dear Colleagues,

Urinary incontinence (UI) is a highly prevalent condition on a global scale, causing a significant impact on patients' quality of life and a considerable economic burden on healthcare systems. It is estimated that more than half of women aged 60 years or older suffer from stress urinary incontinence (SUI). Overactive bladder (OAB) syndrome, whether idiopathic or neurogenic, is another chronic condition associated with urgency incontinence, affecting both genders and negatively impacting multiple aspects of daily life. As UI is an age-related condition, its prevalence is expected to rise significantly in the coming decades.

The management of UI has evolved considerably, offering a broad spectrum of treatment options ranging from conservative and minimally invasive therapies to advanced surgical techniques. First-line conservative treatments, including PFMT, biofeedback, neuromodulation, behavioral therapy, and pharmacological interventions, play a crucial role in the management of symptoms and may prevent the progression of incontinence, especially in its early stages. Additionally, new technologies such as MS and non-surgical energy-based devices are emerging as promising, non-invasive alternatives for patients who are either unfit for surgery or unwilling to undergo it.

Despite the extensive range of available treatments, there is no universal "perfect" therapy for UI. While mid-urethral slings (MUSs) have long been a mainstay of surgical treatment for female SUI, their use has been restricted or abandoned in some countries due to complication risks. This has further reinforced the need to explore safer, less invasive alternatives.

Our aim in launching this Special Issue is to gather high-quality contributions focusing on the latest and most innovative advances in the physiopathology, diagnosis, conservative and surgical management, and prevention of UI. We invite the submission of research articles and comprehensive reviews exploring the following topics:

  • Emerging diagnostic technologies for a more precise evaluation of UI;
  • Advances in conservative therapies, including PFMT, pharmacotherapy, and non-invasive devices;
  • Surgical innovations and minimally invasive procedures for UI management;
  • The impact of UI on quality of life and strategies for patient-centered care.

All researchers are invited to contribute original works and systematic reviews.

Prof. Dr. Adolf Lukanovic
Dr. David Lukanović
Dr. Mija Blaganje
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • female urinary incontinence
  • stress urinary incontinence
  • overactive bladder
  • diagnosis
  • prevention
  • conservative treatment
  • minimally invasive treatment
  • surgery
  • mid-urethral sling
  • new approach
  • energy-based devices

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Published Papers (3 papers)

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Research

17 pages, 665 KB  
Article
Prevalence and Impact of Urinary Incontinence at 5–10 Years After a Singleton Birth
by Lola Serrano-Raya, Ana Esplugues, Inmaculada Ferreros Villar, Nerea Vallés-Murcia, Paula Muñoz Esteban, María Sol Torres López, Elisa Turrión Martínez, Patxi Errandonea García, Francisco Jose Nohales Alfonso and Alba González-Timoneda
J. Clin. Med. 2026, 15(1), 252; https://doi.org/10.3390/jcm15010252 - 29 Dec 2025
Viewed by 1027
Abstract
Background/Objectives: To analyze the prevalence and risk factors associated with the onset of urinary incontinence (UI) in primiparous non-menopausal women with no personal history of pregestational UI, as well as its impact on quality of life. Methods: An ambispective observational cohort study was [...] Read more.
Background/Objectives: To analyze the prevalence and risk factors associated with the onset of urinary incontinence (UI) in primiparous non-menopausal women with no personal history of pregestational UI, as well as its impact on quality of life. Methods: An ambispective observational cohort study was conducted among primiparous women between 5 and 10 years after childbirth. Sociodemographic and health characteristics were analyzed, along with the presence of UI using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI-SF). Results: Of the 425 women analyzed, 228 (53.6%) presented UI. After adjusting for confounding factors, women who delivered by cesarean section showed a lower risk of developing UI (aOR = 0.52; 95% CI: 0.32–0.85; p = 0.009). Conversely, a family history of UI (mother or sister) (aOR = 2.03; 95% CI: 1.25–3.32; p = 0.004) and the presence of medical history (chronic diseases/comorbidities) were associated with a higher risk of UI (aOR = 1.58; 95% CI: 1.02–2.45; p = 0.040). Regarding quality of life, 25.88% of participants responded affirmatively to the specific interview question on UI, whereas 58.65% presented some degree of UI when assessed with the ICIQ-UI-SF. This discrepancy likely corresponds to mild-to-moderate cases. Conclusions: In primiparous, non-menopausal women without prior incontinence, the occurrence of UI in subsequent years following childbirth is associated with vaginal delivery, family history of UI, and the presence of chronic diseases or comorbidities. Evidence-based strategies for detection and prevention should be further developed and implemented. Full article
(This article belongs to the Special Issue Current Clinical Advances in Urinary Incontinence)
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10 pages, 311 KB  
Article
Shortening Indwelling Catheterization After Vaginal Surgery for Pelvic Organ Prolapse: Results from a Prospective Randomized Trial
by Tala Kordis, Ana Kofol and Mija Blaganje
J. Clin. Med. 2025, 14(23), 8295; https://doi.org/10.3390/jcm14238295 - 22 Nov 2025
Cited by 1 | Viewed by 790
Abstract
Background/Objectives: Pelvic organ prolapse (POP) is a common condition affecting women. When conservative treatment fails, surgical correction is indicated. Anterior colporrhaphy (AC) is a standard procedure for anterior vaginal wall prolapse repair. Postoperatively, an indwelling urinary catheter (IUC) is typically inserted to [...] Read more.
Background/Objectives: Pelvic organ prolapse (POP) is a common condition affecting women. When conservative treatment fails, surgical correction is indicated. Anterior colporrhaphy (AC) is a standard procedure for anterior vaginal wall prolapse repair. Postoperatively, an indwelling urinary catheter (IUC) is typically inserted to prevent urinary retention; however, prolonged catheterization is a known risk factor for urinary tract infection (UTI). This study aimed to evaluate whether postoperative catheterization can be safely shortened from 4 days to 24 h after vaginal POP surgery, and to compare the incidence of urinary retention and UTI between the two groups. Methods: A prospective randomized controlled trial was conducted, including 119 patients scheduled for AC for POP repair. All patients received an IUC after surgery and were randomized to catheter removal after either 24 h (group 1) or 4 days (group 2). Urinary retention was defined as a postvoid residual volume > 200 mL after IUC removal. UTI was diagnosed based on typical symptoms and a positive urine culture (≥105 CFU/mL). Results: Data from 80 patients were analyzed. There were no statistically significant differences in catheter reinsertion rates (15% in group 1 vs. 7.5% in group 2, p = 0.288). The incidence of urinary retention was not influenced by the use of Kelly sutures, concomitant procedures, or patient age. No UTIs were confirmed in either group. Median hospital stay was significantly shorter in group 1 (3 [2–4] days vs. 4 [4–4] days, p < 0.001). Conclusions: Short-term catheterization following anterior colporrhaphy is not associated with increased risk of urinary retention or infection. Reducing catheterization duration results in a shorter hospital stay, which may lower healthcare costs and improve patient throughput. Full article
(This article belongs to the Special Issue Current Clinical Advances in Urinary Incontinence)
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8 pages, 199 KB  
Article
An Investigation of the Effect of Combining Tolterodine and Duloxetine in the Treatment of Mixed-Type Urinary Incontinence and the Factors Affecting Success
by Resul Sobay and Eyüp Veli Küçük
J. Clin. Med. 2025, 14(10), 3575; https://doi.org/10.3390/jcm14103575 - 20 May 2025
Cited by 1 | Viewed by 1426
Abstract
Background: Mixed urinary incontinence (MUI), particularly the urge-predominant subtype, involves both stress urinary incontinence (SUI) and urge urinary incontinence (UUI), posing a therapeutic challenge. Duloxetine, a serotonin–norepinephrine reuptake inhibitor (SNRI), enhances urethral tone, while tolterodine, an antimuscarinic agent, reduces detrusor overactivity. Their [...] Read more.
Background: Mixed urinary incontinence (MUI), particularly the urge-predominant subtype, involves both stress urinary incontinence (SUI) and urge urinary incontinence (UUI), posing a therapeutic challenge. Duloxetine, a serotonin–norepinephrine reuptake inhibitor (SNRI), enhances urethral tone, while tolterodine, an antimuscarinic agent, reduces detrusor overactivity. Their combination may offer synergistic benefits. Aim: The aim of this study was to evaluate the efficacy of duloxetine and tolterodine combination therapy in urge-predominant MUI and identify factors influencing treatment success. Method: A retrospective study was conducted on 106 patients (mean age: 56.45 years) with urge-predominant MUI treated with duloxetine (40 mg twice daily) and tolterodine (4 mg once daily) for 12 weeks. Treatment outcomes were evaluated using the overactive bladder symptom score (OABSS), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), 24 h pad test, and Clinical Global Impression Scale (CGI). Univariate and multivariate regression analyses were performed to determine predictors of success. Results: Significant improvements were observed: OABSS decreased from 11.08 to 6.95, ICIQ-SF decreased from 15.69 to 8.84, and pad use decreased from 3.58 to 0.73/day (all p 0.0001). Bladder capacity increased from 315.09 mL to 436.32 mL. Baseline ICIQ-SF scores were independent predictors of success (odds ratio [OR] = 2.919, p = 0.001). Patient satisfaction reached 77.4%, with mild side effects (constipation and dizziness) in 14 patients. Conclusions: Duloxetine and tolterodine combination therapy significantly improved symptoms and quality of life in urge-predominant MUI. Baseline ICIQ-SF scores may predict treatment success. Further prospective studies are needed. Full article
(This article belongs to the Special Issue Current Clinical Advances in Urinary Incontinence)
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