The Urinary Incontinence Treatment Network

The Urinary Incontinence Treatment Network (UITN) is a group of urologists and urogynecologists from all over the country who are conducting research on the treatment of urinary incontinence, or accidental loss of urine.

This research is being funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institute of Child Health and Human Development (NICHD).

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Currently the UITN is conducting three studies. The TOMUS study will be enrolling women until Spring of 2007. The SISTEr and BE-DRI studies are closed for enrollment.

TOMUS (Trial Of Mid-Urethral Slings)

The TOMUS study will compare the outcomes of minimally invasive surgical procedures to treat stress urinary incontinence in women. Stress urinary incontinence is the accidental leakage of urine during activities such as coughing, laughing, sneezing, or lifting heavy objects.
These surgical procedures are called mid-urethral slings. The procedures insert a mesh sling or "hammock" to support the bladder neck so that urine does not leak. Both procedures have been approved by the FDA and have been shown to be safe and successful in treating stress urinary incontinence. However, we do not know if one is better than the other. This study will answer that question.

SISTEr (Stress Incontinence Surgical Treatment Efficacy Trial)

This study is comparing the long-term outcomes of two commonly performed surgeries for the treatment of stress urinary incontinence. The two surgeries are the Burch procedure and the sling procedure. Both of these surgeries have been performed for decades and have estimated cure rates of 60% to 90%. However, the long-term outcomes have not been studied. It is unclear whether one of these surgeries is better than the other and should be offered to all women. The UITN plans to answer this important question.

BE-DRI (Behavior Enhances Drug Reduction of Incontinence)

This study will determine if the addition of behavioral treatment to drug therapy for the treatment of urge incontinence will make it possible to discontinue the drug and still maintain a reduced number of accidents. Urge urinary incontinence is defined as a sudden and strong feeling of the need to pass urine that results in urine leakage. It is sometimes also called overactive bladder.

There are two common treatments for urge incontinence---drug therapy and behavioral therapy. Both have been successful in reducing the number of accidents. Drug therapy is the most common approach for treating urge incontinence. Patients take the drug every day. Behavioral therapy is another treatment option. In behavioral therapy, patients are taught to increase the strength and control of the pelvic floor muscles and then to use these muscles to help the muscles in the bladder wall to relax when they feel a strong urge to pass urine. Behavioral therapy can also include other helpful things that a woman can do to decrease the chances of having an accident.

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