Research Results

The ATLAS Study: Ambulatory Treatments for Leakage Associated with Stress. Pessary versus Pelvic Floor Muscle Therapy versus Combined Therapy: A randomized Controlled Trial of Non-Surgical Treatment for Stress Urinary Incontinence

1)HE Richter, KL Burgio, PS Goode, D Borello-France, CS Bradley, L Brubaker, VL Handa, PM Fine, AG Visco, HM Zyczynski, JT Wei, AM Weber for the Pelvic Floor Disorders Network, Non-Surgical management of stress urinary incontinence:Ambulatory Treatments for Leakage Associated with Stress (ATLAS) trial. Clinical Trials 2007; 4: 92-101.

Many women with stress urinary incontinence (SUI), which is the uncontrollable loss of urine associated with activities such as sneezing or coughing, desire non-surgical treatment. One of the most commonly used non-surgical treatments for SUI is behavioral therapy consisting of pelvic floor muscle training and exercise as well as other strategies to use pelvic muscles to prevent leakage. Another non-surgical approach for the treatment of SUI is the use of a continence pessary (a device which is placed into the vagina giving extra support to the bladder neck). It is unclear which of these treatment options is the more successful for the treatment of SUI. It is also not clear the choice should differ between women based on their life style..

The ATLAS study will help answer these questions:

• Which non-surgical treatment approach, behavioral therapy, use of pessary or a combined treatment using both approached, will provide the best results in the treatment of SUI?
• What are the characteristics of the women who are most successful and satisfied with one or both of these treatment options?
• What are the effects of these non-surgical treatments on the woman’s quality of life.