Non-surgical management of stress urinary incontinence: ambulatory treatments for leakage associated with stress (ATLAS) trial Academic Article uri icon

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  • BACKGROUND: Non-surgical treatment for stress urinary incontinence (SUI) is recommended as first-line therapy, yet few prospective studies and no randomized trials compare the most common non-surgical treatments for SUI. PURPOSE: To present the design and methodology of the ambulatory treatments for leakage associated with stress (ATLAS) trial, a randomized clinical trial comparing three interventions for predominant SUI in women: intravaginal continence pessary; behavioral therapy (including pelvic floor muscle training and exercise and bladder control strategies); and a combination of the two treatments. METHODS: Treatment outcome measures, collected at 12 weeks and six and 12 months post randomization, include the Patient Global Impression of Improvement (PGI-I), the Stress Incontinence Scale of the Pelvic Floor Distress Inventory (PFDI), seven-day bladder diaries, Pelvic Floor Impact Questionnaire (PFIQ), Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ-12), Patient Satisfaction Questionnaire (PSQ) and the Medical Outcomes Study Short Form Health Survey (SF-36). LIMITATIONS: The study design reduces most common biases, but some degree of selection bias may remain. CONCLUSION: This trial will provide useful information to help counsel women with stress and mixed incontinence about the relative efficacy and satisfaction with pessary, behavioral therapy and both treatments combined.


  • Wright, James
  • Richter, Holly E
  • Burgio, Kathryn L
  • Goode, Patricia S
  • Borello-France, Diane
  • Bradley, Catherine S
  • Brubaker, Linda
  • Handa, Victoria L
  • Fine, Paul M
  • Visco, Anthony G
  • Zyczynski, Halina M
  • Wei, John T
  • Weber, Anne M

publication date

  • February 2007