The new therapeutic option for female stress and stress‐predominant mixed urinary incontinence: Periurethral hypertonic saline (10%) injection

2021 ◽  
Author(s):  
Ibrahim Nuvit Tahtali ◽  
Turan Yildiz ◽  
Muhammed Murat Dincer
Keyword(s):  
Urinary Incontinence ◽  
Hypertonic Saline ◽  
Therapeutic Option ◽  
Mixed Urinary Incontinence

Efficacy of combination therapy of mid‐urethral sling and low‐dose Abobotulinumtoxin‐A injection in mixed urinary incontinence

2021 ◽  
Author(s):  
Sakineh Hajebrahimi ◽  
Hooshang Shamsi‐sisi ◽  
Elham Jahantabi ◽  
Hanieh Salehi‐Pourmehr ◽  
Hashim Hashim
Keyword(s):  
Urinary Incontinence ◽  
Combination Therapy ◽  
Low Dose ◽  
Mixed Urinary Incontinence

scholarly journals Management of Urethral Lesions and Urethrovaginal Fistula Formation Following Placement of a Tension-Free Suburethral Sling: Evaluation From a University Continence and Pelvic Floor Centre

2018 ◽  
Vol 78 (10) ◽  
pp. 991-998 ◽  
Author(s):  
Dorit Schöller ◽  
Sara Brucker ◽  
Christl Reisenauer
Keyword(s):  
Urinary Incontinence ◽  
Skin Flap ◽  
Vaginal Surgery ◽  
Mixed Urinary Incontinence ◽  
Fistula Formation ◽  
Anticholinergic Medication ◽  
Two Phase ◽  
Urethrovaginal Fistula ◽  
Tension Free ◽  
Tape Position

Abstract Introduction The complication of tape erosion in the urethra following placement of a retropubic (TVT) or transobturator (TOT) tension-free suburethral vaginal sling or an accidental iatrogenic transurethral tape position can result in the formation of a urethrovaginal or vesicovaginal fistula. The objective of the investigation is the evaluation of the management of such rare complications. Patients and Methods Retrospective analysis of 14 patients who were treated for a urethral lesion or urethrovaginal fistula formation status post TVT/TOT placement between June 2011 and February 2018 in the Tübingen University Department of Gynaecology. Results As surgical therapy, 57.1% (n = 8) cases underwent vaginal fistula closure using a Martius flap of the labium majus and in 21.4% (n = 3) using a vaginal rotation skin flap. In 21.4% (n = 3), exclusively vaginal suture reconstruction of the urethra following excision of the tape running transurethrally or tape erosion was performed. 50% (n = 7) of the patients had lasting continence postoperatively without any further need for therapy. In 28.6% (n = 4), there was ongoing stress urinary incontinence, in 21.4% (n = 3) mixed urinary incontinence. Six of the 7 patients with persistent incontinence underwent new placement of a tension-free suburethral retropubic sling (TVT) an average of 8.8 months (5 – 13 months) postoperatively which was uncomplicated in all patients and achieved satisfactory continence. The 3 patients with mixed urinary incontinence and persistent urgency components additionally received anticholinergic medication. During the time period investigated, there were no long-term complications, in particular no recurrent fistulas. Conclusion The rare but relevant complications of a urethral erosion, transurethral tape position or urethrovaginal fistula formation status post TVT/TOT placement can be successfully managed via vaginal surgery. Persistent postoperative urinary incontinence with the need for a two-phase repeat TVT placement following sufficient wound healing must be preoperatively clarified.

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