Surgical Management of Stress Urinary Incontinence

2018 ◽  
Author(s):  
Danielle Patterson
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Midurethral Sling ◽  
Preoperative Evaluation ◽  
Urine Volume ◽  
Urodynamic Testing ◽  
Fascial Sling ◽  
Urethral Bulking ◽  
Postvoid Residual Urine ◽  
Distressing Condition

Stress urinary incontinence (SUI) is a prevalent and distressing condition that affects up to 50% of women over their lifetime. If nonsurgical treatments are not effective, surgery is highly successful. Preoperative evaluation includes at minimum a thorough history and physical examination, urinalysis, demonstration of SUI, assessment of urethral mobility, and measurement of postvoid residual urine volume. The midurethral sling is the most studied surgical procedure for urinary incontinence and is safe and highly effective. With the recent concern about permanent mesh in urogynecologic surgery, many patients might choose a laparoscopy- or robot-assisted Burch colposuspension or fascial sling. This review contains 5 figures, 5 tables and 38 references Key words: intrinsic sphincter deficiency, mesh, midurethral sling, minimally invasive surgery, preoperative evaluation, retropubic colposuspension, stress urinary incontinence, urethral bulking, urodynamic testing

Preoperative Urodynamics Testing in Stress Urinary Incontinence

2021 ◽  
pp. 197-201
Author(s):  
Megan Bradley ◽  
Linda Burkett
Keyword(s):  
Urinary Incontinence ◽  
Clinical Practice ◽  
Stress Urinary Incontinence ◽  
Preoperative Evaluation ◽  
Secondary Data ◽  
Patient Characteristics ◽  
Urodynamic Testing ◽  
Incontinence Surgery ◽  
Scientific Methods ◽  
Stress Incontinence Surgery

This article outlines the scientific methods, results, and conclusions for the ValUE trial, “A Randomized Trial of Urodynamic Testing before Stress-Incontinence Surgery.” The ValUE trial compared patients with stress urinary incontinence (SUI) who underwent office evaluation with or without preoperative urodynamics (UDS) testing prior to an anti-incontinence procedure. The majority of patients in the study underwent a mid-urethral sling. The study showed no difference in surgical or treatment outcomes for patients with uncomplicated SUI, signifying UDS may not be necessary in preoperative evaluation. Patient characteristics of uncomplicated SUI are discussed for translation into clinical practice. Reviews of related articles with secondary data analysis are summarized.

scholarly journals Management of patients with stress urinary incontinence after failed midurethral sling

2017 ◽  
Vol 11 (6S2) ◽  
pp. 143 ◽  
Author(s):  
Alex Kavanagh ◽  
May Sanaee ◽  
Kevin V. Carlson ◽  
Gregory G. Bailly
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Midurethral Sling ◽  
Cochrane Review ◽  
Quality Data ◽  
Bulking Agents ◽  
Failure Rates ◽  
Patient Goals ◽  
Fascial Sling

Surgical failure rates after midurethral sling (MUS) procedures are variable and range from approximately 8‒57% at five years of followup. The disparity in long-term failure rates is explained by a lack of long-term followup and lack of a clear definition of what constitutes failure. A recent Cochrane review illustrates that no high-quality data exists to recommend or refute any of the different management strategies for recurrent or persistent stress urinary incontinence (SUI) after failed MUS surgery. Clinical evaluation requires a complete history, physical examination, and establishment of patient goals. Conservative treatment measures include pelvic floor physiotherapy, incontinence pessary dish, commercially available devices (Uresta®, Impressa®), or medical therapy. Minimally invasive therapies include periurethral bulking agents (bladder neck injections) and sling plication. Surgical options include repeat MUS with or without mesh removal, salvage autologous fascial sling or Burch colposuspension, or salvage artificial urinary sphincter insertion. In this paper, we present the available evidence to support each of these approaches and include the management strategy used by our review panel for patients that present with SUI after failed midurethral sling.

scholarly journals Urethral bulking for recurrent stress urinary incontinence after midurethral sling failure

2016 ◽  
Vol 36 (3) ◽  
pp. 722-726 ◽  
Author(s):  
Irena Zivanovic ◽  
Oliver Rautenberg ◽  
Kurt Lobodasch ◽  
Günther von Bünau ◽  
Claudia Walser ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Midurethral Sling ◽  
Recurrent Stress Urinary Incontinence ◽  
Urethral Bulking

Repeat Midurethral Sling Compared With Urethral Bulking for Recurrent Stress Urinary Incontinence

2014 ◽  
Vol 123 (6) ◽  
pp. 1207-1212 ◽  
Author(s):  
Anthony Gaddi ◽  
Noelani Guaderrama ◽  
Nora Bassiouni ◽  
Judith Bebchuk ◽  
Emily L. Whitcomb
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Midurethral Sling ◽  
Recurrent Stress Urinary Incontinence ◽  
Urethral Bulking

scholarly journals Clarifying the Role of Urodynamics in the Preoperative Evaluation of Stress Urinary Incontinence

2008 ◽  
Vol 8 ◽  
pp. 1259-1268 ◽  
Author(s):  
Sophie G. Fletcher ◽  
Gary E. Lemack
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Voiding Dysfunction ◽  
Preoperative Evaluation ◽  
Urodynamic Testing ◽  
Preoperative Risk Factors ◽  
Stress Incontinence Surgery ◽  
Surgical Failure

It has not yet been definitively demonstrated that preoperative evaluation of women with stress urinary incontinence (SUI) with urodynamic testing (UDS) enhances surgical outcomes. Nonetheless, UDS is frequently utilized in the assessment of women with SUI in the hopes that results will shed light on preoperative risk factors for failure or postoperative voiding dysfunction. Poorer outcomes for stress incontinence surgery are primarily attributed to intrinsic sphincter deficiency (ISD), detrusor overactivity (DO), and voiding dysfunction. The ability of UDS to identify and characterize those parameters reliably remains under investigation. Furthermore, debate continues regarding the association of each of those factors with postoperative success for various SUI procedures. Since UDS is invasive, costly, and not always available, it is imperative that its benefit be carefully explored. In this review, we discuss the value of UDS in identifying risk factors for poor outcome and how those risk factors are associated with surgical failure.

Urethral bulking therapy for treating stress urinary incontinence in women

2021 ◽  
Author(s):  
Fenne M Casteleijn ◽  
Sandra Zwolsman ◽  
Jan Paul Roovers ◽  
Heidi J Salminen ◽  
Victoria L Lavin ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Urethral Bulking
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