Abstract
Stress urinary incontinence (SUI) is defined as the loss of urine in response to sudden increase in intra-abdominal pressure (‘stress’) in the absence of a detrusor contraction. It occurs primarily in women after vaginal delivery period.
The diagnosis is based on patient history and physical examination. The severity can be assessed with pad testing,.Urodynamic investigation has been the cornerstone for many years, but the importance is questioned lately. Well performed RCT’s demonstrated that in clear cut cases the value of urodynamic investigation is limited. Therefore in most guidelines urodynamic investigation is only recommended in selected, non- clear cut cases.
Treatment options re conservative treatment with life style interventions, physical therapy and pelvic floor muscle therapy. The classical options for surgical intervention are bulking agents, bladderneck colposuspensions and pubovaginal slings. Since the end of the 20st century retropubic and transobturator tapes were introduced. Single incision slings have been developed since the beginning of this century.
Special attention should be paid to obese and elderly patients, patients with mixed incontinence and secondary procedures. Intraoperative, early and long term postoperative complications occur and should be dealt with carefully.
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Further reading
Hay-Smith EJC, Herderschee R, Dumoulin C, Herbison GP. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. [Internet]. Cochrane Database Syst Rev (Online). 2011; p. 149. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22161451.
Richter HE, Albo ME, Zyczynski H, Kenton K. Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med [Internet]. 2010;362(22):2066–76. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22153438.
Nilsson CG, Palva K, Aarnio R, Morcos E, Falconer C. Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J [Internet]. 2013;24(8):1265–9. [cited 29 Jun 2014]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23563892.
Mostafa A, Phay C, Hopper L, Madhuvrata P. Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: an updated systematic review and meta-analysis of effectiveness and complications. Eur Urol [Internet]. 2014;65(2):402–27. European Association of Urology. Available from: http://dx.doi.org/10.1016/j.eururo.2013.08.032.
Costa P, Poinas G, Ben Naoum K, Bouzoubaa K, Wagner L, Soustelle L, et al. Long-term results of artificial urinary sphincter for women with type III stress urinary incontinence. Eur Urol. 2013;63(4):753–8.
Dmochowski R, Athanasiou S, Reid F, Kraus S, Nitti V, Gomelsky A, Robinson D, Smith ARB. Surgery for urinary incontinence in women. In: Abrams P, Cardozo L, Khoury S, Wein A, editors, Incontinence, 5th ed. 5th international consultation on incontinence, Paris February 2012. 2013.
Çetinel B, Tarcan T. Management of complications after tension-free mid-urethral slings. Korean J Urol. 2013;54(10):651–9.
Brubaker L, Norton PA, Albo ME, et al. Adverse events over two years after retropubic or transobturator midurethral sling surgery: findings from the Trial of Midurethral Slings (TOMUS) study. Am J Obstet Gynecol. 2011;205:498.e1–6.
Dmochowski R, Scarpero H, Starkman J. Chap 68: Tension-free vaginal tape procedures. In: Wein AJ, editor. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders Elsevier; 2007. p. 2251–72.
Carr LK, Webster GD. Voiding dysfunction following incontinence surgery: diagnosis and treatment with retropubic or vaginal urethrolysis. J Urol. 1997;157(3):821–3.
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Heesakkers, J., Van der Aa, F., Tarcan, T. (2016). Female Stress Urinary Incontinence. In: Heesakkers, J., Chapple, C., De Ridder, D., Farag, F. (eds) Practical Functional Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-25430-2_5
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DOI: https://doi.org/10.1007/978-3-319-25430-2_5
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