What surgical treatments are available for stress incontinence?

Evaluation of cost-effectiveness of new surgical techniques is important. As the data on incontinence procedures are scarce, we evaluated the cost-effectiveness of tension-free vaginal tape procedure and laparoscopic mesh colposuspension as a primary surgical treatment for female stress urinary incontinence.

Methods:

In four university teaching hospitals and two central hospitals 128 stress incontinent women were randomized to tension-free vaginal tape procedure (n=70) or laparoscopic mesh colposuspension (n=51) in order to investigate the clinical performance of these two procedures. Primary objective clinical outcome measures were: stress test and 48-h pad test. Secondary subjective outcome measures were health-related quality of life measured in terms of visual analogue scale and Urinary Incontinence Severity Score. Alongside the clinical trial, a cost-effectiveness analysis for the main outcome measures was performed.

Results:

The changes in the 48-h pad test result did not reach statistical significance (p=0.105). When the visual analogue scale or Urinary Incontinence Severity Score are used as the outcome measure, the tension-free vaginal tape is more cost-effective than laparoscopic mesh colposuspension over a follow-up period of one year (p<0.000).

Conclusion:

The clinical and economic data of the present study suggest that over a follow-up period of one year the tension-free vaginal tape procedure is more cost-effective than laparoscopic mesh colposuspension as a primary treatment for female stress urinary incontinence.

Please click on the required question.

• 1  How is urine produced?
• 2  What is cystitis?
• 3  How prevalent is cystitis?
• 4  What is honeymoon cystitis?
• 5  What are Frequency and nocturia?
• 6  How prevalent are Frequency and nocturia?
• 7  What is urinary incontinence?
• 8  What is stress incontinence of urine?
• 9  What is urgency, urge incontinence and the urge syndrome?
• 10 What causes stress and urge incontinence?
• 11 What is dribbling incontinence?
• 12 How prevalent is urinary incontinence?
• 13 What is the urethral syndrome?
• 14 How can I record my bladder problems and monitor the effects of treatment?
• 15 What simple measures are available to reduce urinary incontinence?
• 16 What are pelvic floor exercises?
• 17 How successful are pelvic floor exercises?
• 18 What is bladder training?
• 19 How effective is bladder training?
• 20 Are there any alternatives to bladder training for urgency symptoms?
• 21 If simple measures do not suffice, what else is available for the treatment of urinary stress incontinence?
• 22 What are urodynamic studies?
• 23 Where can I obtain further information about bladder problems?
• 24 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.