What surgical treatments are available for stress incontinence?

LaSala CA ,Schimpf MO,Udoh E,O'Sullivan DM,Tulikangas P.

Division of Urogynecology, Hartford Hospital, Hartford, CT 06106, USA.clasala@harthosp.org

Objectives:

The objective of this study was to determine risk factors for intra-operative cystotomy during TVT and whether this affects surgical outcome and morbidity.

Study Design:

Charts of 340 women who underwent TVT were reviewed. Those who had a cystotomy during the procedure (cases) were compared with those without (controls) for the variables: age, race, parity, body mass index (BMI), TVT with or without other procedures, previous pelvic surgery, blood loss, length of catheter drainage, UTI, and voiding dysfunction. The t-test and chi-squared test were used and differences resulting in P< .05 were statistically significant.

Results:

Cystotomy occurred in 49/340 TVT procedures (14.4%). Only those who had a history of abdominal hysterectomy and BMI greater than 26.5 were more likely to have a cystotomy (P = .05 and P = .001, respectively). Cases were more likely to go home with catheter drainage (P = .005). There was no increased risk of UTI or voiding dysfunction, nor was there a difference in surgical cure rate.

Conclusion:

Cystotomy does not seem to negatively affect the outcome of the TVT procedure.

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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