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Surgery for urinary incontinence.

G J Jarvis1

  • 1Department of Urogynaecology, St James's University Hospital, Leeds, UK.

Bailliere'S Best Practice & Research. Clinical Obstetrics & Gynaecology
|July 18, 2000
PubMed
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Surgical treatment for genuine stress incontinence requires individualized plans based on patient factors. Effective management also involves investigating post-operative incontinence to rule out other conditions like detrusor instability or fistulae.

Area of Science:

  • Urology
  • Gynecology
  • Surgical Science

Background:

  • Genuine stress incontinence treatment is complex and patient-specific.
  • No universal first-line surgical procedure exists for all patients.
  • Post-operative incontinence necessitates thorough investigation beyond assuming surgical failure.

Purpose of the Study:

  • To outline the factors influencing surgical treatment decisions for genuine stress incontinence.
  • To emphasize the importance of differential diagnosis for persistent incontinence.
  • To discuss management strategies for detrusor instability and vesico-vaginal fistulae.

Main Methods:

  • Review of current surgical and non-surgical treatment modalities.
  • Emphasis on patient assessment including medical fitness and expectations.

Related Experiment Videos

  • Diagnostic workup for secondary causes of incontinence post-surgery.

    • Main Results:

    • Treatment selection depends on prior surgeries, incontinence severity, patient health, and expectations.
    • Detrusor instability is primarily managed non-surgically, with surgical options for refractory cases.
    • Vesico-vaginal fistula management requires accurate assessment and specialized surgical expertise.

    Conclusions:

    • Individualized surgical approaches are crucial for genuine stress incontinence.
    • Comprehensive evaluation is essential to differentiate causes of post-operative incontinence.
    • Multifaceted management strategies are required for complex urogynaecological conditions.