An overview of stress urinary incontinence treatment in women

Papatsoris, Athanasios; Chrisofos, Michael; Antoniou, Nikolaos; Gekas, Aristomenis; Deliveliotis, Charalambos

doi:10.1007/bf03324711

Cited by 6 publications

(4 citation statements)

References 37 publications

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“…Similarly, there is a low risk of developing de novo urge incontinence after a laparoscopic sacral colpopexy and therefore patients should always be informed accordingly before agreeing to surgery. This could be attributed to the retraction and irritation of the bladder trigone following healing and scaring 15,16 . In our series, patients with concomitant SUI benefited from the TVT placement and this is recommended in proven cases of SUI.…”

Section: Discussionmentioning

confidence: 75%

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Laparoscopic promontofixation for pelvic organ prolapse: A 10‐year single center experience in a series of 501 patients

Bacle

Papatsoris²,

Bigot

et al. 2011

Int J of Urology

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Objectives:To assess the long-term outcomes of laparoscopic promontofixation (LP) for the treatment of pelvic organ prolapse (POP). Methods: A total of 501 consecutive patients with POP were included in this prospective study. The patients' mean age was 63.23 (36-90) years, their mean body mass index was 25.14 (15-36) and their mean number of deliveries was 3.3 (0-14). A POP grade Ն3 was diagnosed in 70.4% of the patients and 38.9% of them had a history of abdominal surgery. The patients underwent a Bonney test and urodynamic study. In cases of stress urinary incontinence (SUI), the patients underwent the simultaneous insertion of a tension-free vaginal tape. A prolapse quality of life questionnaire was sent to all patients. Results: The mean operative time was 97.4 min (50-210) and there were 1.7% cases of intra-operative complications. The mean hospitalization time was 3.7 days (1-13 days). During the mean follow-up of 20.7 months (3-120), 91 (17.8%) complications were recorded , including constipation (5.5%), SUI (3.5%), vaginal erosion (2.4%), and urge incontinence (2%). Recurrences were recorded in 11.5% of the patients within an average time of 37.2 months. Risk factors for recurrence were the use of the polypropylene mesh compared with the polyester mesh (P < 0.0001), an intra-operative hysterectomy (P = 0.02), and bleeding (P = 0.049). There was a statistical significant (P < 0.001) improvement in most of the symptoms in the prolapse quality of life questionnaire. Conclusions: LP is safe with effective long-term results, with low recurrence and morbidity rates, and a good quality of life.

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Section: Discussionmentioning

confidence: 75%

“…This could be attributed to the retraction and irritation of the bladder trigone following healing and scaring. 15,16 In our series, patients with concomitant SUI benefited from the TVT placement and this is recommended in proven cases of SUI.…”

Section: Discussionmentioning

confidence: 84%

Laparoscopic promontofixation for pelvic organ prolapse: A 10‐year single center experience in a series of 501 patients

Bacle

Papatsoris²,

Bigot

et al. 2011

Int J of Urology

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“…Midurethral slings have revolutionized the surgical management of stress urinary incontinence in women[1], and several procedures for midurethral slings have been reported. The highly safe and effective TVT surgery was established by Ulmsten[2] et al in 1993 and TOT surgery was subsequently developed by Delorme[3] et al in 2001.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of tension-free vaginal tape compared with transobturator tape in the treatment of stress urinary incontinence in women: analysis of learning curve, perioperative changes of voiding function

et al. 2011

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BackgroundIn this study, by comparing TVT surgery and TOT surgery for stress urinary incontinence in women, the characteristics and learning curves of both operative methods were studied.MethodsA total of 83 women with stress urinary incontinence treated with tension-free vaginal tape (TVT) (n = 38) or transobturator tape (TOT) (n = 45) at Saiseikai Central Hospital between April 2004 and September 2009 were included. We compare the outcomes and learning curves between TVT surgery and TOT surgery. In statistical analysis, Student's t test, Fisher's exact test, and Mann-Whitney's U test were used.ResultsThe surgical durations were 37.4 ± 15.7 minutes with TVT surgery and 31.0 ± 8.3 minutes with TOT surgery. A longer period of time was required for TVT surgery (p = 0.025). The residual urine at post-operative day 1 was higher in TVT surgery (25.9 ± 44.2 ml) than in TOT surgery (10.6 ± 19.2 ml) (p = 0.0452). The surgical duration of TVT surgery was shortened after the operator had performed 15 operations (p = 0.019).ConclusionsIn comparison of TVT surgery and TOT surgery, the surgical duration of TVT surgery was longer and the residual urine of TVT surgery was higher at post-operative day 1. Surgical experience could shorten the duration of TVT surgery.

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“…The indications for implantation of an AUS in women are much less common and such an indication is female genuine stress UI (SUI) due to intrinsic sphincter deficiency (ISD) [2]. In this case, placing an AUS is an established treatment option of last resort [3]. However, open implantation can be surgically challenging, especially in patients with a history of anti-incontinence/pelvic operations and comorbidities [4].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic artificial urinary sphincter implantation for female genuine stress urinary incontinence: technique and 4‐year experience in 25 patients

Mandron¹,

Bryckaert²,

Papatsoris³

2010

BJU International

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Study Type – Therapy (outcomes research) Level of Evidence 2c OBJECTIVE To assess the safety, feasibility and efficacy of laparoscopic implantation of the artificial urinary sphincter (AUS) in women with genuine stress urinary incontinence (SUI). PATIENTS AND METHODS From April 2005 to July 2009, 25 women (mean age 66.8 years) with genuine SUI had a laparoscopic implantation of the AUS (AMS 800TM, American Medical Systems, Minnetonka, MN, USA). Patients had a negative Marshall test and urodynamic studies showed decreased closure pressure. All patients had a history of urogynaecological surgery. Transperitoneal laparoscopic access was created with two midline 10‐mm and two lateral 5‐mm trocars. One of the lateral port incisions was later extended to facilitate urethrovaginal dissection with scissors and dissector, and the insertion and assembly of the AUS. In six cases of concomitant genito‐urinary prolapse, laparoscopic anterior and posterior mesh promontofixation was also performed. RESULTS The AUS was successfully implanted in all cases with no conversion to open surgery. There were no intra‐ or perioperative complications, except one vaginal perforation which was repaired during surgery. The mean operative duration was 92 min (71 min without and 123 min with simultaneous promontofixation). Five patients developed urinary retention, which was managed with re‐insertion of the urethral catheter for 2 days in four and with insertion of a suprapubic catheter for 4 weeks in a patient with spina bifida. During the mean follow‐up of 26.1 months, two treatment failures were diagnosed due to vaginal erosion and were managed with removal of the AUS. All the remaining 23 patients reported continence, either complete (in 19) or social (in four). However, this was not a randomized comparative study. CONCLUSION Laparoscopic implantation of the AUS in women with genuine SUI is safe, feasible and efficient.

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An overview of stress urinary incontinence treatment in women

Cited by 6 publications

References 37 publications

Laparoscopic promontofixation for pelvic organ prolapse: A 10‐year single center experience in a series of 501 patients

Laparoscopic promontofixation for pelvic organ prolapse: A 10‐year single center experience in a series of 501 patients

Efficacy of tension-free vaginal tape compared with transobturator tape in the treatment of stress urinary incontinence in women: analysis of learning curve, perioperative changes of voiding function

Laparoscopic artificial urinary sphincter implantation for female genuine stress urinary incontinence: technique and 4‐year experience in 25 patients

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