scholarly journals Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Leslie M. Rickey ◽  
Liyuan Huang ◽  
David D. Rahn ◽  
Yvonne Hsu ◽  
Heather J. Litman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Symptom Severity ◽  
Bladder Function ◽  
Incontinence Episode ◽  
Incontinence Surgery ◽  
Fascial Sling ◽  
Patient Reported ◽  
Sui Surgery

Objective.To determine baseline variables associated with urgency urinary incontinence (UUI) in women presenting for stress urinary incontinence (SUI) surgery.Methods. Baseline data from two randomized trials enrolling 1,252 women were analyzed: SISTEr (fascial sling versus Burch colposuspension) and TOMUS (retropubic versus transobturator midurethral sling). Demographic data, POP-Q measures, and validated measures of symptom severity and quality of life were collected. Charlson Comorbidity Index (CCI) and Patient Health Questionnaire-9 were measured in TOMUS. Multivariate models were constructed with UUI and symptom severity as outcomes.Results. Over two-thirds of subjects reported bothersome UUI at baseline. TOMUS patients with more comorbidities had higher UDI irritative scores (CCI score 0 = 39.4, CCI score 1 = 42.1, and CCI score 2+ = 51.0,P=0.0003), and higher depression scores were associated with more severe UUI. Smoking, parity, prior incontinence surgery/treatment, prolapse stage, and incontinence episode frequency were not independently associated with UUI.Conclusions. There were no modifiable risk factors identified for patient-reported UUI in women presenting for SUI surgery. However, the direct relationships between comorbidity level, depression, and worsening of UUI/urgency symptoms may represent targets for preoperative intervention. Further research is necessary to elucidate the pathophysiologic mechanisms that explain the associations between these medical conditions and bladder function.

scholarly journals Contemporary trends for urological training and management of stress urinary incontinence in Ireland

2021 ◽  
Author(s):  
Eoin MacCraith ◽  
James C. Forde ◽  
Fergal J. O’Brien ◽  
Niall F. Davis
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Fold Increase ◽  
Incontinence Surgery ◽  
Stress Urinary Incontinence Surgery ◽  
Urethral Bulking ◽  
Urological Training ◽  
Sui Surgery ◽  
Urinary Incontinence Surgery ◽  
Urethral Bulking Agent

Abstract Introduction and hypothesis The aim of this study is to evaluate the trends in stress urinary incontinence (SUI) surgery since the 2018 pause on use of the polypropylene (PP) mid-urethral sling (MUS) and to quantify the effect this has had on surgical training. Methods Two anonymous surveys were sent to all current urology trainees and to all consultant surgeons who specialise in stress urinary incontinence surgery. Results Prior to the pause, 86% (6 out of 7) of consultant urologists and 73% (11 out of 15) of consultant gynaecologists would “always”/“often” perform MUS for SUI. After that, 100% (22 out of 22) of consultants reported that they “never” perform MUS. There has been a modest increase in the use of urethral bulking agent (UBA) procedures among urologists, with 43% (3 out of 7) now “often” performing this, compared with 71% (5 out of 7) “never” performing it pre-2018. Trainee exposure to SUI surgery reduced by 75% between 2016 and 2020. Despite a ten-fold increase in UBA procedures logged by trainees, the decline in MUS has resulted in a major reduction in total SUI surgeries. Coinciding with this decrease in surgeries, there was a 56% reduction in trainees’ self-assessed competence at SUI surgery. Thirteen percent of trainees are interested in specialising in Female Urology and those trainees had significantly greater exposure to SUI procedures during their training than those who did not (p = 0.0072). Conclusions This study has identified a downward trend in SUI surgery, which is concerning for the undertreatment of females with SUI. A decline in SUI surgery training has resulted in reduced trainee confidence and interest in this subspecialty.

scholarly journals Is it the Time to Revisit Historical Bladder Neck Buttressing for the Treatment of Stress Urinary Incontinence?

2021 ◽  
Vol 16 ◽  
pp. 1
Author(s):  
Bhawana Purwar ◽  
Sarah Knox ◽  
Monika Vij ◽  
Simon Emery
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Patient Reported Outcome ◽  
Postal Questionnaire ◽  
Bladder Function ◽  
Operation Rate ◽  
Patient Reported ◽  
Outcome Tool

Objectives: The aim of our study was to assess improvement in bladder function and quality of life using Australian Pelvic floor questionnaire as Patient Reported Outcome tool following anterior repair and urethral buttressing for treating stress urinary incontinence (SUI) with prolapse using polydioxanone sutures. Material and Methods: This was the prospective review of retrospective data. The data were collected through telephone or postal questionnaire by an independent researcher who was not involved in the patient care directly and analyzed with Stata (14.2). Results: About 78% (61/78) of women responded to the questionnaires. Statistically significant improvement in bladder function scores was noted after surgery (5.12 ± 2.06 vs. 3.69 ± 2.26; P = 0.001) along with an overall improvement in the quality of life scores (17.88 ± 8.03 vs. 11.56 ± 9.01; P = 0.005) at mean follow-up of 31 months. Overall, 54% patients reported improvement in their symptoms. The re-operation rate for second continence procedure for SUI was 1/61 (1.6%). Conclusion: This procedure can be offered to patients as a treatment option for SUI with prolapse.

Lower urinary tract conditions

2020 ◽  
pp. 27-56
Author(s):  
Helen Jefferis ◽  
Natalia Price
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Stress Urinary Incontinence ◽  
Lower Urinary Tract ◽  
Management Strategies ◽  
Bladder Function ◽  
Urinary Continence ◽  
Overactive Bladder Syndrome ◽  
Lower Urinary

This chapter covers conditions affecting the lower urinary tract. It begins with an overview and management strategies of overactive bladder syndrome, including both conservative and pharmacological methods. Stress urinary incontinence (SUI) is covered in detail, from an overview and risk factors, to conservative, surgical, and other interventions. The controversy surrounding synthetic mid-urethral slings is highlighted. Other types of urinary continence are defined, alongside voiding dysfunction. Finally, drugs that can affect bladder function are listed.

scholarly journals Patient reported outcome measures in male incontinence surgery

2014 ◽  
Vol 96 (7) ◽  
pp. 521-525 ◽  
Author(s):  
MGB Tran ◽  
J Yip ◽  
K Uveili ◽  
SM Biers ◽  
N Thiruchelvam
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Categorical Variables ◽  
Incontinence Surgery ◽  
International Consultation ◽  
Patient Reported

Introduction Patient reported outcome measures (PROMs) were used to evaluate outcomes of the artificial urinary sphincter (AUS) and the AdVance™ (American Medical Systems, Minnetonka, MN, US) male sling system (AVMS) for the symptomatic management of male stress urinary incontinence. Methods All male patients with stress urinary incontinence referred to our specialist clinic over a two-year period completed the ICIQ-UI SF (International Consultation on Incontinence Questionnaire on Urinary Incontinence Short Form) and the ICIQ-MLUTS LF (International Consultation on Incontinence Questionnaire on Male Lower Urinary Tract Symptoms Long Form) at consultation as well as at subsequent follow-up appointments. The Wilcoxon signed-rank test for non-parametric paired data was used for pre and postoperative comparisons. The chi-squared test was used for categorical variables. Results Thirty-seven patients (forty surgical cases) completed a preoperative and at least one follow-up questionnaire. There was a statistically significant improvement in PROMs postoperatively, regardless of mode of surgery (p<0.01). Analysis of the ICIQ-MLUTS LF showed that patients with higher preoperative scores (>25) had greater improvement with an AUS than with the AVMS (p<0.01). Conclusions This prospective study shows that completion and collection of PROMs as part of routine clinical practice is achievable and useful in the assessment of male stress incontinence surgery. PROMs are important instruments to assess effectiveness of healthcare intervention and they are useful adjuncts in surgical studies.

Stress Urinary Incontinence Surgery in the United States

2003 ◽  
Vol 101 (4) ◽  
pp. 671-676
Author(s):  
L. Elaine Waetjen ◽  
Leslee L. Subak ◽  
Hui Shen ◽  
Feng Lin ◽  
Tsung-Hsi Wang ◽  
...  
Keyword(s):  
United States ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
The United States ◽  
Incontinence Surgery ◽  
Stress Urinary Incontinence Surgery ◽  
Urinary Incontinence Surgery
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