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The procedure of choice for stress urinary incontinence in females is what is called a sling procedure. A sling implant usually consists of a synthetic mesh material in the shape of a narrow ribbon but sometimes a biomaterial (bovine or porcine) or the patients own tissue that is placed under the urethra through one vaginal incision and two ...
Additionally, despite the novel treatment options (slings, urethral bulking injections, stem-cell therapy), AUS is considered to be the gold standard surgical management both for stress incontinence in men and for urinary incontinence developed as a complication of surgery, such as prostatectomy, cystectomy and TURP. [8] [4] [3]
Women and men that have persistent incontinence despite optimal conservative therapy may be candidates for surgery. Surgery may be used to help stress or overflow incontinence. [8] Common surgical techniques for stress incontinence include slings, tension-free vaginal tape, bladder suspension, artificial urinary sphincters, among others. [8]
Several surgical procedures are available to treat urethral hypermobility. These procedures use combinations of sutures, implanted synthetic mesh, and autotransplanted tissue to support and reposition the urethra in relation to the pubic bone and other pelvic structures. Burch colposuspension; Midurethral sling; Pubovaginal sling; Mini sling
Transvaginal mesh, also known as midurethral or bladder neck sling for SUI repair, can be used to support the urethra or the neck of the bladder in two surgical approaches, namely the retropubic and transobturator. In the retropubic approach, two incisions above the pubic bone and one incision in the vagina are performed. [14]
In men, prostate surgery (prostatectomy, TURP, etc) and radiation therapy can damage the sphincter and cause stress incontinence. [7] Neurogenic bladder dysfunction can involve a malfunctioning urethral sphincter. [8] Urge incontinence can happen when the urethra cannot hold the urine in as the bladder contracts uncontrollably. [9]
When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. [13] Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. [14] According to the FDA, serious complications are "not rare ...
The sling procedure. Slings are or considered the first line surgical treatment for women with stress incontinence [5] Artificial urinary sphincters are considered first line surgical treatment for certain types of incontinence in men [5] Burch colposuspension is a retropubic procedure used in treatment of urinary incontinence in women [1]