There are lots of articles recently concerning a very successful fibrin glue colpofixation used in treating stress urinary incontinence (SUI) instead of sutures according to Burch colposuspension [6, 5, 4]. Being in doubt about each modification of the original Burch surgery method, in spite of reported good results, I have decided to explain my own opinion concerning this problem. According to recent knowledge of the lower urinary tract anatomy, described by DeLancey and S. Raz [3, 11], supporting factors of the vesical neck as a part of the continence mechanism in women is more understandable.
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Role of Preoperative and Postoperative Endovaginal Ultrasound and 24 h Pad Test in Evaluation of Efficacy of Various Treatment Modalities for Stress Urinary Incontinence.
J Midlife Health
October 2024
Departments of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Background: Stress urinary incontinence (SUI) is a common problem affecting the quality of life of women.
Materials And Methods: It is a prospective study conducted over 40 women of SUI by endovaginal ultrasound on rest and Valsalva preoperatively and 6 months postoperatively for levator hiatus (LH), pubovisceral thickness, urethral length, and bladder neck (BN) position. A 24 h pad test was also performed on all women at the same time for grading of SUI.
Instruments Used for the Assessment of SUI Severity in Urogynecologic Surgical Trials: A Scoping Review.
Int Urogynecol J
December 2024
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Periferiaki Odos Thessalonikis, Nea Efkarpia, 56403, Thessaloniki, Greece.
Introduction And Hypothesis: Various instruments are used to evaluate the severity of stress urinary incontinence (SUI) in clinical trials for SUI surgery. We conducted a scoping review with the primary aim of investigating the use of such instruments.
Methods: A comprehensive search in PubMed/MEDLINE, Cochrane Library, ClinicalTrials.
Randomized Trial of Single-Incision Midurethral Sling and Laparoscopic Burch Colposuspension: Postoperative Surgical Outcomes and Complications.
J Minim Invasive Gynecol
September 2024
Department of Obstetrics and Gynecology, Ataturk University, Erzurum, Turkey (all authors).
Study Objective: Various retropubic and midurethral sling techniques have shown high cure rates in the treatment of stress urinary incontinence (SUI). This study aimed to compare single-incision midurethral sling (SIMS) and laparoscopic Burch colposuspension (LBC) procedures in patients with SUI in terms of the effectiveness, patient satisfaction, surgical complications and results.
Design: This is a prospective randomized study.
Tethered vagina syndrome: massive urine loss caused by bladder neck scarring cured by skin graft.
Ann Transl Med
April 2024
St. Antonius Hospital Eschweiler, Inkontinenz und Beckenbodenzentrum, Eschweiler, Germany.
The bladder neck area of the vagina is known as the "zone of critical elasticity" (ZCE). Adequate vaginal elasticity at ZCE is required for the oppositely-acting muscles to independently close the distal urethra and bladder neck. Scarring at ZCE "tethers" the more powerful posterior muscles to the anterior muscles and the bladder neck is forcibly pulled open, resulting in massive urine loss.
View Article and Find Full Text PDFManaging female stress urinary incontinence in a post mesh era: What to do and when to refer.
Aust J Gen Pract
May 2024
MBBS, MS, FRACS (Urol), Urologist, Department of Urology, Royal Melbourne Hospital, Melbourne, Vic; Urologist, Epworth Healthcare, Melbourne, Vic.
Article Synopsis
- Urinary incontinence, particularly stress urinary incontinence (SUI), is a common issue in primary care that can greatly impact a patient's daily life and requires effective assessment and management by healthcare providers.
- The diagnosis of SUI is typically based on the patient's medical history and specific physical exams, with pelvic floor physiotherapy and lifestyle changes as primary treatment options.
- For more severe cases, surgical solutions like urethral bulking agents and different types of slings are available, with synthetic mid-urethral slings remaining a popular choice for treating SUI in women.
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