A critical overview of the evidence base for the contemporary surgical management of stress incontinence

Yvonne Katherine P Koch, Philippe Zimmern

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

PURPOSE OF REVIEW: The purpose of this article is to evaluate the evidence base for surgical management of stress urinary incontinence in women between July 2006 and December 2007. RECENT FINDINGS: The Urinary Incontinence Treatment Network and Pelvic Floor Diseases Network have contributed level 1 evidence in the management of stress urinary incontinence with multicentric randomized controlled trials. Pubovaginal sling has a higher success rate than the Burch at the expense of a higher morbidity. A prophylactic Burch procedure at the time of an abdominal sacrocolpopexy can reduce secondary stress urinary incontinence and urge urinary incontinence. Suburethral tapes have a higher cure rate for patients with predominant stress urinary incontinence and can safely be placed at the time of concomitant pelvic surgery. The tension-free vaginal tape has a higher rate of lower urinary tract injury and voiding dysfunction when compared with transobturator tape. SUMMARY: The Burch and pubovaginal sling have a high success rate for treating stress urinary incontinence. Prospective randomized trials are needed to assess the long-term results of suburethral slings. There is still no consensus on outcome measures when reporting on surgical management for stress urinary incontinence.

Original languageEnglish (US)
Pages (from-to)370-376
Number of pages7
JournalCurrent opinion in urology
Volume18
Issue number4
DOIs
StatePublished - Jul 1 2008

Keywords

  • Burch
  • Incontinence and prolapse
  • Sling
  • Stress incontinence
  • Surgery

ASJC Scopus subject areas

  • Urology

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