Treatment of stress urinary incontinence. 1990

W Fischer-Rasmussen
Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Denmark.

This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy is unlikely to offer more than a placebo effect. Studies of a single surgical procedure usually report high cure rates. In making the appropriate choice of operation the best guidelines are the cure rates from comparative or prospective randomized reports. From such studies an abdominal retropubic suspension operation (cure rates after five years 57-78 %) is more likely to help the patient than an anterior colporrhaphy (cure rates 31-70 %) or a transvaginal needle bladder neck suspension (cure rates 39-61 %). In selected patients sling procedures or the use of artificial sphincters may produce excellent results (70-80 %). To estimate the results of different treatments urine loss should be assessed objectively and physical restrictions and hygienic and social implications taken into account. A method of pre- and post-treatment "performance scores" should be developed.

UI MeSH Term Description Entries
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014550 Urinary Incontinence, Stress Involuntary discharge of URINE as a result of physical activities that increase abdominal pressure on the URINARY BLADDER without detrusor contraction or overdistended bladder. The subtypes are classified by the degree of leakage, descent and opening of the bladder neck and URETHRA without bladder contraction, and sphincter deficiency. Urinary Stress Incontinence,Incontinence, Urinary Stress,Stress Incontinence, Urinary

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