Surgery for female SUI: The ICI algorithm.

Abstract:

INTRODUCTION:Stress urinary incontinence (SUI) is common in women and can significantly impact quality of life. METHODS:This is a review of the 6th International Consultation on Incontinence (ICI) chapter analyzing level of evidence on surgical treatment of SUI as well as the consensus algorithm that resulted from the detailed work in the committee report as of April 2017. Included studies in this review were selected to highlight the algorithm for management. RESULTS:Non-operative and surgical treatment options exist; conservative therapies comprise first line management, but if SUI remains bothersome, surgical treatment should be considered. Bulking agents offer a minimally invasive option with moderate short-term success rates. The most commonly performed surgical treatments for SUI are mid-urethral and pubovaginal slings, with high cure rates and patient satisfaction. Retropubic suspension is a more traditional but widely accepted procedure. Single incision sling, adjustable sling, or artificial urinary sphincter may be appropriate in carefully selected patients. CONCLUSIONS:The choice of surgical procedure should be made only after a thorough discussion and shared decision between the patient and surgeon regarding risks, benefits, and alternatives. A trial of conservative therapy should be conducted where relevant. Referral to a specialist should be considered in women with a more complex presentation.

journal_name

Neurourol Urodyn

authors

Kowalik CG,Dmochowski RR,De EJB

doi

10.1002/nau.23879

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

S21-S27

eissn

0733-2467

issn

1520-6777

journal_volume

38 Suppl 4

pub_type

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