7: The Treatment of Stress Incontinence
- Page ID
- 15611
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- 7.2: 7.2-Where Do We Begin? – Physiotherapy
- The first step in therapy is to have the sufferer visit a physiotherapist with a special interest in pelvic floor rehabilitation. The physio will assess the strength of the patient’s pelvic floor, and suggest exercise to enhance the muscle power of the Levator muscles.
- 7.4: 7.4-The Surgical Management of Stress Incontinence
- Vaginal birth and aging are important causes of urinary stress incontinence. Ingenious operations to cure this common and distressing symptom in women have been devised. As a better understanding of the mechanisms of continence have evolved, 47 operations to cure the condition have improved.
- 7.5: Historical Perspective
- Traditionally the anterior repair of a cystocoele using Kelly plication sutures have been useful in the management of stress incontinence. However the effect is transient, and while it cures anterior compartment prolapse, the anterior repair is not an authentic continence operation
- 7.6: 7.6-The Retropubic TVT (TVT-R)
- Given that transobturator approaches are probably safer and equally as effective as retropubic TVT, the thoughtful continence practitioner must consider if the “inside – out” route is safer, or otherwise, than the “outside – in” transobturator approach.
- 7.7: The New Transobturator Approach
- Transobturator “outside – in” procedures and transobturator “inside – out” procedures
- 7.9: Conclusion and References
- The obturator approach to the treatment of stress incontinence offers many advantages over previous operations, especially ease of surgery, safety and good predictable cure rates.