[Management of pelvic disorders].
Micturition physiology is a complex phenomenon and, for this reason, the management of its disorders is difficult. The initial step in the treatment of urinary incontinence is the identification of type of incontinence, focusing on the origin (medical history, physical examination, additional tests) in order to distinguish between stress and urge urinary incontinence. In the treatment of female stress urinary incontinence due to urethral hypermobility, physical therapy and sling surgical techniques are successful in 90% of patients. In case of male or female urinary incontinence due to intrinsic sphincter deficiency, the treatment of choice is an artificial sphincter. However, another validated techniques or in validation, may be useful, such as intra-urethral bulking agents or microparticles. Finally, urge urinary incontinence is more often treated with antimuscarinic agents. Refractory cases will be successively treated with sacral neuromodulation, Botulinum toxin intravesical injection and, in some cases, with augmentation enterocystoplasty.
Dahan
Mickaël
M
Service d'urologie, CHU Tenon, Paris. micka.dahan@wanadoo.fr
Haab
François
F
D005260:Female; D006801:Humans; D008297:Male; D009135:Muscular Diseases / Q000628:therapy*; D017773:Pelvic Floor