title: Different surgical approaches for stress urinary incontinence in women.
abstract: Stress urinary incontinence (SUI) constitutes involuntary voiding as a consequence of rising intra-abdominal pressure caused by sphincter weakness. In recent years studies were published according to surgical SUI management evaluating and comparing therapy options and outcomes. Therapy options were evaluated using a Medline search, including only publications in English between 2000-2012. Key words used were: SUI, conservative and surgical treatment, midurethral sling, colposuspension. Surgical treatment options demonstrate significantly better results than conservative treatment. MUS demonstrate better subjective and objective cure rates than colposuspension; it is less invasive and more cost-effective. First line SUI therapy such as RP MUS and TVT seem to be favored when compared to transobturator techniques. Retropubic and transobturator MUS showed equivalent objective and subjective success rates. Open colposuspension is an effective treatment possibility for recurrent SUI after failed MUS. TVT, compared with other MUS, seems to show slightly better cure rates. but perioperative complications appear to be similar. Long-term results (>10 years) of repeated SUI surgery showed that the Burch procedure had the lowest 9-year cumulative incidence of repeat SUI surgery. Mini-sling techniques may be underestimated but long-time results are pending and closer monitoring of the adverse event profile must be carried out. MUS are first choice in the treatment of SUI, of which TVT, has the best cure rate. Colpussupension continues to have its place in recurrent SUI. The new mini-MUS needs a longer follow-up for final evaluation.
authors: Department of Urology, University of Tuebingen, Tuebingen, Germany.
authors: J
authors: J
authors: Mischinger
authors: B
authors: B
authors: Amend
authors: C
authors: C
authors: Reisenauer
authors: J
authors: J
authors: Bedke
authors: G
authors: G
authors: Naumann
authors: M
authors: M
authors: Germann
authors: S
authors: S
authors: Kruck
authors: L F
authors: LF
authors: Arenas Desilva
authors: H
authors: H
authors: Wallwiener
authors: H
authors: H
authors: Koelbl
authors: V
authors: V
authors: Nitti
authors: K D
authors: KD
authors: Sievert
mesh_terms: D005260:Female; D006801:Humans; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods