What surgical treatments are available for stress incontinence?

Our aim was to validate the use of intravenous anesthesia as an alternative to epidural anesthesia for the placement of tension-free vaginal tape (TVT) in patients with urodynamic stress incontinence. Eighty-six patients participated in this prospective study. Forty-five patients were operated with intravenous anesthesia and 41 patients with epidural anesthesia. All patients had a full history taken and a complete gynecological examination performed at initial visit. Preoperative and postoperative urodynamic investigations included filling and voiding cystometry, urethral profilometry, uroflow, and cough stress test. Genuine stress incontinence diagnosis was based on the findings of urodynamic investigations. Patients with prolapse more than first degree or detrusor instability were excluded from the study. The objective success rate for patients operated with intravenous anesthesia was 86.6%, whereas for patients operated with epidural anesthesia was 88% at 12 months of follow-up. We had no cases of postoperative bleeding or hematoma development. Postoperative urinary tract infection developed in three cases (3 of 74). Application of TVT procedure with intravenous anesthesia provides comparable results with the use of epidural anesthesia and could be a very good alternative.

Please click on the required question.

• 1  How is urine produced?
• 2  What is cystitis?
• 3  How prevalent is cystitis?
• 4  What is honeymoon cystitis?
• 5  What are Frequency and nocturia?
• 6  How prevalent are Frequency and nocturia?
• 7  What is urinary incontinence?
• 8  What is stress incontinence of urine?
• 9  What is urgency, urge incontinence and the urge syndrome?
• 10 What causes stress and urge incontinence?
• 11 What is dribbling incontinence?
• 12 How prevalent is urinary incontinence?
• 13 What is the urethral syndrome?
• 14 How can I record my bladder problems and monitor the effects of treatment?
• 15 What simple measures are available to reduce urinary incontinence?
• 16 What are pelvic floor exercises?
• 17 How successful are pelvic floor exercises?
• 18 What is bladder training?
• 19 How effective is bladder training?
• 20 Are there any alternatives to bladder training for urgency symptoms?
• 21 If simple measures do not suffice, what else is available for the treatment of urinary stress incontinence?
• 22 What are urodynamic studies?
• 23 Where can I obtain further information about bladder problems?
• 24 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.