Index

Understanding Female Urinary Incontinence & Master Management Prakash H Trivedi, Ajay Rane

CHAPTER 1:Magnitude of Female Urinary Incontinence: A Health Problem
- Introduction and Definitions
- Risk Factors
CHAPTER 2:Anatomical Aspects of Urinary Incontinence: Clinical Applications
- Urethral Anatomy (Figure 2.1)
- Bladder Anatomy (Figure 2.5)
- Retropubic Space Anatomy (Figure 2.6)
- Pelvic Diaphragm Anatomy (Figure 2.7)
- Transobturator Anatomy and Anatomy of the Inner Groin
- Supporting Ligaments and Fascia
CHAPTER 3:Neuroanatomical Aspects of Lower Urinary Tract
CHAPTER 4:Evaluation of a Patient Prior to Treatment of Urinary Incontinence and Role of Urodynamics
- History Taking and Physical Examination
  - A Cough Stress Test
    - Hypermobility
    - Pelvic Organ Prolapse
- Referral
- Patient Questionnaires
- Voiding Diaries
- Pad Test
  - Short-term (1-Hour) Pad Test
  - Long-term Pad Test
- Urinalysis
- Postvoiding Residual Volume
- Imaging
- Other Tests
- Urodynamics
- Urethral Pressure Studies3 (Table 4.3)
  - Leak Point Pressures
  - Urethral Pressure Profilometry
- Discussion
- Conclusion
CHAPTER 5:Imaging in Urinary Incontinence
CHAPTER 6:Medical Management of Urinary Incontinence
- Types of Urinary Incontinence
- Physiology of Continence
- Antimuscarinic Agents
- Anticholinergics (Antimuscarinics) with Mixed Actions
- Tricyclic Antidepressants
- Miscellaneous Agents
  - Serotonin-Noradrenalin Reuptake Inhibitor
  - Medication for Voiding FLUTS
- Botulinum Toxin
- Management of Overflow Incontinence
  - Standard Management of Storage LUTS
  - Standard Management of Voiding LUTS
- Management of Mixed Urinary Incontinence
- Summary
CHAPTER 7:Experience of Open Burch
- Modified Burch Colposuspension
- Historical Aspect: To be Copied
  - Pathophysiology
    - Preoperative Evaluation
- Steps
  - Surgical Technique of Modified Burch Colposuspension
- Concomitant Surgical Procedure with Burch Colposuspension
- Operative Difficulties and their Management
- Outcome
- Complications
- Key Points
CHAPTER 8:Conventional Surgery and Biological Slings for Stress Urinary Incontinence
- Introduction
- Mechanism of Action
- Indications
- Sling Materials
- Technique for Harvest of Rectus Fascia and Placement of Pubovaginal Sling
- Outcomes
- Complications
  - Key Surgical Points
CHAPTER 9:Laparoscopic Surgery for Urinary Incontinence
- Complications
- Discussion
- Operative Steps (Figures 9.1 to 9.5)
- Laparoscopic Repair of Enterocele
- Foley's Catheter Adaptor, Rectal Probe or CCL Trocar
CHAPTER 10:Synthetic Suburethral Slings
- Procedure of Tension-free Vaginal Tape/Trivedi's SUI Tape (TSUIT)
- Our Experience with TVT/TSUIT
CHAPTER 11:Midurethral Transobturator Sling-Tape Techniques for Stress Urinary Incontinence Surgery
- Introduction
- Primary Stress Urinary Incontinence
- Groin Pain
- Dyspareunia
- Vaginal Mesh Erosion
- Conclusion
CHAPTER 12:Newer Small Slings for Stress Urinary Incontinence
- Introduction
- Indications and Patient Selection
- Description of Various Types of Single Incision Slings
- Surgical Techniques
- Outcomes
- Conclusion
CHAPTER 13:Choice of Surgery for Stress Urinary Incontinence
- Preoperative Caveats
- Surgical Options
CHAPTER 14:Long-term Outcomes of Stress Urinary Incontinence Sling Surgery
- Introduction
- Epidemiology
  - Surgical Management
- Anterior Repair with Kelly Plication
- Bladder Neck Suspension Procedures
- Marshall-Marchetti-Krantz (Retropubic Urethropexy)—MMK Procedure
- Burch Colposuspension
- Laparoscopic Colposuspension
- Needle Suspension Procedures
- Sling Procedures
  - Midurethral Slings
- Periurethral Bulking Agents
- Artificial Urinary Sphincter
- Conclusion
CHAPTER 15:Meshplasty for Correction of Stress Urinary Incontinence: Our Experience
- Principles of Meshplasty
- Observation and Results
- Summary and Conclusion
CHAPTER 16:Voiding Dysfunction and Retention after Stress Urinary Incontinence Surgery
- Introduction
  - Immediate Postoperative Retention after Retropubic Synthetic Midurethral Sling
    - Discussion
- Technique for Synthetic Sling Loosening in the Acute Setting (7 to 14 Days)
- Takedown of Retropubic Synthetic Midurethral Sling at Four Months Postoperatively due to Voiding Dysfunction
  - Discussion
  - Steps for Takedown of a Synthetic Midurethral Sling (Figures 16.1 and 16.2)
- Takedown of Rectus Fascia in Pubovaginal Sling
- Retropubic and Vaginal Urethrolysis After Retropubic Suspension
- Postoperative Care after Sling Revision or Takedown
- Outcomes
- Conclusion
CHAPTER 17:Complications, Difficulties and Redo Procedure for Stress Urinary Incontinence Surgeries
- Introduction
- Laparoscopic Burch
  - Tension-free Vaginal Tape, Trivedi's Stress Urinary Incontinence Tape (TSUIT) and Suburethral Sling
    - Difficulties
    - Complications
- Tension-free Vaginal Tape-Obturator, Trivedi Obturator Tape and Trivedi Obturator Tape Adjustable
  - Outside in Techniques
  - Inside Out Techniques
- Mini Arc
- Bulking Agents
- Artificial Urethral Sphincter
  - Intraoperative Complications
CHAPTER 18:Bulking Agents
- Background
- Indications
- Contraindications
- Preparation and Technique
  - Technique
  - Postoperative Care
- Conclusion
CHAPTER 19:Botulinum Toxin Injection Therapy
- Introduction
- Mechanism of Action
- Case Scenario
- Botulinum Toxin Bladder Injection Technique
- Outcomes and Complications
- Conclusion
CHAPTER 20:Sacral Nerve Stimulation
- Definition
- Indications
- Anatomy and Neurophysiology
- History of Neuromodulation
- How does Neuromodulation Work?
- Technique of S3 Neuromodulation
  - Test Phase
    - Peripheral Nerve Evaluation
    - Staged Procedure
  - Second Stage
- Patient Selection
- Results (Figures 20.13 to 20.17)
- Patient Satisfaction (Figures 20.18 and 20.19)
- Cost-effectiveness
- Complications (Figures 20.20 to 20.22)
- Tips and Tricks
- Who Should do this Procedure?
- Future
- Summary
- Appendix
  - Policy
CHAPTER 21:Artificial Urinary Sphincter in the Management of Severe Intrinsic Sphincter Deficiency Incontinence in Women
- Introduction
- Nature and Mechanism of Action
  - Clinical Indications
  - Contraindications and Caveats
- Operative Technique
- Complications
- Clinical Efficacy
- Conclusion

INDEX

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Chapter Notes