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KMID : 0877720070110020113
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Journal of Korean Continence Society
2007 Volume.11 No. 2 p.113 ~ p.118
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Current Trends in the Surgical Management of Stress Urinary Incontinence and Pelvic Organ Prolapse
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Chung Byung-Soo
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Abstract
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Female stress urinary incontinence is composed of anatomical incontinence and intrinsic sphincter deficiency. The goals of surgical treatment in patient with stress urinary incontinence are creation of a strong hammock against which urethra can be compressed with sudden changes of abdominal pressure in case of anatomical incontinence and compression and coaptation of deficient sphincteric unit in case of intrinsic sphincter deficiency. Restoration and reinforcement of the pubourethral ligaments and the suburethral vaginal hammock at the mid-urethra have become basic strategy of surgical treatment after integral theory by Ulmsten. Retropubic or transobturator mid-urethral sling procedure is mainstream of surgical treatment of female stress urinary incontinence in recent days. Tension free readjustable tape, named REMEEX system(R) and the TVT-secur(R) procedure were introduced recently. REMEEX system(R) allows readjustment of urethral suspension level postoperatively that can minimize postoperative urinary retention. TVT-secur procedure needs only one vaginal incision and minimal periurethral dissection for small sized mesh. Therefore, It can help make the surgery quicker and simpler. There are some advances in surgical treatment in pelvic organ prolapse. Robotic sacral colpopexy is one of that. It will be more popular surgery because robotic surgery has a lot of merits than previous conventional surgery
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KEYWORD
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Surgical Management, Stress Urinary Incontinence, Pelvic Organ Prolapse
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