Skip to main content
SpringerLink
Log in

Management of Female Stress Urinary Incontinence

  • Chapter
  • First Online:
Postmenopausal Diseases and Disorders

  • 646 Accesses

Abstract

Stress urinary incontinence (SUI) is a condition characterized by an involuntary loss of urine occurring as result of an increase of intra-abdominal pressure due to effort or exertion or on sneezing or coughing. It is estimated to have a prevalence between 10 and 40% of the female population. Surgical therapy should be indicated only after conservative therapies (rehabilitation, local oestrogenic) have failed. The synthetic midurethral slings are the gold standard for the surgical treatment of the SUI according to the guidelines 2016 of the European Society of Urology and the position statement of the 2017 of the European Urogynaecological Association. When offering a surgical procedure, the specialist should discuss with the woman the risks and benefits of the different treatment options for SUI. Patients should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. The therapeutic options available today are numerous, but the current trend is aimed at the continuous research of new therapeutic strategies in order to achieve an ever better balance between high efficacy and maximum reduction of adverse events.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tantanasis T, Daniilidis A, Pantelis A, Chatzis P, Vrachnis N. Minimally invasive techniques for female stress urinary incontinence, how, why, when. Arch Gynecol Obstet. 2013;288(5):995–1001.

    Article  PubMed  Google Scholar 

  2. Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjälmås K, Lapitan MC. Epidemiology and natural history of urinary incontinence in women. Urology. 2003;62(4Suppl 1):16–23.

    Article  PubMed  Google Scholar 

  3. Patel DA, Xu X, Thomason AD, Ransom SB, Ivy JS, DeLancey JO. Childbirth and pelvic floor dysfunction: an epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol. 2006;195(1):23–8.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Alas AN, Chinthakanan O, Espaillat L, Plowright L, Davila GW, Aguilar VC. De novo stress urinary incontinence after pelvic organ prolapse surgery in women without occult incontinence. Int Urogynecol J. 2017;28(4):583–90.

    Article  PubMed  Google Scholar 

  5. Urinary Incontinence in Women. The management of urinary incontinence in women: NICE clinical guideline CG171. London: National Institute for Health and Care Excellence; 2013. http://guidance.nice.org.uk/CG171

  6. Thüroff JW, Abrams P, Andersson KE, et al. European Association of Urology. EAU guidelines on urinary incontinence. Actas Urol Esp. 2011;35(7):373–88.

    Article  PubMed  Google Scholar 

  7. Capobianco G, Wenger JM, Meloni GB, Dessole M, Cherchi PL, Dessole S. Triple therapy with lactobacilli acidophili, estriol plus pelvic floor rehabilitation for symptoms of urogenital aging in postmenopausal women. Arch Gynecol Obstet. 2014;289(3):601–8.

    Article  PubMed  Google Scholar 

  8. Maund E, Schow Guski L, Gotzsche PC. Considering benefits and harms of duloxetine for treatment of stress urinary incontinence: a meta-analysis of clinical study reports. CMAJ. 2017;189:E194–203.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gambacciani M, Palacios S. Laser therapy for the restoration of vaginal function. Maturitas. 2017;99:10–5.

    Article  PubMed  Google Scholar 

  10. Baraldi CE, Puricelli E, Kulkes S, Martins GL. Er YAG laser in oral soft tissue surgery. JOLA. 2001;59:17–20.

    Google Scholar 

  11. Fistonić N, Fistonić I, Guštek ŠF, et al. Minimally invasive, non-ablative Er: YAG laser treatment of stress urinary incontinence in women--a pilot study. Lasers Med Sci. 2016;31(4):635–43.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gambacciani M, Levancini M, Cervigni M. Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause. Climacteric. 2015;18(5):757–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Iosif CS, Batra S, Ek A, Astedt B. Estrogen receptors in the human female lower urinary tract. Am J Obstet Gynecol. 1981;141(7):817–20.

    Article  CAS  PubMed  Google Scholar 

  14. Matsubara S, Okada H, Shirakawa T, Gotoh A, Kuno T, Kamidono S. Estrogen levels influence beta-3-adrenoceptor-mediated relaxation of the female rat detrusor muscle. Urology. 2002;59(4):621–5.

    Article  PubMed  Google Scholar 

  15. Fantl JA, Cardozo L, McClish DK. Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta-analysis. First report of the hormones and urogenital therapy committee. Obstet Gynecol. 1994;83(1):12–8.

    CAS  PubMed  Google Scholar 

  16. Dessole S, Rubattu G, Ambrosini G, et al. Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women. Menopause. 2004;11(1):49–56.

    Article  PubMed  Google Scholar 

  17. Capobianco G, Donolo E, Borghero G, Dessole F, Cherchi PL, Dessole S. Effects of intravaginal estriol and pelvic floor rehabilitation on urogenital aging in postmenopausal women. Arch Gynecol Obstet. 2012;285(2):397–403.

    Article  PubMed  Google Scholar 

  18. Committee Opinion No. 603. Evaluation of uncomplicated stress urinary incontinence in women before surgical treatment. Obstet Gynecol. 2014;123(6):1403–7.

    Article  Google Scholar 

  19. Stoppelli I, Milia S, Dessole S, Geromino A. Further considerations on colpo-suspension by Burch’s method in the correction of stress urinary incontinence. Minerva Ginecol. 1983;35(6):417–21.

    CAS  PubMed  Google Scholar 

  20. Capobianco G, Madonia M, Morelli S, Dessole F, De Vita D, Cherchi PL, Dessole S. Management of female stress urinary incontinence: a care pathway and update. Maturitas. 2018;109:32–8.

    Article  PubMed  Google Scholar 

  21. Capobianco G, Morelli S, Dessole F, Cherchi PL, Dessole S, Madonia M, De Vita D. Reply to Dr Wael Agur. Maturitas. 2018;110:125.

    Article  PubMed  Google Scholar 

  22. Ogah J, Cody JD, Rogerson L. Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2009;(4):CD006375.

    Google Scholar 

  23. Novara G, Artibani W, Barber MD, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. 2010;58(2):218–38.

    Article  PubMed  Google Scholar 

  24. Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol. 1995;29(1):75–82.

    Article  CAS  PubMed  Google Scholar 

  25. Ulmsten U, Falconer C, Johnson P, et al. A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(4):210–3.

    Article  CAS  PubMed  Google Scholar 

  26. Kristensen I, Eldoma M, Williamson T, Wood S, Mainprize T, Ross S. Complications of the tension-free vaginal tape procedure for stress urinary incontinence. Int Urogynecol J. 2010;21(11):1353–7.

    Article  PubMed  Google Scholar 

  27. Kim HG, Park HK, Paick SH, Choi WS. Comparison of effectiveness between tension-free vaginal tape (TVT) and trans-obturator tape (TOT) in patients with stress urinary incontinence and intrinsic sphincter deficiency. PLoS One. 2016;11(5):e0156306.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Long CY, Hsu CS, Wu MP, Liu CM, Wang TN, Tsai EM. Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. Curr Opin Obstet Gynecol. 2009;21(4):342–7.

    Article  PubMed  Google Scholar 

  29. Ford AA, Rogerson L, Cody JD, Aluko P, Ogah J. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;(7):CD006375.

    Google Scholar 

  30. Kurien A, Narang S, Han HC. Tension-free vaginal tape-Abbrevo procedure for female stress urinary incontinence: a prospective analysis over 22 months. Singap Med J. 2017;58(6):338–42.

    Article  Google Scholar 

  31. Capobianco G, Dessole M, Lutzoni R, Surico D, Ambrosini G, Dessole S. TVT-ABBREVO: efficacy and two years follow-up for the treatment of stress urinary incontinence. Clin Exp Obstet Gynecol. 2014;41(4):445–7.

    CAS  PubMed  Google Scholar 

  32. Leone Roberti Maggiore U, Finazzi Agrò E, Soligo M, Li Marzi V, Digesu A, Serati M. Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2017;28(8):1119–30.

    Article  PubMed  Google Scholar 

  33. Tommaselli GA, Di Carlo C, Formisano C, Fabozzi A, Nappi C. Medium-term and long-term outcomes following placement of midurethral slings for stress urinary incontinence: a systematic review and metaanalysis. Int Urogynecol J. 2015;26(9):1253–68.

    Article  PubMed  Google Scholar 

  34. Frigerio M, Regini C, Manodoro S, Spelzini F, Milani R. Mini-sling efficacy in obese versus non-obese patients for treatment of stress urinary incontinence. Minerva Ginecol. 2017;69(6):533–7.

    Google Scholar 

  35. American Urological Association. Incontinence 2017. https://www.auanet.org/education/guidelines/incontinence.cfm.

  36. Mamut A, Carlson KV. Periurethral bulking agents for female stress urinary incontinence in Canada. Can Urol Assoc J. 2017;11(6 Suppl 2):S152–4.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Herschorn S. Injection therapy for urinary incontinence. In: Wein A, Kavoussi LR, Novick AC, et al., editors. Campbell-Walsh urology. 11th ed. Philadelphia: Saunders; 2013. p. 2049–69.

    Google Scholar 

  38. Kotb AF, Campeau L, Corcos J. Urethral bulking agents: techniques and outcomes. Curr Urol Rep. 2009;10:396–400.

    Article  PubMed  Google Scholar 

  39. American Urological Association. Incontinence 2016. Linthicum: American Urological Association; 2017. https://www.auanet.org/education/guidelines/incontinence.cfm. Accessed 30 Jan 2017.

    Google Scholar 

  40. National Institute for Health and Care Excellence. Intramural urethral bulking procedures for stress urinary incontinence in women. London: National Institute for Health and Care Excellence; 2005. https://www.nice.org.uk/guidance/IPG138/chapter/2-Theprocedure. Accessed 30 Jan 2017.

    Google Scholar 

  41. Kasi AD, Pergialiotis V, Perrea DN, Khunda A, Doumouchtsis SK. Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature. Int Urogynecol J. 2016;27(3):367–75.

    Article  PubMed  Google Scholar 

  42. Siddiqui ZA, Abboudi H, Crawford R, Shah S. Intraurethral bulking agents for the management of female stress urinary incontinence: a systematic review. Int Urogynecol J. 2017;28(9):1275–84.

    Article  PubMed  Google Scholar 

  43. Ghoniem G, Corcos J, Comiter C, Westney OL, Herschorn S. Durability of urethral bulking agent injection for female stress urinary incontinence: 2-year multicenter study results. J Urol. 2010;183(4):1444–9.

    Article  PubMed  Google Scholar 

  44. Ghoniem GM, Miller CJ. A systematic review and meta-analysis of Macroplastique for treating female stress urinary incontinence. Int Urogynecol J. 2013;24(1):27–36.

    Article  PubMed  Google Scholar 

  45. Kirchin V, Page T, Keegan PE, Atiemo K, Cody JD, McClinton S. Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev. 2012;(2):CD003881.

    Google Scholar 

  46. de Vries AM, van Breda HM, Fernandes JG, Venema PL, Heesakkers JP. Para-urethral injections with Urolastic® for treatment of female stress urinary incontinence: subjective improvement and safety. Urol Int. 2017;99(1):91–7.

    Article  PubMed  Google Scholar 

  47. Capobianco G, Azzena A, Saderi L, Dessole F, Dessole S, Sotgiu G. Urolastic®, a new bulking agent for treatment of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2018:29(9):1239–47.

    Article  PubMed  Google Scholar 

  48. Smith AR, Dmochowski R, Hilton P, et al. Committee 14: surgery for urinary incontinence in women. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 4th ed. Paris: Health Publication; 2009. p. 1191–272.

    Google Scholar 

  49. Jonsson Funk M, Siddiqui NY, Kawasaki A, Wu JM. Long-term outcomes after stress urinary incontinence surgery. Obstet Gynecol. 2012;120(1):83–90.

    Article  PubMed  Google Scholar 

  50. Fialkow M, Symons RG, Flum D. Reoperation for urinary incontinence. Am J Obstet Gynecol. 2008;199:546.e1–8.

    Article  Google Scholar 

  51. Zimmern PE, Gormley EA, Stoddard AM, et al. Management of recurrent stress urinary incontinence after burch and sling procedures. Neurourol Urodyn. 2016;35(3):344–8.

    Article  PubMed  Google Scholar 

  52. Eandi JA, Tanaka ST, Hellenthal NJ, et al. Self-reported urinary continence outcomes for repeat midurethral synthetic sling placement. Int Braz J Urol. 2008;34:336–44.

    Article  PubMed  Google Scholar 

  53. Pradhan A, Jain P, Latthe PM. Effectiveness of midurethral slings in recurrent stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2012;23(7):831–41.

    Article  PubMed  Google Scholar 

  54. Parden AM, Gleason JL, Jauk V, Garner R, Ballard A, Richter HE. Incontinence outcomes in women undergoing primary and repeat midurethral sling procedures. Obstet Gynecol. 2013;121(2 Pt 1):273–8.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Hashim H, Terry T. Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women. Ann R Coll Surg Engl. 2012;94(7):517–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Cerniauskiene A, Barisiene M, Jankevicius F, Januska G. Treatment of recurrent stress urinary incontinence in women: comparison of treatment results for different surgical techniques. Wideochir Inne Tech Maloinwazyjne. 2014;9(2):239–45.

    PubMed  PubMed Central  Google Scholar 

  57. Sivaslioglu AA, Unlubilgin E, Keskin HL, et al. The management of recurrent cases after the Burch colposuspension: 7 years experience. Arch Gynecol Obstet. 2011;283:787–90.

    Article  PubMed  Google Scholar 

  58. Gaddi A, Guaderrama N, Bassiouni N, Bebchuk J, Whitcomb EL. Repeat midurethral sling compared with urethral bulking for recurrent stress urinary incontinence. Obstet Gynecol. 2014;123(6):1207–12.

    Article  PubMed  Google Scholar 

  59. Aref-Adib M, Lamb BW, Lee HB, et al. Stem cell therapy for stress urinary incontinence: a systematic review in human subjects. Arch Gynecol Obstet. 2013;288(6):1213–21.

    Article  CAS  PubMed  Google Scholar 

  60. Biardeau X, Aharony S, AUS Consensus Group, Campeau L, Corcos J. Overview of the 2015 ICS consensus conference. Neurourol Urodyn. 2016;35(4):437–43.

    Article  CAS  PubMed  Google Scholar 

  61. Lucas MG, Bosch RJL, Burkhard FC, et al. European Association of Urology guidelines on assessment and nonsurgical management of urinary incontinence. Actas Urol Esp. 2013;37(4):199–213.

    Article  CAS  PubMed  Google Scholar 

  62. Fritel X, Fauconnier A, Bader G, et al. Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol. 2010;151(1):14–9.

    Article  PubMed  Google Scholar 

  63. Hermieu J-F, Conquy S, Leriche B, et al. Synthèse des recommand-tion pour le traitement de l’incontinence urinaire feminine non neurologique. Prog Urol. 2010;20:S94–9.

    Article  PubMed  Google Scholar 

  64. Chapple CR, Cruz F, Deffieux X, et al. Consensus Statement of the European Urology Association and the European Urogynaecological Association on the Use of Implanted Materials for Treating Pelvic Organ Prolapse and Stress Urinary Incontinence. Eur Urol. 2017;72(3):424–31.

    Google Scholar 

  65. Fusco F, Abdel-Fattah M, Chapple CR, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. 2017;72(4):567–91.

    Google Scholar 

  66. Nadeau G, Herschorn S. Management of recurrent stress incontinence following a sling. Curr Urol Rep. 2014;15(8):427.

    Google Scholar 

Download references

Conflict of Interest Disclosure

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Author information

Authors and Affiliations

  1. Department of Medical, Surgical and Experimental Sciences, University of Sassari, Gynecologic and Obstetric Clinic, Sassari, Italy

    Giampiero Capobianco, Pier Luigi Cherchi & Salvatore Dessole

Authors
  1. Giampiero Capobianco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pier Luigi Cherchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Salvatore Dessole
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giampiero Capobianco .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Zaragoza Facultad de Medicina, Zaragoza, Spain

    Faustino R. Pérez-López

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Capobianco, G., Cherchi, P.L., Dessole, S. (2019). Management of Female Stress Urinary Incontinence. In: Pérez-López, F. (eds) Postmenopausal Diseases and Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-13936-0_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-13936-0_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-13935-3

  • Online ISBN: 978-3-030-13936-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation