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Standard Treatment Modality for Female Stress Incontinence

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Clinical Guidelines in Urological Management

Part of the book series: Recent Advances in Endourology ((ENDOUROLOGY,volume 4))

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Summary

The treatment modalities for female stress incontinence include physiotherapy, drug therapy, surgical treatment, and the use of absorbents, and devices. In general, physiotherapy is selected first for mild to moderate cases. The efficacy of drug therapy for stress incontinence has not been evaluated in a randomized, controlled trial, such that drug therapy is currently positioned as a supplemental treatment. Surgical treatment is used in moderate to severe cases. Surgical treatment can be classified into five categories: retropubic suspension, transvaginal suspension, sling operation, anterior repair, and periurethral injection of bulking agents. Meta-analytical results of a long-term study (4 years or more) showed that the rates of elimination of incontinence were 84% for retropubic suspension, 67% for transvaginal suspension, 83% for sling operation, and 61% for anterior repair. Retropubic suspension and sling operation were more effective than the other surgical techniques. Major complications in surgical treatment include urinary disturbance due to urethral obstruction and postoperative de novo urgency. Meta-analysis showed that the frequency of urinary retention was about 5% after transvaginal suspension and about 8% after sling operation. The frequency of postoperative de novo urgency after retropubic suspension and sling operation is a little more than that after transvaginal suspension. The use of absorbents and devices are reasonable treatments for female stress incontinence in the short term but are not ideal in the long term.

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Author information

Authors and Affiliations

  1. Department of Urology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Osamu Nishizawa

  2. Department of Urology, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8560, Japan

    Yoko Yoshikawa & Momokazu Gotoh

  3. Department of Obstetrics and Gynecology, Tokyo Metropolitan Police Hospital, 2-10-41 Fujimi, Chiyoda-ku, Tokyo, 102-8161, Japan

    Maki Nakata

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  1. Osamu Nishizawa
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  2. Yoko Yoshikawa
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  3. Momokazu Gotoh
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  4. Maki Nakata
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Editors and Affiliations

  1. Nagoya University Hospital, Japan

    Shinichi Ohshima M.D., Ph.D. (Vice-President, Professor and Chairman) (Vice-President, Professor and Chairman)

  2. Department of Urology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, 466-8550, Showa-ku, Nagoya, Japan

    Shinichi Ohshima M.D., Ph.D. (Vice-President, Professor and Chairman) (Vice-President, Professor and Chairman)

  3. Department of Urology, Nara Prefectural Medical University, 840 Shijo-cho, 634-0813, Kashihara, Nara, Japan

    Yoshihiko Hirao M.D. (Professor and Chairman) (Professor and Chairman)

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© 2003 The Japanese Society of Endourology and ESWL

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Nishizawa, O., Yoshikawa, Y., Gotoh, M., Nakata, M. (2003). Standard Treatment Modality for Female Stress Incontinence. In: Ohshima, S., Hirao, Y. (eds) Clinical Guidelines in Urological Management. Recent Advances in Endourology, vol 4. Springer, Tokyo. https://doi.org/10.1007/978-4-431-65944-0_10

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  • DOI: https://doi.org/10.1007/978-4-431-65944-0_10

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-65946-4

  • Online ISBN: 978-4-431-65944-0

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