Current treatments for female primary stress urinary incontinence

Abstract

Stress urinary incontinence (SUI) affects millions of women worldwide. Pelvic floor muscle training is the first-line treatment for SUI, and if this fails, midurethral sling surgery has become the gold-standard treatment. More recently, complications from midurethral mesh slings, particularly chronic pain and dyspareunia, have become a major concern. Although traditional SUI treatments, such as colposuspension and fascia slings, are used, the future of SUI treatment likely will rely on less invasive alternatives. Modern bulking agents could have the potential to become a first-line treatment for SUI, but further long-term studies are needed. Patients should be involved in decision-making prior to any surgery to ensure that they are aware of the risks and also any reasonable treatment alternatives. Furthermore, the effectiveness of a procedure should be balanced with its invasiveness and possible risks to provide women individually with the best possible treatment option.

摘要

张力性尿失禁影响了世界上成千上万女性的生活。盆底肌肉训练是张力性尿失禁的一线治疗方法, 如果保守治疗失败, 尿道中段悬吊术是治疗的金标准术式。近来, 尿道中段悬吊术网片的并发症逐渐突显出来, 主要是慢性疼痛和性交痛已经成为目前主要关注的内容。尽管传统的张力性尿失禁的治疗方法, 如阴道悬吊术和网片的应用, 将来张力性尿失禁的治疗需要依赖于更无创的治疗方式。新的膨胀支架有可能成为将来张力性尿失禁的一线治疗方式, 但是仍需要长期的随访研究来证实其有效性。患者应在手术前参与决策, 以确保他们了解风险和其他可以替代的治疗方案。此外, 还应平衡每种治疗方式的创伤性及可能存在的风险, 根据患者个体化的情况选择针对于个人的最佳治疗方式。

Keywords:

• Female stress urinary incontinence
• pelvic floor muscle training
• midurethral mesh sling
• Burch urethropexy
• colposuspension
• bulking agents
• laser treatment
• stem cell treatment

Conflict of interest

Tomi S. Mikkola received personal lecture fees from Astellas and Mylan, and an unrestricted research-grant from Contura. Päivi Rahkola-Soisalo received funding for congress trips from Astellas and Olympus.

Additional information

Funding

Nil.