Female Stress Urinary Incontinence Clinical Guidelines Panel Summary Report on Surgical Management of Female Stress Urinary Incontinence

Abstract

No AccessJournal of UrologyClinical Urology: Special Communication1 Sep 1997Female Stress Urinary Incontinence Clinical Guidelines Panel Summary Report on Surgical Management of Female Stress Urinary Incontinence Gary E. Leach, Roger R. Dmochowski, Rodney Appell, A. Jerry G. Blaivas, H. Roger Hadley, Karl M. Luber, Jacek L. Mostwin, Pat D. O'Donnell, and Claus G. Roehrborn Gary E. LeachGary E. Leach , Roger R. DmochowskiRoger R. Dmochowski , Rodney AppellRodney Appell , Jerry G. BlaivasJerry G. Blaivas , H. Roger HadleyH. Roger Hadley , Karl M. LuberKarl M. Luber , Jacek L. MostwinJacek L. Mostwin , Pat D. O'DonnellPat D. O'Donnell , and Claus G. RoehrbornClaus G. Roehrborn View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64346-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The American Urological Association convened the Female Stress Urinary Incontinence Clinical Guidelines Panel to analyze the literature regarding surgical procedures for treating stress urinary incontinence in the otherwise healthy female subject and to make practice recommendations based on the treatment outcomes data. Materials and Methods: The panel searched the MEDLINE data base for all articles through 1993 on surgical treatment of female stress urinary incontinence. Outcomes data were extracted from articles accepted after panel review. The data were then meta-analyzed to produce outcome estimates for alternative surgical procedures. Results: The data indicate that after 48 months retropubic suspensions and slings appear to be more efficacious than transvaginal suspensions, and also more efficacious than anterior repairs. The literature suggests higher complication rates when synthetic materials are used for slings. Conclusions: The panel found sufficient acceptable long-term outcomes data (longer than 48 months) to conclude that surgical treatment of female stress urinary incontinence is effective, offering a long-term cure in a significant percentage of women. The evidence supports surgery as initial therapy and as a secondary form of therapy after failure of other treatments for stress urinary incontinence. Retropubic suspensions and slings are the most efficacious procedures for long-term success (based on cure/dry rates). However, in the panel's opinion retropubic suspensions and sling procedures are associated with slightly higher complication rates, including longer convalescence and postoperative voiding dysfunction. References 1 : Female Stress Urinary Incontinence Clinical Guidelines Panel: Report on the Surgical Management of Female Stress Urinary Incontinence. Baltimore: American Urological Association, Inc.1997. Google Scholar 2 : The confidence profile method: a bayesian method for assessing health technologies.. Oper. Res.1989; 37: 210. Google Scholar 3 : A bayesian method for synthesizing evidence. The Confidence Profile Method.. Int. J. Technol. Assess. Health Care1990; 6: 31. Google Scholar 4 : FAST*PRO. Software for meta-analysis by the confidence profile method. San Diego: Academic Press, Harcourt Brace Jovanovich1992. Google Scholar 5 : The mortality risk associated with hysterectomy.. Amer. J. Obst. Gynec.1985; 152: 803. 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Volume 158Issue 3September 1997Page: 875-880 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.Metrics Author Information Gary E. Leach More articles by this author Roger R. Dmochowski More articles by this author Rodney Appell More articles by this author Jerry G. Blaivas More articles by this author H. Roger Hadley More articles by this author Karl M. Luber More articles by this author Jacek L. Mostwin More articles by this author Pat D. O'Donnell More articles by this author Claus G. Roehrborn More articles by this author Expand All Advertisement PDF downloadLoading ...