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Abstract
Stress urinary incontinence (SUI) is the most common type of incontinence in women. SUI is defined by the International Continence Society (ICS) as the complaint of involuntary leakage of urine on effort or exertion, or on sneezing or coughing. Stress incontinence is classified into two types: urethral hypermobility (type I) and intrinsic sphincter deficiency (ISD) (type II).
Diagnosis of stress urinary incontinence depends mainly on the full detailed history to determine the severity. Urodynamic tests may help in diagnosis and determine the type of stress incontinence
The mid-urethral sling remains the best studied, prospectively and retrospectively, incontinence therapy known. The midurethral TVT and TOT slings are effective treatments of female stress urinary incontinence, with high rates of short- and long-term efficacy, in addition to a low complication and side effect profile.
Overall, injection therapy for stress incontinence is easy to perform, minimally morbid, convenient for the patient, and remains very cost-effective, especially when performed in the outpatient office setting. Autologous Muscle-Derived Cells and Adipose derived Stem Cells. Pure injection therapy may be a promising treatment to restore urethral sphincter function.
The question arises, however: has colposuspension had its day with the introduction of TVT and other midurethral tapes?
The success of non-surgical treatment for urinary stress incontinence seems to lie in a multimodality treatment regimen, such as a combination of pelvic floor exercise with biofeedback or pharmacological therapy. Committed physicians or therapist are require to reinforce the success of conservative therapy for incontinence with patients understanding the rationale behind the therapy, its non-invasiveness and that they have a realistic approach to the improvement rates. Compliance is best if the patient understands these factors and positive reinforcement is usually constantly required.