Surgery for Urinary Incontinence

Roger R. Dmochowski is Professor of Urology and Surgery in the Department of Urology at Vanderbilt University Medical Center, Nashville, Tennessee, USA.

• 1. Etiology and Epidemiology of Urinary Incontinence2. Preoperative Evaluation of Patients with Urinary Incontinence and Selection of Appropriate Surgical Procedures for Stress Incontinence2-1 Discussion of Normal Lower Urinary Tract Function2-2 Live Patient Interview2-3 Case Study of a Patient with Mixed Urinary Incontinence 2-4 Examination of a Patient with Significant Anterior Vaginal Wall Prolapse2-5 Case Study of a Patient with Symptomatic Prolapse and Incontinence2-6 Demonstration of "Eyeball" Filling Study in a Patient with Incontinence and Prolapse2-7 Q-Tip Test in a Patient with Minimal Urethral Mobility2-8 Overview of Specific Urodynamics Studies3. Surgical Anatomy of the Anterior Vaginal Wall, Retropubic Space, and Inner Groin3-1 Anatomy of the Anterior Vaginal Wall3-2 Anatomy of the Lower Urinary Tract3-3 Anatomy of Retropubic Space (Cadaveric Dissection) 3-4 Anatomy of Retropubic Space (Live Surgical Demonstration)3-5 Anatomy Relevant to Retropubic Midurethral Slings3-6 Anatomy Relevant to Transobturator Midurethral Slings4. Retropubic Operations for Stress Urinary Incontinence4-1 Modified Burch Colposuspension4-2 Laparoscopic Paravaginal Repair5. Biologic Bladder Neck Pubovaginal Slings5-1 Rectus Fascia Pubovaginal Sling Procedure5-2 Urethral Reconstruction with Martius Fat Pad Transposition and Cadaveric Fascia Lata Pubovaginal Sling6. Retropubic Synthetic Midurethral Slings6-1 Traditional Tension-Free Vaginal Tape Procedure6-2 Tension-Free Vaginal Tape EXACT Procedure6-3 SPARC Procedure7. Transobturator Synthetic Midurethral Slings7-1 Transobturator Sling: Inside-Out Technique (Example 1)7-2 Transobturator Sling: Inside-Out Technique (Example 2)7-3 Transobturator Sling: Outside-In Technique (MONARC) 8. Single Incision Synthetic Midurethral Slings8-1 TVT-Secur - Hammock Placement8-2 TVT-Secur - "U" Placement8-3 MiniArc Single-Incision Sling System8-4 Solyx SIS System8-5 AJUST Adjustable Single-Incision Sling9. Surgical Management of Voiding Dysfunction and Retention Following Stress Incontinence Surgery9-1 Loosening of Retropubic Synthetic Sling at 8 days Postoperatively9-2 Excision of Suburethral Portion of Retropubic Synthetic Sling9-3 Excision of Single Incision Synthetic Sling9-4 Incision of Pubovaginal Sling 9-5 Retropubic Vesicourethrolysis 9-6 Vaginal Urethrolysis 10. Bulk Enhancing Agents for Stress Incontinence: Indications and Techniques10-1 Cystoscopic Injection of Urethral Bulking Agent (Coaptite)11. Sacral Neuromodulation11-1 Percutaneous Nerve Evaluation 11-2 Stage I Implant11-3 Stage II Implant12. Botulinum Toxin Injection Therapy12-1 Technique of Intravesical Injection of Botulinum Toxin13. Bladder Augmentation13-1 Technique for Bladder Augmentation (Example 1)13-2 Technique for Bladder Augmentation (Example 2)14. Managing Surgical Complications Related to Procedures for Incontinence14-1 Recurrent Stress Incontinence After Two Previous Unsuccessful Synthetic Midurethral Sling Procedures14-2 Bladder Perforation at the Time of Retropubic Synthetic Midurethral Sling Procedure14-3 Excision of Subrutheral Portion of Synthetic Sling and Partial Cystectomy to Remove Eroded Sling with Stone Formation from Bladder14-4 Excision of TVT-Secur Sling from Urethra with Urethral Reconstruction and Placement of Cadaveric Fascial Pubovaginal Sling14-5 Complete Removal of Transobturator Tape (OB Tape) Secondary to Recurrent Granulation Tissue and Vaginal Bleeding14-6 Recurrent Incontinence After Tension-Free Vaginal Tape Secondary to Complex Urethral Diverticulum14-7 Excision of Eroded Tension-Free Vaginal Tape with Repair of Urethrovaginal Fistula and Placement of Cadaveric Fascia Pubovaginal Sling14-8 Avoiding and Managing Bleeding During Placement of Retropubic Midurethral Sling14-9 Avoiding And Managing Small Bowel Injury During Placement of Retropubic Midurethral Sling

"Urologic and gynecologic surgeons who treat patients with urinary incontinence should look to this up-to-date surgical atlas for helpful videos and concise descriptions of surgical techniques. It provides a practical guide for both novice and experienced female pelvic reconstructive surgeons and the videos add an invaluable teaching tool. Overall, it would be a helpful addition to the collection of any urologic or gynecologic training program or the bookshelf of pelvic reconstructive surgeons."- Alana Murphy, MD (Thomas Jefferson University) Doody Review Services