| December 2007 · Vol. 19, No. 12 UPDATE
HOW DEVELOPMENTS ARE CHANGING PATIENT CARE
URINARY INCONTINENCE
We now know more about incidence, the fascial sling versus Burch colposuspension, complication rates of mid-urethral slings, and Botox for detrusor overactivity
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Fast Track
At a BMI greater than 35, severe incontinence increased by a factor of 5
Overall success and “stress success” were slightly higher in women who underwent sling placement than in those treated by Burch
Data suggest that the transobturator mid-urethral sling reduces the risk of major bladder and urethral injury and vascular complications
The pooled odds ratio for complications from transobturator sling placement was 0.40, compared with the retropubic approach
Because of a higher-than-expected rate of urinary retention, enrollment was halted after 43 women received Botox injections
Even if Botox relieves symptoms, evidence suggests that its effect is time-limited, probably on the order of several months
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Anne
M.
Weber,
MD, MSDr. Weber is Program Officer in the Female Pelvic Floor Disorders Program, Contraception and Reproductive Health Branch, Center for Population Research, at the National Institute of Child Health and Human Development, National Institutes of Health, in Bethesda, Md.
The author reports no financial relationships relevant to this article.
The past year has seen the publication of much useful evidence regarding urinary incontinence, from both epidemiologic studies and clinical trials. Research into the pathophysiology of incontinence continues to move forward, slowly but surely, measured not in breakthroughs but in gradually increasing knowledge of how the urethra and bladder function in the continent person and how that function can break down, leading to incontinence and other urinary symptoms.
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