Evaluation and surgery for stress urinary incontinence: A FIGO working group report

Medina, Carlos A.; Costantini, Elisabetta; Petri, E.; Mourad, Sherif; Singla, Anand; Rodríguez-Colorado, S; Ortiz, Oscar Contreras; Doumouchtsis, Stergios K.

doi:10.1002/nau.22960

Cited by 42 publications

(45 citation statements)

References 118 publications

(371 reference statements)

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“…According to the recent International Federation of Gynecology and Obstetrics (FIGO) Working Group guidelines, the only useful application of ultrasound examination in the evaluation of patients with urinary incontinence is measurement of the post-void residual volume (PVR) [8]. This is in concert with recommendations provided by the 5 th International Consultation on Incontinence [9], which conclude that:…”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

“…Studies showed that in the general population 15% of women have post-void residual volume (PVR) greater than 50 ml, 5% greater than 100 ml, 6% greater than 149 ml and 4% greater than 200 ml [21, 22]. The recent FIGO Group guidelines, in concert with other recommendations, advise that volumes greater than 150 ml should be regarded as abnormal [8]. Higher incidence of elevated PVR is observed among patients with stress urinary incontinence, previous incontinence surgery, overactive bladder, multiple sclerosis and pelvic organ prolapse stage 2 or greater [23].…”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

“…Nowadays, ultrasound is the preferred method for PVR assessment in clinical practice, mainly due to its noninvasiveness [8, 9]. Ultrasound estimations may be performed using either three diameters (length, height, width) or the surface area in the transverse image and the length obtained in the longitudinal image.…”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

“…Measurements are taken at rest and on maximal straining. The angle ≥ 30° defines urethral hypermobility [8]. …”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

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Ultrasound imaging in urogynecology – state of the art 2016

Bogusiewicz

2016

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The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue. However, in many instances, including planning and audit of surgical procedures, management of recurrences or complications, ultrasound may be proposed as the initial examination of choice. Ultrasound may be used for assessment of bladder neck mobility before anti-incontinence procedures. On rare occasions it is helpful in recognition of pathologies mimicking vaginal prolapse such as vaginal cyst, urethral diverticula or rectal intussusception. In patients subjected to suburethral slings, causes of surgery failure or postsurgical voiding dysfunctions can be revealed by imaging. Many reports link the location of a tape close to the bladder neck to unfavorable outcomes of sling surgery. Some postoperative complications, such as urinary retention, mesh malposition, hematoma, or urinary tract injury, can be diagnosed by ultrasound. On the other hand, the clinical value of some applications of ultrasound in urogynecology, for example measurement of the bladder wall thickness as a marker of detrusor overactivity, has not been proved.

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Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

“…Measurements are taken at rest and on maximal straining. The angle ≥ 30° defines urethral hypermobility [8]. …”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

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Ultrasound imaging in urogynecology – state of the art 2016

Bogusiewicz

2016

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“…Transobturator tape (TOT) procedure has been developed as a second-generation midurethral sling operation. A mesh tape is inserted under the urethra through 3 small incisions in this minimally invasive procedure that is performed to treat stress urinary incontinence by avoiding retropubic damage and providing urethral support [4-6]. …”

Section: Introductionmentioning

confidence: 99%

Two-Year Follow-Up Results of Transobturator Tape Procedure with and without Concomitant Vaginal Surgery

et al. 2018

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Objective: This study aims to evaluate the subjective and objective outcomes of the transobturator tape (TOT) procedure performed to treat stress urinary incontinence and to determine the efficacy and safety of the TOT procedure when used along with vaginal surgery. Methods: This is a prospective review of 24 women who had the TOT procedure done only due to stress incontinence; 22 women who underwent concomitant TOT and pelvic floor repair; and 20 women who received concurrent TOT, transvaginal hysterectomy, and sacrospinous ligament fixation. Results: When compared to the patients who had TOT with pelvic floor repair, the patients who underwent TOT with hysterectomy declared to have more dyspareunia (p = 0.008) and they were found to have significantly higher post-void residual volume (p = 0.014). When compared to the patients who had only TOT, the patients who underwent TOT with hysterectomy claimed to have more pelvic pain (p = 0.012) and significantly higher post-void residual volume (p = 0.020). Conclusion: The TOT procedure results in moderately high objective cure rates, and concurrent application of pelvic floor repair or transvaginal hysterectomy does not affect these rates. The relatively higher incidences for voiding problems and pelvic pain in women who underwent TOT, hysterectomy, and sacropinous fixation simultaneously suggest that the extent of surgery directly correlates with the severity of postoperative complications.

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An update of a former FIGO Working Group Report on Management of Posterior Compartment Prolapse

Doumouchtsis

Raheem

Haddad

et al. 2019

Intl J Gynecology & Obste

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BackgroundThe FIGO Working Group (FWG) in Pelvic Floor Medicine and Reconstructive Surgery (2012–2015) established a consensus among international opinion leaders in evaluating current evidence and providing practice recommendations.ObjectivesTo provide an update of the previous clinical opinion report on conservative and surgical treatment of posterior compartment prolapse.Search strategySearch of evidence was performed using Pubmed, Embase, and Cochrane Library databases up to August 2018.Selection criteriaControlled trials on posterior colporrhaphy, site‐specific defect, transanal, abdominal, laparoscopic, and mesh repair.Data collection and analysisCollective consensus on surgical outcomes was based on a decision‐making process during meetings and multiple group consultations.Main resultsBasic evaluation and conservative treatment precede surgical management. Surgical techniques are performed by vaginal, transperineal, transanal, abdominal, or laparoscopic approach. The transvaginal surgical route without mesh appears superior to the transanal route. No conclusions can be drawn based on clinical studies or randomized controlled trials of posterior colporrhaphy and laparoscopic rectopexy.ConclusionsManagement of rectocele should include patients’ history, quality of life questionnaires, and, in case of complex anorectal symptoms, imaging and functional studies. Evidence on the best type of posterior vaginal wall repair is still scarce. Randomized controlled trials are needed to determine the best approach to achieve safe, effective, and long‐term anatomical and functional outcomes.

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Evaluation and surgery for stress urinary incontinence: A FIGO working group report

Abstract: MUS, PVS, and Burch colposuspension are effective treatments for SUI. Evidence for recommendations to treat patients in underserved low resource areas is lacking. Neurourol. Urodynam. 36:518-528, 2017. © 2016 Wiley Periodicals, Inc.

Cited by 42 publications

References 118 publications

Ultrasound imaging in urogynecology – state of the art 2016

Ultrasound imaging in urogynecology – state of the art 2016

Two-Year Follow-Up Results of Transobturator Tape Procedure with and without Concomitant Vaginal Surgery

An update of a former FIGO Working Group Report on Management of Posterior Compartment Prolapse

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