Ebook Bonney’s gynaecological surgery (12/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Bonney’s gynaecological surgery (12/E): Part 2
Ebook Bonney’s gynaecological surgery (12/E): Part 2
CHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2nd the survey method used result in a wide range of prevalence estimates. Some women may not see their urinary incontinence as a major problem; for others, who do perceive a problem for which they would like help, there are often barriers to presentation. Where the most Inclusive definitions have be Ebook Bonney’s gynaecological surgery (12/E): Part 2en used, prevalence estimates In the general population range from 5% to 69% in women 15 years and older, with most studies in the range 25-45%.'The pEbook Bonney’s gynaecological surgery (12/E): Part 2
revalence of any urinary incontinence tends to increase up to middle age, then plateaus or falls between so and 70 years, with a steady increase with CHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2ten?Stress urinary incontinenceEbook Bonney’s gynaecological surgery (12/E): Part 2
ith an Increase in urgency and mixed urinary Incontinence In women aged 60 years and above?*There are relatively few epidemiological data on the prevaCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2nce of the same order, at around 10% overall in women, rising from around 5% in those aged less than 45 years to 20% In those over 65 yeare.4-6It must be recognized that most urinary Incontinence can be treated without surgery, by lifestyle adaptations, behavioural modification, pelvic floor muscle Ebook Bonney’s gynaecological surgery (12/E): Part 2exercises or drug treatments. Where these methods arc not effective or are not acceptable to patients, surgery should be considered.Classification ofEbook Bonney’s gynaecological surgery (12/E): Part 2
proceduresThere are said to have been over 200 operations, modifications and devices used In the treatment of SUI over the past century and a half, maCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2 published in 2005 (Table 17.1)? This chapter reviews those procedures (highlighted in bold text in the table) that are currently in use and of proven value.Alternative classifications include more complicated forms of urethral disruption Including post-surgical trauma, sling erosion, other trauma, Ebook Bonney’s gynaecological surgery (12/E): Part 2drainpipe' urethra, radiotherapy damage and congenital abnormality, such as female epispadias? Many (but not all) of these pathologies can be managedEbook Bonney’s gynaecological surgery (12/E): Part 2
by the procedures categorized in the table, so are not described separately here.Bonney'i Gynaecological Surgery, Twelfth Edition. Alberto (Tito) de BCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 217Table 17.1 classification of stress urinary Incontinence procedures.ProcedureApproachExamplesUrethral/bladder neck supporting: Vaginal wall suspensionVaginalAnterior colporrhaphy with Kelly, Kennedy and Green modificationsNeedle suspensionStamey. Peyrera. Raz. GittesSuprapubKBurch colposuspension. Ebook Bonney’s gynaecological surgery (12/E): Part 2 Marshall-Marchetti- Krantz. vagmo-obturator shelfSuburethral retropubic space slingsSynthetic tapes Biological autologous, allograft. xenograft - 'trEbook Bonney’s gynaecological surgery (12/E): Part 2
aditional' sfcngsTension-free vaginal tape - TVT™Suburethral trans-obturatorSynthetic tapesMonarc*. Obtryx*foramenBiological tapesBioarc*. Pelvilace*UCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2retropubic adjustable compression devicesProACT™ balloonFixed-reststance perineal devices (in men) Circumferential variable resistance devices, l.e artificial urinary sphincterAMS 800™The role of urodynamic assessment before surgery for stress urinary incontinenceUrodynamic assessment has been a rou Ebook Bonney’s gynaecological surgery (12/E): Part 2tine Investigation In patients with urinary incontinence over the past 40 years, the aim being to demonstrate urine leakage objectively and to differeEbook Bonney’s gynaecological surgery (12/E): Part 2
ntiate between types of incontinence so that the most effective method of treatment for the individual patient can be determined. However, there has bCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2ssessment might change clinical decision making but no evidence that this resulted In Improvements In continence rates after treatment.* Despite two major trials on the subject, a 2015 feasibility study concluded that there was still a place for a further definitive trial on the role of urodynamic a Ebook Bonney’s gynaecological surgery (12/E): Part 2ssessment prior to surgery in women with stress or stress-predominant mixed urinary incontinence10 and that such further researchwould have added healEbook Bonney’s gynaecological surgery (12/E): Part 2
th economic value." Paraphrasing only slightly the current recommendations from the National Institute for Health and Care Excellence (NICE) In the UKCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence an Ebook Bonney’s gynaecological surgery (12/E): Part 2 to justify treatment, and•where conservative management (by pelvic floor muscle exercises) has been ineffective, and•where she wishes to consider surgery, and•where, in addition to the above, one or more of the following situations pertain:o In addition to SU1:■there are symptoms of frequency, urge Ebook Bonney’s gynaecological surgery (12/E): Part 2ncy or urgency urinary Incontinence (raising the possibility of detrusor overactlvlty)■there are symptoms of poor or Intermittent urinary stream or aEbook Bonney’s gynaecological surgery (12/E): Part 2
feeling of incomplete bladder emptying (which may indicate voiding dysfunction)CHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence anCHAPTER 17Operations for urinary incontinencePaul HiltonDifferences in study populations, the definition and quantification of urinary incontinence anGọi ngay
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