Review article

Contemporary Approach to Diagnosis and Treatment of Women with Urinary Incontinence and Pelvic Defects

Slavko Orešković

Abstract

Gynecologic urology deals with pelvic organ
prolapse and urinary incontinence. Pelvic organ prolapse
occurs in nearly every second woman older than 50 years of
age. Urinary incontinence signifi cantly reduces quality of life,
and it is an important public health problem with great impact
on physical and mental health. It is known that nearly 25-30%
of older women develop stress urinary incontinence. Stress urinary
incontinence results from inborn or acquired pelvic organ
support impairment, with loss of anatomic support to vesicourethral
segment. The diagnosis of pelvic organ prolapse and
urinary incontinence is based on anamnesis, gynecologic examination,
clinical testing, cystometry, cystoscopy and urodynamic
testing. The treatment of pelvic organ prolapse is surgical,
while urinary incontinence can be treated with both surgical
and conservative therapies. Currently, there are more than one
hundred surgical methods to treat stress urinary incontinence.
A current trend in surgical therapy for stress urinary incontinence
is the application of simple, effective and safe laparoscopic
surgery and sling methods (TVT, SPARC), as well as the use of
APOGEE and PERIGEE methods in pelvic organ prolapse therapy.
These methods signifi cantly reduce hospitalization and therapy
expenses, with earlier restoration of working ability. Local
tissue impairment and intervention is minimal which decreases
postoperative complications and provides for restoration of the
normal function. Treatment success depends on a diagnostic
procedure and a properly chosen therapy method (operative or
conservative). The use of contemporary diagnostic and therapy
procedures yields optimal therapeutic effects and helps maintain
a patient’s quality of life.

Keywords

pelvic organ prolapse; urinary incontinence; “hammock” hypothesis; surgical therapy; SLING methods; conservative therapy

Hrčak ID:

18155

URI

https://hrcak.srce.hr/18155

Publication date:

29.12.2006.

Article data in other languages: croatian

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