The Urologic clinics of North America
-
Urol. Clin. North Am. · Aug 2012
ReviewRobotic/Laparoscopic prolapse repair and the role of hysteropexy: a urology perspective.
Approximately 11% of women will undergo a surgical procedure for the treatment of pelvic organ prolapse (POP) or urinary incontinence by age 80 years. Abdominal sacrocolpopexy has been found in multiple studies to have high long-term success rates for repair of severe vault prolapse. ⋯ This article describes the techniques of laparoscopic sacrocolpopexy and robotic sacrocolpopexy. The role of hysteropexy for the treatment of POP is also discussed.
-
Urol. Clin. North Am. · Aug 2012
ReviewUrodynamics: role in incontinence and prolapse: a urology perspective.
Changes in pelvic floor as well as urethral anatomy and function occur with aging, which can result in prolapse and urinary incontinence. Aside from the socially debilitating impact incontinence has on patient's lives, it significantly affects the health care systems economically. Rates of incontinence and pelvic organ prolapse (POP) in women of this age demographic is estimated to be 30% to 94%, and 1 in 8 women may require surgical repair for POP or incontinence by their eighth decade, with a reoperation rate of 30%. This article reviews the role of UDS in the evaluation of urinary incontinence and POP.
-
Urol. Clin. North Am. · Aug 2012
ReviewMaking sense of urodynamic studies for women with urinary incontinence and pelvic organ prolapse: a urogynecology perspective.
The support for routine urodynamic testing in the management of women with urinary incontinence or pelvic organ prolapse is eroding. The reasons for this change largely reflect the growing evidence that urodynamic testing in this context renders little additional information over basic office assessment. The clinical features of urodynamic testing and its diagnostic and prognostic precision and accuracy are all problematic. As our understanding of female lower urinary tract dysfunction improves, the inadequacy of urodynamic testing to meaningfully improve patient and clinician decision making has become more apparent.