Retropubične i opturatorne sling korekcije kod stresne urinarne inkontinencije
Abstract
Stress urinary incontinence (SUI) is defined as involuntary loss of urine caused by conditions that elevate the abdominal pressure. Urinary incontinence is not just medical, but also significant social and hygiene issue. Pelvic floor muscles may lose strength because of tissue injury during childbirth, low estrogen levels during menopause and other factors that may worsen stress incontinence including obesity, previous pelvic surgery, chronic cough and heavy lifting at work. Stress incontinence is easily diagnosed just by anamnesis. Patients experience urinary leakage while coughing, sneezing, etc. It is also important to perform physical exam and urodynamic testing to evaluate how the bladder stores and releases urine. Stress incontinence is not a life-threatening disease, but nevertheless has a huge impact on patients quality of life. Surgical correction is first choice treatment for SUI. The goal of every procedure is to restore anatomical position and provide adequate support of vesicourethral segment. Among many options, sling methods such as TVT, using retropubic approach, and TOA, using transobturator approach, represent minimally invasive and highly effective solution. Indications for sling method are hipermobility and/or intrinsic sphincter deficiency. Minimally invasive procedure is suitable for patients with SUI, previous pelvic surgery and patients with mixed urinary incontinence.
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