Skip to main content

Advertisement

SpringerLink
Log in

What is the best surgical intervention for stress urinary incontinence in the very young and very old? An International Consultation on Incontinence Research Society update

  • Clinical Opinion
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

An increasing number of continence procedures are being performed in women of all ages. An overview of the existing literature and consensus regarding surgery for stress urinary incontinence (SUI) in the young and the old was presented and discussed at the International Consultation on Incontinence Research Society Think Tank. This manuscript reflects the Think Tank's summary and opinion. Despite the increasing number of continence procedures, there are relatively few data to guide management in the very young and the very old. When considering continence surgery in the young, long-term efficacy and safety are paramount, and the future effects of pregnancy and childbirth need to be carefully considered. Conversely, in the elderly, minimally invasive procedures with low morbidity are important, especially in the frail elderly who may have significant co-morbidities. Further research including prospective randomised trials, cohort studies and national registries, should help guide our management in these two challenging groups of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

BMI:

Body Mass Index

BSUG:

British Society of Urogynaecology

ICI-RS:

International Consultation on Incontinence – Research Society (ICI-RS)

LUTD:

Lower Urinary Tract Dysfunction

OAB:

Overactive Bladder

PGI-I:

Patient Global Impression of Improvement

QoL:

Quality of Life

SIMT:

Single-Incision Mini-Tape

SMUT:

Standard Mid-Urethral Tape

SUI:

Stress Urinary Incontinence

TT:

Think Tank

TVT:

Tension free Vaginal Tape

TVTO:

Tension free Vaginal Tape Obturator

References

  1. Hannestad YS, Rortveit G, Sandvik H, Hunskar S (2000) A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT Study. J Clin Epidemiol 53:1150–1157

    Article  CAS  PubMed  Google Scholar 

  2. Abrams P, Cardozo L, Wein A (2010) The International Consultation on Incontinence, Research Society (ICI-RS). Neurourol Urodyn 29:596–597

    Article  PubMed  Google Scholar 

  3. Alcalay M, Monga A, Stanton SL (1995) Burch colposuspension: a 10-20 year follow up. Br J Obstet Gynaecol 102:740–745

    Article  CAS  PubMed  Google Scholar 

  4. Albo ME, Richter HE, Brubaker L et al (2007) Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 356:2143–2155

    Article  CAS  PubMed  Google Scholar 

  5. Nilsson CG, Palva K, Aarnio R, Morcos E, Falconer C (2013) Seventeen years’ follow up of the tension free vaginal tape procedure for female stress urinary incontinence. Int Urogynaecol J 24:1265–1269

    Article  CAS  Google Scholar 

  6. Pace G, Vicentini C (2008) Female sexual function evaluation of the tension-free vaginal tape (TVT) and transobturator suburethral tape (TOT) incontinence surgery: results of a prospective study. J Sex Med 5:387–393

    Article  PubMed  Google Scholar 

  7. Jones R, Abrams P, Hilton P, Ward K, Drake M (2010) Risk of tape-related complications after TVT is at least 4%. Neurourol Urodyn 29:40–41

    Article  PubMed  Google Scholar 

  8. Ghoniem G, Corcos J, Comiter C, Westney OL, Herschorn S (2010) Durability of urethral bulking agent injection for female stress urinary incontinence: 2 year multicentre results. J Urol 183:1444–1449

    Article  PubMed  Google Scholar 

  9. Ghoniem GM, Miller CJ (2013) A systematic review and meta-analysis of Macroplastique for treating female stress urinary incontinence. Int Urogynaecol J 24:27–36

    Article  Google Scholar 

  10. Toozs-Hobson P, Freeman R, Barber M et al (2012) An International Urogynecological Association(IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Int Urogynecol J 23:527–535

    Article  PubMed  Google Scholar 

  11. Casper FW, Linn JF, Black P (1999) Obsterical management following incontinence surgery. J Obstet Gynaecol Res 25:51–53

    Article  CAS  PubMed  Google Scholar 

  12. Tan HJ, Siu W, Faerber GJ, McGuire EJ, Latini JM (2010) Long term durability of pubovaginal fascial slings in women who then become pregnant and deliver. Int Urogynaecol J 21:631–635

    Article  Google Scholar 

  13. Vella M, Robinson D, Brown R, Cardozo L (2007) Pregnancy and delivery following tension free vaginal tape. Int Urogynaecol J Pelvic Floor Dysfunct 18:347–348

    Article  Google Scholar 

  14. Orimo H, Ito H, Suzuki T, Araki A, Hosoi T, Sawabe M (2006) Reviewing the definition of elderly. Geriatr Gerontol Int 6:149–158

    Article  Google Scholar 

  15. Lee J, Dwyer P (2010) Age related trends in female stress urinary incontinence surgery in Australia – Medicare data for 1994-2009. Aust N Z J Obstet Gynaecol 50:543–549

    Article  PubMed  Google Scholar 

  16. Richter H, Goode PS, Brubaker L et al (2008) Two year outcomes after surgery for stress urinary incontinence in older compared with younger women. Obstet Gynaecol 112:621–629

    Article  Google Scholar 

  17. Stav K, Dwyer P, Rosamilia A, Schierlitz L, Lim YN, Lee J (2010) Midurethral sling procedures for stress urinary incontinencein women over 80 years. Neurourol Urodyn 29:1262–1266

    Article  PubMed  Google Scholar 

  18. Groutz A, Cohen A, Gold R, Pauzner D, Lessing JB, Gordon D (2011) The safety and efficacy of the ‘inside out’ trans-obturator TVT in elderly versus younger stress incontinent women: a prospective study of 353 consecutive patients. Neurourol Urodyn 30:380–383

    Article  PubMed  Google Scholar 

  19. Jha S, Jones G, Radley S, Farkas A (2009) Factors influencing outcome following the tension free vaginal tape (TVT). Eur J Obstet Gynaecol Reprod Biol 144:85–87

    Article  Google Scholar 

  20. Rechberger T, Futyma K, Jankiewicz K, Adamiak A, Bogusiewicz M, Skorupski P (2010) Body mass index does not influence the outcome of anti- incontinence surgery among women whereas menopausal status and aging do: a randomised trial. Int Urogynaecol J 21:801–806

    Article  Google Scholar 

  21. Sung VW, Joo K, Marques F, Myers DL (2009) Patient reported outcomes after combined surgery for pelvic floor disorders in older compared to younger women. Am J Obstet Gyanecol 201(534):e1–e5

    Google Scholar 

  22. Trabuco EC, Klingele CJ, Weaver AL, McGree ME, Lightner DJ, Gebhart JB (2011) Preoperative and postoperative predictors of satisfaction after surgical treatment of stress urinary incontinence. Am J Obstet Gynaecol 204(444):e1–e6

    Google Scholar 

  23. Burton C, Toozs-Hobson P (2013) Personal communication. Unpublished

  24. Abdel- Fattah M, Ford JA, Lim CP, Madhuvrata P (2011) Single incision mini slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol 60:468–480

    Article  PubMed  Google Scholar 

  25. Mostafa A, Agur W, Abdel-All M et al (2012) A multicentre prospective randomised study of single-incision mini-sling (Ajust®) versus tension-free vaginal tape-obturator (TVT-O™) in the management of female stress urinary incontinence: pain profile and short-term outcomes. Eur J Obstet Gynecol Reprod Biol 165:115–121

    Article  PubMed  Google Scholar 

Download references

Financial disclaimers/conflict of interest

D Robinson - Consultant: Allergan, Astellas, Ferring, Pfizer; Speaker honorarium: Allergan, Astellas, Ferring, Pfizer; Trial participation: Allergan, Astellas, Pfizer

D Castro-Diaz - Consultant: Allergan, AMS, Astellas; Speaker honorarium: Allergan, AMS, Astellas, Medtronic; Trial participation: Allergan, Astellas

I Giarenis - Speaker honorarium: Astellas, Travel expenses: Astellas, Ethicon, Pfizer

P Toozs-Hobson – Consultant: Allergan, Astellas; Speaker honorarium: Allergan, Astellas

R Anding - Speaker honorarium: Allergan, Pfizer; Trial participation: Allergan, Astellas

C Burton – Speaker honorarium: Astellas, Pfizer

L Cardozo - Consultant: Allergan, AMS, Astellas; Speaker honorarium: Astellas, Allergan; Trial participation: Pfizer

Author information

Authors and Affiliations

  1. Department of Urogynaecology, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK

    Dudley Robinson, Ilias Giarenis & Linda Cardozo

  2. Department of Urology, Hospital Universitario de Canarias Universidad de La Laguna, Canary Islands, Spain

    David Castro-Diaz

  3. Department of Urogynaecology, Birmingham Women’s Hospital, Birmingham, UK

    Philip Toozs-Hobson

  4. Department of Neurourology, Rheinische Friedrich-Wilhelms-Universitaet Bonn, Bonn, Germany

    Ralf Anding

  5. Department of Obstetrics and Gynaecology, Queen Alexandra Hospital, Portsmouth, UK

    Claire Burton

Authors
  1. Dudley Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Castro-Diaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ilias Giarenis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Philip Toozs-Hobson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ralf Anding
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Claire Burton
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Linda Cardozo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dudley Robinson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robinson, D., Castro-Diaz, D., Giarenis, I. et al. What is the best surgical intervention for stress urinary incontinence in the very young and very old? An International Consultation on Incontinence Research Society update. Int Urogynecol J 26, 1599–1604 (2015). https://doi.org/10.1007/s00192-015-2783-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-015-2783-9

Keywords

Search

Navigation