Surgery for Urinary Incontinence

Roger R. Dmochowski is Professor of Urology and Surgery in the Department of Urology at Vanderbilt University Medical Center, Nashville, Tennessee, USA.

"Urologic and gynecologic surgeons who treat patients with urinary incontinence should look to this up-to-date surgical atlas for helpful videos and concise descriptions of surgical techniques. It provides a practical guide for both novice and experienced female pelvic reconstructive surgeons and the videos add an invaluable teaching tool. Overall, it would be a helpful addition to the collection of any urologic or gynecologic training program or the bookshelf of pelvic reconstructive surgeons."- Alana Murphy, MD (Thomas Jefferson University) Doody Review Services

• 1. Etiology and Epidemiology of Urinary Incontinence2. Preoperative Evaluation of Patients with Urinary Incontinence and Selection of Appropriate Surgical Procedures for Stress Incontinence2-1 Discussion of Normal Lower Urinary Tract Function2-2 Live Patient Interview2-3 Case Study of a Patient with Mixed Urinary Incontinence 2-4 Examination of a Patient with Significant Anterior Vaginal Wall Prolapse2-5 Case Study of a Patient with Symptomatic Prolapse and Incontinence2-6 Demonstration of "Eyeball" Filling Study in a Patient with Incontinence and Prolapse2-7 Q-Tip Test in a Patient with Minimal Urethral Mobility2-8 Overview of Specific Urodynamics Studies3. Surgical Anatomy of the Anterior Vaginal Wall, Retropubic Space, and Inner Groin3-1 Anatomy of the Anterior Vaginal Wall3-2 Anatomy of the Lower Urinary Tract3-3 Anatomy of Retropubic Space (Cadaveric Dissection) 3-4 Anatomy of Retropubic Space (Live Surgical Demonstration)3-5 Anatomy Relevant to Retropubic Midurethral Slings3-6 Anatomy Relevant to Transobturator Midurethral Slings4. Retropubic Operations for Stress Urinary Incontinence4-1 Modified Burch Colposuspension4-2 Laparoscopic Paravaginal Repair5. Biologic Bladder Neck Pubovaginal Slings5-1 Rectus Fascia Pubovaginal Sling Procedure5-2 Urethral Reconstruction with Martius Fat Pad Transposition and Cadaveric Fascia Lata Pubovaginal Sling6. Retropubic Synthetic Midurethral Slings6-1 Traditional Tension-Free Vaginal Tape Procedure6-2 Tension-Free Vaginal Tape EXACT Procedure6-3 SPARC Procedure7. Transobturator Synthetic Midurethral Slings7-1 Transobturator Sling: Inside-Out Technique (Example 1)7-2 Transobturator Sling: Inside-Out Technique (Example 2)7-3 Transobturator Sling: Outside-In Technique (MONARC) 8. Single Incision Synthetic Midurethral Slings8-1 TVT-Secur - Hammock Placement8-2 TVT-Secur - "U" Placement8-3 MiniArc Single-Incision Sling System8-4 Solyx SIS System8-5 AJUST Adjustable Single-Incision Sling9. Surgical Management of Voiding Dysfunction and Retention Following Stress Incontinence Surgery9-1 Loosening of Retropubic Synthetic Sling at 8 days Postoperatively9-2 Excision of Suburethral Portion of Retropubic Synthetic Sling9-3 Excision of Single Incision Synthetic Sling9-4 Incision of Pubovaginal Sling 9-5 Retropubic Vesicourethrolysis 9-6 Vaginal Urethrolysis 10. Bulk Enhancing Agents for Stress Incontinence: Indications and Techniques10-1 Cystoscopic Injection of Urethral Bulking Agent (Coaptite)11. Sacral Neuromodulation11-1 Percutaneous Nerve Evaluation 11-2 Stage I Implant11-3 Stage II Implant12. Botulinum Toxin Injection Therapy12-1 Technique of Intravesical Injection of Botulinum Toxin13. Bladder Augmentation13-1 Technique for Bladder Augmentation (Example 1)13-2 Technique for Bladder Augmentation (Example 2)14. Managing Surgical Complications Related to Procedures for Incontinence14-1 Recurrent Stress Incontinence After Two Previous Unsuccessful Synthetic Midurethral Sling Procedures14-2 Bladder Perforation at the Time of Retropubic Synthetic Midurethral Sling Procedure14-3 Excision of Subrutheral Portion of Synthetic Sling and Partial Cystectomy to Remove Eroded Sling with Stone Formation from Bladder14-4 Excision of TVT-Secur Sling from Urethra with Urethral Reconstruction and Placement of Cadaveric Fascial Pubovaginal Sling14-5 Complete Removal of Transobturator Tape (OB Tape) Secondary to Recurrent Granulation Tissue and Vaginal Bleeding14-6 Recurrent Incontinence After Tension-Free Vaginal Tape Secondary to Complex Urethral Diverticulum14-7 Excision of Eroded Tension-Free Vaginal Tape with Repair of Urethrovaginal Fistula and Placement of Cadaveric Fascia Pubovaginal Sling14-8 Avoiding and Managing Bleeding During Placement of Retropubic Midurethral Sling14-9 Avoiding And Managing Small Bowel Injury During Placement of Retropubic Midurethral Sling