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Urinary incontinence and female urology 

Urinary incontinence and female urology
Chapter:
Urinary incontinence and female urology
Author(s):

John Reynard

, Simon F Brewster

, Suzanne Biers

, and Naomi Laura Neal

DOI:
10.1093/med/9780198783480.003.0005
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date: 07 June 2020

All aspects of female and male urinary incontinence assessment, investigation, and management are outlined. Definitions of incontinence are provided, with a review of the epidemiology, risk factors, and management of stress urinary incontinence (SUI), post-prostatectomy (male) incontinence, overactive bladder syndrome (OAB), mixed urinary incontinence, and incontinence in older populations. Conservative, drug, and surgical therapies are explored, including bulking agents, synthetic mid-urethral tapes, colposuspension, autologous fascial slings, and artificial urinary sphincters (AUS) for female SUI, and urethral slings and AUS for male incontinence, and botulinum toxin, ileocystoplasty, and sacral nerve stimulation for OAB. Clear management pathways are included which are supported by the International Continence Society, with guideline recommendations from the National Institute for Health and Care Excellence and European Association of Urology. Vesicovaginal fistula, urethral diverticulum, and pelvic organ prolapse (POP), are illustrated, and controversies including the use of mesh in POP and incontinence surgery, and anticholinergic drug burden in OAB are discussed.

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