sodium-ethylxanthate and Urinary-Incontinence--Stress

The purpose of this article is to evaluate the recent evidence base for the choice between transobturator and retropubic approaches to midurethral slings used to treat stress urinary incontinence. While the retropubic and transobturator approaches to midurethral sling surgery for stress urinary incontinence demonstrate equivalent efficacy across a number of randomized controlled trials, they do not appear to be equivalent when particular patient populations are considered separately. The retropubic approach appears to be a better option in patients with intrinsic sphincter deficiency and limited urethral mobility.

Topics: Age Factors; Body Mass Index; Female; Humans; Postmenopause; Reoperation; Risk Factors; Sex; Suburethral Slings; Treatment Outcome; Urethra; Urinary Incontinence, Stress; Urologic Surgical Procedures

Urinary incontinence can have a profound negative impact on female sexuality. Not only feelings of shame and loss of libido are important; complaints of urine loss during sexual activity can also exist. The prevalence of this phenomenon was examined in a study of 245 patients complaining of urinary incontinence. We also analysed the evoking moments and the impact of the complaint on the sexual relation. 20% of the patients had no partner. 66 (34%) of the remaining women reported losing urine during sexual activity. It was often experienced during pressure on the abdomen and deep vaginal penetration. Non-mechanical factors played an important part as well. Neither the history nor the urodynamic diagnosis had a clear relationship with evoking moments during intercourse. Incontinence was frequently (also) experienced during orgasm and sexual excitement. We found a strong negative effect of this complaint on the sexual lives of many women and their partners. Adequate relief of stress incontinence by colpo-suspension will also stop urine loss during intercourse.

Topics: Adult; Aged; Coitus; Female; Humans; Libido; Male; Middle Aged; Sex; Sexual Behavior; Urinary Incontinence; Urinary Incontinence, Stress

A variety of operations for stress incontinence or genital descensus are performed in gynecological department. The purpose of this study was to find out whether these operations influenced the patients' sexual life. In a prospective study of 55 women, all sexually active prior to the operation, various characteristics were evaluated by interview and gynaecological examination, immediately before and 6 months after the operation. We had adviced early resumption of sexual intercourse. Postoperatively, 13 of 55 (24%) patients experienced improvement in their sexual life, 37 of 55 (67%) no change, and 5 of 55 (9%) experienced a deterioration. Improvement often resulted from cessation of urinary incontinence. Deterioration was in all 5 cases due to dyspareunia and all 5 patients underwent a posterior colporrhaphy as part of the operation. We conclude that provided the patients are well-informed the prognosis for sexual life after these operations is good. However, colpoperineoplasty in combination with anterior colporrhaphy might cause dyspareunia in some patients.

Topics: Adult; Aged; Evaluation Studies as Topic; Female; Genital Diseases, Female; Humans; Middle Aged; Prospective Studies; Sex; Urinary Incontinence, Stress

Elderly women can develop any of the gynecologic disorders that occur prior to the menopause. They also experience some genital problems that are, for the most part, peculiar to their age. They should, therefore, receive periodic examinations, including tests for cancer, just as they did when they were younger. Many of their distressing symptoms, particularly those caused by hypoestrogenism, minor vulvar diseases, the vulvar dystrophies, stress incontinence, and relaxations of the pelvic musculofascial tissues, can be either alleviated or cured by appropriate treatment. Some of those who are still sexually active or who would like to be will be helped by counseling. With good care, given by one who appreciates their special need for understanding, gentleness, and patience, most of the genital disorders that affect elderly women can be diagnosed and treated in such a fashion that these patients, if not otherwise disabled, can lead relatively active lives.

Topics: Aged; Diagnosis, Differential; Estrogens; Female; Genital Diseases, Female; Genital Neoplasms, Female; Humans; Menopause; Middle Aged; Physical Exertion; Sex; Urinary Incontinence, Stress; Vulvar Diseases; Vulvar Neoplasms