Surgery for Urinary Incontinence, Female Pelvic Surgery Video Atlas Series: Expert Consult: Online and Print

Surgery for Urinary Incontinence

Female Pelvic Surgery Video Atlas Series: Expert Consult: Online and Print

By Roger R. Dmochowski, MD, Professor, Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, Tennesse ; Mickey M. Karram, MD, Director of Urogynecology & Reconstructive Pelvic Surgery, Director and Founder of the Fellowship Training Program in Female Pelvic Medicine and Reconstructive Surgery, Professor, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio and W. Stuart. Reynolds, MD, MPH, W. Stuart Reynolds, MD, MPH Assistant Professor Department of Urologic Surgery Vanderbilt University Medical Center Nashville, Tennessee


1. Etiology and Epidemiology of Urinary Incontinence

2. Preoperative Evaluation of Patients with Urinary Incontinence and Selection of Appropriate Surgical Procedures for Stress Incontinence

2-1 Discussion of Normal Lower Urinary Tract Function

2-2 Live Patient Interview

2-3 Case Study of a Patient with Mixed Urinary Incontinence

2-4 Examination of a Patient with Significant Anterior Vaginal Wall Prolapse

2-5 Case Study of a Patient with Symptomatic Prolapse and Incontinence

2-6 Demonstration of "Eyeball" Filling Study in a Patient with Incontinence and Prolapse

2-7 Q-Tip Test in a Patient with Minimal Urethral Mobility

2-8 Overview of Specific Urodynamics Studies

3. Surgical Anatomy of the Anterior Vaginal Wall, Retropubic Space, and Inner Groin

3-1 Anatomy of the Anterior Vaginal Wall

3-2 Anatomy of the Lower Urinary Tract

3-3 Anatomy of Retropubic Space (Cadaveric Dissection)

3-4 Anatomy of Retropubic Space (Live Surgical Demonstration)

3-5 Anatomy Relevant to Retropubic Midurethral Slings

3-6 Anatomy Relevant to Transobturator Midurethral Slings

4. Retropubic Operations for Stress Urinary Incontinence

4-1 Modified Burch Colposuspension

4-2 Laparoscopic Paravaginal Repair

5. Biologic Bladder Neck Pubovaginal Slings

5-1 Rectus Fascia Pubovaginal Sling Procedure

5-2 Urethral Reconstruction with Martius Fat Pad Transposition and Cadaveric Fascia Lata Pubovaginal Sling

6. Retropubic Synthetic Midurethral Slings

6-1 Traditional Tension-Free Vaginal Tape Procedure

6-2 Tension-Free Vaginal Tape EXACT Procedure

6-3 SPARC Procedure

7. Transobturator Synthetic Midurethral Slings

7-1 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 Slings

8-1 TVT-Secur - Hammock Placement

8-2 TVT-Secur - "U" Placement

8-3 MiniArc Single-Incision Sling System

8-4 Solyx SIS System

8-5 AJUST Adjustable Single-Incision Sling

9. Surgical Management of Voiding Dysfunction and Retention Following Stress Incontinence Surgery

9-1 Loosening of Retropubic Synthetic Sling at 8 days Postoperatively

9-2 Excision of Suburethral Portion of Retropubic Synthetic Sling

9-3 Excision of Single Incision Synthetic Sling

9-4 Incision of Pubovaginal Sling

9-5 Retropubic Vesicourethrolysis

9-6 Vaginal Urethrolysis

10. Bulk Enhancing Agents for Stress Incontinence: Indications and Techniques

10-1 Cystoscopic Injection of Urethral Bulking Agent (Coaptite)

11. Sacral Neuromodulation

11-1 Percutaneous Nerve Evaluation

11-2 Stage I Implant

11-3 Stage II Implant

12. Botulinum Toxin Injection Therapy

12-1 Technique of Intravesical Injection of Botulinum Toxin

13. Bladder Augmentation

13-1 Technique for Bladder Augmentation (Example 1)

13-2 Technique for Bladder Augmentation (Example 2)

14. Managing Surgical Complications Related to Procedures for Incontinence

14-1 Recurrent Stress Incontinence After Two Previous Unsuccessful Synthetic Midurethral Sling Procedures

14-2 Bladder Perforation at the Time of Retropubic Synthetic Midurethral Sling Procedure

14-3 Excision of Subrutheral Portion of Synthetic Sling and Partial Cystectomy to Remove Eroded Sling with Stone Formation from Bladder

14-4 Excision of TVT-Secur Sling from Urethra with Urethral Reconstruction and Placement of Cadaveric Fascial Pubovaginal Sling

14-5 Complete Removal of Transobturator Tape (OB Tape) Secondary to Recurrent Granulation Tissue and Vaginal Bleeding

14-6 Recurrent Incontinence After Tension-Free Vaginal Tape Secondary to Complex Urethral Diverticulum

14-7 Excision of Eroded Tension-Free Vaginal Tape with Repair of Urethrovaginal Fistula and Placement of Cadaveric Fascia Pubovaginal Sling

14-8 Avoiding and Managing Bleeding During Placement of Retropubic Midurethral Sling

14-9 Avoiding And Managing Small Bowel Injury During Placement of Retropubic Midurethral Sling