Female Urology (eBook)

Preface 7
Contents 8
Contributors 11
I EVALUATION 23
Anatomy of Pelvic Support 24
CONTENTS 24
INTRODUCTION 24
BONY PELVIS 24
MUSCULATURE AND FASCIAE OF THE PELVIS 26
PELVIC CIRCULATION 28
FEMALE PELVIC VISCERA Lower Urinary Tract 31
Genital Structures 33
PERINEUM 35
CONCLUSION 38
REFERENCES 38
Neurophysiological Control of Bladder Function 40
CONTENTS 40
INTRODUCTION 40
HIGHER LEVEL CENTRAL NERVOUS SYSTEM CONTROL OF MICTURITION AND STORAGE 47
CONCLUSION 51
REFERENCES 51
Office Evaluation of Urinary Incontinence 55
CONTENTS 55
INTRODUCTION 55
HISTORY 55
FLUID INTAKE/VOIDING DIARY 56
PHYSICAL EXAMINATION 56
LABORATORY TESTS 57
MULTICHANNEL URODYNAMICS 57
REFERENCES 59
Urodynamic Evaluation of Female Stress Urinary Incontinence 60
CONTENTS 60
INTRODUCTION 60
LEAK-POINT PRESSURES 60
URETHRAL PRESSURE PROFILOMETRY 64
URETHRAL RETRORESISTANCE PRESSURE 67
ROLE OF URODYNAMIC TESTING IN THE ASSESSMENT OF FEMALE SUI 67
REFERENCES 68
Urodynamic Assessment of Overactive Bladder 69
CONTENTS 69
INTRODUCTION 69
WHO REQUIRES URODYNAMICS? 70
KEY COMPONENTS IN URODYNAMIC TESTING OF OVERACTIVE BLADDER 71
FINDINGS IN NONNEUROGENIC OVERACTIVE BLADDER 72
FINDINGS IN NEUROGENIC OAB 75
CONCLUSION 76
REFERENCES 78
II TREATMENT 79
Conservative Therapy for Incontinence 80
CONTENTS 80
INTRODUCTION 80
LIFESTYLE CHANGES/BEHAVIOR MODIFICATION 80
TOILETING PROGRAMS 84
PELVIC FLOOR MUSCLE REHABILITATION OR TRAINING 86
CONCLUSION 92
REFERENCES 92
APPENDIX 94
II PART A: STRESS URINARY INCONTINENCE 97
Pharmacological Therapy for Stress Urinary Incontinence 98
CONTENTS 98
ANATOMIC AND FUNCTIONAL INFLUENCES ON CONTINENCE 99
HORMONE REPLACEMENT THERAPY 101
IMIPRAMINE 103
ADRENERGIC AGONISTS 104
ADRENOCEPTOR 105
AGONISTS AND ANTAGONISTS 105
SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS 105
CONCLUSION 108
REFERENCES 108
Urethral Injectables for Stress Urinary Incontinence 111
CONTENTS 111
HISTORICAL PERSPECTIVE 111
PATIENT SELECTION 112
SURGICAL TECHNIQUE 114
RESULTS 116
COMPLICATIONS 117
OTHER FDA-APPROVED INJECTABLE AGENTS Carbon- Coated Beads ( Durasphere) 118
CONCLUSION 121
ACKNOWLEDGMENT 121
REFERENCES 121
Midurethral Slings 124
CONTENTS 124
INTRODUCTION 124
HISTORY AND BACKGROUND 124
PATIENT SELECTION 127
ANESTHETIC REQUIREMENTS 128
TECHNIQUES 128
MATERIALS 130
OUTCOMES 131
COMPLICATIONS 134
SUMMARY 139
REFERENCES 139
Bladder Neck Slings for Stress Urinary Incontinence 144
CONTENTS 144
INTRODUCTION 144
HISTORY 144
PATIENT SELECTION 145
SURGICAL TECHNIQUE AND VARIATIONS 146
MATERIAL, EQUIPMENT, AND TECHNICAL VARIATIONS Sling Material Selection 151
REFERENCES 166
Complications of Sling Surgery 172
CONTENTS 172
INTRODUCTION 172
INTRAOPERATIVE COMPLICATIONS Bleeding/ Hematoma Formation 173
POSTOPERATIVE COMPLICATIONS Postoperative Voiding Dysfunction 175
CONCLUSION 182
REFERENCES 183
II PART B: OVERACTIVE BLADDER 187
Pharmacological Therapy for Overactive Bladder 188
CONTENTS 188
INTRODUCTION 188
UROSELECTIVITY 189
SPECIFIC AGENTS Relatively Pure Antimuscarinic Agents 190
CONCLUSION 206
REFERENCES 206
Intravesical Treatments for Overactive Bladder 211
CONTENTS 211
ANATOMY AND FUNCTION OF THE UROEPITHELIUM 212
EFFERENT INNERVATION OF THE URINARY BLADDER 212
INTRAVESICAL OXYBUTYNIN 212
AFFERENT INNERVATION OF THE URINARY BLADDER: 213
VANILLOID PHARMACOLOGY 213
CLINICAL RESULTS OF INTRAVESICAL CAPSAICIN Hypersensitivity Disorders 216
CLINICAL RESULTS OF INTRAVESICAL RESINIFERATOXIN Interstitial Cystitis 218
TECHNIQUE OF INTRAVESICAL CAPSAICIN AND RESINIFERATOXIN ADMINISTRATION 219
CONCLUSION 219
REFERENCES 220
Urological Applications of Botulinum Toxin 223
CONTENTS 223
INTRODUCTION 223
APPLICATIONS IN UROLOGY 224
INJECTION TECHNIQUES 227
ADVERSE EVENTS AND CONTRAINDICATIONS 228
CONCLUSION 229
REFERENCES 229
Nonsacral Neuromodulation 231
CONTENTS 231
INTRODUCTION 231
TIBIAL NERVE STIMULATION 231
ANOGENITAL ELECTRICAL STIMULATION 233
PUDENDAL NERVE STIMULATION 234
CONCLUSION 244
REFERENCES 244
Sacral Neuromodulation for the Treatment of Overactive Bladder 246
CONTENTS 246
INTRODUCTION 246
CASE 1 247
CASE 2 247
HISTORY 248
MECHANISM OF ACTION 248
INDICATIONS 249
TEST PROCEDURE 249
IMPLANTABLE PULSE GENERATOR IMPLANTATION PROCEDURE 252
RESULTS 252
COMPLICATIONS 255
CASE STUDIES 256
DISCUSSION 256
REFERENCES 257
Augmentation Cystoplasty 259
CONTENTS 259
INTRODUCTION 259
INDICATIONS AND CONTRAINDICATIONS 259
ALTERNATIVES TO AUGMENTATION 260
SURGICAL TECHNIQUE OF BLADDER AUGMENTATION 260
RESULTS AND COMPLICATIONS 264
CONCLUSION 266
REFERENCES 266
Mixed Incontinence 268
CONTENTS 268
INTRODUCTION 268
DEFINITIONS AND APPROACH 268
EXPECTATIONS FOR RESULTS 269
CONCLUSION: WHAT WE DO 270
REFERENCES 271
II PART C: PROLAPSE 272
Evaluation and Management of Anterior Vaginal Wall Prolapse 273
CONTENTS 273
INTRODUCTION 273
EVALUATION History 274
SURGICAL TECHNIQUES 275
OUTCOMES Anterior Colporrhaphy 281
COMPLICATIONS 283
REFERENCES 284
Treatment of Vaginal Wall Prolapse 286
CONTENTS 286
INTRODUCTION 286
ANATOMY 287
SYMPTOMS 288
DIAGNOSIS History 288
INDICATIONS FOR SURGERY 291
SURGICAL REPAIR OF RECTOCELE 292
CONCLUSION 299
REFERENCES 299
Diagnosis and Management of Apical Prolapse 302
CONTENTS 302
INTRODUCTION 302
PREOPERATIVE EVALUATION 302
MANAGEMENT OF APICAL PROLAPSE Observation 304
CONCLUSION 310
REFERENCES 310
Evaluation and Management of Vesicovaginal Fistulas 313
CONTENTS 313
INTRODUCTION 313
ETIOLOGY 314
PREVENTION 314
DIAGNOSIS 314
CONSERVATIVE MANAGEMENT 315
OPERATIVE MANAGEMENT 316
COMPLEX FISTULAS 323
TISSUE INTERPOSITION 323
INTRAOPERATIVE COMPLICATIONS 327
POSTOPERATIVE MANAGEMENT (TRANSVAGINAL REPAIR) 328
OUTCOMES 328
POSTOPERATIVE COMPLICATIONS 329
CONCLUSION 329
REFERENCES 329
Female Urethral Diverticula 331
CONTENTS 331
INTRODUCTION 331
ETIOLOGY 331
CLASSIFICATION 332
INCIDENCE 333
PRESENTATION AND EVALUATION 333
TREATMENT 336
PATHOLOGY 338
CONCLUSION 339
CASE 1 339
CASE 2 339
CASE 3 341
REFERENCES 343
III CASE STUDIES 345
Recurrent Stress Urinary Incontinence 346
COMMENTARY BY JERRY BLAIVAS, 346
SOURCES 347
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 347
Recurrent Urinary Tract Infections and Pelvic Organ Prolapse 348
COMMENTARY BY JENNIFER TAKACS, AND PHILIPPE ZIMMERN, 348
REFERENCES 351
EDITORÌS COMMENTS BY SANDIP P. VASAVADA, 352
Mixed Incontinence 353
COMMENTARY BY WACHIRA KOCHAKARN, 353
REFERENCES 355
COMMENTARY BY GARY E. LEACH, 355
Summary 356
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 356
Urinary Tract Infections and Pelvic Pain 358
COMMENTARY BY SUZETTE E. SUTHERLAND, Step 1: Physical Exam and Labs 358
REFERENCES 360
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 360
COMMENTARY BY E. JAMES WRIGHT, 361
Multiple Sclerosis and Voiding Dysfunction 361
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 363
De novo Overactive Bladder Symptoms After a Sling 365
COMMENTARY BY VICTOR W. NITTI, 365
REFERENCES 367
COMMENTARY BY CARL G. KLUTKE, AND TRAVIS L. BULLOCK, 367
REFERENCES 369
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 370
Recurrent Pelvic Organ Prolapse 371
COMMENTARY BY CHRISTOPHER C. ROTH, AND J. CHRISTIAN WINTERS, 371
REFERENCES 373
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 373
Recalcitrant Urinary Frequency and Urgency 374
COMMENTARY BY MICHAEL CHANCELLOR, 374
COMMENTARY BY GAMAL M. GHONIEM, 375
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 376
Difficulty Voiding and Overactive Bladder Symptoms 377
COMMENTARY BY MICHAEL J. KENNELLY, 377
REFERENCE 379
COMMENTARY BY DEBORAH LIGHTNER, 380
REFERENCES 381
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 382
Post-Hysterectomy Incontinence 383
COMMENTARY BY COURTENAY K. MOORE, 383
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 384
Severe Incontinence After Multiple Prior Procedures 385
COMMENTARY BY ROGER DMOCHOWSKI, 385
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 387
Urinary Frequency and Pelvic Pain 389
COMMENTARY BY E. ANN GORMLEY, 389
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 391
EDITOR’S NOTE 391
COMMENTARY BY JEFFREY P. WEISS, 391
REFERENCES 392
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 393
Pelvic Organ Prolapse 394
COMMENTARY BY SHLOMO RAZ, AND MATTHEW P. RUTMAN, 394
COMMENTARY BY KATHLEEN C. KOBASHI, History 396
REFERENCES 399
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 399
COMMENTARY BY RAYMOND RACKLEY, 401
Recurrent Pelvic Organ Prolapse After Colpocleisis 401
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 402
Stress Incontinence and Straining to Void 403
COMMENTARY BY STEVEN SIEGEL, 403
REFERENCES 405
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 405
Male With Post-Prostatectomy Incontinence 406
COMMENTARY BY CRAIG V. COMITER, 406
COMMENTARY BY FRED E. GOVIER, 408
REFERENCES 410
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 410
Mixed Incontinence in an Elderly Woman 411
COMMENTARY BY TOMAS L. GRIEBLING, 411
REFERENCES 414
EDITOR’S COMMENTS BY HOWARD B. GOLDMAN, 414
Male With Post-Prostatectomy Incontinence 415
COMMENTARY BY AJAY SINGLA, 415
REFERENCE 416
EDITOR’S COMMENTS BY SANDIP P. VASAVADA, 416
Index 417