Stress urinary incontinence

This 48 years lady, presented to us with involuntary leak during coughing,rising from sitting to standing position from last 2 1/2 months...

No other comorbidity.
Cystoscopy done...shows urine leaked with cough at 200ml ns
Vaginal examination...no prolapse..
How to investigate this case further...?
Surgical options...TOT vs TVT vs PVS?

Stress urinary incontinenceStress urinary incontinence

Comments(7)

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    23 Mar 2020 09:37:51 AM

    All lab investigation normal.

  • Rahul Kapoor
    Rahul Kapoor
    24 Mar 2020 08:05:02 AM

    I feel nothing else needed. 

    She has severe SUI. 
    Urine RM and USG with PVR is needed. 

  • Utsav Shah
    Utsav Shah
    24 Mar 2020 05:48:59 PM

    The procedure will depend on your training. We at our institute, and I believe Urologists at most Centers are trained to do Transobturator Taping. 

    So yes, TOT should be the procedure of choice. 

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    27 Mar 2020 09:59:11 PM

    Rahul sir these cases don’t need urodynamic study


  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    27 Mar 2020 10:01:34 PM

    Dear Utsav  our surgical procedure of choice also TOT.but..

    why not TVT or PVS

  • Rahul Kapoor
    Rahul Kapoor
    28 Mar 2020 07:11:30 PM

    Hi Tikenjit

    The role of UDS is not in clear cut SUI cases as you presented. 
    But one must consider same, 
    1. History of any neurological event
    2. High PVR
    3. Redo Surgery for SUI

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    28 Mar 2020 07:29:23 PM

    Thank u sir...

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