UPDATE ON URINARY INCONTINENCE

Level 1 evidence from the past year on the prophylactic placement of a midurethral sling in vaginal prolapse repair, value of urodynamic testing, and best sling insertion approach for intrinsic sphincter deficiency

Dr. Noblett is Professor and Director, Female Pelvic Medicine and Reconstructive Surgery, in the Division of Urogynecology, Department of Obstetrics and Gynecology, University of California, Irvine.

Dr. Jacobs is a Clinical Instructor and Third-Year Fellow, Female Pelvic Medicine and Reconstructive Surgery, in the Division of Urogynecology, Department of Obstetrics and Gynecology, University of California, Irvine.

Dr. Noblett reports that she receives grant or research support from, and is a consultant to, Boston Scientific. Dr. Jacobs reports no financial relationships relevant to this article.

Urinary incontinence affects up to one-half of adult women,¹ with 16% of those women having bothersome symptoms.² The prevalence of urinary incontinence increases with age, and with our aging population (expected to more than double by 2050³), an increased number of women will be presenting for evaluation and treatment.

In 2010, there were approximately 260,000 surgeries performed for stress urinary incontinence (SUI).⁴ In addition, women have up to a 20% lifetime risk of needing surgery to correct pelvic organ prolapse. Surgery to repair prolapse may increase incontinence rates by unmasking urinary leakage in approximately 25% of women.⁵ Clearly, improving the foundation of clinical knowledge surrounding preoperative, operative, and prophylactic management of incontinence is of great value to our patients.

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