Insertion of extraurethral (non-circumferential) retropubic adjustable compression devices for stress urinary incontinence in women
Summary
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on the insertion of extrauretheral (non-circumferential) retropubic adjustable compression devices for stress urinary incontinence in women.
Description
Stress urinary incontinence is the involuntary leakage of urine during exercise or certain movements such as coughing, sneezing and laughing. It is usually due to weak or damaged muscles in the pelvic floor or sphincter.
Conservative treatments include pelvic floor muscle training, electrical stimulation, and biofeedback. Surgery is usually used if conservative treatments fail. There are four main types of surgical intervention: colposuspension, insertion of a tension-free vaginal tape, traditional suburethral slings, and injectable agents.
This procedure involves inserting two small silicone balloons on either side of the urethra, using either local or regional anaesthesia. Specially designed instruments are used to introduce the balloons via a percutaneous perineal approach and radiological guidance is used to ensure correct positioning. Each balloon is then attached to a subcutaneous port sited in the major labia. These ports can be used to add or remove fluid to the balloon postoperatively, thereby achieving the best balance between controlled leakage and voiding.
OPCS code:
Details
Urogenital
British Association of Urological Surgeons
Royal College of Obstetricians and Gynaecologists
Contact details:
(for general enquiries or comments)
(for procedure specific enquiries or comments)
ip@nice.org.uk
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
