Insertion of biological slings for stress urinary incontinence

 
Guidance issued
 
IPG Number: IPG154

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 insertion of biological slings for stress urinary incontinence.

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, biofeedback, and mechanical devices (urethral plugs and inserts). 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.

Sling procedures are performed partly through the vagina and partly through a small abdominal incision, usually under general anaesthesia. The sling may be made of a strip of tissue from the patient's own abdominal fascia, from human donor tissue or from animal tissue. A tunnel is created under the mid or proximal urethra, extending upwards through the endopelvic fascia on both sides towards the back of the rectus sheath. The sling of allograft or xenograft material is suspended from the rectus sheath or anterior abdominal wall by loose sutures, creating a supporting 'hammock' for the urethra. Bone screws may sometimes be used to hold the sutures in place and anchor the sling to the pubis.

OPCS4.6 Code(s):

Depending on the exact procedure performed one of the following OPCS-4 codes is selected:

M51.1             Abdominoperineal suspension of urethra

            Includes: Abdominovaginal suspension of urethra

M52.1 Suprapubic sling operation

M52.2 Retropubic suspension of neck of bladder 

M52.3 Colposuspension of neck of bladder

Note: OPCS-4 code Y27.1 Autograft to organ NOC, Y27.2 Allograft to organ NOC or Y27.3 Xenograft to organ NOC is assigned in addition to one of the above codes if the information is available.

The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

Details

Arrangement:
Normal
Topic area:
Surgical procedures
Urogenital
Specialty:
Genito-urinary medicine
Urological surgery
Urology
Specialist advice sought from:

British Association of Urological Surgeons

Royal College of Obstetricians and Gynaecologists

Date notified to NICE:
15 November 2003
Provisional consultation date:
August 2005
Guidance issue date:
25 January 2006

Contact details:

Contact NICE about this project
Technical lead
(for procedure specific enquiries or comments)
Helen Gallo
ip@nice.org.uk
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA

Links:

This page was last updated: 04 April 2011

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright @ 2012 National Institute for Health and Clinical Excellence. All rights reserved.