Surgery for genuine stress urinary incontinence is?
Correct Answer: Retropubic urethropexy
Description: Ans-BRetropubic urethropexyStress Urinary Incontinenceo Involuntary escape of urine when intraabdominal pressure is increased as in sneezing, coughing or laughing.o It is the most common type of urinary incontinence in women accounting for 50 - 70% of the cases.Managemento 1st line management is pelvic floor exercises i. e. Kegel exerciseso Definitive management is the surgical management. Retropubic urethropexy and sling operations are currently employed first line operations for stress incontinence.Retropubic urethropexy fcolposuspension):o Involves attaching the fascia around the urethra and bladder neck to a supporting structure in the anterior pelvis. The main problem is postoperative voiding dysfunction, detrusor overactivity, and enterocele formation.o Two types of surgeries are done:The Burch colposuspension:Fascia at the level of the bladder neck is attached to the iliopectineal ligament or the Cooper's ligament. The Marshall:Marchetti - Krantz or MMK: involves attachment of the periurethral fascia to the hack of the pubic symphysis.Complication specific to this procedure is osteitis pubis.Sling operationo The sling is passed around the bladder neck and urethra and attached above to the anterior rectus fascia so that a supporting hammock is created for the urethra.o The two procedures :Tension-Free Vaginal Tape andTrans-Obturator Tape is currently used as the primary operations for stress urinary incontinence.
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