Surgery for Urinary Incontinence in Women
Committee 14 Surgery for Urinary Incontinence in Women Chair A.R.B. SMITH (U.K) Members R. DMOCHOWSKI (USA), P. H ILTON (U.K), E. ROVNER (USA), C.G. NILSSON (Fin) Consultants F.M. REID (U.K), D. CHANG (USA) 1191 CONTENTS INTRODUCTION VI. COMPLICATIONS OF SURGERY FOR DETRUSOR OVERACTIVITY I. SURGERY FOR STRESS INCONTINENCE VII. NEUROMODULATION VIII. URETHRAL DIVERTICULUM II. CONFOUNDING VARIABLES IX. NON-OBSTETRIC URINARY III. STRESS INCONTINENCE WITH FISTULAE PROLAPSE X. OUTCOME MEASURES IV. COMPLICATIONS OF SURGERY FOR STRESS INCONTINENCE IX. ARTIFICIAL URINARY SPHINCTER IN WOMEN V. SURGERY FOR DETRUSOR OVERACTIVITY REFERENCES 1192 Surgery for Urinary Incontinence in Women A.R.B. SMITH R. DMOCHOWSKI, P. HILTON, E. ROVNER, C.G. NILSSON, F.M. REID, D. CHANG literature available at the time (Black & Downs, 1996, INTRODUCTION Downs & Black, 1996) [2,3]. In particular they highlighted the difficulties posed by case definition Surgeons have been criticised for the lack of rigour and the uniformity of surgical technique both between with which they have analysed their results. This and within surgical teams, the problem of variations chapter highlights the progress made, particularly in in outcome measures used, the handling of con- surgery for stress incontinence where more founding variables, the generalisability or external randomised controlled trials have been reported, and validity of the results, and the lack of statistical power illustrates areas where more studies are needed. The in most studies. Most systematic reviews published section on outcome measures illustrates that whilst since on the topic of surgery for incontinence in general the measurement of subjective and objective outcome or relating to individual surgical procedures have may clarify the value of an operation some standa- made similar comments regarding the quality of rdisation of outcome measures is required in order to available evidence.
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