tailieunhanh - Ebook Bonney’s gynaecological surgery (12/E): Part 2

(BQ) Part 2 book “Bonney’s gynaecological surgery” has contents: Cervical cancer, uterine cancer, ovarian cancer, exenterative surgery, vaginal cancer surgery, reconstructive procedures, operations for urogenital fistulae, operations for urinary incontinence, and other contents. | C H APT ER 1 7 Operations for urinary incontinence Paul Hilton Differences in study populations, the definition and quantification of urinary incontinence and the sur­ vey method used result in a wide range of preva­ lence estimates. Some women may not see their urinary incontinence as a major problem; for oth­ ers, who do perceive a problem for which they would like help, there are often barriers to presen­ tation. Where the most inclusive definitions have been used, prevalence estimates in the general pop­ ulation range from 5% to 69% in women 15 years and older, with most studies in the range 25–45%.1 The prevalence of any urinary incontinence tends to increase up to middle age, then plateaus or falls between 50 and 70 years, with a steady increase with more advanced age. Slight to moder­ ate incontinence is more common in younger women, while moderate and severe incontinence affects the elderly more Stress urinary incontinence (SUI) or exertional incontinence is the most common type in sympto­ matic terms and, overall, 50% of women in one large epidemiological survey reported this as their only symptom; 11% described only urgency uri­ nary incontinence and 36% reported mixed incon­ tinence symptoms. The trends in the prevalence of urinary incontinence at different ages reflect a reduction in complaints of SUI in those aged 50 years and over, with an increase in urgency and mixed urinary incontinence in women aged 60 years and There are relatively few epidemiological data on the prevalence of overactive bladder syndrome, although surveys from the United States, Europe and the UK all report the prevalence of urgency urinary incontinence of the same order, at around 10% overall in women, rising from around 5% in those aged less than 45 years to 20% in those over 65 –6 It must be recognized that most urinary ­incontinence can be treated without surgery, by lifestyle adaptations, behavioural modification, pelvic floor muscle exercises or