Surgery for Urinary Incontinence

1. Etiology and Epidemiology of Urinary Incontinence

2. Preoperative Evaluation of Patients with Urinary Incontinence and Selection of Appropriate Surgical Procedures for Stress Incontinence

2-1 Discussion of Normal Lower Urinary Tract Function

2-2 Live Patient Interview

2-3 Case Study of a Patient with Mixed Urinary Incontinence

2-4 Examination of a Patient with Significant Anterior Vaginal Wall Prolapse

2-5 Case Study of a Patient with Symptomatic Prolapse and Incontinence

2-6 Demonstration of Eyeball Filling Study in a Patient with Incontinence and Prolapse

2-7 Q-Tip Test in a Patient with Minimal Urethral Mobility

2-8 Overview of Specific Urodynamics Studies

3. Surgical Anatomy of the Anterior Vaginal Wall, Retropubic Space, and Inner Groin

3-1 Anatomy of the Anterior Vaginal Wall

3-2 Anatomy of the Lower Urinary Tract

3-3 Anatomy of Retropubic Space (Cadaveric Dissection)

3-4 Anatomy of Retropubic Space (Live Surgical Demonstration)

3-5 Anatomy Relevant to Retropubic Midurethral Slings

3-6 Anatomy Relevant to Transobturator Midurethral Slings

4. Retropubic Operations for Stress Urinary Incontinence

4-1 Modified Burch Colposuspension

4-2 Laparoscopic Paravaginal Repair

5. Biologic Bladder Neck Pubovaginal Slings

5-1 Rectus Fascia Pubovaginal Sling Procedure

5-2 Urethral Reconstruction with Martius Fat Pad Transposition and Cadaveric Fascia Lata Pubovaginal Sling

6. Retropubic Synthetic Midurethral Slings

6-1 Traditional Tension-Free Vaginal Tape Procedure

6-2 Tension-Free Vaginal Tape EXACT Procedure

6-3 SPARC Procedure

7. Transobturator Synthetic Midurethral Slings

7-1 Transobturator Sling: Inside-Out Technique (Example 1)

7-2 Transobturator Sling: Inside-Out Technique (Example 2)

7-3 Transobturator Sling: Outside-In Technique (MONARC)

8. Single Incision Synthetic Midurethral Slings

8-1 TVT-Secur - Hammock Placement

8-2 TVT-Secur - U Placement

8-3 MiniArc Single-Incision Sling System

8-4 Solyx SIS System

8-5 AJUST Adjustable Single-Incision Sling

9. Surgical Management of Voiding Dysfunction and Retention Following Stress Incontinence Surgery

9-1 Loosening of Retropubic Synthetic Sling at 8 days Postoperatively

9-2 Excision of Suburethral Portion of Retropubic Synthetic Sling

9-3 Excision of Single Incision Synthetic Sling

9-4 Incision of Pubovaginal Sling

9-5 Retropubic Vesicourethrolysis

9-6 Vaginal Urethrolysis

10. Bulk Enhancing Agents for Stress Incontinence: Indications and Techniques

10-1 Cystoscopic Injection of Urethral Bulking Agent (Coaptite)

11. Sacral Neuromodulation

11-1 Percutaneous Nerve Evaluation

11-2 Stage I Implant

11-3 Stage II Implant

12. Botulinum Toxin Injection Therapy

12-1 Technique of Intravesical Injection of Botulinum Toxin

13. Bladder Augmentation

13-1 Technique for Bladder Augmentation (Example 1)

13-2 Technique for Bladder Augmentation (Example 2)

14. Managing Surgical Complications Related to Procedures for Incontinence

14-1 Recurrent Stress Incontinence After Two Previous Unsuccessful Synthetic Midurethral Sling Procedures

14-2 Bladder Perforation at the Time of Retropubic Synthetic Midurethral Sling Procedure

14-3 Excision of Subrutheral Portion of Synthetic Sling and Partial Cystectomy to Remove Eroded Sling with Stone Formation from Bladder

14-4 Excision of TVT-Secur Sling from Urethra with Urethral Reconstruction and Placement of Cadaveric Fascial Pubovaginal Sling

14-5 Complete Removal of Transobturator Tape (OB Tape) Secondary to Recurrent Granulation Tissue and Vaginal Bleeding

14-6 Recurrent Incontinence After Tension-Free Vaginal Tape Secondary to Complex Urethral Diverticulum

14-7 Excision of Eroded Tension-Free Vaginal Tape with Repair of Urethrovaginal Fistula and Placement of Cadaveric Fascia Pubovaginal Sling

14-8 Avoiding and Managing Bleeding During Placement of Retropubic Midurethral Sling

14-9 Avoiding And Managing Small Bowel Injury During Placement of Retropubic Midurethral Sling