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Yang X, Wang X, Gao Z, Li L, Lin H, Wang H, Zhou H, Tian D, Zhang Q, Shen J. The Anatomical Pathogenesis of Stress Urinary Incontinence in Women. Medicina (B Aires) 2022; 59:medicina59010005. [PMID: 36676629 PMCID: PMC9865065 DOI: 10.3390/medicina59010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Stress urinary incontinence is a common disease in middle-aged and elderly women, which seriously affects the physical and mental health of the patients. For this reason, researchers have carried out a large number of studies on stress urinary incontinence. At present, it is believed that the pathogenesis of the disease is mainly due to changes related to age, childbirth, obesity, constipation and other risk factors that induce changes in the urinary control anatomy, including the anatomical factors of the urethra itself, the anatomical factors around the urethra and the anatomical factors of the pelvic nerve. The combined actions of a variety of factors lead to the occurrence of stress urinary incontinence. This review aims to summarize the anatomical pathogenesis of stress urinary incontinence from the above three perspectives.
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Affiliation(s)
- Xunguo Yang
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Xingqi Wang
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Zhenhua Gao
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Ling Li
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Han Lin
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Haifeng Wang
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Hang Zhou
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Daoming Tian
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Quan Zhang
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
| | - Jihong Shen
- The First Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming 650032, China
- Correspondence: ; Tel.: +86-135-7700-9705
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Nomura Y, Okada Y, Hiramatsu A, Matsubara E, Kato K, Yoshimura Y. A new method of adjusting mesh tension using cystoscopy during laparoscopic sacrocolpopexy. Int Urogynecol J 2021; 32:3089-3093. [PMID: 33871668 PMCID: PMC8536586 DOI: 10.1007/s00192-021-04791-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/01/2021] [Indexed: 10/25/2022]
Abstract
We aimed to examine the usefulness of cystoscopic findings to guide mesh tension adjustment during laparoscopic sacrocolpopexy (LSC) to promote better repair of pelvic organ prolapse (POP) and prevent de novo stress urinary incontinence (SUI). In this technique, the bladder wall was observed using a cystoscope when various traction pressures were applied by pulling the mesh arm with forceps before fixation to the promontory during LSC. Adjustment was performed on 20 patients, and postoperative outcomes of POP repair and development of de novo SUI were evaluated. When excessive traction was applied on the mesh arm, a bladder neck opening and a cord-like elevation in the center of the trigone and posterior wall were observed in all cases. The tension was gradually loosened, and precisely when the above-mentioned cystoscopic finding ("Central Road") disappeared, an anatomically appropriate elevation of the vaginal apex was achieved; the mesh arm was fixed to the promontory. At 6 months after LSC, anterior wall recurrences were diagnosed in four patients (beyond the hymen in one) with few symptoms, while no occurrence of de novo SUI. Cystoscopic findings during mesh tension adjustment in LSC could be useful in achieving improved POP repair.
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Affiliation(s)
- Yukiko Nomura
- Department of Female Pelvic Health Center, Showa University Northern Yokohama Hospital, 35-1, Chigasakichuo, Tsuzuki Ward, Yokohama City, Kanagawa Prefecture, 224-8503, Japan. .,Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
| | - Yoshiyuki Okada
- Department of Female Pelvic Health Center, Showa University Northern Yokohama Hospital, 35-1, Chigasakichuo, Tsuzuki Ward, Yokohama City, Kanagawa Prefecture, 224-8503, Japan.,Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Aya Hiramatsu
- Department of Female Pelvic Health Center, Showa University Northern Yokohama Hospital, 35-1, Chigasakichuo, Tsuzuki Ward, Yokohama City, Kanagawa Prefecture, 224-8503, Japan.,Department of Urology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Eiji Matsubara
- Department of Urology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Kumiko Kato
- Department of Female Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Yasukuni Yoshimura
- Department of Female Pelvic Health Center, Showa University Northern Yokohama Hospital, 35-1, Chigasakichuo, Tsuzuki Ward, Yokohama City, Kanagawa Prefecture, 224-8503, Japan.,Department of Urology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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