Introduction: Advances in the Treatment of Stress Urinary Incontinence

INTRODUCTION Advances in the Treatment of Stress Urinary Incontinence Roger R. Dmochowski, MD, FACS Vanderbilt University Medical Center, Nashville, TN [Rev Urol. 2004;6(suppl 5):S1] © 2004 MedReviews, LLC etween 10% and 35% of women in the United States suffer from urinary incontinence, the majority of whom have stress urinary incontinence (SUI), defined as the involuntary leakage of urine with an increase in abdominal pressure, as occurs with coughing, sneezing, exercise, and other forms of exertion.1 However, fewer than half of women with urinary incontinence seek medical care for their condition, in part due to a lack of knowledge about treatment options available. Costs associated with urinary incontinence in the United States have been estimated to be $19.5 billion (2000 US dollars).2 As the US population continues to age, the number of women affected by SUI, as well as the associated costs, will likely increase. This supplement to Reviews in Urology is the first in a 2-part series summarizing the proceedings of a summit on SUI treatment advances held in Dallas, Tex, in January 2004. Sender Herschorn, MD, begins the supplement with an overview of our current understanding of normal anatomy and physiology of voiding function. Edward J. McGuire, MD, follows with a state-of-the-art analysis of the pathophysiology that underlies SUI. Jeffrey L. Cornella, MD, then reviews the current treatment options for SUI, including conservative therapies as well as surgery. Alfred E. Bent, MD, concludes the supplement with a description of sling and bulking agent procedures. Each author is an acknowledged expert in the field of voiding dysfunction and has provided superb contributions on the unique topics within. Our knowledge of voiding dysfunction continues to expand, and the included articles review the respective topics with an emphasis on evolving concepts and areas of controversy. It is hoped that the interested reader will find that this edition sets the stage for clear and lucid selection of appropriate interventions for SUI. B References 1. 2. Clinical Practice Guideline Number 2: Urinary Incontinence in Adults. Rockville, MD: Agency for Health Care Policy and Research, US Dept of Health and Human Services; 1996. AHCPR publication 96-0682. Hu TW, Waganer TH, Bentkover JD, et al. Costs of urinary incontinence and overactive bladder in the United States: a comparative study. Urology. 2004;63:461-465. VOL. 6 SUPPL. 5 2004 REVIEWS IN UROLOGY S1