Sling surgery for stress urinary incontinence; the perfect solution?

Leiden Repository

Sling surgery for stress urinary incontinence; the perfect solution?

Type: Doctoral Thesis
Title: Sling surgery for stress urinary incontinence; the perfect solution?
Author: Hogewoning, C.R.C.
Issue Date: 2017-05-10
Keywords: Stress Urinary Incontinence
Sexuality
Mid urethral sling
TVT
TVT-O
Abstract: Stress urinary incontinence (SUI) is the most observed type of urinary incontinence and is defined as the loss of urine following a rise in abdominal pressure. The TVT (Tension-free Vaginal Tape), a mid-urethral sling (MUS), was introduced in 1996 and soon became the gold standard in the surgical treatment of SUI. Over the last decade, numerous MUS devices have been introduced but only some were able to achieve similar results in comparison to the original TVT. The main question of this thesis is whether slings, old and new, for either male and female, can live up to the expectations of both patients and physicians by being both safe and effective in curing urinary incontinence. Secondly, the question is raised whether sling surgery is anatomically safe with regard to those nervous systems which are essential for the sexual function or may actually be responsible for iatrogenic neurological damage during placement. In this thesis we conclude that many slings were, or still are, freely available on the market without any proper pre-market research. Moreover sling surgery can have serious negative side-effects on sexual function that should be a standard part of the informed consent provided when opting for surgery.
Promotor: Supervisor: R.C.M. Pelger, M.C. de Ruiter Co-Supervisor: H.W. Elzevier
Faculty: Faculty of Medicine, Leiden University Medical Center (LUMC)
University: Leiden
Handle: http://hdl.handle.net/1887/48617
 

Files in this item

Description Size View
application/pdf Full Text 30.45Mb View/Open
application/pdf Cover 8.830Mb View/Open
application/pdf Title Pages_Contents 631.6Kb View/Open
application/pdf Chapter 1 2.103Mb View/Open
application/pdf Chapter 2 692.8Kb View/Open Full text at publisher site
application/pdf Chapter 3 687.6Kb View/Open Full text at publisher site
application/pdf Chapter 4 685.3Kb View/Open Full text at publisher site
application/pdf Chapter 5 707.4Kb View/Open Full text at publisher site
application/pdf Chapter 6 744.8Kb View/Open Full text at publisher site
application/pdf Chapter 7 19.27Mb View/Open Full text at publisher site
application/pdf Chapter 8 1.637Mb View/Open Full text at publisher site
application/pdf Chapter 9 663.0Kb View/Open
application/pdf Chapter 10 677.1Kb View/Open
application/pdf Summary in Dutch 653.5Kb View/Open
application/pdf Curriculum Vitae_Publications_Acknowledgements 659.1Kb View/Open
application/pdf Propositions 136.2Kb View/Open

This item appears in the following Collection(s)