Type III stress urinary incontinence (SUI) is generally defined as a condition that involves intrinsic sphincter deficiency (ISD).
Although the clinical parameters for ISD are loosely defined as a Valsalva leak-point pressure < 60 cmH2O or a maximal urethral closure pressure < 20 cmH2O, consensus is lacking. As a result, studies evaluating the success of any treatment for ISD are difficult to interpret. Regardless, several studies over the past 20 years have evaluated a number of surgical and nonsurgical treatments specifically for SUI caused by ISD. Surgical options include retropubic suspension, needle suspensions, various types of suburethral slings and the artificial urinary sphincter, whereas nonsurgical options include urethral bulking agents. Assessing urethral function (specifically, leak-point pressure or maximal urethral closure pressure) and urethral hypermobility will enable treating physicians to determine the ideal solution for individual patients, especially as no standardized treatment for ISD exists.
Written by:
Shah SM, Gaunay GS. Are you the author?
Sol and Margaret Berger Department of Urology, Beth Israel Medical Center Phillips Ambulatory Care Center, New York, NY 10003, USA.
Reference: Nat Rev Urol. 2012 Nov;9(11):638-51.
doi: 10.1038/nrurol.2012.177
PubMed Abstract
PMID: 23027065
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