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What is Best treatment for severe stress incontinence without prolapse is and explain in detail?
Students, Please read this: From Novaks Gynecology 15th edition Comparing various surgeries for the treatment of stress incontinence, Numerous panels and studies conducted in the late 90's concluded that colposuspension (e.g., Burch, Marshall- Marchetti-Krantz ) and slings were more effective than transvaginal needle suspensions or anterior repairs for long-term success (48-month cure/dry rates).... Now, there were many journals which came out with the information that the TVT/TOT are now better, but since it never came in a book, it was actually never asked of you for the last 5-6 years Now, the 2020 Novaks gynecology 16th writes this: Over the past two decades, there has been an accumulation of a large body of evidence on mid-urethral slings from randomized controlled trials, including several meta-analyses and Cochrane reviews . The overarching summary is that mid-urethral slings have become the procedure of choice in treating women with stress urinary incontinence. They have a good safety profile with a significant improvement of QOL measures, and irrespective of route of placement, they are highly effective in the sho, medium, and long term. There is evidence to suggest that the mid-urethral slings are more effective than the Burch colposuspension procedure, and as effective as the autologous pubovaginal sling ... SO yes, now we change our answer to: that the mid urethral TVT/TOT slings are the best procedures..