Urethral hypermobility
Hypersensitivity
Previous use of an injectable agent
Detrusor overactivity
Previous surgery
to create obstruction.
to improve the hermetic seal.
not yet defined.
to improve urethral coaptation.
to augment urethral mucosa.
The diagnostic and predictive value of urethral pressure profilometry in characterizing ISD has been proved.
The presence of hypermobility always raises the leak point pressure, thus excluding ISD.
A low urethral pressure point characteristically predicts the presence of ISD.
Many studies have not confirmed the value of leak point pressure measurement in quantifying ISD.
ISD is not present if the leak point pressure is greater than 90╯cm H2O.
The relative degree of ISD versus hypermobility can be ascertained.
Cystoscopy should not be done before the use of injectable agents.
Bladder neck mobility, which contraindicates the use of injectable agents, can be measured.
The amount of SUI can be assessed.
Adverse urethral factors such as scarring or diverticula can be assessed.
The transurethral technique can be done only with cystoscopic monitoring.
Both the periurethral and transurethral techniques have shown similar results.
The transurethral technique is more painful for patients.
The periurethral technique always requires a general anesthetic.
The periurethral approach is more commonly done.
Bovine collagen
Calcium hydroxylapatite (Coaptite)
Hyaluronic acid detranomer (Deflux)
Silicone microimplants (Macroplastique)
Carbon-coated zirconium beads (Durasphere)
One week of a second-generation cephalosporin is required.
An aminoglycoside should be given intravenously 1 hour before treatment.
Prophylactic antibiotics are not effective for prevention of a urinary tract infection.
A fluoroquinolone or trimethoprim-sulfamethoxazole for 24 hours or less can be recommended.
A 3-day course of a fluoroquinolone has been shown in randomized studies of injectable agents to be most effective.
The site of reinjection should always be away from the previous injection site.
Reinjections should always be done within 1 week.
The minimum timing for reinjections is variable and depends on the agent.
Long-term reinjections are superior to short-term ones.
Reinjections rarely restore continence.
Repeat injections usually fail to restore success.
Eliminating the failures from the denominator artificially raises the success rate.
Systematic reviews have confirmed efficacy versus pelvic floor muscle training.
Randomized trials with midurethral slings demonstrated superiority of injectable agents.
The Stamey (0-3) Grading System has been subject to extensive epidemiologic testing.
Carbon-coated zirconium beads
Autologous fat
Silicone macroparticles
Porcine collagen
Retention
Urethrovaginal fistula
Urgency incontinence
Hematuria
Urinary tract infection
80╯μm
100╯μm
60╯μm
40╯μm
20╯μm
Particle migration
Recurrent SUI
Urgency and retention
Mucosal prolapse
Coaptite (calcium hydroxyapatite)
Durasphere (carbon-coated zirconium bead)
Macroplastique (silicone microimplant)
Zuidex (hyaluronic acid dextranomer)
Tegress (ethylene vinyl alcohol)
Zuidex (hyaluronic acid dextranomer with Implacer)
All of the above
Teflon (polytetrafluoroethylene paste)
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