••• Chapter 39^ Urinary Incontinence and Urodynamics^389
❍ What is the gold standard treatment of SUI?
Midurethral tension-free vaginal sling.
❍ What are the risks/benefits of the midurethral transobturator pubovaginal sling?
Risks: Higher incidence of groin and inner thigh pain postoperatively, higher incidence of dyspareunia due to the
proximity of the sling to the anterolateral vaginal sulcus, and decreased efficacy in patients with ISD.
Benefits: Decreased incidence of both bladder and bowel injuries as well as decreased incidence of voiding
dysfunction.
❍ What are the risks/benefits of the retropubic midurethral pubovaginal sling?
Risks: Higher incidence of bowel and bladder perforations, slight higher incidence of voiding dysfunction and
blood loss, with higher risk of developing a hematoma.
Benefits: Less incidence of neuropathic complications (such as groin pain), less incidence of postoperative
dyspareunia, and higher success rates for patients with ISD.
❍ What is the treatment option for women who continue with SUI after surgical intervention or are not
candidates for surgery?
Periurethral injection of bulking agents.