الفهرس 
Stress Urinary Incontinence: Anatomic CorrelatesOnly 14 pages are availabe for public view
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Abstract
During the past decades several operations have been introduced to treat SUI. Of these the retropubic suspensions demonstrated a long record of efficacy. However, the morbidity associated with these procedures is unsatisfactory and various efforts have been made to reduce it. Minimally invasive vaginal needle suspension procedures are associated with less morbidity but they have also proved to be less effective. Later on MUS procedures were introduced. The pubovaginal fascial sling has been used effectively for the treatment of SUI. Ulmsten and Petros introduced the TVT in 1996. Subsequently, a number of variations on retropubically positioned mid urethral slings have been introduced. The transobturator tape described by Delorme in 2001 was the first MUS to be placed through a nonretropubic route. Subsequently, a number of variations of this method have been introduced. It is possible that the use of the MUS will be further encouraged because its efficacy and low morbidity. Health-related quality of life (HRQOL) is one of several variables commonly studied in the evaluation of severity of urinary incontinence as well as in the post operative evaluation The last two decades evidenced the development of multiple urinary incontinence specific quality of life measures. In 1994 Shumaker et al., presented a life-impact assessment instrument specific to urinary incontinence, the Incontinence Impact Questionnaire (IIQ) and a symptom inventory, the Urogenital Distress Inventory (UDI), specific to the symptoms associated with lower urinary tract dysfunction. Ubersax et al. reported in 1995 short forms of the UDI and the IIQ questionnaires and were termed UDI-6 and IIQ7. Arabic versions of the UDI-6 and IIQ-7 have been adopted and utilized successfully. Sexual function following mid-urethral slings has been investigated in few reports. Mesh exposure can create dyspareunia and vaginal bleeding. At times, the sexual partner complains of penile pain or scratches after vaginal penetration. If the tension-free vaginal tape needle is too laterally aimed or rotated, vascular injury may alter sexual function. Despite improved urinary stress leakage, worse postoperative scores in the domains of sexual pain, orgasm and overall sexual satisfaction were noted. Long term evaluation of mid-urethral slings has been in most studies inconsistent, and in many instances outcomes have not been globally assessed and have not included patient driven subjective assessment of quality of life. theless, the impact of surgery on female sexual function and reproductive activity has not been adequately studied.