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Care Pathway for the Management of Stress Urinary Incontinence (SUI)

SPECIALIST MANAGEMENT

This may include care by gynaecologists, urogynaecologists, urologists and geriatricians with an interest in pelvic floor disorders

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No treatment
Non-surgical treatments
Patient assessed as requiring operative management
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SUI Surgery Pathway – routine cases

Bothersome SUI not responding to conservative treatment
 
 
 
 
Mid-urethral sling
(synthetic mesh)
Bulking Agent
Colposuspension
(native tissue)
Pubovaginal sling
(native tissue)
 
 
 
Retropubic
tape
Obturator
tape
Mini-sling

Patients should be offered the opportunity for a minimum period of six months follow-up after surgery.

Green arrow
Preferred options for treatment – use of mesh for these procedures is supported by evidence.
Orange arrow
Possible pathway – use of native tissue and mesh for these procedures is supported by evidence.
Red arrow
Not recommended.

Bothersome SUI not responding to conservative treatment
 
Mid-Urethral Sling (synthetic mesh)
 
 
Retropubic tape
 
 
Obturator tape
 
 
Mini-sling
 
Bulking Agent
 
Colposuspension (native tissue)
 
Pubovaginal sling (native tissue)

Patients should be offered the opportunity for a minimum period of six months follow-up after surgery.

Green arrow
Preferred options for treatment – use of mesh for these procedures is supported by evidence.
Orange arrow
Possible pathway – use of native tissue and mesh for these procedures is supported by evidence.
Red arrow
Not recommended.

 

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