Julien Labrie, M.D http://achatdecialis.com/categorie/soins-medicaux ., Bary L.C.M. Berghmans, Ph.D., Kathelijn Fischer, M.D., Ph.D., Alfredo L. Milani, M.D., Ph.D., Ileana van der Wijk, M.D., Dina J.C. Smalbraak, M.D., Astrid Vollebregt, M.D., Ph.D. Schellart, M.D., Giuseppe C.M. Graziosi, M.D., Ph.D., J. Marinus van der Ploeg, M.D., Joseph F.G.M. Brouns, M.D., Ph.D., E. Stella M. Tiersma, M.D., Ph.D., Annette G. Groenendijk, M.D., Ph.D., Piet Scholten, M.D., Ph.D., Ben Willem Mol, M.D., Ph.D., Elisabeth E. Blokhuis, M.D., Albert H. Adriaanse, M.D., Ph.D., Aaltje Schram, M.D., Ph.D., Jan-Paul W.R. Roovers, M.D., Ph.D., Antoine L.M. Lagro-Janssen, M.D., Ph.D., and Carl H. Van der Vaart, M.D., Ph.D.: Surgery versus Physiotherapy for Tension Urinary Incontinence Stress urinary incontinence is a common medical condition among women that negatively affects quality of life.1-3 The International Consultation about Incontinence defines stress bladder control problems as an involuntary lack of urine on physical exertion, sneezing, or coughing.4 Pelvic-floor strength-training is generally thought to be first-line administration for the problem.5 However, physiotherapy is associated with broad variation in the rates of subjective success and objective success , and more severe symptoms are connected with worse outcomes.6,7 After 3 to 15 years, 25 to 50 percent of ladies initially treated with physiotherapy possess proceeded to surgery.7-9 Midurethral-sling surgery is a invasive surgical technique for the treatment of stress urinary incontinence minimally,10 with subjective remedy rates between 75 percent and 94 percent and objective cure rates between 57 percent and 92 percent.1,11,12 The procedure is undoubtedly effective, with reduced complications.11 The difference in the reported frequencies of a successful outcome between surgery and physiotherapy raises the question of whether all women with moderate-to-severe stress-predominant urinary incontinence should initially be treated with physiotherapy or should immediately undergo surgery as initial treatment.

Jon F.R. Barrett, M.B., B.Ch., M.D., Mary E. Hannah, M.D.C.M., Eileen K. Hutton, Ph.D., Andrew R. Willan, Ph.D., Alexander C. Allen, M.D.C.M., B. Anthony Armson, M.D., Amiram Gafni, D.Sc., K.S. Joseph, M.D., Ph.D., Dalah Mason, M.P.H., Arne Ohlsson, M.D., Susan Ross, Ph.D., J. Johanna Sanchez, M.I.P.H., and Elizabeth V. Asztalos, M.D. For the Twin Birth Study Collaborative Group: A Randomized Trial of Planned Cesarean or Vaginal Delivery for Twin Pregnancy.