UROGYNECOLOGICAL SURGERY CURRENT APPROACHES AND TREATMENTS FOR INCONTINENCE

Urogynecological_Surgery_Kapak

UROGYNECOLOGIC PATIENT SELECTION CRITERIA AND PREOPERATIVE EVALUATION

Sedef Kavaz1 Batuhan Üstün2

1Tekirdağ State Hospital, Department of Gynecology and Obstetrics, Tekirdağ, Türkiye
2Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Gynecology and Obstetrics, Tekirdağ, Türkiye

Kavaz S, Üstün B. Urogynecologic Patient Selection Criteria and Preoperative Evaluation. In: Balsak D, Çim N, Ege S editors. Urogynecological Surgery Current Approaches and Treatments for Incontinence. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.337-346.

ABSTRACT

Urogynecology focuses on the evaluation and treatment of pelvic floor disorders, including stress urinary incontinence (SUI) and pelvic organ prolapse (POP), which significantly impact women’s quality of life. The decision-making process for surgical intervention in this field is complex and must be based on thorough patient evaluation, considering medical history, physical examination, and diagnostic tests. Key factors such as age, comorbidities, symptom severity, and patient preferences must be carefully assessed. Conservative treatment options, including pelvic floor muscle training, pessary use, and lifestyle modifications, serve as first-line therapies due to their low risk and cost-effectiveness. When conservative management fails or is not suitable, surgical treatment becomes the main approach. For SUI, mid-urethral slings (retropubic or transobturator) are widely used due to their high efficacy and patient satisfaction. For POP, vaginal native tissue repairs and laparoscopic or robotic sacrocolpopexy are commonly performed. The choice of technique depends on the patient’s anatomy, expectations, and surgical risk profile. Surgical mesh may be used in selected cases, though it is associated with complications such as erosion, infection, and pain; therefore, patient education regarding risks is essential. Preoperative counseling, shared decision-making, and clear communication enhance patient satisfaction and treatment outcomes. Informed consent must include discussion of procedure details, alternatives, potential complications, and postoperative expectations. Effective education tools such as verbal explanation, visual aids, and printed materials support the informed consent process. Ethical considerations in urogynecology emphasize patient autonomy, beneficence, and non-maleficence. Confidentiality, equitable care, and patient safety are core principles. Surgeons should possess up-to-date knowledge and report unsafe practices. Ultimately, a patient-centered and individualized approach supported by current guidelines and multidisciplinary evaluation increases surgical success and minimizes complications.

Keywords: Risk factors; Pelvic organ prolapse; Preoperative care; Urinary incontinence, stress

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