Treatment options for intrinsic sphincter deficiency

Sovrin M. Shah, Geoffrey S. Gaunay

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


Type III stress urinary incontinence (SUI) is generally defined as a condition that involves intrinsic sphincter deficiency (ISD). Although the clinical parameters for ISD are loosely defined as a Valsalva leak-point pressure <60 cmH 2 O or a maximal urethral closure pressure <20 cmH 2 O, consensus is lacking. As a result, studies evaluating the success of any treatment for ISD are difficult to interpret. Regardless, several studies over the past 20 years have evaluated a number of surgical and nonsurgical treatments specifically for SUI caused by ISD. Surgical options include retropubic suspension, needle suspensions, various types of suburethral slings and the artificial urinary sphincter, whereas nonsurgical options include urethral bulking agents. Assessing urethral function (specifically, leak-point pressure or maximal urethral closure pressure) and urethral hypermobility will enable treating physicians to determine the ideal solution for individual patients, especially as no standardized treatment for ISD exists.

Original languageEnglish
Pages (from-to)638-651
Number of pages14
JournalNature Reviews Urology
Issue number11
StatePublished - Nov 2012
Externally publishedYes


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