Which option is NOT typically used to treat ISD-related stress incontinence?

Which option is NOT typically used to treat ISD-related stress incontinence?

• A. Periurethral bulking injections
• B. Anterior vaginal repair
• C. Bladder retraining
• D. Urge inhibition

Answer: (B)

Intrinsically, stress incontinence due to ISD comes from urethral closure weakness. Treatments aim to boost the urethra’s ability to stay closed or support it during things like coughing or lifting. Periurethral bulking injections do this by adding bulk around the urethra to improve coaptation, which directly helps ISD-related leakage. An anterior vaginal repair, on the other hand, is designed to fix prolapse of the anterior vaginal wall (a cystocele). It doesn’t address the urethral sphincter problem or improve urethral closure, so it isn’t a typical treatment for ISD-related stress incontinence. Bladder retraining and urge inhibition target bladder overactivity and urge symptoms rather than the urethral closure mechanism, so they’re not primary treatments for ISD-related stress incontinence either.

Intrinsically, stress incontinence due to ISD comes from urethral closure weakness. Treatments aim to boost the urethra’s ability to stay closed or support it during things like coughing or lifting. Periurethral bulking injections do this by adding bulk around the urethra to improve coaptation, which directly helps ISD-related leakage.

An anterior vaginal repair, on the other hand, is designed to fix prolapse of the anterior vaginal wall (a cystocele). It doesn’t address the urethral sphincter problem or improve urethral closure, so it isn’t a typical treatment for ISD-related stress incontinence.

Bladder retraining and urge inhibition target bladder overactivity and urge symptoms rather than the urethral closure mechanism, so they’re not primary treatments for ISD-related stress incontinence either.