Continence and micturition involve a balance between urethral closure and detrusor muscle activity. Urethral pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder. The proximal urethra and bladder are both within the pelvis. Intra-abdominal pressure increases (from coughing and sneezing) are transmitted to both urethra and bladder equally, leaving the pressure differential unchanged, resulting in continence.
Urinary incontinence in Japan grew by 8% in current value terms in 2014, rising to 178 billion as the irreversible ageing of Japanese population remained the most important driver of growth in the category. The number of people among the Japanese population aged 65 and older increased by 3% over the course of the year to reach 33 million despite the overall negative population in Japan growth since 2011, according to Euromonitor International’s demographic data.
Treatment is keyed to the type of incontinence. The usual approaches are as follows: • Stress incontinence - Surgery, pelvic floor physiotherapy, anti-incontinence devices, and medication • Urge incontinence - Changes in diet, behavioral modification, pelvic-floor exercises, and/or medications and new forms of surgical intervention • Mixed incontinence - Anticholinergic drugs and surgery
Currently, minimally invasive mid-urethral slings, such as the Tension-Free Vaginal Tape (TVT) Procedure, are the most common treatment option. TVT-SECUR is a newer, less invasive option that is performed through a single incision. It may offer some advantages to the traditional approach in that it is performed with fewer anesthesia’s and may be associated with less postoperative discomfort.