November

Stress urinary incontinence (SUI) is a common problem in women, with an estimated incidence of 29% in the community.[1] More than 100 different surgical procedures for the treatment of incontinence have been described in the surgical literature.[2] Two of the more popular procedures in this group are the retropubic and the vaginal sling and tape procedures. Other procedures such as the anterior repair, bone anchor suspension, and laparoscopic bladder neck repair have not proven to be as satisfactory and are no longer commonly used.

Background

The word “concussion” derives from the Latin concussus, which means to shake violently. Concussion was initially felt to involve only transient disturbance of brain function without gross structural change. It is now recognized that some concussions do involve structural damage with loss of neurons. Sports concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.[1] A high incidence of concussion in contact sports is well documented in the literature.[1-5]

The annual incidence of mild traumatic brain injury (mTBI) is estimated to be 100 to 300 per 100 000.[1] One difficulty in identifying and reporting mild traumatic brain injury involves the many definitions used. We prefer the definition proposed by the Mild Traumatic Brain Injury Committee of the American Congress of Rehabilitation Medicine, which describes mTBI as a traumatically induced physiological disruption of brain functioning with at least one of the following:

• Any period of loss of consciousness.

In Canada, approximately 50 000[1] patients suffer a traumatic brain injury each year. Of these, 80% fall into the mild traumatic brain injury (mTBI) category. The annual cost of treating mTBI in Canada is about $3 billion[2] and the long-term financial burden to individuals, their families, and society is considerable.