Surgical procedures for uncomplicated ("routine") female stress incontinence

Abstract

Routine incontinence in the woman is defined as stress urinary incontinence associated with a hypermobile urethra and bladder neck that has not been subjected to an operative procedure. Although urgency and occasional urgency incontinence may accompany the symptoms of stress incontinence, they are not a significant component of the patient's complaints. Regardless of technique, the goal common to all procedures designed to cure stress urinary incontinence is to immobilize and support the hypermobile urethra. The support provided by the operation creates a foundation on which the urethra can be compressed shut during abdominal straining. The operation of choice is determined by its ability to provide this strong foundation over a long period of time. Although numerous reports have been published outlining the results of bladder neck suspension, most authors have not utilized objective long-term follow-up when assessing cure rates. We prefer either the Burch colpourethropexy or the modified Pereyra needle bladder neck suspension because the vaginal wall is firmly supportive without interfering with the delicate mechanisms of the urethra.