SURGICAL-TREATMENT CONCEPT FOR FEMALE URINARY STRESS-INCONTINENCE

Since 1988 we have tried to select the surgical procedure for the therapy of female urinary stress incontinence according to a concept based on clinical, urodynamical and radiological findings. The results of 279 patients are presented, all of them urodynamically examined before and at least once after incontinence surgery. Control examinations were done 6 weeks, 6 months and 1 year after surgery. The clinical failure rate was 58 % six weeks after anterior and posterior colporrhaphy (n = 119), 43 % after 6 months and 37 % after one year. The corresponding figures for the Burch colposuspension (n = 136) were 27 % after 6 weks, 27 % after 6 months and 26 % after 12 months. The combined procedure of anterior vaginal repair and Burch colposuspension during one operation resulted in failure rates of 50% after 6 weeks, 32 % after 6 months and 33 % after a year. Following our concept, the cure rates of all three procedures tend towards an almost identical value one year after surgery. Concerning the postoperative urodynamic findings we think that different mechanisms may be responsible for eliminating stress incontinence in women treated by anterior colporrhaphy or Burch colposuspension.