[Urinary stress incontinence in women: comparison of treatments]

A technique of surgical treatment of urinary stress incontinence (USI) in women is proposed. It consists of three stages. Stage 1 (intervaginal)--anterior colporaphy with plastic reconstruction of urogenital diaphragmatic muscles. Stage 2 (an original procedure)--fixation of the neck of the urinary bladder to musculus rectus abdominis and aponeurosis by means of three caprone ligatures by dissection of the anterior abdominal wall to the peritoneum. Stage 3--posterior colporaphy, perineolevatoroplasty. Stage 3 is conducted if the patient has marked rectocele simultaneously or 6 months after the initial operation. As shown by examination of 60 patients 1-20 years after the operation, good results were achieved in 91.2% of cases. The proposed method is simple, effective, involves all the pathogenetic links, corrects the changes in anatomofunctional condition of the lower urinary tracts restoring the "integral sphincter mechanism of the pelvis". It is recommended for treatment of females with moderate and severe USI or patients with enuresis type 2 and 3.