[Repair of the female urethra and its natural support. Another surgical concept. 224 cases over 9 years]

This technique has been applied to 224 female patients over 9 years with a mean follow-up to the last control of 2 years 3 months. The sub-urethral fold of the fascia, the inferior and infero-lateral aspects of the urethra are dissected, the length and the width of the tube are restored by direct resuture, the sub-urethral fascia is doubled by overlapping. No suspension nor foreign tissue. Genito-urinary ptosis is treated by the same time. Application to stress incontinence, diverticulae, abscesses, periurethritis and a few cases of non malignant pathology. In stress incontinence, selected by suprapubic expression test, full success in 76.3%, primary failure in 5.4% and imperfect result with no permanent or necessary padding in 18.2%. In these imperfect results and failures as well as in periurethral pathology the importance of relapsing inferior of the low tract suggests that sexual infections be more investigated and that mechanical causes of infection, such as reflux be more operated on. On the 224 cases, 1 fistula and 1 urethral avulsion, in particular conditions which do not affect the general principle. No fistula in 12 cases of urethral diverticulae and abscesses. The suprapubic expression test in simple and valuable in selecting before and testing after operation the static mechanical incontinence.