[Diagnosis and therapy of female incontinence]

The different types of urinary incontinence in the female are defined and described. A meticulous differential diagnosis is a prerequisite for adequate treatment. The pre-treatment examination includes a detailed history, a residual urine, a gynaecological examination, a neurological examination, an intravenous pyelogram, the incontinence test, the Bonney and Bethoux tests, and a urethrocystoscopy. In difficult cases urodynamic tests and X-rays of the bladder and the pelvic organs are added to the workup. Two types of incontinence can be differentiated. We recommend to manage type 1 with an anterior vaginal repair or with colposuspension. Type 2 should be treated with colposuspension and if necessary vaginal repair or levatorplasty. Recurrences should be managed always with colposuspension. It is stressed that after correction of incontinence bladder outlet obstruction can occur.