"Recurrent" stress urinary incontinence

This report constitutes a 15 year review of 205 operations performed upon 198 adult women suffering from "recurrent" stress urinary incontinence (SUI). All patients received special preoperative investigation including direct electronic urethrocystometry and metallic bead-chain urethrocystography. From these studies 163 of the patients were determined to have pure "anatomic SUI" and 42 demonstrated characteristics of anatomic SUI plus some anatomic or physiologic defect which might compromise the final results ("compromised SUI"). Preoperative radiographs demonstrating the previous causes for failure fell into four general categories: philosophic, pragmatic, subjective, and psychological. All patients were operated upon with the single objective of achieving high retropubic elevation and fixation of the urethrovesical junction. In those have pure "anatomic SUI" the failure rate was 5 per cent. In the "compromised SUI" group the failure rate was 39 per cent. Type II detrusor dyssynergia was the most common cause of failure.