[Pathogenesis of urinary stress incontinence and principles of its surgical treatment]

As in different types of stress incontinence the mechanism of the destroyed urethral support is not the same, the principles of their surgical treatment are bound to differ. Generally speaking, the surgical intervention in stress incontinence aims at securing adequate mobility of the lower urinary organs, forming an effective suburethral support, and correcting the elements of the prolapse. Applying these principles in 508 women with stress incontinence having been surgically treated at the University Hospital Department of Gynecology and Obstetrics in Skopje from 1968 to 1976 and followed up at least two years afterwards, the global rate of relapses was 6.1%, by which the best results were obtained by Burch's modified method (2.1%), while after operations after Bonney or Barnett the frequency of relapses was relatively higher (7.1%). Analysing technical details in the carrying out of the above mentioned procedures, the authors plead for a most adequate preoperative preparation of patients, so as to determine and categorize the type of stress incontinence in question and allow the choice of the most appropriate surgical intervention in any given case.