Clinical and urodynamic evaluation of urethrocystopexy for stress urinary incontinence: preliminary report

Thirteen patients presenting with stress urinary incontinence associated with a notion of urgency were evaluated. Each patient underwent a full clinical and paraclinical preoperative evaluation. The urodynamic evaluation included flowmetry, urethral profile, cystometry lying down and standing, and intrarectal pressure measurement. All these patients were operated on (urethrocystopexy), and the evaluation was repeated between one and eight months. The frequency, both diurnal and nocturnal, was reduced in the postoperative period. The urgency decreased from 46 per cent prior to surgery to 7.6 per cent postoperatively. Thirty-eight per cent of patients had urgency incontinence prior to surgery, and none of these patients was incontinent postoperatively. Stress incontinence was corrected in all patients during the period of follow-up. The urodynamic parameters were practically unchanged by the surgery. These parameters included the urethral length, maximum urethral pressure, vesical capacity, and maximum vesical pressure both while lying down and standing. In 4 patients with urgency incontinence preoperatively, the bladder capacity lying down was significantly higher than the bladder capacity standing up whereas the difference was not significant in the patients without urgency incontinence. This difference disappeared postoperatively. No evidence of true uninhibited bladder contractions were noted in any of these patients while lying down or standing.