[Treatment of urinary incontinence by vaginal approach]

The vaginal route is routinely used for surgical cure of exersion-induced urinary incontinence. This technique has the advantage of being rapid and easily performed during a short hospital stay. Long-term results however, have been debated. Certain factors have been identified in the literature which would affect long-term failure. These factors indicate that the "ideal" vaginal route should be based on the Burch operation starting at the upper portion and working downwardly. Finally, sphincter failure or detrusor instability must be eliminated before an operation for exertion-induced incontinence can be indicated since such a combination would modify the procedure.