MODIFID PUBO-VAGINAL SIlING IN COMPLICATED FEMALE -URINARY INCONTINENCE

Abstract

Every patient with urinary stress incontinence deserves a careful evaluation. The initial surgery to treat stress urinary incontinence should be performed with meticulous care by a competent surgeon who will continue the same care following surgery. Statistically the best chance of cure is with the first operation.

A patient with recurrent urinary stress incontinence requ.ires even more careful evaluation and qualified care. The quality of the local support tissues should receive serious consideration. If the local tissues are weak, another primary procedure is doomed to failure. Too often the gynecologist mechanistically follows an anterior colporrhaphy with a ventral suspension or vice versa without asking, "Is this support

tissue really reparable?" Lack of though in this regard may be due to an egotistic belief that one can cure where others have failed, or to a slavish adherence to routine and ritual.