Surgical treatment of mixed and urge urinary incontinence in women.
OBJECTIVE
The etiology of urge urinary incontinence is unknown. Pharmacological treatments are disappointing, since they are only slightly more effective than a placebo. In this study, we analyzed whether the surgical replacement of the uterosacral ligaments by an alloplastic tape can cure patients with mixed and urge urinary incontinence.


METHODS
This study was a nonrandomized clinical trial. The study was performed in the Department of Gynecology of a general hospital and a university clinic. 135 women with urge or mixed urinary incontinence were operated on. The utero-sacral ligaments as well as the pubo-urethral ligaments - if necessary - were replaced by alloplastic tapes. Clinical outcome was evaluated immediately after surgery, 3 months later and 1 year later. Outcome was classified as cure, improvement or failure and recurrences.


RESULTS
102 patients (77%) were cured and a further 24 patients (18%) showed improvement after surgery. 19 patients developed a recurrence between 5 and 33 months after surgery.


CONCLUSIONS
We therefore conclude that most patients with urge and mixed urinary incontinence can be cured by surgery.
Urogynaecology Unit, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany. wolframjaeger@gmx.de
Wolfram
W
Jäger
Olga
O
Mirenska
Sabine
S
Brügge
D000368:Aged; D002584:Cervix Uteri; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008022:Ligaments; D008875:Middle Aged; D012007:Rectum; D012008:Recurrence; D012447:Sacrum; D053832:Surgical Tape; D013536:Suture Techniques; D016896:Treatment Outcome; D014521:Urethra; D014549:Urinary Incontinence / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery; D053202:Urinary Incontinence, Urge / Q000601:surgery*; D014599:Uterus; D014621:Vagina