THE UCLA SURGICAL APPROACH TO SPHINCTERIC INCONTINENCE IN WOMEN

Stress urinary incontinence (SUI) in the female may be treated by a va riety of non-surgical and surgical therapies. However, once the patien t has chosen to undergo operative repair the ideal procedure is based on three considerations: the degree of anterior vaginal wall prolapse, the degree of incontinence and associated anatomic abnormalities requ iring surgical repair. In the vast majority of cases vaginal wall slin g is our procedure of choice for the surgical treatment of SUI in the female. Vaginal wall sling is based on sound anatomic principles, may be performed as an outpatient procedure and is equally efficacious for the treatment of SUI due to anatomic incontinence (urethral hypermobi lity) and intrinsic sphincter deficiency. Since vaginal wall sling is performed through a transvaginal approach, other associated manifestat ions of pelvic floor prolapse such as rectocele can be addressed and r epaired simultaneously. When necessary the vaginal wall sling can be e asily modified to repair large grade cystoceles.