The surgical management of total urinary incontinence in the female patient.

A total of 14 female patients with complete urinary incontinence underwent urethral reconstruction by a variety of techniques. Included were 2 patients with acquired urethral defects, 5 with congenitally short urethras, 2 with epispadias, 3 with remnant ureteroceles and 2 with cloacal anomalies. Complete continence was restored in 10 patients, 3 were improved markedly and there was 1 failure owing to obstruction with overflow incontinence. In several patients full control was acquired slowly and was hastened by bladder retraining. Urodynamic studies proved to be extremely valuable for the postoperative as well as preoperative assessment of these patients.