The role of anti-incontinence surgery in management of occult urinary stress incontinence.

Combining anti-incontinence and pelvic organ prolapse surgery for patients with occult urinary stress incontinence is controversial. The concern is that some of these patients may remain continent after vaginal prolapse repair making the addition of anti-incontinence surgery unnecessary. However, this can be explained by the fact that the anterior vaginal repair has a curative effect on stress incontinence. Therefore, these patients are denied the more successful anti-incontinence surgery by treating their incontinence with vaginal repair. Once we are able to detect the true cases of occult urinary stress incontinence, all patients should be offered anti-incontinence surgery in combination of vaginal prolapse surgery.