[Anatomic findings during 509 microscopic sphincteroplasties for urinary stress incontinence in women. Diagnostic and surgical consequences].

Stress incontinence of urine without cervicocystoptosis secondary to difficult labor and delivery is essentially due to rupture of the smooth muscle sphincter of the bladder. Other changes affecting the anterior vaginal wall (thinning of fibrous tissue, partial splitting of the striated urethral sphincter, etc.) are found before difficult labor without stress incontinence of urine. Only operative microscopy enables anatomical analysis. Lateral cystography confirms the clinical diagnosis. There is no correlation between the extent of lesions and functional study results. Surgery is limited to the dissection and apposition of the residual zone of the smooth muscle sphincter retracted laterally. There were neither postoperative dysuria nor dyspareunia. There were 11 recurrences. No marked symptomatic change 5 years later.