[The pathogenesis and results of the surgical treatment of stress urinary incontinence in women].

The paper presents the incidence rate (3-19.6%) of stress-induced enuresis (SIE) in females. The impact of birth injuries, obstetric instrumentation and heavy physical work resulting in the impairments of the sphincter-detrusor system of the bladder and the musculature of the pelvic bottom on the pathogenesis of SIE is indicated. As a result the bottom of the bladder, the posterior walls of the neck and urethra moved backward to form an obtuse angle with an anterior wall of the urethra that was roentgenologically evidenced as vesiculation. In this line the angle between the anterior and posterior walls of the urethra and neck became more obtuse with no contact upon contractility of their muscles which caused the stress-induced escape of urine. To eliminate vesiculation and enuresis, the authors used successfully the technique of urethral angulation by the duplication formed by the anterior vaginal wall over the cervix and urethra followed by their fixation to the posterior surface of the pubic area on one side and free skin graft on the other. Hebell-Schteckel's technique was a prototype for the method proposed. A total of 156 females with stages II and III SIE were successfully operated on. The results of 1-15 year follow-ups were good and satisfactory in 97 (89.9%) of 109 females. The relapses were more common in the females who had a repeated delivery or were engaged in heavy physical work as well as in two persons operated on in the menopause.