A simplified retropubic urethropexy in the treatment of primary and recurrent urinary stress incontinence in the female.

Urinary incontinence presents a severe social handicap to the patient and a challenge which has taxed the imagination and ingenuity of surgeons for over a century. Restoration of the urethrovesical junction to its normal retropubic intra-abdominal level will usually result in the cure of pure anatomic female stress incontinence. A retropubic approach is utilized in order to provide for identification and mobilization of the urethra, bladder neck, and vagina. Nonabsorbable sutures are used to attach the perivaginal fascia to the pectineal ligament. The operative technique is described in detail. A series of 77 patients who have been followed for up to 3 1/2 years is presented, showing a stress incontinence cure rate of 96.1%.