Abdominoperineal urethral suspension: a ten-year experience in the management of recurrent stress incontinence of urine.

The most important factors in the management of recurrent stress incontinence in the absence of genital prolapse are proper case selection and the proper choice of surgical intervention. All suitable patients at the Alfred Hospital, Melbourne, since 1965 have been managed by the technic of abdominoperineal urethral suspension, which involves passing two aponeurotic bands, cut from the anterior abdominal wall, through the paraurethral attachment of the posterior pubourethral ligament on either side. It is our conviction that urinary continence control in the human female is effected by this upper urethral anatomy and that for a technic to be successful it must exert its influence at this precise point. It is suggested that this technic is the procedure of choice in the management of recurrent stress incontinence.