SURGERY FOR FEMALE URINARY-INCONTINENCE

There has been very little advance in the surgery of female urinary incontinence over the past 20 years. In our opinion this is due to 1) uncritical acceptance of the intraabdominal pressure transmission theory, 2) uncritical acceptance of the concept of "detrusor instability," and 3) limited and uncritical evaluation of results of surgery. A new theory for female urinary incontinence is presented. This theory explains existing phenomena in terms of anatomic defects in the vagina and its supporting ligaments. Based on this theory, a new classification of female urinary incontinence and several new minimally invasive surgical procedures are briefly introduced.