Treatment of female incontinence with or without urethral instability

Summary

A group of 75 non-neuropathic female patients with persisting complaints (71 incontinent and 4 urge patients) had been selected earlier for extensive urodynamic study. Based on an objectified history and urodynamic results, 28 patients were diagnosed as genuine stress incontinent (12 of whom showed urethral instability as well), 19 as motor urge incontinent (16 unstable urethras) and 18 as sensory urge incontinent (14 unstable urethras). Three patients were incontinent during cystometry only as a result of progressive loss of urethral pressure following multiple coughs, 2 others were reflex incontinent and 1 had nocturnal enuresis. The efficacy of incontinence therapy was studied to evaluate the possible influence of urethral instability. It appears that in stress incontinent patients the favourable results of suspension procedures are not impaired if urethral instability co-exists. In the urge incontinent patients, the majority of whom demonstrate urethral instability, therapy is less effective and especially sensory urge incontinence with urethral instability is therapy-resistent.