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Logo of procrsmedFormerly medchtJournal of the Royal Society of MedicineProceedings of the Royal Society of Medicine
 
Proc R Soc Med. 1939 May; 32(7): 777–790.
PMCID: PMC1997601

Some Observations on the Surgical Treatment of Urinary Incontinence

(Section of Urology)

Abstract

Types: A. Essential. B. Paradoxical. C. False. D. True.

True incontinence.—A. Congenital: (a) Developmental abnormalities. (b) Malformations of nervous system. B. Acquired: (a) Local abnormalities. (b) False passages. (c) Disturbance of innervation.

Anatomy of sphincteric mechanism in male and female.

Diagnosis: Need for careful investigation including cysto-urethroscopy, cysto-urethrography, and cysto-manometry.

Treatment: A. Physiotherapy. B. Direct surgical repair. C. Surgical diversion of urine.

Types of true incontinence amenable to direct surgical repair: A. Epispadias. B. Aberrant ureteric ostia. C. Fistulæ. D. Congenital or acquired defective sphincteric mechanism.

Operative treatment of vesico-vaginal fistulæ.

Transvesical operation for cure of congenitally defective sphincteric mechanism—report of seven cases.

Stress incontinence.—Value of urethrograms to ascertain nature of defect. Operative treatment.

Incontinence following prostatic surgery.—Types of operation advocated.

New operative procedure utilizing ribbon catgut with demonstrative moving picture.

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