ABSTRACT

Aim:

To critically analyze the anatomical basis of historical vaginal operations for urinary stress incontinence (USI).

Materials and Methods:

Historical vaginal operations for cure of USI were critically analyzed as regards their modus operandi from an anatomical perspective using a 15 point system: 1. Minimal invasiveness. 2. Ease of performance. 3. Built-in safety of the procedure. 4. Short term complications. 5. Long term complications. 6. Applicability to obese patients and those with poor tissues. 7. Applicability to patients with previous operations for stress incontinence. 8. Blood loss. 9. Length of operation. 10. Early discharge from hospital. 11. Urinary retention. 12. Long-term continence. 13. Early resumption of normal activities. 14. Anatomical damage. 15. Physiological mode of action of the operation.

Results:

A critical analysis is given for each type of vaginal repair.

Discussion and Conclusions:

some surgeons, for example Ingelman-Sundberg believed that there was a very firm place for vaginal repair operation. Others such as Tanagho categorically stated that there was no place for vaginal repair, believing that a bladder neck elevation operation should be performed as a first choice operation.