ABSTRACT

A 46 year old woman entirely cured of stress incontinence by a midurethral sling, continued to leak a large amount of urine. A tampon improved this urine loss from a mean 227 gm/24 hours to 44 gm/24 hours, and a prepubic sling to a residual complaint of drops of urine on bending for household chores. It was concluded that the external urethral ligaments are an important component of distal urethral closure, and that this mechanism is concerned primarily with sealing of the urethra, rather than stress incontinence control.