Experience with colpocystography used routinely in 586 cases of genital prolapse and urinary stress incontinence is described. Radiologic aspects are discussed and related to clinical findings by means of an original classification. The technique is described in detail. Systematic opacification of the urethra permits the study of changes in the urethrovaginal region. Contrary to prevailing opinion, the lower urinary system and the anterior vaginal wall do not participate concomitantly in the process of prolapse but sliding bladder prolapse, which may cause urinary stress incontinence, is often seen. Colpocystography is simple, easy, inexpensive, and safe. Its use in surgical gynecology assits in evaluation the tactical and technical indications, assessing the effectiveness of the operation, and studying recurrences and postoperative complications.

Barium Sulfate↗

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[Results of an inquiry on stress urinary incontinence in women].

The authors present the results of an inquiry into urinary stress incontinence in 415 women chosen at random, in whom the genital prolapse or stress incontinence were not complaints for hospitalization. The analysis also excluded all states of pregnancy or puerperium. As in other statistics, the frequency of urinary stress incontinence proved very high (39.2%). It is particularly interesting that 52.8% of the women questioned considered it as a completely normal event. A progressive increase in the frequency of stress incontinence related to aging. Stress incontinence was also twice as frequent in manual workers and housewives as in office workers, school girls, and students. In relation to obstetric traumatism, the disease is more frequent in parous women, showing a progressive increase with parity and the delivery of higher-weight newborns, whereas, quite unexpectedly, it proved rare in women with deliveries in intervals shorter than three years. A high incidence was recorded of stress incontinence having appeared in pregnancy for the first time (23.9%); in 59.0% of these women it persisted also after childbirth, which is very significant. Although the trouble is more frequent in menopausal patients, the effect of this period can hardly be separated from the effects related to senile involution. Besides emphasizing the role of the gynecologist, urologist, and general practitioner in the diagnosis of urinary stress incontinence in women, the data obtained raise the question of the revision of the existing views on the physiology of this disorder.

Adult↗

PubMedDate not supplied

[Terminology problems in connection with urinary stress incontinence].

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Female↗

PubMedDate not supplied

[Pathogenesis of urinary stress incontinence and principles of its surgical treatment].

As in different types of stress incontinence the mechanism of the destroyed urethral support is not the same, the principles of their surgical treatment are bound to differ. Generally speaking, the surgical intervention in stress incontinence aims at securing adequate mobility of the lower urinary organs, forming an effective suburethral support, and correcting the elements of the prolapse. Applying these principles in 508 women with stress incontinence having been surgically treated at the University Hospital Department of Gynecology and Obstetrics in Skopje from 1968 to 1976 and followed up at least two years afterwards, the global rate of relapses was 6.1%, by which the best results were obtained by Burch's modified method (2.1%), while after operations after Bonney or Barnett the frequency of relapses was relatively higher (7.1%). Analysing technical details in the carrying out of the above mentioned procedures, the authors plead for a most adequate preoperative preparation of patients, so as to determine and categorize the type of stress incontinence in question and allow the choice of the most appropriate surgical intervention in any given case.

Female↗

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[New radiologico-clinical classification of changes in stress incontinence in women].

Setting forth their experience in over 800 colpocystographies applied in genital prolapse and stress incontinence, the authors propose an original classification of changes in urinary stress incontinence with a view to unifying clinical and radiological findings. Along with classical, wellknown radiological aspects (urethral vesicalization and the prolapse of the urinary bladder) one new type of changes is described. It is named the slipping prolapse of the urinary bladder and is determined by the deterioration of the urethro-vaginal septum leading to a completely isolated dislocation of the lower urinary organs and the frontal vaginal wall. The combination of these aspects gives the three types and six variants of stress incontinence which, from the clinical point of view, may be manifest, masked, and potential. The pathogenesis of different types of the disease is analysed, as well as the principles of their therapy. The authors plead for the widest possible use of colpocystography in the preoperative preparation on patients, especially in relapses, since the method is simple and harmless, yielding extremely useful informations in the study of the morphotopography of pelvic organs.

Female↗