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URGE AND STRESS INCONTINENCE FACT AND FICTION
Author(s) -
Frewen W. K.
Publication year - 1970
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1970.tb03429.x
Subject(s) - medicine , stress incontinence , urinary incontinence , urge incontinence , urine , surgery , urology
Summary A preliminary postoperative follow‐up of 600 personal cases of stress incontinence was made. A complete analysis of 412 of these cases had been accomplished up to the date of publication. This analysis showed a postoperative cure rate of 74·3 per cent. The apparent postoperative failure rate of 25·7 per cent (106 cases), which is in line with the majority of published works, is misleading and, indeed, fictitious. Incontinence of urine in 76 of the 106 cases was due to urge incontinence. The exclusion of urge incontinence by the psychomedical therapeutic test is an essential preliminary in almost all cases of incontinence. The operative results from primary vaginal surgery are probably much better than those usually postulated. Twenty‐three cases had had two or more operations and in all of these the incontinence was of the urge variety. The extensive literature on incontinence of urine in the female has not established with sufficient emphasis the role of urge incontinence and its symptomatic similarity to stress incontinence. The two conditions are frequently indistinguishable clinically and may well need a searching investigation in hospital to clarify the diagnosis. The psychomedical therapeutic test is a simple and practical method of differentiating one type of incontinence from the other and, in the author's opinion, should be universally adopted in almost all cases of incontinence of urine. This, in particular, applies to all cases of recurrent incontinence after previous surgery.