The outcome of transvaginal cystourethropexy in patients with anatomical stress urinary incontinence and outlet weakness.

Preoperative urodynamic and radiographic evaluation identified features of bladder neck and urethral weakness in 62 women undergoing cystourethropexy for the correction of anatomical stress urinary incontinence. Despite the coexistence of anatomical and outlet factors persistent stress incontinence due to intrinsic urethral weakness occurred in only 2 patients (3%), neither of whom was identifiable by preoperative urethral function evaluation. Preoperative coexisting urgency symptoms had no impact on the surgical outcome, resolving in the majority of patients with sensory urgency and responding to alternate postoperative management in those with bladder instability. We conclude that anatomical correction by cystourethropexy is appropriate for women with mixed etiology incontinence in whom urethrovesical hypermobility is present.