Surgery of Female Incontinence

1 The Mechanism of Continence.- Embryology of the Lower Urinary Tract.- Anatomy of the Lower Urinary Tract.- Neurological Control of Micturition.- Physiology of the Lower Urinary Tract.- Pathophysiology of Urinary Incontinence.- The Effects of Incontinence Surgery on Urethral Function.- Conclusions.- 2 Investigation of Incontinence.- Clinical Assessment.- Investigations.- The Future.- 3 Congenital Causes of Incontinence.- Assessment of the Wet Girl.- Ureteric Ectopia.- Urogenital Sinus Abnormalities.- Exstrophic Anomalies.- Congenital Neuropathic Bladder.- 4 Anterior Repair.- Operative Technique.- Post-operative Management.- 5 The Marshall-Marchetti-Krantz Procedure.- Operative Technique.- Post-operative Management.- 6 Colposuspension.- Operative Technique.- Post-operative Management.- 7 Sling Procedures.- Operative Technique.- Post-operative Management.- Summary.- 8 Endoscopic Suspension of the Vesical Neck.- Operative Technique.- Post-operative Management.- Summary.- 9 Abdominoperineal Urethral Suspension: The Zacharin Procedure.- Operative Technique.- Post-operative Management.- Conclusions.- 10 Neourethra: Rationale, Surgical Technique and Indications.- Operative Technique.- Post-operative Management.- Summary.- 11 Artificial Sphincter.- Developmental History.- Indications.- Pre-operative Evaluation.- Selection of Model.- Operative Technique.- Post-operative Management.- Results and Discussion.- Summary.- 12 Urinary Diversion.- Ileal Loop.- Ureterocolic Anastomosis.- Continent Heal Pouch.- 13 Urethrotomy.- Methods of Investigation.- Techniques.- Bladder Drainage.- Conclusions.- 14 The Management of Vesicovaginal and Urethral Fistulae.- Aetiological Groups.- Clinical Presentation.- Pre-operative Care.- Surgical Repair.- Post-operative Management.- Management of Failure.- 15 Ureterovaginal Fistulae.- Time of Occurrence.- Recognition of Fistula.- Spontaneous Closure of Fistulae.- Timing of Operative Intervention.- Pre-operative Investigation and Preparation.- Operative Procedures.- Post-operative Complications.- Summary.- 16 Pharmacology of the Bladder and Urethra.- Pharmacology of the Lower Urinary Tract.- Principles of Pharmacological Therapy.- Specific Methods of Pharmacological Therapy.- Effect of Tricyclic Antidepressants.- Effects of Other Pharmacological Agents.- 17 Electrostimulation.- Sacral Root Stimulation.- Electrode Implantation.- Summary.- 18 Post-operative Voiding Dysfunction.- Pathophysiology.- Problems of Inhibition—the Large Bladder.- Problems of Facilitation—the Unstable Bladder.- Surgical Causes.- Prevention.- Treatment.- Long-term Management.- 19 Post-operative Catheter Drainage.- Indications.- Suprapubic Versus Urethral Drainage.- Technique.- Conclusion.- 20 Choice of Surgery.- I.- Coexistent Gynaecological Conditions.- Urodynamic Contraindications.- Urodynamic Factors.- Choice of Surgery.- II.- Differential Diagnosis.- Treatment.- Problems in Management.