Prevalence of Urinary Incontinence and Incontinence-related Quality of Life in Korean Women: A Population-based Study

PURPOSE: To assess the prevalence of urinary incontinence (UI) and incontinence-related quality of life in Korean women. MATERIALS AND METHODS: During April 2003, the prevalence of overall, stress, urge and mixed UI, frequency of incontinence symptom and quality of life influenced by UI in Korean women was assessed by telephone survey. RESULTS: Of the 1,303 women with a mean age of 48.1 (+/-12.9, S.D.) years, 537 (41.2%) reported UI, comprising 492 (37.8%) with stress UI, 234 (18.0%) with urge UI, 194 (14.9%) with mixed UI and unclassified 5 (0.4%). The prevalence of UI increased with age significantly (p< 0.05). The frequency of stress UI symptom was as follows: 'always' 3.0%, 'a few times a day' 3.7%, 'about once a day' 3.9%, '2-3 times a week' 7.5%, 'less than 1 in a week' 81.9%. Incontinence-related quality of life was significantly dependent on the type of incontinence: the proportion of women who feel unsatisfactory with their incontinence was significantly higher in urge UI and mixed UI than stress UI (p< 0.01). The need for medical consultation for UI was also variable according to the type of incontinence: 20.0% in urge UI, 19.1% with stress U and 25.8% in mixed UI. However, the proportion of women who do not willing to consult medical help was significantly higher in stress UI than other types of UI. CONCLUSION: The present study revealed that there was a high prevalence of UI in Korean women and the impact of UI on the quality of life was high. Therefore, tailored education to the women about the UI seems to be highly necessary.

The Effects of a Pubovaginal Sling Procedure, with Martius Labial Fat Pad Interposition, after a Female Urethral Diverticulectomy / 대한비뇨기과학회지

PURPOSE: We evaluated the effects of a pubovaginal sling (PVS), with a Martius labial fat pad interposition (MLFI), on patients with a female urethral diverticulum. MATERIALS AND METHODS: 23 consecutive cases with a female urethral diverticulum were retrospectively reviewed. The pre-operative evaluations included the history, physical examination, voiding cystourethrogram, cystoscopy, transperineal ultrasound and urodynamic studies to investigate the urethral function and the concomitant stress urinary incontinence. The treatment consisted of a transvaginal diverticulectomy alone, or with a PVS only, or combined with a MLFI. RESULTS: A transvaginal diverticulectomy only was performed, using a 3-layer closure, in nine patients (39.1%) and a concomitant PVS with a diverticulectomy in eight (34.8%) with stress urinary incontinence. A MLFI, combined with the above procedure, was performed in six patients (26.1%) with large defects of the urethra following the resection of diverticulum. No women having undergone a diverticulectomy with, or without, a PVS and MLFI had an urethrovaginal fistula, recurrent diverticulum or postoperative incontinence. CONCLUSIONS: In complicated cases, a simultaneous transvaginal diverticulectomy, pubovaginal sling and Martius labial fat pad interposition can be performed safely and effectively.

Relationship between Microdeletions on the Y Chromosome and Defect of Spermatogenesis / 대한불임학회지

OBJECTIVES: To estimate the frequency of Y chromosome microdeletions in the Korean population of infertile men and to evaluate the relationship between microdeletion on the Y chromosome and clinical phenotypes of infertile men with idiopathic azoospermia and oligozoospermia. MATERIALS AND METHODS: Genomic DNA was extracted from blood samples collected from 330 infertile men attending the Infertility Clinic at Samsung Cheil Hospital, Korea. Six sequence tagged sites (STSs) spanning the azoospermia factor (AZF) regions of the Y chromosome were amplified by polymerase chain reactions (PCRs). RESULTS: Microdeletions on Y chromosome were detected in 35 (10.6%) of the 330 infertile men. Most of the microdeletions (91.4%) involved AZFb or AZFc. The high incidence of microdeletions were found in AZFc region (57.1%), but the low in AZFa (8.6%) and AZFb (5.7%). Larger microdeletions involving two or three AZF regions were detected in 28.6% of cases. All patients (6 patients) with deletion of AZFa region showed no germ cell phenotypes, Sertoli cell only syndrome or Leydig cell hyperplasia in histopathologic examinations. CONCLUSION: Microdeletions on the Y chromosome, especially, at AZFc/DAZ regions may be the major cause of azoospermia and severe oligozoospermia. We suggest that idiopathic infertile men have genetic counselling and microdeletion analysis on the Y chromosome before IVF-ET and ART program.

Relationship between Microdeletions on the Y Chromosome and Defect of Spermatogenesis / 대한불임학회지

OBJECTIVES: To estimate the frequency of Y chromosome microdeletions in the Korean population of infertile men and to evaluate the relationship between microdeletion on the Y chromosome and clinical phenotypes of infertile men with idiopathic azoospermia and oligozoospermia. MATERIALS AND METHODS: Genomic DNA was extracted from blood samples collected from 330 infertile men attending the Infertility Clinic at Samsung Cheil Hospital, Korea. Six sequence tagged sites (STSs) spanning the azoospermia factor (AZF) regions of the Y chromosome were amplified by polymerase chain reactions (PCRs). RESULTS: Microdeletions on Y chromosome were detected in 35 (10.6%) of the 330 infertile men. Most of the microdeletions (91.4%) involved AZFb or AZFc. The high incidence of microdeletions were found in AZFc region (57.1%), but the low in AZFa (8.6%) and AZFb (5.7%). Larger microdeletions involving two or three AZF regions were detected in 28.6% of cases. All patients (6 patients) with deletion of AZFa region showed no germ cell phenotypes, Sertoli cell only syndrome or Leydig cell hyperplasia in histopathologic examinations. CONCLUSION: Microdeletions on the Y chromosome, especially, at AZFc/DAZ regions may be the major cause of azoospermia and severe oligozoospermia. We suggest that idiopathic infertile men have genetic counselling and microdeletion analysis on the Y chromosome before IVF-ET and ART program.

Influence on the Pregnancy Rate of Motility of Fresh and Frozen Testicular Spermatozoa in Obstructive Azoospermic Patients / 대한불임학회지

OBJECTIVE: ICSI with testicular sperm could achieve optimal fertilization and pregnancy. This study was performed to observe the influence on fertilization and pregnancy of motility of fresh testicular sperm and sperm extracted from frozen-thawed seminiferous tubules in obstructive azoospermia. MATERIALS ANDMETHODS: We analysed clinical outcome of ICSI using fresh testicular sperm and sperm extracted from thawed seminiferous tubules. The presence of motility were compared to determine the factor for optimal fertilization and pregnancy rates. RESULTS: In 316 cases of TESE-ICSI in obstructive azoospermia, ICSI with fresh testicular sperm (fresh sperm group) were 163 cases and ICSI with sperm testicular sperm extracted from frozen-thawed seminiferous tubule (thawed sperm group) were 153 cases. The fertilization rates were 71.3% and pregnancy rates were 32.5% in fresh sperm group, in thawed sperm group, 65.1% and 33.3% respectively. The fertilization and pregnancy rates of motile and non-motile testicular sperm were 72.9% and 33.6%, 50.0% and 18.2%, respectively (p<0.05). The fertilization and pregnancy rates of motile and non-motile sperm extracted from the thawed seminiferous tubule were 67.8% and 34.7%, 55.1% and 28.1%, respectively (p<0.05). The comparative of the results of ICSI using motile fresh testicular sperm and motile sperm extracted from thawed seminiferous tubule, fertilization and pregnancy rates were not significantly different (72.9% and 33.6%, 67.8% and 34.7%, respectively). CONCLUSION: These results suggest that successful pregnancy in TESE-ICSI treatment is influenced by the motility of fresh testicular sperm and sperm extracted from thawed seminiferous tubule in obstructive azoospermic patients.

Early Clinical Outcome and Complications of Tension Free Vaginal Tape Procedure in Stress Incontinent Women / 대한비뇨기과학회지

PURPOSE: The aim of the study was to evaluate the clinical outcome and complications of tension free vaginal tape (TVT) procedure for the surgical treatment of female stress urinary incontinence. MATERIALS AND METHODS: Between April 1999 and May 2000, 41 women with stress urinary incontinence underwent TVT procedure. Preoperative evaluation included questionnaires study, physical examination, one hour pad test and urodynamic study. Postoperative clinical outcome, patient's satisfaction and complications were checked after 3-months. RESULTS: The mean age of patients was 51.6 years (range 40-76) and mean hospital stay 2.1 days (range 1-10). The mean follow-up period was 9.9 months (range 3-15). Thirty six patients (87.8%) were cured, 2 patients (4.9%) were improved. Two of 3 patients with failed operation who developed postoperative urge incontinence had grade III cystocele. Five bladder perforations and 1 obturator nerve injury occurred. The abdominal leak point pressure (LPP) increased from 50.6cmH20 to 110.8cmH2O, detrusor pressure of maximal flow rate (Pdet.Qmax) increased from 15.8cmH2O to 28.6cmH2O and maximal flow rate (Qmax) decreased from 32.8ml/s to 22.5ml/s after operation. CONCLUSIONS: The TVT procedure is an effective and feasible surgical treatment for female stress urinary incontinence. However, in patients with grade III cystocele, postoperative urge incontinence may develop after the procedure. Since TVT procedure involves securing the mid-urethra, urinary obstruction may also occur, necessitating the need for continued follow-up as well as a careful comparison with other sling procedure.

Effects and Compliance of Pelvic Floor Muscle Exercise using Biofeedback in Women with Stress Urinary Incontinence

No abstract available in English.

Analysis of Influencing Factors on the Successful Pregnancy in Human IVF-ET Program Using Testicular Sperm Extraction (TESE) with Intracytoplasmic Sperm Injection (ICSI) / 대한비뇨기과학회지

No abstract available.

Comparison between Cadaveric Fascia Lata and Autologous Rectus Fascia in the Pubovaginal Sling Operation / 대한비뇨기과학회지

No abstract available.

Analysis of Inactivating Point Mutation of the Follicle Stimulating Hormone Receptor Gene in Korean Infertile Men / 대한남성과학회지

PURPOSE: Follicle stimulating hormone (FSH) is essential for normal gametogenesis. In females FSH is required for ovarian development and follicle maturation whereas in males FSH determines Sertoli cell number and normal spermatogenesis quantitatively and qualitatively. Recently, Tapanainen et al. (1) reported that an anactivating point mutation (C566T) of the FSH receptor gene in males suppressed spermatogenesis but did not cause azoospermia or absolute infertility. To study the significance of the C566T inactivating point mutation in male infertility, we examine the FSH receptor gene in men with azoospermia or oligozoospermia. MATERIALS AND METHODS: Peripheral blood was collected from each patient who had elevated serum FSH. To amplify a suitable segment of the FSHR gene containing nuceotide 566, primer flanking the region was used. And to screen individuals for the C566T mutation, PCR was performed for exon 7 of the FSH receptor gene in 58 patients. RESULTS: The 78-bp fragment containing nucleotide 566 was present in all patient, the PCR product in cleaved into fragments 51-bp and 27-bp by Bsm I digestion. No inactivating point mutations of FSH receptor gene was identified in men with azoospermia or oligozoospermia. CONCLUSIONS: Inactivating point mutation (C566T) of the FSH receptor is not a common cause of male infertility. However we cannot exclude point mutations in other regions of the FSH receptor gene in some patient with azoospermia or oligozoospermia.

Percutaneous Bladder Neck Suspension using Bone Anchors for the Treatment of Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: We investigated the technical feasibility and clinical results of percutaneous bladder neck suspension(PBNS) using bone anchors(Vesica) which represents a minimally invasive surgical procedure for the treatment of stress urinary incontinence caused by hypermobility of the proximal urethra and bladder neck. MATERIALS AND METHODS: Among women who underwent PBNS using bone anchors for type I or type II stress urinary incontinence, 22 women were followed for at least postoperative 9 months. A miniature bone anchor was used. On each side the suture was attached to the pubocervical fascia and the vaginal wall via a broad ?Z-stitch?. Postoperative voiding status was evaluated during office follow-up visits and telephone surveys. RESULTS: Mean operation time was 32 minutes. Mean hospital stay was 0.9 days. Mean follow-up was 13 months(9 to 18 months). In the 22 patients, the procedure was successful in 18 cases(82%), with 11(50%) of the patients completely dry and 7(32%) significantly improved. Preoperative urgency was present in 10 patients(45%). Postoperative resolution rate of urgency was 60%(6 of 10 patients). In 4 cases(18%), de novo urgency was documented. Removal of the bone anchor and suture was necessary in only one patient, because of persistent vaginal infection. Other complications were transient urinary retention in 3 patients(14%), prolonged suprapubic discomfort in 1 patient(4.5%) and incidental bladder perforation in 1 patient(4.5%). Major complications such as chronic urinary retention, osteitis pubis were not noted. CONCLUSIONS: The use of this bone anchoring technique and preservation of the endopelvic fascia appears to enhance the success rate without increasing the risk to the patient and, as minimally invasive procedures, reduce the surgery time and the length of hospitalization. However, the suspension sutures of PBNS may pull through the paraurethral tissue because there is no paravesical scar formation as in open procedures. Therefore we conclude that modifications of the suspension technique should be required for the improvement of long-term results.

The Efficacy of Biofeedback Treatment and Functional Electrical Stimulation in the Treatment of Stress Urinary Incontinence Patients / 대한비뇨기과학회지

PURPOSE: The purpose of this study is to evaluate the efficacy of biofeedback 1 treatment and functional electrical stimulation in stress incontinence patients as a physiotherapy and to know which factors affect on the outcome. MATERIALS AND METHOD: A group of 65 patients with stress incontinence were treated with combined alternating biofeedback and intravaginal electrical stimulation during 12 sessions, each 21 minutes in length, during 6 weeks. All patients had type l or ll stress incontinence. RESULTS: At immediate post treatment, subjective cure(complete dryness) rate was 15% and improvement(recovery to avoid other forms of treatment) rate was 60% and failure rate was 25%. Thus, the overall success rate for this treatment was 75%. In 49 patients who had all scheduled sessions and good compliance, subjective cure rate was 14% and improvement rate was 71%, but in 16 patients not to have good compliance, cure rate was 19%, improvement rate was 25%. In compliant patients, the result of 3 months after treatment showed cure rate was 11%, improvement rate was 54%. Compliance with reatment was the most significant parameter predictive of a good outcome(p<0.01) and the degree of stress incontinence was also significant in compliant patients(p<0.05). No clinical correlation with outcome was found in age, type, severity of cystocele, pelvic muscle strength, initial degree of vaginal contraction. Intravaginal pressure increased by an average of 10cmH20. Increased vaginal pressure was found in 93% of the patients and at least 50%improvement was 61%. Urge incontinence and urgency were present in 10(15%) and 19(29%) of the patients and improvement including cure was found 90% in urge incontinence and 89% in urgency. CONCLUSIONS: Biofeedback treatment and functional electrical stimulation is more effective for the patients who have good compliance, low degree stress incontinence and combined bladder irritation symptoms. In order to attain and maintain good results, a well structured biofeedback and functional electrical stimulation program that teaches specific muscle exercise should be used and the patients should be followed by a maintenance program and reinforcement.

Efficacy and Fertilizing Ability of Frozen-thawed Testicular Spermatozoa and Spermatozoa Extracted from the Seminiferous Tubule with Intracytoplasmic Sperm Injection (ICSI) / 대한불임학회지

The combination of testicular sperm extraction (TESE) with ICSI can achieve normal fertilization and pregnancy rate and is affective method in obstructive and non-obstructive azoospermic patients. But, when pregnancy was not occurred, repeated testicular biopsies are not evitable. Therefore, in this study, we observed the survival rate of testicular spermatozoa and spermatozoa extracted from the seminiferous tubules after cryopreserved-thawed used for next IVF cycle with ICSI. In a total of 23 cases, obstructive azoospermia was 17 cases and non-obstructive azoospermia was 6 cases. In obstructive azoospermia, after thawing, motile spermatozoa was observed in 13 cases (76.5%). The fertilization rate with 2PN was 67.6% and 5 pregnancies (29.4%) were achieved. In non-obstructive azoospermia, motile spermatozoa was observed in 2 case (33.3%) after thawing. The fertilization rates with 2PN was 53.7% and 3 pregnancies (50.0%) were achieved. A comparison of the results of motile spermatozoa after thawed testicular spermatozoa find spermatozoa extracted from the thawed seminiferous tubule section were 3 cases (60.0%) and 12 cases (86.6%), respectively, The fertilization and pregnancy rates of thawed testicular spermatozoa and spermatozoa extracted from the thawed seminiferous tubule section were 69.4% and 20.0%, 62.5% and 38.8%, respectively. Conclusively, thawed testicular spermatozoa and spermatozoa extracted from the thawed seminiferous tubule section can achieve normal fertilization and pregnancy and cryopreservation of testicular spermatozoa and seminiferous tubule may avoid repetition of testicular biopsies in azoospermic patients in whom the only source of spermatozoa is the testis.

The Comparison of Long Term Outcome after Burch and Stamey Operation in Stress Urinary Incontinence Patients / 대한비뇨기과학회지

Burch and Stamey operations are reliable techniques for correcting genuine stress urinary - incontinence. The purpose of this study is to evaluate which operation brings better success and which factors affect the postoperative outcome. We reviewed 103 patients who underwent Burch (53 patients) and Stamey (50 patients) operations between January 1992 and June 1994 for stress urinary incontinence. The followup period of all patients was over 2 years and mean followup was 37 months. A standardized questionnaire using telephone was used to evaluate postoperative outcome. Cure (complete dryness) rate was 72% in Burch and 48% in Stamey group. Overall, a successful outcome (cure or rare stress incontinence not requiring protection) was 92% of patients in Burch and 76% in Stamey group. In Stamey group, the only significant predictor of outcome was the degree of preoperative stress urinary incontinence (mild, moderate, severe) but not in Burch group. No statistical correlation in success was found with patients age, number of parity, prior hysterectomy, combined operation (hysterectomy, anterior and posterior colporraphy), preoperative urgency and urge incontinence. Preoperative urgency was present in 23% of Burch, and 30% of Stamey group patients. Postoperative resolution of urgency was 58% in Burch, and 60% in Stamey group. De novo urgency occurred in 20% of Burch group patients, and in 14% of Stamey group patients. Persistent or de novo urgency was more common among failure group than success group (75% vs 20% in Burch group, 42% vs 16% in Stamey group). The success rate of Burch operation was higher than Stamey operation. So we think Burch operation is better management for stress urinary incontinence. In Stamey group, the only factor affecting on outcome was the degree of preoperative stress urinary incontinence.

Analysis of the Azoospermia Factor (AZF) Gene on Y Chromosome and Expression Pattern of DAZ Gene in Korean Infertile Men / 대한불임학회지

Cytogenetic observations of loss of the distal portion of the Y chromosome long arm were found to be associated with disrupted spermatogenesis. The existence of a gene involved in the regulation of spermatogenesis, the azoospermia factor (AZF), was postulated. In this study, we screened the AZF region including DAZ and DAZH genes and observed the expression pattern of DAZ and DAZH transcript in infertile men with azoospermia and oligospermia by using a sequence-tagged site (STS)-based PCR method. PCR primers were synthesized for 11 STSs that span Yq interval 6, SRY, DAZ, and DAZH, functional DAZ homologue on chromosome 3. Microdeletions were detected in 4/32 (12.5%) azoospermic men and 1/11 (9%) severe oligospermic men. Only 2 of 5 patients had microdeletions of Yq that contained the 342 gene, whereas the other 3 patients had deletions extending from intervals 5L-6F proximal to the DAZ gene on Yq. Testis biopsies of the azoospermic patients revealed a variety from Sertoli cell-only syndrome to testicular maturation arrest. Of 4 men with clinical data available, average testis size was R: 13.8 co, L: 13.8 co, serum T was 4.0+/-1.25 ng/ml, LH was 3.63+/-1.90 mIU/ml, and FSH was 8.85 +/- 5.13 mIU/ml. These values did not differ significantly from the remainder of the patients tested. We could not observed the DAZ transcript in 2 patients, who have no mature spermatozoa. In 11,6% of patients microdeletions of the AZF could be detected. These deletions in the AZF region seem to be involved causing spermatogenic failure. But the frequency of microdeletions proximal to DAZ suggests that DAZ is not the only gene associated with spermatogenic failure.

The treatment of Non-obstructive Azoospermia / 대한불임학회지

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.

Fertilization and Pregnancy Rate of Testicular Sperm after Testicular Sperm Extraction (TESE) with Intracytoplasmic Sperm Injection(ICSI) / 대한불임학회지

This study was carried to determine the possibility of finding motile spermatozoa and fertilization, pregnancy rate after testicular sperm extraction(TESE) with ICSI in obstructive and non-obstructive azoospermic patients. In 154 cases(132 patients), obstructive azoospermia was 77 cases and non-obstructive azoospermia was 77 cases. In obstructive azoospermia, patients generally showed normal spermatogenesis and included vas agenesis(n=8), multiple vas obstruction(n=7), epididymal obstruction (n=54). Total of 982 retrieved oocytes were obtained and 84.4% were injected. The fertilization rates with 2 PN and cleavage rate were 72.5% and 62.3%, .respectively. 30 pregnancies(38.9%) were achieved and the ongoing pregnancies were 22 cases (28.6%). In non-obstructive azoospermia, patients showed hypospermatogenesis(n=49), maturation arrest(n=4), Sertoli cell only syndrome (n=24). The various stages of spermatogenic cell could be retrieved by TESE and could be reached normal fertilization and embryo development with ICSI. Total of 1072 retrieved oocytes obtained and 80.2% were injected. The fertilization rates with 2 PN and cleavage rate were 52.8% and 68.9%, respectively. 22 pregnancies(30.1%) were achieved and the ongoing pregnancies were 19 cases(26.0%). Conclusively, the combination of TESE with ICSI using testicular spermatozoa can achieve normal fertilization and pregnancy rate and effective method in obstructive and non-obstructive azoospermic patients.

Comparison of Extraperitoneal Laparoscopic Burch versus Open Burch and Raz`s Suspension for Female Genuine Stress Urinary Incontinence / 대한비뇨기과학회지

The purpose of this study was to determine the feasibility of treating female stress incontinence with a extraperitoneal laparoscopic Burch. We compared the operative data of laparoscopic Burch, open Burch and Raz`s suspension and we introduced our technique, hybrid of the laparoscopic Burch and Gittes` procedure which avoids traditional intracorporeal suturing entirely. Twenty patients underwent a laparoscopic Burch were compared with 15 open Burch and 21 Raz`s suspension during the same time period for anatomical stress incontinence. We did not use the application of balloon dissection and intracorporeal suturing but extracorporeal knot tying. The results showed that laparoscopic Burch operation could shorten the Foley catheter removal day and hospital day compared to other methods. There were no significant differences in operation time and the complications. Laparoscopic Burch operation offers a less invasive approach to surgical correction of stress urinary incontinence and a rapid return to normal activities. Further clinical assessment is necessary to evaluate the long-term feasibility.

Biofeedback Therapy

No abstract available.

Is Pressure Transmission Ratio in Genuine Stress Urinary Incontinence a Good Parameter of Success after Operation? / 대한비뇨기과학회지

Pressure transmission ratio (PTR; A urethral pressure/A bladder pressure x 100) is obtained during cough profile and has been extensively used in pre and postoperative evaluation of patients with genuine stress urinary incontinence. The purpose of this study is to evaluate which urodynamic parameters are most effective for the decision of success after Burch operation in patients with genuine stress urinary incontinence. Twenty-one women with genuine stress urinary incontinence were evaluated urodynamically both before and after Burch operations. The patients` age was 49.5+/-7.51 and parity, 3.1+/-1.5. Mean follow up period was 8.7 months after operations (range 3-36 months). Dynamic and static urethral pressure profilometry were measured with microtip transducer catheter pre and postoperatively. The preoperative and postoperative functional urethral length (2.76+/-0.48 vs 2.75+/-0.47cm, p>0.05) and maximal urethral closure pressure (71.9+/-15.7 vs 72.8+/-15.2cmH20, p>0.05) showed no significant changes after eighteen successful Burch procedures. The PTR at the points of MUCP (maximal urethral closure pressure) was significantly improved after eighteen successful surgeries (85.9+/- 10.9 vs 113.4+/-13.5%, p0.05). The reasons for successful surgical treatment of stress urinary incontinence are not related to any changes in functional urethral length or maximal urethral closure pressure. However, the comparison of preoperative and postoperative PTR is helpful and objective in determining the adequacy of surgical correction of anatomical defect associated with genuine stress urinary incontinence.