[Subjective and objective improvement of urinary incontinence in females following vaginal and abdominal incontinence operations]. / Subjektive und objektive Verbesserung der weiblichen Harninkontinenz nach vaginalen und abdominalen Inkontinenzoperationen.

236 patients were reevaluated one year after vaginal or suprapubic continence surgery. Personal history, clinico-gynaecological status, morphology and urodynamics were considered. 70.6% respectively 82% of all patients considered themselves cured. These numbers correlate well with objective control parameters. The clinical examination shows that a suprapubic approach is better for an urethrocele whereas vaginal surgery is more successful for a cystocele or rectocele. The correction of an urethrocele has however a greater influence on the chance of cure. Obesity is a risk factor especially for vaginal surgery and in both groups oestrogen application improved the healing process. The morphological examination demonstrates the importance of urethro-vesical suspension giving better results after suprapubic than after vaginal operation. The urodynamic results depend on the choice of measurement parameters. Suprapubic surgery generally brings about a greater improvement in pressure conditions than vaginal surgery. The best parameter seems to be the Dep Q. Vaginal continence surgery needs a good indication with a best possible urethro-vesical suspension. This is not an operation for beginners.