Abstract
This review summarizes the latest developments in surgery for genuine stress urinary incontinence, vaginal vault prolapse, and vesicovaginal fistula repair. Abdominal or endoscopie bladder-neck procedures are superior to classic anterior colporrhaphy in restoring continence. Needle suspension procedures tend to produce slightly higher long-term failure rates than the Burch operation does; pathophysiological reasons for this are discussed, as is the development of genital prolapse (an important complication after bladder-neck elevation). The anatomical and functional background of surgical therapy for vaginal vault prolapse is still poorly understood, although the existence of this distressing condition has long been established, and new aspects of it are being investigated. The role of injectables continues to be discussed controversially; recent results have tended to be disappointing.
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