A.G.V.G. 60 years old coming from Montevideo. Without any family antecedents to mention; with personal pathological antecedents of arterial hypertension treated with a diet. multiple pregnancies 4, multiple deliveries 4. Menopause at 55 years old. Without climacteric syndrome.
Operated in 1972 for urinary incontinence to minimum efforts according to Kelly-Marion Technique - relapse in 1973. Operated in 1977 according to Burch Technique but at a posterior time. Relapse in 1995 with urine loss in a progressive way, being at the moment of the consultation in April 1996 to minimum efforts. There are no elements of urinary urgency. There is no complaint about others urinary symptomes.
In general, an obese patient, height 1.65 mts. Insuficient chronic veins in left inferior limb. No trophic disorders.
In the genital area: Urinary incontinence is proven to minimum efforts. Hipotonic elevators muscle, perineum category III.
Perineal Ultrasound: Fixed urethra during increases of the abdominal pressure.
Urethrocystoscopy: incompetent sphincter during to minimum efforts. Limited urethral closure during to retention handling.
Urodinamic: Stress urinary incontinence, falling of urethral resistance. There is no element of bladder instability.