The Intravaginal Slingplasty Operation, A Minimally Invasive Technique For Cure Of Urinary Incontinence In The Female

EDITORIAL COMMENT: All readers surely believe that everyone with a new idea has a right to be heard although in the case of a journal this means passing scrutiny of the referees. In obstetrics the curse of all clinicians is prematurity. In gynaecology it is urinary incontinence. Stress incontinence is the urogynaecologist's delight with a specific diagnosis and a range of special procedures for its surgical treatment with high prospects of lasting cure. The enigma is detrus or instability and other forms of incontinence where there is no prolapse or evidence of stress incontinence clinically or on urodynamic investigation. Twenty years ago when the editor began attending the Repatriation General Hospital Gynaecology Clinic in Melbourne, which had a population of mainly elderly women, the overriding impression was of a group of miserable women with excoriated vulvas and urinary incontinence not amenable to surgery. Modern appliances provided in incontinence clinics and the widespread use of oestrogen has totally changed this picture but the problem of nonstress urinary incontinence remains. Many operations have been used for these patients. The present paper is written by an author with a passion for the management of women with urinary incontinence but with a frustration that this Journal has rejected his previous offerings after review by urogynaecologists with the editor's acceptance of their decisions. We have decided to publish this paper to give Dr Papa Petros a hearing. Some of the author's ideas are not easy to follow. Accordingly we asked him to encapsulate his philosophy concerning urinary incontinence in the female into about 800 words. This additional contribution is published as an epilogue to this paper; do not overlook it!