The results of a clinical study of conservative treatment of women with stress incontinence are presented. A daily dose of 75 mg. imipramine hydrochloride was given for 4 weeks. Special attention was paid to the effects of imipramine on the functional urethral length and maximum urethral closure pressure. A total of 21 women (71 per cent) stated that they were continent after treatment with imipramine, while 9 (29 per cent) did not improve and treatment was stopped. According to our results, imipramine extended the functional urethral length and made it independent of stress factors in women who were continent after treatment with imipramine. In patients with persistent incontinence the functional urethral length was extended significantly but was shortened with stress despite imipramine therapy. We believe that imipramine could be an alternative treatment in selected cases with stress incontinence.

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A total of 36 female patients with genuine stress urinary incontinence underwent Raz needle suspension with fixation of suspension sutures to the iliopectineal ligament (transvaginal Burch procedure). By fixing suspension sutures to the iliopectineal ligament we expected to achieve a static suspension independent of everyday patient activities. Considering the small number of patients and limited followup, our results revealed continence in 80 to 85% of the patients after 3 years. We believe that fixation of suspension sutures to the iliopectineal ligament can favorably influence long-term results of needle suspension in the treatment of female stress urinary incontinence.

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