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Surgical management of stress incontinence in patients with low urethral pressure.

Thirty-four women with genuine stress incontinence and low urethral closure pressure were studied pre- and postoperatively. A modified Burch retropubic urethropexy was performed in 29 patients with a cure rate of 78%, improvement in 7%, and failure in 15%. The modified Stamey procedure was performed in 5 patients with significant pelvic floor relaxation with a cure rate of 40% and improvement in 60%. If urethral mobility is present, traditional anti-incontinence procedures appear to be a reasonable alternative in patients with low urethral pressure.