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Combined Raz urethral suspension and McGuire pubovaginal sling for treatment of complicated stress urinary incontinence.

Urinary incontinence is a debilitating problem that affects over 20 million people in the United States. Anatomical stress incontinence in women has an excellent continence outcome following urethral suspension procedures. However, intrinsic urethral incontinence has a high failure rate following urethral suspension procedures and is usually managed with a pubovaginal sling procedure. Eight patients with both anatomical and intrinsic urethral incontinence were managed with a combined urethral suspension procedure and pubovaginal sling procedure. Seven patients remain continent while one continues to have intrinsic urethral incontinence. The combined urethral suspension procedure and pubovaginal sling procedure appears to provide a treatment option for patients with coexisting anatomical and intrinsic urethral incontinence.