Lack of a Specific Urethral Lesion in Exertional Urinary Incontinence

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Abstract
IT IS generally believed that exertional urinary incontinence is due to trauma of childbirth. Although there is no agreement on the precise structure that has been injured, prevailing opinion ascribes this symptom to tears or fixations of the urethral sphincters or to attenuations of the bladder and urethral supports. The signs of obstetric trauma, however, are often not discernible on pelvic examination or at operation, and even when present they frequently cannot be correlated with the degree of urinary incontinence. Thus, marked urinary leakage may occur in patients with intact pelvic structures, whereas women who on exertion lose only a . . .

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