The anterior vaginal wall as an organ for the transmission of active forces to the urethra and the clitoris.

Attention is drawn to the fact that the anterior vaginal wall is not a simple mucous membrane but an active organ, with a hammock-like effect on the urethra. It also functions during intercourse to transmit the effect of penile introduction into the vagina to the clitoris, by stretching the two ligaments that insert around its base.

The influence of an early diagnosis on the results of surgical treatment of ectopic pregnancy.

The postoperative fertility of 292 cases of ectopic pregnancy treated 1972-1979 was studied. Of these 156 were operated upon during 1972-1976, when only determinations of HCG in urine were available and 136 during 1977-1979, when RIA-determinations of HCG in serum made an earlier pregnancy diagnosis possible. In spite of the fact that the time of observation was shorter in the second group the pregnancy rate was 41% compared to 31% in the first one (P less than 0.

[Operative therapy of urinary incontinence. Preoperative requirements--operation methods--after care].

Optimum success may be obtained from those incontinence operations which form one coherent unity with presurgical and postsurgical measures. Full elucidation of the symptom of urinary incontinence has proved to be the most important preoperative necessity. More comprehensive urometric objectivation will be required for problems which cannot be answered by a minimum programme.

Surgical treatment of post abortum endometriosis of the bladder and postoperative bladder function.

During the years 1953-1967, 17 women with endometriosis of the urinary bladder were treated with extirpation of the endometrial tissue, including partial or total resection of the trigone. In all cases the endometriosis had followed vaginal hysterotomy for legal abortion. Urethrocystoscopy was performed and the residual urine and bladder capacity were measured in all the patients one month and one year after the bladder operation.

Surgical treatment of urinary fistulae.

A survey is presented, based upon a personal material of 225 cases of urinary fistulae. 173 of them were postoperative or obstetric fistulae, whereas 52 had appeared after a radiological or combined radiological and surgical treatment for cancer of the uterus. --The author's method for preparing the fistula region from a transverse incision under the external urethral orifice is described as well as his grafting techniques.

Pressure transmission to the pre-urethral space in stress incontinence.

Pressure transmission from the abdomen to the pre-urethral space has been studied in stress- incontinent women and in some women following pubococcygeal repair for stress incontinence. Pressure was recorded at different levels of the pre-urethral space and simultaneously in the bladder. Simultaneous measurements inside and outside the urethra at different levels above the external urethral meatus showed that an intra-abdominal pressure rise was transmitted via the pre-urethral space to the urethra.

Urethral pressure profile before, during and after pubococcygeal repair for stress incontinence.

In two groups of women the urethral pressure profile was recorded using a microtransducer catheter. Both groups were of approximately the same age, one consisting of continent women, the other of women with severe stress incontinence. Sixteen stress incontinent woman were examined before and after pubococcygeal repair and 10 of these were also examined during the operation.

Reversible sterilization.

The present techniques for sterilization of women consist of different methods to block the passage through the oviducts. The disadvantage of all techniques is that the possiblity of restoring fertility is very limited. The aim of the present study is to demonstrate a method of sterilization which is reversible.

In vivo determination of the stress-strain relation of the human myometrium.

Smooth muscle is capable of responding by contraction to mechanical distension. Neither the structural basis for this phenomenon nor the theories of smooth muscle behavior are completely clear. A method is now described by which the contractile response to mechanical distension of the human uterine muscle in vivo is determined.

Urge incontinence in women.

A survey has been presented of the author's personal methods to treat urge incontinence in women caused by neurogenic disturbances or by urethritis. Denervation of the bladder by unilateral or bilateral resection of the inferior hypogastric plexus is used for neurogenic disturbances with uninhibited bladder contractions or hypertonic bladders and in cases of interstitial cystitis, if a preoperative blockade with local anaesthesia has given a favourable result. Urethral diverticula are extirpated.