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A case of penile replantation is reported in which a 37-year-old man suffered a self-inflicted complete penile amputation. Replantation was successfully performed; at 3 months after surgery, a urethrocystogram demonstrated the absence of urethral stricture. Although complete erection has yet to be obtained, no other functional impairments have been encountered at 7 months after replantation. Reconstruction of the venous system is considered to be one of the most important factors in achieving a successful penile replantation.

In 398 patients suffering from urinary incontinence seven urodynamic parameters were investigated. 75% resp. 78% had a normal max. urethral closure pressure. Only a part of the women was characterized by a descensus of the genital tract. Some more patients showed anatomic abnormalities in the urethrovesical configuration by x-ray urethrocystogram. 1/5 res. 1/3 of descendent anterior vaginal walls proved to have a cystocele. If one requires for successful incontinence operation a normal max. urethral closure pressure and an objectively proven abnormality of the urethrovesical configuration, only 65% resp. 67% of our incontinence women have a chance of being cured by incontinence operation.

In Reply.— I believe that a number of urologists would agree with Dr Langlois, and I would gladly rebut his comments. The available data on urgency and frequency and the prevalence of meatal stenosis do not match Dr Langlois's impressions, but rather suggest that he sees a select population of enuretics. Hallgren,1in a study of several hundred enuretic children attending a clinic, found that 22% experienced frequent urination; 7%, urgent urination, and 14%, both. Only 2.5% of the enuretic children had malformed urinary tracts; 3% were found to have obstructive lesions by urethrocystogram; and less than 1% of intravenous pyelograms showed an anomaly. Very different figures have been reported from urologic clinics, for example, by Mahony.2The answer to these questions seems to depend on the pool of patients and on one's special interest, but Hallgren's data are probably closest to the experience of family practitioners and