Surgical management of urinary stress incontinence in women: a historical and clinical overview

Abstract

Urinary incontinence is a highly prevalent condition that has a significant impact on the affected patients' quality of life. Approximately one in three women suffers from some degree of urinary incontinence. Six to ten percent of them are severely affected. Cure or significant improvement can often be achieved after making the right diagnosis, tailoring the treatment accordingly and realistically counseling the patient on the expected outcome. This article focuses on the pathophysiology of genuine or urodynamic stress incontinence (USI) and its surgical management. Until now more than 200 surgical techniques have been described for the treatment of USI. An overview of the historically most important and most commonly used procedures is included. In view of the level I data and the long-term observational studies available on the TVT procedure, it can be considered to be the new gold standard for the treatment of USI.