Management of Stress Urinary Incontinence

  • Aswini Balachandran
  • Jonathan Duckett


Stress urinary incontinence is a common debilitating condition affecting millions of women worldwide. Conservative treatments are recommended as first-line therapies, but many women need surgical treatment if pelvic floor muscle training is ineffective. In the past the colposuspension operation was the gold standard, but over the last 15 years, this technique has been replaced by mid-urethral sling procedures. These have a high success rate and reduced morbidity. The original retropubic (down-up) sling has been modified and now transobturator slings (inside-out and outside-in) are also available. Recently, short single-incision slings (mini-slings) have been introduced, although current evidence suggests an inferior outcome. We are still learning the benefits and limitations of each type of sling, and many surgeons express a keen preference for one sling over another. Different surgeons obtain very different results with similar slings. As surgeons we should aim to audit our results so that we ensure we give our patients the best possible outcome. This article reviews the current surgical treatment options for stress urinary incontinence.


Stress Urinary Incontinence Detrusor Overactivity Pelvic Floor Muscle Training Artificial Urinary Sphincter Pubovaginal Sling 
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Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.Department Obstetrics and GynaecologyMedway HospitalGillingham, KentUK

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