[Surgical therapy of female urinary incontinence]

Within the past years, surgical concepts for treating females with urinary incontinence have greatly changed. The spectrum of indications is becoming increasingly narrower. All possible conservative treatment modalities must first be attempted. Should the incontinence still continue to evoke social or hygienic problems, stress incontinence is usually treated with the minimally invasive TVT procedure (Tension-free Vaginal Tape), and in special cases, a modern modification of colposuspension is undertaken. Based on a success rate and specific complications, it is now known which slings and colposuspension techniques should no longer be used. Vaginal reconstructive surgery for pelvic organ prolapse, such as anterior and posterior repair and sacrospinous colpopexy are now obsolete for treating incontinence. Likewise discussed are operative procedures for rare forms of female incontinence and for urge incontinence, resistant to therapy.