[Surgical therapy for stress urinary incontinence]

Stress urinary incontinence (SUI) is a common disorder among women of all ages, which compromises their quality of life. It may compromise self-esteem, restrict lifestyle, strain relationships, and may ultimately lead to social embarrassment and isolation. Therefore, SUI management does not only imply cure or improvement of SUI, but also includes psychological and social assistance to help sufferers to cope with their condition. In this regard, it is important to acknowledge the role of the patient in the selection of an appropriate treatment. Physicians and patients can choose between conservative, pharmacological, and surgical treatments. Surgical techniques for SUI have evolved over the last 150 years. Accurate diagnosis of SUI is essential before surgery is undertaken. Many surgical procedures have been employed, which can be divided into four basic types: anterior colporrhaphy, colposuspensions, suburethral sling procedures, including TVT, as well as suburethral bulking agents. This wide variety of surgical procedures indicates the lack of consensus on which procedure is best. In most continence surgery, the benefit of restoring continence often comes at the expense of instigating new symptoms or exacerbating existing lower urinary tract symptoms.