Surgical Treatment of Stress Urinary Incontinence in Women in the Mainland of China: Current Status and Outlook

Surgery for female stress urinary incontinence (SUI) has been making remarkable progress in recent decades. Hammock theory[1] has been a milestone in explaining the etiology of SUI, as introduced by Ulmsten, illustrating that dysfunction of pubourethral ligament and pubococcygeus is the major pathological mechanism of SUI. Anti‐incontinence sling is divided into retropubic route[2] and obturator route:[3] retropubic route embraces “down‐up” and “up‐down” approach to complete puncture of sling placement and obturator route consists of “inside‐out” and “outside‐in” approaches to complete the puncture sling placement. Moreover, in recent years, a more minimally invasive operation has been developed based on these two kinds of routes: the single mini‐incision sling, with minimal invasiveness, less sling implanted, and no skin incision of the skin. Tension‐free vaginal tape (TVT) with the application of synthetic sling to strengthen the vagina pubourethral ligament has become the first choice of SUI treatment performed by urinary gynecologists, urologists, and gynecologists worldwide for its minimal invasion and durable effect.