Surgical Treatment of Urodynamic Stress Incontinence

The aim of this guideline is to highlight the evidence for different surgical approaches, since the best chance of surgical ‘cure’ for stress incontinence is successful primary surgery. Primary surgery should only be considered after a period of conservative treatment from a specialist therapist has been offered and rejected, or has failed. There is evidence from a Cochrane review that pelvic-floor muscle training is effective in patients with stress or mixed incontinence, and that intensive therapy is better than standard pelvic floor training. The role of conservative therapy following previous continence surgery has not been established.