Surgical management of urinary stress incontinence - Where are we now?

Mid-urethral sling procedures (MUS) have been the surgical option of choice for most gynaecologists and urologists treating stress urinary incontinence (SUI) in women around the world for almost 20 years, since their introduction in the late 1990s. The evidence suggests that the long-term effectiveness of the MUS is good and similar to the Burch Colposuspension and the fascial pubovaginal slings. The bulking agents are now being put forward as another minimally invasive option for the surgical treatment of SUI. Despite the increasing evidence that the retropubic MUS are more effective in long term and in high failure risk women with recurrent SUI and ISD, the TOT continues to have a high satisfaction and usage worldwide.