Colposuspension and the more recently introduced tension-free vaginal tape are the operations of choice for stress urinary incontinence. However, this condition rarely presents alone. Common co-existing problems are bladder overactivity and pelvic organ prolapse. Voiding difficulty, menstrual problems or pelvic masses may also be present. Increasing age, obesity, frailty or a history of previous failed surgery are additional complicating factors. Surgery for stress incontinence needs to take all these variables into account.
Not all symptoms may be cured by one operation; co-existing conditions might worsen and complications may develop. The outcome of surgery for stress incontinence also relies on careful pre-operative counselling and discussion on what will and will not be helped, as well as success rates and complications.
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