Surgical management of urinary incontinence

Surgical treatment for urinary stress incontinence includes those correctiv e procedures for genuine stress incontinence (GSI), and these for severe fo rms of incontinence-including recurrent stress incontinence and intrinsic u rethral sphincter deficiency (ISD). Patients with GSI and a mobile bladder neck should have a retropubic suspension procedure either by open or laparo scopic technique. Anterior repairs and needle procedures do not have long-t erm effectiveness. Patients with ISD and an mobile bladder neck may be trea ted with periurethral bulking with collagen. Patients with ISD and a mobile bladder neck, or those with recurrent GSI or a complicating issue such as asthma, should have a suburethral sling procedure.