Treatment of female urinary stress incontinence: retraining or surgery?

Considerable progress has been made in the treatment of female urinary inco ntinence over the last 20 years, affecting both surgical treatment, by the introduction, apart from reference techniques, of so-called "minimal" techn iques, which allow an extension of the indications to elderly patients, and medical treatment? but also due to the introduction of increasingly better defined retraining techniques. A better understanding of the pathophysiolo gy of incontinence and the growth of urodynamic techniques allow a better a nalysis of the mechanisms responsible for incontinence, which is often mult ifactorial. The prevalence of female urinary incontinence also gives this d isease a considerable economic significance. Surgery is therefore no longer currently the only treatment that can be proposed to the patient. The resp ective indications for retraining and surgery need to be discussed, bearing in mind that? schematically, the 2-year results of surgery achieve 80 to 8 5% of cure with a more marked erosion over time when the initial repair was less solid, and retraining cures approximately 30% of women and improves a nother 30%.