title: Surgical treatment for female stress urinary incontinence: what is the gold-standard procedure?
abstract: In the last few years, the Burch colposuspension and the fascial slings were often defined from the pages of the most relevant journals of general medicine, as gold-standard procedures for the surgical treatment of stress urinary incontinence (SUI), whereas mid-urethral slings (tension-free vaginal tape (TVT) and tension-free vaginal tape obturator) were attributed a marginal and almost experimental role in this field. This poorly reflect the current scenario of the surgical management of SUI: Recently, a number of meta-analysis have demonstrated that TVT is significantly more effective if compared to colposuspension and that it is followed by significantly lower perioperative morbidity if compared to pubovaginal slings. It is not realistic to suggest to general practitioners that the surgical gold standard for SUI includes the performance of a wide laparotomy, long hospital stays and a high risk of long-lasting intermittent self-catheterisation. This would inevitably discourage women from embarking on surgical treatment, which instead could actually improve their quality of life.
authors.affiliation: Urogynaecology Unit, Del Ponte Hospital, University of Insubria, Varese, Italy. mauserati@hotmail.com
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.forename: Stefano
authors.initials: S
authors.lastname: Salvatore
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Linda
authors.initials: L
authors.lastname: Cardozo
authors.forename: PierFrancesco
authors.initials: P
authors.lastname: Bolis
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods