What are the effects of nonsurgical treatments for women with stress incontinence?
Likely to be beneficialPelvic floor electrical stimulation
Pelvic floor muscle exercises
Selective serotonin reuptake inhibitors (duloxetine)
Vaginal cones
Trade-off between benefits and harmsEstrogen supplements
Unknown effectivenessAdrenoceptor agonists
What are the effects of surgical treatments for women with stress incontinence?
BeneficialLaparoscopic colposuspension (similar cure rates to open retropubic colposuspension and TVT)
Open retropubic colposuspension (higher cure rates than nonsurgical treatment, anterior vaginal repair, or needle suspension, and similar cure rates to laparoscopic colposuspension, traditional suburethral slings, transobturator foramen procedures, and TVT)
Suburethral slings other than TVT (similar cure rates to open retropubic colposuspension, TVT, and needle suspension, but more perioperative complications than needle suspension)
Likely to be beneficialTransobturator foramen procedures (similar cure rates to TVT and open retropubic colposuspension)
Trade-off between benefits and harmsTVT (similar cure rates to laparoscopic colposuspension, non-TVT suburethral slings, transobturator foramen procedures, and open retropubic colposuspension, but associated with more bladder and vaginal perforations)
Unlikely to be beneficialAnterior vaginal repair (lower cure rates than open retropubic colposuspension, but similar cure rates to needle suspension)
Needle suspension (lower cure rates and more surgical complications than open retropubic colposuspension)