Treatment of Urinary Stress Incontinence — Which Surgery Is Best?

Urinary incontinence affects approximately one third of older women, and the rate of surgical procedures to address this condition has doubled during the past two decades. In this 2-year multicenter trial, investigators randomized women who met criteria for urinary stress incontinence to one of two traditional surgeries: autologous rectus fascial sling or Burch colposuspension. Overall treatment success was defined as no self-reported incontinence; <15-g increase in pad weight during 24 hours; no incontinence episodes reported in a 3-day diary; negative urinary stress test with a bladder volume of 300 mL; and no behavioral, pharmacologic, or surgical retreatment. Success specific to stress incontinence was defined as no self-reported stress…