Table 5.

Goals of Surgical Options for Stress Urinary Incontinence

Surgical Option	Goal
Anterior repair	Reposition the urethra or “plicate” the sphincter
Retropubic approach: MMK,	Reposition and/or stabilize urethra or create a
Burch colposuspension	“backboard” of support for urethral compression
	during increased intraabdominal pressure
Vaginal approach: Pereyra,	Same as retropubic approach with avoidance of a
Stamey, Gittes, Raz	large abdominal incision and associated morbidity
Sling: autologous,	Same as retropubic approach with or without
cadaveric, synthetic,	direct urethral coaptation or compression
vaginal wall, etc
TVT and other polypropylene	Dynamic midurethral support
midurethral slings
Artificial urinary sphincter	Intermittent, dynamic urethral coaptation and
	compression
Bulk injectables	Improve urethral coaptation
Radiofrequency	Reposition or stabilize urethra

MMK, Marshall-Marchetti-Krantz procedure; TVT, tension-free vaginal tape.