Abstract
Conservative treatment of stress incontinence consists of pelvic floor muscle rehabilitation (Kegel exercises, vaginal cones, electrostimulation), drug treatment (alpha-sympathomimetics, tricyclic antidepressants, estrogens, duloxetine) and pessarotherapy. Conservative treatment of urge incontinence is based mainly on behavioral therapy and drug treatment with anticholinergics.
A revolutionary change in the surgical treatment of stress incontinence, polypropylene tape placed loosely under the distal urethra (TVT) achieving 90% success, was presented in 1996. A newer modification of tape surgery - TOT (transobturator application) was introduced in 2003 and marked a significant step to increase safety of mini-invasive surgical treatment of stress incontinence.
These operations are now fully replacing the most successful anti-incontinence operation in the past - colposuspension according to Burch.