A 45-year-old woman leaks urine with coughing, sneezing, and exercise. Urodynamic study confirms genuine stress urinary incontinence (SUI) with a urethral closure pressure of 28 cmH₂O and no detrusor overactivity. She has failed supervised pelvic floor muscle training. The gold standard surgical procedure for genuine SUI is:

• A Colposuspension (Burch procedure)
• B Periurethral bulking agent injection
• C Anterior colporrhaphy
• D Mid-urethral sling (tension-free vaginal tape, TVT) ✓

Explanation

Mid-urethral slings (tension-free vaginal tape — TVT or transobturator tape — TOT) are now the gold standard surgical treatment for genuine stress urinary incontinence, based on multiple RCTs and long-term data showing 85–90% cure rates at 5 years with low complication profiles. The Burch colposuspension was the historical gold standard and remains valid but is now less commonly performed. Periurethral bulking agents have lower and less durable success rates. Anterior colporrhaphy has a high recurrence rate for SUI and is no longer recommended for isolated SUI.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.