A woman reports leakage of urine with coughing, sneezing, and exercise with no urgency. Urodynamic study shows a significant leak at 60 cmH2O Valsalva leak point pressure with no detrusor overactivity. The most appropriate surgical treatment is:

• A Anterior colporrhaphy
• B Burch colposuspension
• C Pelvic floor exercises alone
• D Mid-urethral sling (tension-free vaginal tape) ✓

Explanation

This presentation is classic genuine stress urinary incontinence (SUI) confirmed urodynamically. Mid-urethral sling procedures, particularly tension-free vaginal tape (TVT) or transobturator tape (TOT), are the gold-standard surgical treatment with the highest cure rates (up to 85–90%). Burch colposuspension is an alternative open/laparoscopic procedure. Anterior colporrhaphy has poor long-term continence outcomes and is not recommended for SUI.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.