With nearly 50% of women in the United States experiencing symptoms of stress urinary incontinence (SUI), the American Urological Association (AUA), a leading global urology association and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU), the premier urological subspecialty society dedicated to improving the art and science of female pelvic medicine and reconstructive surgery, recently released a joint evidence–based clinical guideline on the surgical treatment of SUI in women.

SUI is defined as the involuntary leakage of urine due to increased abdominal pressure, which can be caused by such activities as physical exercise, sneezing, laughing or coughing. Approximately half of all women experience SUI symptoms during their lifetime, and many of these women are sufficiently bothered by their symptoms to seek treatment from a physician. Pelvic floor muscle exercises and other nonsurgical treatments can be effective therapies, but many women choose to undergo surgery to treat their SUI symptoms.

The joint clinical guideline for the surgical treatment of SUI makes 24 recommendations in total. Determining when to perform additional evaluations to confirm and characterize SUI; discussing risks, benefits and alternatives to various surgical treatment options such as midurethral synthetic sling procedures; and suggesting surgical treatment of SUI be deferred until after child bearing is complete, are among the recommendations made.

"SUI can have a significant negative impact on a woman's quality of life," said Kathleen Kobashi, MD, who served as chair on the panel that developed this guideline. "The surgical treatment options for SUI have evolved significantly over the past decade. These new guideline statements provide the best–available clinical direction for selecting today's most effective surgical treatment methods while concomitantly considering the risks, benefits, and caveats specific to individual patients."

More than 200 million people worldwide have struggled with SUI, which can seriously affect the quality of life of both men and women. As a disease whose prevalence is related to advancing age, it affects more women than men with an approximate ratio of 3:?1.

"Both the AUA and SUFU have long been committed to researching, treating and developing clinical guidance for urologists and practitioners of varying disciplines," said Gary Lemack, MD, SUFU President. "This guideline is fully aligned with the latest science and provides physicians with a relevant blueprint for treating patients with SUI."

This clinical guideline was created by a panel with specific expertise in the guideline subject. Additionally it was distributed to 93 peer reviewers of varying backgrounds before being reviewed and approved by the AUA Board of Directors and SUFU Executive Committee.

The full text of the evidence–based SUI guideline is now available online.