Genuine stress incontinence theories of etiology and surgical correction.

Urinary loss (flow) results from a relative lack of CM resistance with respect to the intravesical pressure. Surgical stabilization of the continence mechanism, at the level of the bladder neck or mid-urethra, compensates for the existing loss of urethral support and function by creating new zones for compression, absorption of transmitted pressure, and the preservation of sphincteric configuration. Our understanding of the pathophysiology of stress incontinence and the basis for surgical compensation continues to evolve. Mid-urethral complex support procedures have stimulated further investigation into the mechanics of continence.