Stress incontinence: new alternatives.

Stress incontinence is a symptomatic disease that can be defined as urinary loss resulting from activities that increase abdominal pressure. Treatment of stress incontinence includes behavioral modification, pelvic floor exercises, biofeedback, various medications including estrogens and alpha adrenergic agonists, and surgery, including the surgical implantation of materials, and the use of artificial sphincters. Unfortunately, no standard method of diagnosis exists, and most diagnoses are purely clinical, or based on "tests" that are non-validated. Results of treatment are difficult to assess since the starting point is unknown generally, and the precise effect of a given "treatment" or "intervention" is, thus, usually not determinable. Until we know precisely what we are treating, we will not be able to choose the most effective, or least noxious, treatment for a particular patient, even though effective, non-destructive treatments do exist for specific types of female stress incontinence, a multifactorial problem.