The main procedures used to treat female stress urinary incontinence include: filler injection, cystourethral suspension, tension-free midurethral sling, classic sling suspension, and artificial urethral sphincter implantation. Cystourethral suspension is the traditional procedure for the treatment of female stress urinary incontinence. Since the introduction of tension-free midurethral slings (TVT, TVT-O, TOT) for the surgical treatment of female stress urinary incontinence, the surgical treatment of female stress urinary incontinence has undergone profound changes in the procedure. The anatomical basis of female urinary control is the function of the structure of the urethral wall itself and its surrounding support structures. There are two main categories of female stress incontinence pathogenesis: anatomic stress incontinence with damage to the supporting structures; and stress incontinence with damage to the structure of the urethral wall itself – absence of the intrinsic urethral sphincter. The efficacy of different procedures for different pathogenesis of stress urinary incontinence varies, and the most common clinical stress urinary incontinence in women is mixed pathogenesis, with the least invasive and most effective tension-free midurethral sling procedure. Anatomic stress incontinence refers to a defect or loss of function of the supporting structures around the bladder neck urethra, resulting in impaired pressure transmission, allowing bladder pressure to exceed urethral pressure when abdominal pressure increases and stress incontinence to occur. Intrinsic urethral sphincter dysfunction type of stress incontinence refers to dysfunction of the urethral sphincter itself for urinary control. The integrity of the innervation of the pubic nerves, the number and function of the transverse sphincter, the function of the smooth muscle of the urethra, and the sealing of the urethral mucosa and submucosal connective tissue all affect the ability to control urine. As we age, the smooth muscle and transverse muscle within the urethral wall gradually decrease and the transverse urethral sphincter gradually ages. The decrease in estrogen after menopause and radiation therapy can lead to atrophy of the urethral mucosa and its submucosal lax connective tissue. In fact, most women with stress urinary incontinence have both a defect in the periurethral support structures of the bladder neck and a dysfunction of the intrinsic urethral sphincter. The placement of a tension-free sling below the midurethra through an anterior vaginal incision is a safe and effective minimally invasive procedure for women with stress urinary incontinence. The two main types of tension-free midurethral sling procedures include the transvaginal tension-free midurethral sling and the closed-hole tension-free midurethral sling. Tension-free vaginal tape (TVT): The sling is suspended in a U-shape below the mid-urethra and then passed through 2 small incisions in the lower abdomen above the pubic bone in an approximately vertical direction. Tension-free mid-urethral sling via closed holes (Outside-In Transobturator Tape, TOT; Intside-Out Transobturator Tape, TVT-O): the sling is suspended through the lower part of the mid-urethra and then passed through 2 small incisions on the inner thigh via closed holes on both sides in an approximately horizontal direction. The tension-free transvaginal midurethral sling is indicated for moderate to severe stress urinary incontinence for which conservative treatment such as pelvic floor training has failed. From 2006 to 2008, professors Meschia, Laurikainen, and Rinne compared the efficacy and complication rates of TVT and TVT-O. Their results showed that the overall subjective and objective cure rates of TVT and TVT-O at 6 to 12 months of postoperative follow-up were not different. There was no difference in the cure rates.