Stress incontinence is the involuntary leakage of urine during straining, exercise, sneezing or coughing, which often causes distress and affects the patient’s quality of life. It is estimated that approximately 15.7% of adult women are affected by this condition. Among women with stress incontinence, 77.5% suffer from this symptom and 28.8% suffer from moderate to severe distress. The degree of distress correlates with the severity of incontinence. Conservative treatments for stress incontinence include pelvic floor muscle training alone, or a combination of physical therapy, vaginal weight exercises, and catheterization. Surgical treatment options for urinary incontinence include retropubic bladder neck suspension, autologous broad fascial suspension, urethral filling, and midurethral suspension. For treatment, the first emphasis is on conservative treatment. For female patients with symptoms of stress urinary incontinence, the clinician should evaluate the patient in at least 6 areas before performing midurethral suspension: 1. Obtain a medical history, including urologic history, detailed medical history, history of neurologic disease, and history of medications such as over-the-counter medications. 2. 2. Perform urinalysis to rule out urinary tract infection. 3, Perform physical examination to rule out confounding or influencing factors, including urethral diverticula, vaginal discharge, or extra-urethral incontinence. Pelvic organ prolapse is a manifestation of complex stress incontinence because prolapse can cause relative obstruction of the urethral orifice, thereby impeding bladder emptying. 4, Perform a cough test to demonstrate stress incontinence. 5, Assess urodynamics with a cotton swab test, quantitative staging method for pelvic organ prolapse, visual examination, palpation or ultrasonography. Patients with abnormal urodynamic changes have more successful incontinence procedures. 6. Measurement of residual urine volume. In women with simple stress incontinence, the volume of urine involved is usually less than 150 ml. Increased residual urine volume indicates that the patient has impaired bladder emptying or urinary incontinence associated with chronic urinary retention.