Principles of treatment of stress urinary incontinence The treatment methods of true stress urinary incontinence are various, and the efficacy of each report is not the same, but no matter which method is chosen, the following principles should be followed: 1, the diagnosis must be accurate, true stress urinary incontinence, or else misdiagnosis and mismanagement will occur, and even lead to serious consequences. 2, should be a comprehensive examination of the signs found to determine the cause of each patient’s morbidity, for the cause of non-surgical treatment first. 3.Nonsurgical treatment is appropriate for mild cases. 4, obese, elderly patients should be the first to use non-surgical treatment. Or the non-surgical treatment as a preoperative preparation, after adequate preparation, and then surgery. 5, understand the theoretical basis of various types of surgical treatment and treatment principles, choose the surgical treatment method that is consistent with the etiology of stress urinary incontinence exercise Ask the patient to regularly and consciously carry out daily anal and perineal muscle stretching and contraction exercises, in order to enhance the pelvic floor muscles and urethral muscle tone, improve the muscle contraction force of the reaction to the pressure effect. In mild cases, it can improve the symptoms, and in severe cases, it can improve the efficacy of surgery. So it is both a treatment method and can be used as a preoperative preparation. Functional electrical stimulation therapy Functional electrical stimulation therapy has two electrodes, anal pessary and vaginal pessary. Functional electrical stimulation therapy has two types of electrodes: anal pessary and vaginal pessary. The mechanism ① stimulate the efferent fibers of the pubic nerve to enhance the function of the detrusor muscle and other pelvic floor muscles and the periurethral transverse muscle, and increase the urethral closure pressure; ② stimulate the efferent fibers of the pubic nerve through the neuron connection to the sacral medulla oblongata nucleus of the forced urinary tract, inhibit the excitability of the nucleus of the forced urinary tract, and then through the pelvic nerve to the forced urinary tract muscle, inhibit the contraction of the forced urinary tract muscle; ③ the impulse of the stimulation of the electrical impulses to the upward movement to the thoracolumbar segment, so that the sympathetic neurons are excited, and the α-adrenergic receptors are stimulated. ③Electrical stimulation impulses go up to the thoracolumbar segment, causing sympathetic neuron excitation, and α-adrenergic receptors cause the bladder neck and proximal urethra to contract, further increasing urethral closure, α-adrenergic excitation, bladder base relaxation, and increasing the closure of the bladder neck. Medication The purpose of medication is twofold: ①Increase urethral resistance: medication is used to increase the contractile function of the urethra and increase the urethral closure pressure. For example, oral ephedrine; ② drugs to enhance the tension of the pelvic floor to make the atrophied supportive tissue plump: such as the application of estrogen. Adapted to menopausal women and other causes of estrogen deficiency due to true stress incontinence, can make the atrophic epithelium of the urethra due to estrogen deficiency hyperplasia, enhance the closure function of the urethra, and at the same time, it can make the urethral mucosa under the vascular network enrichment, increase the urethral pressure and urethral closure pressure, which can be healed or improve the purpose. Oral estrogen, has more side effects (Hilton, 1983). Applying estrogen paste preparations intravaginally can proliferate the epithelial cells of the urethral mucosa. Surgery There are more than 100 surgical procedures for the treatment of stress urinary incontinence, which can be summarized into four categories: (1) Retropubic vesicourethral suspension. (2) Bladder neck pin suspension. (3) Anterior vaginal wall repair. (4) New sling surgery.