In the outpatient clinic, I met a young girl who came to ask about the treatment of urinary incontinence. At first I was quite puzzled, because most of these patients are concentrated in middle-aged and elderly women. Careful questioning, only to understand the careful daughter noticed that usually lively and active mom recently less and less go out to dance, ask the reason, the mother was embarrassed to tell the child, recently casually move will have urine leakage, began to cough or sneeze when there is a leakage of urine, the symptoms have worsened, exercise a little more strenuous will appear, and then simply at home to rest. This girl was very thoughtful and discovered her mother’s unspeakable problem and came to find a solution. As a matter of fact, urinary incontinence is a very frequent disease in the general population of middle-aged and elderly women, with an average of about one in five patients, most of whom are suffering from stress urinary incontinence. The main manifestation is that when coughing, sneezing, laughing or exercising, the urine flows out of the urethra involuntarily due to the increase in abdominal pressure. Stress incontinence is associated with a number of factors, some of which are currently well recognized, including a high number of births (and lack of proper perineal muscle training after childbirth), pelvic prolapse, and obesity. Despite the high incidence, many patients take treatment lightly due to a lack of awareness of the need to seek medical attention or an inability to find the correct pathway to diagnosis and treatment. Many people even think that this is a common physiological state after age, pads, just make do. In fact, stress incontinence is a disease that is easy to occur, easy to diagnose, and easy to cure! In terms of diagnosis, if the symptoms mentioned above are present, the diagnosis is basically confirmed, but it should also be evaluated in detail by a specialist, graded, and further differentiated from other diseases. I often encounter patients who have a combination of urge incontinence, and then the approach and sequence of treatment will be adjusted. Therapeutically, in the case of simple female stress incontinence, there are three levels of treatment: first, pelvic floor muscle training, second, medication, and third, surgery. First, by repeatedly and autonomously contracting the pelvic floor muscle groups to increase their toughness, endurance and responsiveness, the problem of urinary incontinence and vaginal laxity will be improved to a certain extent. This kind of training is simple and easy to do, and will be effective for mild stress incontinence. The key question is how to find the “pelvic floor muscles”. In fact, it is not difficult, try, in urination, for sudden abortive urination action, is not the use of a group of muscles? That is the pelvic floor muscle, contract it on the line. Standing, sitting, lying can be trained. Hold each contraction for 10 seconds. 10 seconds between each movement. 10 movements per set. Train 3 groups per day. Stick to it for 3 months. See what the results are? If not ideal, we have to consider drugs or surgical treatment. Second, drugs: clinical use is not very common, first, because the effect is not very sure, often only temporary relief, can not achieve the goal of “cure”; the second is due to the existence of certain side effects of drugs, such as nausea, vomiting, or cause hypertension. For middle-aged and elderly women, the use of these drugs should be very careful, must be prescribed by a specialist and regular monitoring. Third, surgical treatment: once upon a time, there were a lot of surgical procedures, and the effect is not exact, but since 1996, people invented the use of tension-free transvaginal urethral sling (TVT) for the treatment of stress urinary incontinence can bring about very good results, and thus brought about a surgical revolution, due to the minimally invasive, simple, easy to carry out, and has become the mainstream of the treatment of stress urinary incontinence surgical procedures, and the operation can even be carried out under local anesthesia, the time of the operation, and the time of the operation can also be adjusted. can be performed under local anesthesia and in a very short time, less than 30 minutes. In recent years, sling procedures have also been improved, like TVT- EXACT, TVT-O, TVT-Abbrevo, etc., which have resulted in less and less trauma and fewer and fewer complications. In addition, newer procedures like paraurethral filler injections and stem cell injections are being researched and developed. Overall, my advice as a urologist is as follows: Ask yourself (or the woman you care for) if you leak urine when you cough, laugh, run or jump. If so, come to the hospital and be evaluated by a doctor who is familiar with urinary control – is it stress incontinence? Is it urgency or mixed? What is the severity? Can you train your pelvic floor muscles to see if your symptoms improve? If you are obese, lose weight to see if urinary control improves. Minimally invasive sling surgery is very effective and easy to perform. If conservative treatment is not effective, it should be considered, once and for all.