Female stress urinary incontinence (SUI) is a common condition with a prevalence of 5% to 25% in middle-aged and elderly women, which can seriously affect the quality of life of female patients. As people’s understanding of the pathogenesis of female stress urinary incontinence has been improved, the treatment has been simplified, more effective and less invasive. As a new method of minimally invasive surgical treatment for clinical female stress urinary incontinence, the transvaginal tension-free sling (TVT-O) treatment technique has been developing rapidly both at home and abroad in recent years, and has been well received by patients. First, a new understanding of female SUI In 1994, foreign researchers Dr. Delancey put forward the “hammock theory”, that the female urethra is located in the pelvic fascia and the anterior wall of the vagina composed of a layer of support structure above the layer of tissue to the sides attached to the pelvic side wall of the arcus tendonitis and the anus muscles, thus constituting a stable support for the urethra (the urethra), the urethra and the anus muscle. This layer of tissue attaches to the arcuate tendon membrane of the lateral pelvic wall and the anal tibial muscle on both sides, thus forming a stable support for the urethra (hammock-like structure). When the patient coughs to increase abdominal pressure, the pressure exerted on the urethra from above squeezes the urethra downward against the hammock-like supportive tissues below, thus closing the urethral cavity. Therefore, the treatment of female stress urinary incontinence should first consider rebuilding the supportive tissues below the patient’s urethra, rather than changing the position of the bladder and urethra and the angle between the two, as traditionally believed. Second, the new TVT-O surgery Based on the above theory, the researcher Ulmsten et al. first proposed the TVT surgical method of transvaginal urethral sling for the treatment of female stress urinary incontinence in 1995, and studied its clinical treatment effect. The procedure involves the use of a special puncture needle, which is placed through a small incision in the anterior wall of the patient’s vagina, on either side of the urethra, and medially through the closed hole at the base of the thigh, thus fixing a polypropylene mesh belt suspended in a U-shape below the mid-urethra. The position of the sling was then adjusted to control the non-spillage of urine when the webbing was tension-free. The self-adhesive nature of the webbing allows it to be self-anchored without the need for sutures. The surgically placed webbing, together with surrounding tissue growths, forms a “hammock-like” structure that replaces the loose, lengthened pelvic floor support structures and pubic urethral ligaments, thus restoring normal urethral closure in patients with urinary incontinence. Because of the tension-free nature of the sling, it is called the Transvaginal Tension-free Sling Technique. The TVT-O procedure is simple and easy to perform, usually under local anesthesia, and is made of polypropylene mesh straps, which are non-absorbable, durable, biocompatible, and self-adhesive for tight fixation due to the special mesh and barbed structures on the surface of the straps. When the researchers placed the mesh tape in contact with the patient’s pelvic cavity, the friction generated by the barbs could suspend the mesh tape without the need for surgical sutures. In addition, the patient’s postoperative collagenous tissue grows into the mesh of the sling, which further strengthens the sling. Clinical application of the TVT technique provides an effective tension-free platform in the urethra of women with urinary incontinence. This support sling does not produce tension when the patient’s body is at rest and only produces stronger support when abdominal pressure increases to provide effective urethral atresia function (valve effect). Because the TVT-O procedure is tension-free, irritation, discomfort and urethral obstruction caused by tension can be avoided. Third, TVT-O surgery efficacy and reliable researchers, TVT-O technology is mainly applicable to female stress urinary incontinence, as well as with internal sphincter function abnormalities, urethra high mobility, vaginal or bladder bulge, previous surgical failure of patients. Available studies confirm that the TVT-O procedure is contraindicated in patients receiving anticoagulation therapy and in those with acute urinary tract infections. The efficacy of the TVT-O procedure is reliable and has been popularized both nationally and internationally in recent years. According to the literature, the effective cure rate of TVT-O is 85% to 90% at 5 years after surgery. In addition, Ward’s research group confirmed through a large-scale multicenter randomized controlled study that the results of TVT-O surgical treatment are all superior to the Burch procedure, which is currently the gold standard in clinical use. Therefore, TVT-O surgery is safe and effective for middle-aged and elderly women. In the three years since our hospital launched this technique, 40 cases have been completed, and except for two cases in which the urinary catheter was left in place for a short period of time after the operation to return to normal, the rest of the urinary catheters were removed to return to normal urination, with an effective rate of more than 95%.