الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Stress urinary incontinence is defined as the involuntary loss of urine per urethra with a sudden increase in the intra abdominal pressure and in the absence of detruser contraction and over distended bladder (Scott, 1969). SUI in females is caused either by anatomic malposition of the urethra and bladder neck (anatomical type) or caused by ISD(sphencteric type).
The initial evaluation of the female with SUI should begin with a thorough history, bladder diary and laboratory investigations .The severity of incontinence, and the degree of improvement after therapy were determined by the degree of incontinence and the number of pads before and after thearpy.
Physical examination should include pelvic, rectal examination and neurological examination especially the anal muscle tone and sensation of the saddle shape area. Cystourethrography provides an excellent tool to asses anatomic defects and bladder neck. If the history ,physical findings and cystourethrography are consistent with SUI, urodynamic evaluation may be unnecessary.
All patient subjected to fluoro-video-urodynamic evaluation including uroflowmetry, sphincter function (MUCP), filling and voiding cystometrogram, ALPP and cysto-urethrogram at rest and during valsalva to assure the SUI, to determine its type, to exclude uninhibited bladder contractions. ALPP is more important than the MUCP.
Treatment of SUI includes nonsurgical and surgical measures. Non surgical measures usually is effective in the mild cases.Surgery is indicated in motivated patients with significant loss of urine creating a social /or hygienic proplem. Age, prior pelvic surgery and previously failed anti incontinence surgery are not contraindications to the surgery.
There are many techniques described for the surgical treatment of SUI, but the common techniques are Burch colposuspention, PVS(restore the bladder neck to a high fixed retropubic position) and transurethral injections (increase the bulk and resistance of the urethra).