Women with occult stress incontinence should not routinely have a mid-urethral sling with prolapse surgery.

The risk of postoperative stress incontinence (SI) is increased in women with occult stress incontinence (OSI) but the majority of patients will not develop troublesome SI postoperatively or need further SI surgery. This risk reported in current studies does not warrant a mid-urethral sling at the time of surgery for pelvic organ prolapse in women with OSI. However, if performed, the risks as well as the benefits need to be discussed with the patient.