Sling and bulking agent placement procedures.

Sling procedures have been used for the treatment of stress urinary incontinence since the early 1900s. Traditional sling procedures are best performed with autologous rectus fascia or fascia lata, and the sling material should penetrate the urogenital diaphragm (perineal membrane) into the retropubic space. Tension-free slings using polypropylene have excellent efficacy and safety data and are applicable in an outpatient setting. They are a good firstline surgical choice. Periurethral bulking agents have application for patients with a relatively immobile bladder neck and in cases of medical compromise or a desire for a simple, office-type treatment.