ABSTRACT
This chapter discusses Evidence-Based Medicine on the Surgical Treatment of urinary stress incontinence (USI) and Genital Prolapse. Evidence-based medicine is the conscientious, explicit, and judicious use of the best evidence to determine the effectiveness and safety of therapeutic interventions. The rationale of the surgical treatment of USI and genital prolapse has changed over the past few years because of the introduction of techniques of urethral suspension that use slings and the surgical management of urogenital prolapse by vaginal approach with the use of meshes. The incidence of pelvic organ prolapse increases with age, and the proportion of population increases along with the progresses in medicine. The lifetime risk of surgery for prolapse by age 80 years is estimated to be 11.1%. Vaginal approach of the vaginal vault prolapse has been popularized by Randall and Nichols in United States and Richter in Europe. Vaginal vault suspension to the sacrospinous ligaments can be done unilaterally or bilaterally.
