The autologous fascial sling results in a higher rate of successful treatment of stress incontinence but also greater morbidity than the Burch colposuspension. (ClinicalTrials.gov number, NCT00064662 [ClinicalTrials.gov] .).

Biofeedback to teach pelvic floor muscle control, verbal feedback based on vaginal palpation, and a self-help booklet in a first-line behavioral training program all achieved comparable improvements in urge incontinence in community-dwelling older women. Patients' perceptions of treatment were significantly better for the 2 behavioral training interventions.

ELVIC FLOOR ELECTRICAL STIMUlation (PFES) has been used for the treatment of urinary incontinence since 1952. 1 In the original study, PFES was added to pelvic floor muscle exercises and cured 7 of 17 women who had failed previous attempts to treat their stress urinary incontinence with exercise alone. The treatment of PFES using a vaginal probe was not reported in the literature until 1967 when interest in this therapy resurfaced. 2 Since then, PFES has become widely used and is now approved for reimbursement by Medicare and many other insurance plans. Pelvic floor electrical stimulation activates pudendal nerve afferents, which in turn results in activation of pudendal and hypogastric nerve efferents, causing contraction of smooth and striated periurethral muscles and striated pelvic floor muscles. 3 This provides a form of passive exercise with the goal of improving the urethral closure mechanism. In addition, PFES can be useful in teaching pelvic floor muscle contraction to women who cannot identify or contract these muscles voluntarily because of extreme weakness. Previous research has demonstrated the efficacy of PFES compared with sham PFES. 4,5 There is also some evidence that PFES yields results similar to

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