ARTICLE IN PRESSTHE JOURNAL0UROLOGYCheck forAUA Guideline Articlewww.auajournals.ong/journal/juroupdatesUpdates to Surgical Treatment of Female Stress UrinaryIncontinence (SUl):AUA/SUFU Guideline (2023)Kathleen C.Kobashi,1*Sandip Vasavada,2 Aaron Bloschichak,3 Linnea Hermanson,3Janice Kaczmarek,3 Sennett K.Kim,4 Erin Kirkby,4 Norma Varela,5 and Rena Malik'Houston Methodist Hospital,Houston,Texas2Cleveland Clinic,Cleveland,OhioECRI"American Urological Association,Linthicum,Maryland5EBM Methodologist ConsultanteUniversity of MarylandPurpose:The purpose of this guideline is to provide a clinical structure withwhich to approach the diagnosis,counseling,and treatment of female patientswith stress urinary incontinence(SUI).Materials/Methods:The primary source of evidence for the 2017 version of theSUI guideline was the systematic literature review conducted by the ECRIInstitute.The initial search spanned literature from January 2005 to December2015,with an additional updated abstract search through September 2016.Thecurrent amendment represents the first update to the 2017 iteration and in-cludes updated literature published through February 2022.Results:This guideline has been amended to reflect changes in and additions tothe literature since 2017.The Panel maintained that the differentiation betweenindex and non-index patients remained important.The index patient is a healthyfemale with minimal or no prolapse who desires surgical therapy for treatment ofpure SUI or stress-predominant mixed urinary incontinence.Non-index patientshave factors that may affect their treatment options and outcomes,such as highgrade prolapse (grade 3 or 4),urgency-predominant mixed incontinence,neuro-genic lower urinary tract dysfunction,incomplete bladder emptying,dysfunc-tional voiding,SUI following anti-incontinence treatment,mesh complications,high body mass index,or advanced age.Conclusion:While gains have been made in the field to support new methods forthe diagnosis,treatment,and follow-up of patients with SUI,the field continuesto expand.As such,future reviews of this guideline will take place to stay inkeeping with the highest levels of patient care.Key Words:stress urinary incontinence,counseling,diagnosis,education,complications,surgery,therapy,femaleSUI is a prevalent condition ie,char-modalities have continued to evolve.acterized by loss of urine in the settingAs length of patient follow-up hasof increased abdominal pressure.Theincreased and new therapeutic optionsvarious treatment alternatives rangehave emerged,counseling of patientsfrom non-surgical to surgical,and theshould inevitably progress as well.ThisSubmitted March 14.2023:accepted Mach 15.2023:published 000.The complete unabridged version of the guideline is available at http//ww.juology.com.This document is being printed as submitted,independent of standad editorial or peer review by the editors of The Joural of roogyComespondence:Houston Methodist Haspital,Houston,Texas(telephone:.emait:kkobashihou
