Stress urinary incontinence (SUI) is the most common subtype of urinary incontinence in women and significantly their affects quality of life.
The aim of this study was to summarize the current evidence about conservative (non-surgical) treatments for female SUI and outline their clinical applicability.
A narrative review was performed using structured research involving medical databases over the last 15 years, including systematic reviews, randomized controlled trials, observational studies and key guidelines regarding pelvic floor muscle training (PFMT), electrical and tibial nerve stimulation, acupuncture, pharmacological therapies, local estrogen, pessaries and bulking agents.
PFMT represents the primary first-line therapy, with strongest evidence for reducing leakage episodes and improving quality of life when performed correctly and consistently. Other conservative options (electrical and tibial nerve stimulation, acupuncture, duloxetine, local vaginal estrogen, pessaries and bulking agents) may be efficient for selected patients, but generally they have a weaker or more heterogeneous evidence base. They are considered adjuncts or tailored alternatives when PFMT alone is insufficient, not feasible or not accepted.
Conservative management, centered on PFMT, should be offered as initial treatment to most women with mild to moderate SUI, with additional modalities being used selectively according to symptom profile, comorbidities and patient preference. A stepwise, individualized approach can control symptoms in many women and may delay or avoid surgical therapy.
Life (Basel, Switzerland). 2026 Jan 02*** epublish ***
Mircea-Octavian Poenaru, Liana Ples, Cristian-Valentin Toma, Fernanda-Ecaterina Augustin, Romina-Marina Sima, Mihaela Amza, Irina Pacu, Giorgia Zampieri, Andrei Sebastian Diaconescu, Daniela Poenaru
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania., Department of Urology, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania., Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania., Department of Rehabilitation, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania.