Genuine stress incontinence is a major clinical problem which is prevalent, disruptive and complex. It is the condition in which urine loss occurs when the bladder pressure exceeds the maximal urethral pressure. The etiologies of urinary incontinence are many. The pathophysiology may be multifactorial. Conservative management should be the first lire of treatment in any age group. Over 150 operative procedures for treatment of incontinence have been described in order to offer good long term results.