Surgical management for urinary incontinence is appropriate when conservative treatment is unsuccessful or not desired. Although many operations have been developed for the treatment of incontinence, there is no consensus on which is the single 'best' treatment and therapy should be individualized for each patient. This review will mainly focus on stress urinary incontinence, discuss some of the theories behind the pathophysiology of this condition, and provide some rationale for selecting a particular surgical procedure for incontinence.