Abstract
Dear editor, Dr. Nager’s editorial [1], based on a major study in the New England Journal of Medicine, reduces the concept of urinary stress incontinence (USI) to one simple and obvious fact: it is, and always has been, a mechanical problem. No evidence for this is required other than that USI can be corrected surgically with a midurethral sling. As a mechanical problem, the diagnosis is, as Nager asserts [1], simply a matter of asking the patient to cough with a full bladder and observing urine escaping from the
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