The ICS Standardisation Committee (Abrams et al, 2002) defines the symptom of stress urinary incontinence as the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing. Genuine stress incontinence (now known as urodynamically proven stress incontinence) is the involuntary loss of urine occurring when, in the absence of a detrusor contraction, the intravesical pressure exceeds the maximal urethral pressure. These definitions tend to look at the urinary mechanism in isolation, and many clinicians now advocate that a more holistic view should be taken of this problem.