<prompt> Best treatment for severe stress incontinence without prolapse isPelvic floor exerciseKellys repairBurch colposuspensionTension free Transvaginal tape  <response>: Students, Please read this: From Novaks Gynecology 15th edition Comparing various surgeries for the treatment of stress incontinence, Numerous panels and studies conducted in the late 90s concluded that colposuspension e.g., Burch, Marshall- Marchetti-Krantz and slings were more effective than transvaginal needle suspensions or anterior repairs for long-term success 48-month curedry rates... Now, there were many journals which came out with the information that the TVTTOT are now better, but since it never came in a book, it was actually never asked of you for the last 5-6 years Now, the 2020 Novaks gynecology 16th writes this: Over the past two decades, there has been an accumulation of a large body of evidence on mid-urethral slings from randomized controlled trials, including several meta-analyses and Cochrane reviews . The overarching summary is that mid-urethral slings have become the procedure of choice in treating women with stress urinary incontinence. They have a good safety profile with a significant improvement of QOL measures, and irrespective of route of placement, they are highly effective in the sho, medium, and long term. There is evidence to suggest that the mid-urethral slings are more effective than the Burch colposuspension procedure, and as effective as the autologous pubovaginal sling ... SO yes, now we change our answer to: that the mid urethral TVTTOT slings are the best procedures.. 