Stress Incontinence is loss of urine during physical activity like laughing, lifting, exercising, sneezing or coughing. Incontinence can be caused by pelvic muscles around the bladder or urethra (the channel that carries urine from the bladder) being too tight or too relaxed from normal. Change in muscle tension can be caused by age, physical activity, diet, vaginal delivery, obesity/BMI, surgery, hysterectomy, smoking, family history, and other medical conditions. All women will be offered non-surgical options such as physical therapy that will assess pelvic muscle function. Physical therapy will determine if the muscle is too relaxed or too tight as the cause of incontinence and customize the therapy program for each patient. If surgical therapy is desired, urethral support sling is a minimally invasive procedure that can help to correct incontinence. The urethra rests on the sling, acting like a hammock, to prevent activity related urine loss. It is highly effective and long lasting. A sling can be made of different materials mesh or non-mesh. Alternatively, urethral bulking agents are a great choice as well as minimally invasive.