The integral theory of continence

The Integral Theory was originally met with a great deal of skepticism, that is, until the tension-free vaginal tape (TVT) was introduced. This remarkably successful technology was born out of the observations from this theory. Following the success of the TVT, skeptics became fewer and fewer and the tenets of the Integral Theory became accepted as truth. However, this has also had a deleterious effect, hampering research into the other aspects of the Integral Theory. As often happens, once something is "understood and verified" it is inviolate and research slows down or stops.We, researchers into pelvic floor disorders, have failed in our fiduciary responsibility to study and prove or disprove the various observations that have been proposed by the Integral Theory. The two commentaries that follow will hopefully serve to re-invigorate discussion and investigations into the Integral Theory of incontinence. Professor Petros provides an excellent short description of the Integral Theory and how various pelvic floor disorders are explained by this theory. Dr Woodman's commentary serves as a reality check into what we can and cannot attribute to the various tenets of the Integral Theory. One thing that comes through in both is that we need more research in this area. We should not fall back on the success of the TVT but should look forward at this theory to help us improve our treatment of other pelvic floor disorders.