Treatment options for female and male stress urinary incontinence are continually being developed. In female patients, the effectiveness of suburethral slings has been demonstrated to be equal to classical retropubic Burch colposuspension. A minimally invasive procedure has been approximated through a stepwise enhancement of the retropubic approach, to the transobturator approach, and, finally, to the single-incision sling approach. As a result, surgical options with gender-specific differences have emerged; increasingly different sling systems have been established for male stress urinary incontinence. Further individualization of surgical incontinence treatment can be achieved based on adjustable sling devices. Thus, the use of bulking agents for stress urinary incontinence has been abandoned, and therapeutic options besides the artificial urinary sphincter are now available.