Choosing the Right Sling for Your Patient

Overview

Journal Can Urol Assoc J

Specialty Urology

Date 2017 Jun 16

PMID 28616112

Citations 1

Authors

Stephen S Steele

Gregory G Bailly

Affiliations

Soon will be listed here.

Abstract

Recent data has demonstrated a one in five lifetime risk of a woman requiring stress urinary incontinence (SUI) surgery. Currently, most women opt for a synthetic midurethral sling (MUS), with over 3.6 million placed worldwide. This article attempts to identify whether a gold standard exists with regards to surgical correction of female SUI. When considering which sling type to use for which incontinent woman, the published data demonstrates excellent results for both synthetic mesh (retropubic or transobturator routes) and fascial pubovaginal slings for most patients. Intrinsic sphincter deficiency does appear to be better treated with the use of a retropubic approach, although still with less than stellar results. With little to differentiate, the treatment of most female SUI may be solely based on which sling the surgeon feels most comfortable performing. Currently, most urologists and gynecologists favour synthetic MUS over fascial slings in surgical-naïve patients; however, recent U.S Food and Drug Administration (FDA) warnings concerning the use of mesh in transvaginal surgery have patients questioning the safety of synthetic MUS for the treatment of SUI.

Citing Articles

Midurethral Sling Mesh Exposure Confers a High Risk of Persistent Stress Urinary Incontinence.

Siblini T, Baracy M, Kulkarni S, Mabis C, Hagglund K, Aslam M Int Urogynecol J. 2024; 35(6):1177-1182.

PMID: 38703222 DOI: 10.1007/s00192-024-05762-y.

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