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Related Experiment Videos

Synthetic slings: which material, which approach.

Christopher C Roth1, Thomas D Holley, J Christian Winters

  • 1Department of Urology, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA.

Current Opinion in Urology
|June 14, 2006
PubMed
Summary

Tension-free midurethral slings using Type I mesh are safe and effective for stress urinary incontinence. Newer mesh types may offer solutions for complex cases.

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Editorial Comment.

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Area of Science:

  • Urology
  • Gynecology
  • Biomaterials

Background:

  • Tension-free midurethral sling procedures have revolutionized stress urinary incontinence (SUI) management.
  • Synthetic mesh use has resurged with these minimally invasive techniques.

Purpose of the Study:

  • Analyze synthetic mesh characteristics for sling grafts.
  • Explain the rationale for using monofilament, macroporous materials.
  • Introduce surgeons to available mesh options for SUI surgery.

Main Methods:

  • Review of synthetic mesh properties.
  • Analysis of commercially available sling materials.
  • Evaluation of implantation approaches (retropubic, transobturator).

Main Results:

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  • Type I macroporous mesh is optimal for transvaginal implantation.
  • Minimally invasive slings show promising early/intermediate outcomes for urethral hypermobility and SUI.
  • Controlled data are lacking for complex SUI cases.

Conclusions:

  • Minimally invasive slings with Type I mesh are safe and effective for SUI.
  • 'Hybrid' slings present potential alternatives for difficult SUI cases.