Retropubic synthetic midurethral slings: techniques and outcomes

Retropubic midurethral slings have evolved to become one of the standard therapies for treatment of stress urinary incontinence. The current slings can be placed through a small vaginal incision, with minimal dissection, in the ambulatory setting. With improvements in technique, complications are minimal. Although the tension-free vaginal tape has the most prospective data in the literature, the suprapubic arc sling appears to have equal cure and complication rates in shorter-term studies. Other retropubic slings have a paucity of data, and long-term equivalency studies have yet to be reported. This article describes the techniques of the most commonly performed retropubic synthetic slings and reports on efficacy and outcomes based on recently published studies.