Midurethral slings for all stress incontinence: a urology perspective

The midurethral sling (MUS) is now the most commonly performed surgical treatment for stress urinary incontinence (SUI), and is considered the gold standard for patients with genuine SUI. This article examines the use of the MUS to treat all forms of SUI, with an emphasis on the nonindex patient (ie, intrinsic sphincter deficiency, lack of urethral hypermobility, mixed incontinence, failed MUS, concomitant prolapse, obesity, and elderly). The efficacy and safety of the MUS to treat SUI is assessed in these specific populations. Based on the available evidence, the discussion attempts to identify populations in whom MUS may not be appropriate.