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Related Experiment Videos

Pubovaginal slings: past, present and future

R Sarver1, F E Govier

  • 1Department of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, Washington 98111, USA.

International Urogynecology Journal and Pelvic Floor Dysfunction
|January 1, 1997
PubMed
Summary

The pubovaginal sling procedure is gaining renewed interest for stress urinary incontinence due to limitations with other methods. This review covers its evaluation, techniques, and outcomes for this challenging surgical option.

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Area of Science:

  • Urology
  • Female Pelvic Medicine and Reconstructive Surgery

Background:

  • Stress urinary incontinence (SUI) management is evolving, with renewed focus on the pubovaginal sling procedure.
  • Previous treatments like simple cystourethropexy show inconsistent efficacy and durability.
  • Intrinsic sphincteric deficiency is often an unrecognized factor in SUI treatment failures.

Purpose of the Study:

  • To review the preoperative evaluation and indications for pubovaginal slings in SUI management.
  • To describe the evolution of current pubovaginal sling surgical techniques.
  • To discuss the choice of sling material, surgical approach, outcomes, and potential complications.

Main Methods:

  • Review of existing literature on pubovaginal sling procedures for stress urinary incontinence.

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  • Analysis of historical and current surgical techniques and materials.
  • Discussion of patient selection, surgical approaches, and complication profiles.

    • Main Results:

    • Pubovaginal slings offer a potentially favorable cure rate for SUI.
    • Historical concerns include high rates of prolonged urinary retention and secondary detrusor instability.
    • Modern techniques aim to mitigate these historical complications.

    Conclusions:

    • The pubovaginal sling is a versatile, albeit technically challenging, option for SUI.
    • Careful preoperative evaluation and appropriate technique selection are crucial for success.
    • Further interest and refinement of this procedure are warranted for managing complex SUI cases.