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Sling Operations for Stress Urinary Incontinence and Their Historical Evolution: Autologous, Cadaveric, and Synthetic Slings

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Female Genitourinary and Pelvic Floor Reconstruction

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Abstract

Stress urinary incontinence is common in women affecting up to 50% worldwide. The development of surgical techniques and materials has been informed and refined by improved understanding of physiology and anatomy (the hammock hypothesis and integral theory) as well as learning from failures in the past. Pubovaginal slings for stress urinary incontinence were first described in the 1900s with various materials and tissues including autograft, allograft, xenograft, and synthetic with varying results.

The mid-urethral synthetic sling became popular in the 1990s owing to properties of resistance to degradation, persistent tensile strength, resistance to transmissible diseases, and reduction in intraoperative and postoperative recovery time. Continence rates ranged from 70 to 80%. Concerns over vaginal and urinary tract exposure and extrusion related to mesh implants have led to caution and reviews over the use of mesh implants. This has driven an increase in the use of the autologous pubovaginal sling and stimulated the potential need for further developments toward the ideal anti-stress urinary incontinence procedure.

In this chapter we explore the historical developments related to surgery for stress urinary incontinence in women, their risks, benefits, and published outcomes. The challenge exists to find the ideal method to treat stress urinary incontinence with optimum tensioning and anchoring technique.

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Author information

Authors and Affiliations

  1. Addenbrookes Hospital, Cambridge, UK

    Felicity Reeves

  2. University College London Hospitals, London, UK

    Tamsin Greenwell

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  1. Felicity Reeves
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  2. Tamsin Greenwell
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Correspondence to Tamsin Greenwell .

Editor information

Editors and Affiliations

  1. University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. University of Oslo, Oslo, Norway

    Henriette Veiby Holm

  3. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jaspreet S. Sandhu

  4. Eastern Virginia Medical School, Norfolk, VA, USA

    Kurt A McCammon

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Reeves, F., Greenwell, T. (2023). Sling Operations for Stress Urinary Incontinence and Their Historical Evolution: Autologous, Cadaveric, and Synthetic Slings. In: Martins, F.E., Holm, H.V., Sandhu, J.S., McCammon, K.A. (eds) Female Genitourinary and Pelvic Floor Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-031-19598-3_22

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  • DOI: https://doi.org/10.1007/978-3-031-19598-3_22

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