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Schlingen im Zeichen des „mesh ban“: was nun?

Slings in the era of the mesh ban: now what?

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Zusammenfassung

Hintergrund

Seit der FDA-Warnung (Food and Drug Administration) zur Verwendung alloplastischer Materialien ist es zu einem deutlichen Rückgang auch des Einsatzes der suburethralen Schlingen als Goldstandard der Inkontinenzchirurgie gekommen.

Fragestellung

Wie ist der gegenwärtige Stand der aktuellen Behandlung der Belastungsinkontinenz der Frau? Welchen Einfluss haben die regelmäßigen Warnungen der FDA und zahlreichen Verbote weltweit?

Material und Methode

Die aktuelle Literatur zur Behandlung der Inkontinenz, Analyse der Artikel aus der Presse und Literatur zur FDA-Warnung, Beleuchtung eines exemplarischen juristischen Falles in England Montgomery-Fall wurde ausgewertet.

Ergebnisse

Trotz der klaren positiven Datenlage zu hoher Effektivität und Sicherheit alloplastischer suburethraler Schlingen werden diese weltweit weniger eingesetzt. Die aktuelle deutschsprachige Leitlinie zur Behandlung der Harninkontinenz der Frau aus 2022 bestätigt den Goldstandard der suburethralen Bänder.

Schlussfolgerung

Die Analyse der aktuellen Literatur unterstützt die Notwendigkeit von Langzeitanalysen zum Einsatz von suburethralen Schlingen bei der Behandlung der Belastungsinkontinenz der Frau.

Abstract

Background

Use of midurethral slings (MUS) as gold standard for stress urinary incontinence declined after the recent US Food and Drug Administration (FDA) communication.

Objectives

What is the current status in the surgical treatment of stress urinary incontinence? What impact do regular FDA communications and numerous restrictions around the world have?

Materials and methods

The current literature on surgical treatment of incontinence was evaluated; medical press information and literature regarding the FDA communication were assessed. The legal situation is illustrated using the example of the Montgomery case in England.

Results

Despite positive results from literature and gynecological and urological societies, there has been a significant decline in the use of MUS. The current 2022 German interdisciplinary 2k-guideline for the treatment of female stress urinary incontinence confirms the efficacy and safety of MUS.

Conclusion

Analysis of recent literature supports the importance of continued long-term outcome data regarding the safety and efficacy of suburethral slings for treatment of female stress urinary incontinence.

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Authors and Affiliations

  1. Frauenklinik Helios Klinikum Erfurt, Helios Klinikum Erfurt, Universitätsfrauenklinik, Heinrich-Heine-Universität Düsseldorf, Nordhäuser Str. 74, 90089, Erfurt, Deutschland

    Gert Naumann

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Correspondence to Gert Naumann.

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G. Naumann gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Naumann, G. Schlingen im Zeichen des „mesh ban“: was nun?. Urologie 62, 165–170 (2023). https://doi.org/10.1007/s00120-022-02017-w

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