Skip to main content

Advertisement

Log in

Synthetic slings: Pros and cons

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Historically, the choice of sling material for the treatment of urinary incontinence has been based on the surgeon’s preference and experience. In general, pelvic surgeons have not differentiated artificial graft materials by their inherent qualities or for biocompatibility in the female pelvis and vaginal wall. The introduction of new artificial graft materials and new methods of implantation for the correction of genuine stress incontinence has generated renewed interest in the “pros and cons” associated with nonabsorbable material use. In this review, we discuss and differentiate sling materials and techniques. We consider some of the physical and biologic qualities of artificial graft materials, present theories and practices associated with the successful use of permanent grafts, and discuss the natural evolution of artificial graft slings to the current use of the tension-free vaginal tape and Suprapubic Arc Sling System (American Medical Systems, Minneapolis, MN).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Clemens JQ, DeLancey JO, Faerber GJ, et al.: Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy. Urology 2000, 56:589–595.

    Article  PubMed  CAS  Google Scholar 

  2. Meschia M, Pifarotti P, Bernasconi F, et al.: Tension-free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 2001, 12(Suppl 2):S24-S27.

    Article  PubMed  Google Scholar 

  3. Morehead JM, Holt RG: Soft-tissue response to synthetic biomaterials. Otolargyngol Clin North Am 1994, 27:195–201.

    CAS  Google Scholar 

  4. Avtan L, Avci C, Bulut T, Fourtanier G: Mesh infections after laparoscopic hernia repair. Surg Laparosc Endosc 1997, 7:192–195.

    Article  PubMed  CAS  Google Scholar 

  5. Miller K, Junger W: Ileocutaneous fistula formation following laparoscopic polypropylene mesh hernia repair. Surg Endosc 1997, 11:772–773.

    Article  PubMed  CAS  Google Scholar 

  6. Pourdeyhimi B: Porosity of surgical mesh fabrics: new technology. J Biomed Mater Res 1989, 23(A1 Suppl):145–152.

    Article  PubMed  CAS  Google Scholar 

  7. Iglesia CB, Fenner DE, Brubaker L: The use of mesh in gynecologic surgery. Int Urogynecol J Pelvic Floor Dysfunct 1997, 8:105–115. This is an excellent review of the published results of mesh use in gynecologic surgery. However, it should be noted that the review omits reports from the urologic stress incontinence literature. There are multiple tables that analyze cure rates and complications by the type of material and procedure.

    PubMed  CAS  Google Scholar 

  8. Debodinance P, Cosson M, Burlet GL: Tolerance of synthetic tissues in touch with vaginal scars: review to the point of 287 cases. Eur J Obstet Gynecol Reprod Biol 1999, 87:23–30.

    Article  PubMed  CAS  Google Scholar 

  9. Falconer C, Soderberg M, Blomgren B, Ulmsten U: Influence of different sling materials on connective tissue metabolism is stress urinary incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 2001, 12(Suppl 2):S19–23.

    Article  PubMed  Google Scholar 

  10. Klutke JJ, Carlin BI, Klutke CG: The tension-free vaginal tape procedure: correction of stress incontinence with minimal alteration in proximal urethral mobility. Urology 2000, 55:512–514. This article presents information on the anatomic findings following midurethral suspension. The persistence of bladder neck motion is documented in patients who are continent, and the absence of obstructive symptoms is also noted.

    Article  PubMed  CAS  Google Scholar 

  11. Nilsson JC, Kuuva N, Falconer M, et al.: Long-term results of the tension free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2001, 12(Suppl 2):S5–8.

    Article  PubMed  Google Scholar 

  12. Rezapour M, Falconer C, Ulmsten U: Tension-free vaginal tape (TVT) in stress incontinent women with intrinsic sphincter deficiency (ISD):a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct 2001, 12(Suppl 2):S12–14.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Staskin, D.R., Plzak, L. Synthetic slings: Pros and cons. Curr Urol Rep 3, 414–417 (2002). https://doi.org/10.1007/s11934-002-0087-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-002-0087-3

Keywords

Navigation