Skip to main content

Advertisement

Log in

Lessons from the past: directions for the future

Do new marketed surgical procedures and grafts produce ethical, personal liability, and legal concerns for physicians?

  • Special Contribution
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

New procedures and materials for incontinence and prolapse are proliferating rapidly. Surgical procedures were developed by physicians and carried their names, but over the last 15 years, these procedures are developed by industry and bear the trade names of the companies selling the kits needed to perform them. The Food and Drug Administration (FDA) approves devices, not procedures, and does not require submission of efficacy or adverse-event data to gain this approval by the 510-K process. Evidence-based medicine is lacking in the performance of these procedures that may be considered experimental by an insurance company or malpractice carrier with denial of payment or coverage. Physicians and hospitals are exposing themselves to financial, legal, and ethical risks when performing or allowing such procedures to be performed. Informed consent from the patient cannot be obtained. We must not confuse medical marketing with evidence-based medicine.

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

  1. Cornella JL (1996) Urogynecology and urodynamics, theory and practice. In: Ostergard DR, Bent AE (eds) Williams and Wilkins, Baltimore, pp 533–554

  2. Pereyra AJ (1959) A simplified surgical procedure for the correction of stress incontinence in women. West J Surg 67:223–226

    PubMed  CAS  Google Scholar 

  3. Stamey TA (1973) Endoscopic suspension of the vesical neck for urinary incontinence. Surg Gynecol Obstet 136:547–554

    PubMed  CAS  Google Scholar 

  4. Gittes RF, Loughlin KR (1987) No-incision pubovaginal suspension for stress incontinence. J Urol 138:568–570

    PubMed  CAS  Google Scholar 

  5. Benderev TV (1992) Anchor fixation and other modifications of endoscopic bladder neck suspension. Urology 40:409–418

    Article  PubMed  CAS  Google Scholar 

  6. Benderev TV (1994) A modified percutaneous outpatient bladder neck suspension system. J Urol 152(6pt2):2316–2320

    PubMed  CAS  Google Scholar 

  7. Cornella JL, Pereyra AJ (1990) Historical vignette of Armand J. Pereyra and the modified Pereyra procedure. Int Urogynecol J 1:25–30

    Article  Google Scholar 

  8. Mainprize TC, Drutz HP (1988) The Marshall–Marchetti–Krantz procedure: a critical review. Obstet Gynecol Surv 43:724–729

    Article  PubMed  CAS  Google Scholar 

  9. Rackley RR, Abdelmalak JB, Medjar S et al (2001) Bone anchor infections in female pelvic reconstructive procedures: a literature review of series and case reports. J Urol 165(6pt1):1975–1978

    PubMed  CAS  Google Scholar 

  10. FitzGerald NP (1999) Pubic osteomyelitis and granuloma after bone anchor placement. Int Urogynecol J 10:346–348

    Article  CAS  Google Scholar 

  11. Pereyra AJ, Lebherz TB (1967) Combined urethrovesical suspension and vaginourethroplasty for correction of urinary stress incontinence. Obstet Gynecol 30:537–546

    PubMed  CAS  Google Scholar 

  12. Stamey TA (1980) Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients. Ann Surg 192:465–471

    Article  PubMed  CAS  Google Scholar 

  13. Kobashi KC, Dmochowski R, Mee SL et al (2000) Erosion of woven polyester pubovaginal sling. J Urol 164:2070–2072

    Article  Google Scholar 

  14. Amundsen CL, Flynn BJ, Webster GD (2003) Urethral erosion after synthetic and nonsynthetic pubovaginal slings: differences in management and continence outcome. J Urol 170:134–137

    Article  PubMed  Google Scholar 

  15. Walter A, Magtibay P, Cornella JL (2000) Percutaneous bone anchor sling using synthetic mesh associated with urethral overcorrection and erosion. Int Urogynecol J 11:328–329

    Article  CAS  Google Scholar 

  16. Owens DC, Winters JC (2004) Pubovaginal sling using Duraderm graft: intermediate follow-up and patient satisfaction. Neurourol Urodyn 23:115–118

    Article  PubMed  Google Scholar 

  17. Paraiso MFR, Barber MD, Muir TW et al (2006) Rectocele repair: a randomized trial of three surgical techniques including graft material. Am J Obstet Gynecol 108:1589–1596

    Google Scholar 

  18. Ward KL, Hilton P et al (2004) A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol 190:324–331

    Article  PubMed  Google Scholar 

  19. 2005 IUGA grafts roundtable (2006) Int Urogynecol J 17:Suppl 1

  20. American College of Obstetricians and Gynecologists, Committee Opinion, Committee on Ethics (2006) Innovative practice: ethical guidelines. Obstet Gynecol 195:1762–1771

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Donald R. Ostergard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ostergard, D.R. Lessons from the past: directions for the future. Int Urogynecol J 18, 591–598 (2007). https://doi.org/10.1007/s00192-007-0330-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-007-0330-z

Keywords

Navigation