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October 2005 · Vol. 17, No. 10

UPDATE on UROGYNECOLOGY

New Developments That are Changing Patient Care

Tradition is yielding to new technology’s advantages, time-tested though they are not—yet

IN THIS ARTICLE

Fast Track

The adjustable sling may be especially useful in patients at risk of postoperative voiding dysfunction

Complication rates may reflect early evolution, and may improve with time and experience

Neeraj  Kohli,  MD, MBA

OBG Management
Board of Editors
Director, Division of Urogynecology,
Brigham and Women’s Hospital,
Assistant Professor,
Harvard Medical School

Even as we scramble to gather definitive evidence on the immediate and long-term benefits of new technologies, they are supplanting tradition in the surgical treatment of incontinence and prolapse. Surgeons have been swift to adopt synthetic mesh and the new generation of needle suspension procedures, which offer the double advantage of a shorter operative time and shorter postoperative recovery. Yet, we lack well-designed randomized prospective clinical studies on whether outcomes and complication rates are better than traditional therapies such as vaginal colporrhaphy and paravaginal repair.

There hasn’t been time.

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