|October 2008 · Vol. 20, No. 10
Update on pelvic surgery
The midurethral sling has become the standard treatment for stress urinary incontinence. But are all sling techniques equally effective? Recent studies shed some light on that question.
We have a wealth of midurethral slings to choose from, but we haven’t been able to tell whether variations in technique or instrumentation translate to better long-term efficacy
Surgeons who use SPARC should 1) be comfortable with a “top-down” approach and 2) take care to avoid over-tensioning the sling
For patients with mild or moderate SUI, the Monarc TOT is similar in efficacy to TVT but has a lower rate of cystotomy
For patients with ISD, the pubovaginal sling and retropubic TVT remain the treatments of choice
Dr. Siddiqui is a Fellow in Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.
Dr. Amundsen is Associate Professor and Fellowship Director, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.
The authors report no financial relationships relevant to this article.
Over the past 10 years, the midurethral sling has replaced the Burch urethropexy as the most common surgical procedure for correcting stress urinary incontinence (SUI). In this “Update” on midurethral slings, we highlight three recently published studies that compare popular surgical approaches to SUI: