Are slings now the gold standard treatment for the management of female urinary stress incontinence and if so which technique?

Current Opinion in Urology

Volumn 13, Issue 4, 2003, Pages 301-307

  Bemelmans, Bart L H ^a   Chapple, Christopher R ^b  

^a RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

^b ROYAL HALLAMSHIRE HOSPITAL   (United Kingdom)

Author keywords

Female incontinence; Sling; Stress incontinence; Treatment

Indexed keywords

BIOMATERIAL; POLYPROPYLENE;

FEMALE; HUMAN; MINIMALLY INVASIVE SURGERY; PATHOPHYSIOLOGY; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; REVIEW; STRESS INCONTINENCE; SURGICAL TECHNIQUE; URETHRA SURGERY;

FEMALE; HUMANS; POLYPROPYLENES; TRANSPLANTATION, HETEROLOGOUS; TRANSPLANTATION, HOMOLOGOUS; URETHRA; URINARY INCONTINENCE, STRESS; UROLOGIC SURGICAL PROCEDURES;

EID: 0041866631     PISSN: 09630643     EISSN: None     Source Type: Journal    
DOI: 10.1097/00042307-200307000-00006     Document Type: Review

References (55)

1. Aldridge AH. Transplantation of fascia for the relief of urinary incontinence. Am J Obstet Gynecol 1942; 44:398-411.
2. DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol 1994; 170:1713-1720.
3. Enhorning GE. A concept of urinary continence. Urol Int 1976; 31:3-5.
4. Haab F, Zimmern PE, Leach GE. Female stress urinary incontinence due to intrinsic sphincteric deficiency: recognition and management. J Urol 1996; 156:3-17.
5. Fantl JA, Cardozo L, McClish DK. Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta analysis. First report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol 1994; 83:12-18.
6. McGuire EJ, Lytton B. Pubovaginal sling procedure for stress incontinence. J Urol 1978; 119:82-84.
7. Borup K, Nielsen JB. Results in 32 women operated for genuine stress incontinence with the pubovaginal sling procedure ad modum McGuire. Scand J Urol Nephrol 2002; 36:128-133. Patients who underwent a classic abdominal wall fascia sling show excellent results and minimal complications after a follow-up of at least 5 years. A limitation of this study is the small number of patients (n = 32).
8. Hawkins E, Taylor D, Hughes-Nurse J. Long term follow up of the crutiate fascial sling for women with genuine stress incontinence. Br J Obstet Gynaecol 2002; 109:327-338. Long term follow up of the abdominal wall sling of up to 18 years shows persistently positive results. Also a comprehensive overview of the literature is given.
9. Franco N, Shobeiri A, Echols KT. Medium-term follow-up of transvaginal suburethral slings: variance in outcome success using two different evaluation methods. Urology 2002; 60:607-611. There is a huge discrepancy between the notions of doctors and patients about 'cure'. In this paper doctors felt that 91% of their patients were cured, whereas only 37% of patients reported cures.
10. Flynn BJ, Yap WT. Pubovaginal sling using allograft fascia lata versus autograft fascia for all types of stress urinary incontinence: 2 year minimum followup. J Urol 2002; 167:608-612. Cadaveric fascia lata for pubovaginal sling showed equally good results as autologous fascia with respect to efficacy. However, morbidity was more serious in the latter.
11. Lemer ML, Chaikin DC, Blaivas JG. Tissue strength analysis of autologous and cadeveric allografts for the pubovaginal sling. Neurourol Urodyn 1999; 18:497-503.
12. Weinberger MW, Ostergard DR. Long-term clinical and urodynamic evaluation of the polytetrafluoroethylene suburethral sling for treatment of genuine stress incontinence. Obstet Gynecol 1995; 86:92-96.
13. Errando C, Batista JE, Arano P. Polytetrafluoroethylene sling for failure in female stress incontinence surgery. World J Urol 1996; 14 (Suppl 1):48-50.
14. Debodinance P, De Bievre O, Parmentier D, et al. The 'hazards' of using Gore-Tex sling in the treatment of stress urinary incontinence [in French]. J Gynecol Obstet Biol Reprod 1994; 23:665-670.
15. Duckett JR, Constantine G. Complications of silicone sling insertion for stress urinary incontinence. J Urol 2000; 163:1835-1837.
16. Kobashi KC, Dmochowski R, Mee SL, et al. Erosion of woven polyester pubovaginal sling. Urology 1999; 162:2070-2072.
17. Persson J, Iosif C, Wølner-Hanssen P. Risk factors for rejection of synthetic sub-urethral slings for stress urinary incontinence: a case control study. Obstet Gynecol 2002; 99:629-634. This paper nicely underlines the importance of preoperative administration of antibiotics (including anti-anaerobes) and vaginal disinfection before sling surgery.
18. Blaivas JG, Olsson CA. Stress incontinence: classification and surgical approach. J Urol 1988; 39:727-731.
19. Bergman A, McCarthy TA, Ballard CA, et al. Role of the Q-tip test in evaluating stress urinary incontinence. J Reprod Med 1987; 32:273-275.
20. Ghoniem GM, Elgamasy A-N, Elsergany R, et al. Grades of intrinsic sphincteric deficiency (ISD) associated with female stress urinary incontinence. Int Urogynecol J 2002; 13:99-105. This study tries to combine video-urodynamic findings and leak-point pressures and to classify SUI in type A (subtle/urodynamic), type B (beak-shaped) and type C (pipe-stem). Each type is related to a defined therapeutic strategy.
21. Petros PE, Ulmsten UI. An integral theory of female urinary incontinence: experimental and clinical considerations. Acta Obstet Gynecol Scand 1990; 153 (Suppl):7-31.
22. Ulmsten U. Some reflections and hypotheses on the pathophysiology of female urinary incontinence. Acta Obstet Gynecol Scand 1997; 166 (Suppl):3-8.
23. Ulmsten U, Henriksson L, Johson P, et al. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7:81-85.
24. Ulmsten U, Johnson P, Rezapour M. A three-year follow-up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynecol 1999; 106:345-350.
25. Olsson I, Kroon U-B. A three year postoperative evaluation of tension-free vaginal tape. Gynecol Invest 1999; 48:267-269.
26. Rezapour M, Ulmsten U. Tension-free vaginal tape (TVT) in women with recurrent stress urinary incontinence: a long term follow up. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12 (Suppl):9-11. In the hands of the inventor, TVT also proves to be highly successful in redo cases with a long follow-up of at least 3 years.
27. Nilsson CG, Kuuva N, Falconer C, 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):5-8. Key paper on a multi-center study that proves that even after 5 years of follow-up the efficacy of TVT does not deteriorate.
28. Deval B, Jeffry L, Al Najjar F, et al. Determinants of patient dissatisfaction after a tension-free vagina tape procedure for urinary incontinence. J Urol 2002; 167:2093-2097. Paper reporting on the success and complication rates after TVT. Interestingly the authors found a relevant discrepancy between objective (90%) and subjective (70%) cure rates.
29. Bodelsson G, Henriksson L, Osser S, et al. Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women. Br J Obstet Gynaecol 2002; 109:566-569. Not surprisingly, complications relate to the expertise of the individual surgeons.
30. Haab F, Sananes S, Amarenco G, et al. Results of tension-free vaginal tape procedure for the treatment of type II stress urinary incontinence at a minimum follow up of 1 year. J Urol 2001; 165:159-162. Paper reporting on success and complication rates after TVT. Patients who underwent previous incontinence surgery were prone to perioperative bladder perforation.
31. Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 2002; 81:72-77. Excellent report on the Finnish experience with TVT. In a series of 1455 operations all known complications were seen in limited numbers. No lethal complications were reported.
32. Zilbert AW, Farrell SA. External iliac artery laceration during tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12:141-143. A case report on a rare complication of TVT.
33. Tamussino K, Hanzal E, Kolle D, et al. The Austrian tension-free vaginal tape registry. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12 (Suppl):28-29. Complications of TVT are reported based on a large patient cohort study (n = 800).
34. Boublil V, Ciofu C, Traxer O, et al. Complications of urethral sling procedures. Curr Opin Obstet Gynecol 2002; 14:515-520. Comprehensive overview of complications and literature regarding complications of TVT.
35. Moran PA, Ward KL, Johnson D, et al. Tension-free vaginal tape for primary stress incontinence: a two-centre follow-up study. BJU Int 2000; 86:39-42.
36. Scarpero HM, Nitti VW. Management of urinary retention and obstruction following surgery for stress urinary incontinence. Curr Urol Rep 2002; 3:354-359. Not only after TVT, but also after other types of sub-urethral sling surgery, urethral obstruction can be successfully cured by urethrolysis or vaginal section of the tape.
37. 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):12-14. Interesting paper suggesting that TVT can also be applied in 'bad urethras'. In fact the paper proves the opposite, namely that patients with real ISD did not do well at all.
38. Staskin DR, Plzak L. Synthetic slings: pros and cons. Curr Urol Rep 2002; 3:414-417. Outstanding cooking book review of advantages and limitations of polypropylene meshes for sling surgery. This paper is compulsory reading for every surgeon interested in the field of stress incontinence treatment.
39. Chaikin DC, Rosenthal J, Blaivas JG. Pubovaginal sling for all types of stress urinary incontinence: long-term analysis. J Urol 1998; 160:1312-1316.
40. McGuire EJ, Fitzpatrick CC, Wan J, et al. Clinical assessment of urethral sphincter function. J Urol 1993; 150:1452-1454.
41. Weber AM. Is urethral pressure profilometry a useful diagnostic test for stress urinary incontinence? Obstet Gynecol Surv 2001; 56:720-735. Milestone paper that winds up the ongoing discussion on the value of urethral pressure profilometry. It concludes that such tests have no clinical value
42. Weber AM. Leak point pressure measurement and stress urinary incontinence: a review. Curr Women's Health Rep 2001; 1:45-52. Milestone paper that winds up the ongoing discussion on the value of leak-point pressure measurement. Its clinical value is strongly questioned.
43. Bodell DM, Leach GE. Needle suspension procedures for female incontinence. Urol Clin North Am 2002; 29:575-584. Comprehensive overview with the clear conclusion that needle suspensions are out.
44. Ward K, Hilton P. Prospective multicenter randomized trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ 2002; 325:789-790. Key paper showing comparable clinical efficacy of TVT and colposuspension. Also these authors recognize that the TVT technique is simpler and associated with a quicker post-operative recovery period.
45. Jackson S, James M, Abrams P. The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG 2002; 109:339-344. In a placebo-controlled study it was found that estrogen replacement therapy for a period of 6 months enhances collagen degradation as well as synthesis. This finding challenges the old notion that application of collagen in post-menopausal women with SUI will improve their incontinence symptoms.
46. Kershen RT, Dmochowski RR, Appell RA. Beyond collagen: injectable therapies for the treatment of female stress urinary incontinence in the new millennium. Urol Clin North Am 2002; 29:559-574. Comprehensive overview of injection therapy for SUI, its background, available products and results.
47. Martinez AM, Ramos NM, Requena JF, et al. Analysis of retropubic colpourethrosuspension results by suburethral sling with REMEEX prosthesis. Eur J Obstet Gynecol Reprod Biol 2003; 106:179-183. Preliminary report on a new adjustable sling technique.
48. Pelosi-II MA, Pelosi-III MA, Pelekanos M. The YAMA Uropatch sling for treatment of female stress urinary incontinence: a pilot study. J Laparoendosc Adv Surg Tech 2002; 12:27-33. A sling patch made from bovine pericardium is used in a limited number of patients (n=22). Good clinical results with few complications are reported. This paper recognizes the fact that bio-slings can be used in either 'good' or 'bad' urethras.
49. Kayigil O, Biri A. Double forced sling by combining in situ vaginal wall and infast pubic bone suburethral stabilization techniques: a new method. J Urol 2002; 167:2481-2483. This paper proves that there are no limits to doctors' fantasy and imagination.
50. Palma PCR, Dambros M, Riccetto CLZ, et al. Pubovaginal sling using porcine small intestine submucosa for stress urinary incontinence. Braz J Urol 2001; 27:483-488. Introduction of a new bio-material into the field of incontinence therapy.
51. Barrington JW, Edwards G, Arunkalaivanan AS, et al. The use of porcine dermal implant in a minimally invasive pubovaginal sling procedure for genuine stress incontinence. BJU Int 2002; 90:224-227. The use of procine skin (Pelvicol) for sling surgery shows results similar to TVT. However, the follow-up in this study is rather short (average 6 months).
52. Bemelmans B. The use of bio-materials in incontinence surgery. Eur Urol 2002; 1 (Suppl):12-16. This paper briefly demonstrates a TVT-like technique for placement of a bio-sling.
53. Lee C-L, Yen C-F, Wang C-J, et al. Trocar-assisted sling suspension for stress urinary incontinence. J Am Assoc Gynecol Laparosc 2002; 9:500-502. Insertion of a prolene mesh using a trocar for retropubic passage of the tape. Although feasible, this technique does not provide any apparent advantage.
54. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001; 11:1306-1313. Early French report on an alternative implantation route for a polypropylene sling.
55. Daher N, Boulanger JC, Ulmsten U. Pre-pubic TVT: an alternative to classic TVT in selected patients with urinary stress incontinence. Eur J Obstet Gynecol Reprod Biol 2003; 107:205-207. Study describing an alternative and hypothetically safer route for TVT insertion. No long-term data are available to support this claim.