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Risks and benefits of sling procedures

St Mary's Hospital, London W2 1NY UK. email: c.chaliha{at}ic.ac.uk (corresponding author).

Stuart L Stanton, FRCS FRCOG FRANZCOG (Hon), Emeritus Professor of Pelvic Surgery and Urogynaecology

Flat 10, 43 Wimpole St., London W1G 8AE, UK. email: sstantonwimpole{at}yahoo.com

Over the past century over 150 operations have been described for the treatment of urodynamic stress incontinence. The spectrum of operative approaches that are used reflect its variety of causes. Classical sling procedures provide bladder neck support, permitting urethral compression or kinking with increases in intra-abdominal pressure and decreasing voiding dysfunction. There are well-documented complications associated with sling procedures. Modifications of operative technique and sling materials, in particular the tension-free vaginal tape, have lowered complication rates and operative morbidity. This article discusses potential benefits and risks associated with different surgical options, to aid selection of the most appropriate treatment for any individual.

Keywords Keywords / intrinsic sphincter deficiency / midurethral tape / urodynamic stress incontinence / sling procedure / voiding dysfunction