OJU  Vol.1 No.2 , May 2011
Cadaveric Assessment of Synthetic Mid-Urethral Sling Placement
Abstract: Purpose: To determine if 3 types of mid-urethral synthetic slings are visually the same. Materials and Methods: A retropubic, obturator, and single incision sling was individually placed in three cadavers. Tension was set using a spacer (obturator and retropubic). Single incision sling (SIS) tension was set by visual inspection. Thirty physicians were asked to determine placement method, tension, and location of the 3 slings. Results: Physicians were composed of 5 urologists, 7 urogynecologist, and 18 general gynecologists, with an average of 53 slings performed per year. Conclusion: This study showed that after placement of a sling it is hard to tell how the sling was placed and that most physicians felt the SIS was tensioned the best and most likely at the mid-urethra.
Cite this paper: nullS. Serels, "Cadaveric Assessment of Synthetic Mid-Urethral Sling Placement," Open Journal of Urology, Vol. 1 No. 2, 2011, pp. 19-24. doi: 10.4236/oju.2011.12006.

[1]   S. Hunskaar, G. Lose, D. Sykes, et al., “The Prevalence of Urinary Incontinence in Women in Four European Countries,” Journal of the British Association of Urological Surgeons, Vol. 93, 2004, pp. 324-330.

[2]   P.E Petros and U. Ulmsten, “An Integral Theory of Female Urinary Incontinence,” Acta Obstetricia et Gynecologica Scandinavica, Supplement 153, Vol. 69, 1990, pp. 7-31.

[3]   C. G. Nilsson, N. Kuuva, C. Falconer, et al., “Long-Term Results of the Tension-Free Vaginal Tape (TVT) Procedure for Surgical Treatment of Female Stress Urinary Incontinence,” International Urogynecology Journal and Pelvic Floor Dysfunction, Supplement 2, Vol. 12, 2001, pp. S5-S8. doi:10.1007/s001920170003

[4]   K. L. Ward and P. Hilton, “UK and Ireland TVT Trial Group. Tension-Free Vaginal Tape Versus Colposuspension for Primary Urodynamic Stress Incontinence: 5-Year Follow Up,” BJOG, Vol. 115, No. 2, 2008, pp. 226-233. doi:10.1111/j.1471-0528.2007.01548.x

[5]   V. W. Sung, M. D. Schleinitz, C. R. Rardin, et al., “Comparison of Retropubic versus Transobturator Approach to Midurethral Slings: A Systematic Review and Meta- Analysis,” American Journal of Obstetrics and Gynecology, Vol. 197, No. 1, 2007, pp. 3-11. doi:10.1016/j.ajog.2006.09.025

[6]   A. C. Wang, “The Techniques of Trocar Insertion and Intraoperative Urethrocystoscopy in Tension-Free Vaginal Taping: An Experience of 600 Cases,” Acta Obstetricia et Gynecologica Scandinavica, Vol. 83, No. 3, 2004, pp. 293-298.

[7]   E. Delorme, “Transobturator Urethral Suspension: Mini- Invasive Procedure in the Treatment of Stress Urinary Incontinence in Women [in French],” Prog Urol, Vol. 11, No. 6, 2001, pp. 1306-1313.

[8]   W. Al-Singary, I. S. Shergill, S. E. Allen, et al., “Transobturator Tape for Incontinence: A 3-Year Follow-Up,” Urologia Internationalis, Vol. 78, No. 3, 2007, pp. 198-201. doi:10.1159/000099337

[9]   P. M. Latthe, R. Foon and P. Toozs-Hobson, “Transobturator and Retropubic Tape Procedures in Stress Urinary Incontinence: A Systematic Review and Meta-Analysis of Effectiveness and Complications,” BJOG, Vol. 114, No. 5, 2007, pp. 522-531. doi:10.1111/j.1471-0528.2007.01268.x

[10]   P. Grise, S. Droupy, C. Saussine, et al., “Transobturator Tape Sling for Female Stress Incontinence with Polypropy-Lene Tape and Outside-In Procedure: Prospective Study with 1 Year of Minimal Follow-Up and Review of Transob-Turator Tape Sling,” Urology, Vol. 68, 2006, pp. 759-763. doi:10.1016/j.urology.2006.04.020

[11]   R. Moore, T. Erickson, S. Serels, et al., “Retrospective Review of Early Experience Using the AMS MiniArc Single Incision Sling,” Journal of Minimally Invasive Gynecology, Vol. 14, No. 6, 2007, pp. S129-130 (Abst.357).

[12]   R. D. Moore, S. R. Serels and G. W. Davila, “Minimally Invasive Treatment for Female Stress Urinary Incontinence,” Expert Review of Obstetrics & Gynecology, Vol. 3, No. 2, 2008, pp. 257-272. doi:10.1586/17474108.3.2.257