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Autologous pubovaginal slings: back to the future or a lost art?

Authors Bang S, Belal M

Received 23 September 2015

Accepted for publication 16 November 2015

Published 18 January 2016 Volume 2016:8 Pages 11—20

DOI https://doi.org/10.2147/RRU.S96957

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Federico Soria

Peer reviewer comments 2

Editor who approved publication: Dr Jan Colli


Shieh-Ling Bang, Mohammed Belal

Department of Urology, Queen Elizabeth Hospital, Birmingham, UK

Abstract: Stress urinary incontinence (SUI) is an under-diagnosed problem affecting up to 50% of women worldwide. SUI is a source of psychological distress to the individual and also imposes a financial burden to the individual and the health care system. The role of surgery in the treatment in SUI has evolved steadily in the last two decades. The synthetic mid-urethral sling and its different insertion methods have gained widespread popularity and are now the most frequently used surgical interventions for women with SUI in Europe. As the use of synthetic slings becomes more widespread, an increasing number of complications are being reported. With the recent concerns surrounding the use of synthetic transvaginal meshes in organ prolapse surgery, synthetic slings have been put under further scrutiny. It is imperative for health care providers to be aware of the current issues associated with synthetic slings and the alternative surgical options available. Traditional autologous pubovaginal slings (PVS) have re-emerged as a viable alternative to synthetic slings in light of the issues with synthetic slings. The re-adoption of autologous PVS has however, been slow due to the technical difficulty of the surgery and perceived higher morbidity rates. In this article, we will discuss the various aspects of autologous PVS and its indications as an alternative to synthetic slings. We will also touch on the current evidence and controversies for synthetic mesh slings.

Keywords: autologous pubovaginal sling, stress urinary incontinence, synthetic sling, erosions
 

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