Female incontinence: a review of biomaterials and minimally invasive techniques.
OBJECTIVE
This article discusses the various grafts or biomaterials, minimally invasive techniques, and recent advances for the treatment of female stress urinary incontinence and pelvic organ prolapse.


RESULTS
The studies reviewed in this paper compared certain biologic grafts to synthetic grafts in clinical trials and histopathological studies. Data from long-term outcome studies for tension-free vaginal tape are evaluated. As tension-free vaginal tape is the foremost technique for stress urinary incontinence correction, many of the newer modalities such as transobturator tape and laparoscopy are compared with it. Immediate and long-term complications from mesh use in stress urinary incontinence and pelvic organ prolapse repair are examined. Correction of prolapse may eventually entail the use of specially designed 'kits' that allow total pelvic floor reconstruction with a single piece of mesh.


CONCLUSIONS
Although biological grafts are initially efficacious, the trend is to use synthetic grafts in repair of stress urinary incontinence and pelvic organ prolapse. Midurethral slings continue to be the front-line therapeutic modality for stress urinary incontinence. After analysis of long-term data, other surgical techniques may gain popularity. With increasing use of synthetic grafts, however, long-term complications such as de-novo urgency, erosion, and dyspareunia need to be assessed.
Long Island Jewish Medical Center, Department of Urology, New Hyde Park, New York 11040, USA.
Kaytan V
KV
Amrute
Gopal H
GH
Badlani
D001672:Biocompatible Materials; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D017773:Pelvic Floor / Q000601:surgery; D011183:Postoperative Complications; D019736:Prostheses and Implants; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*
D001672:Biocompatible Materials