Is mid-urethral placement of synthetic minimal access tapes important in stress urinary incontinence surgery?
The introduction of the tension free vaginal tape over a decade ago heralded the adoption of sub-urethral sling placement under the mid-urethra rather than the proximal urethra. This paper reviews the literature which led to the change in practice and also looks at which factors concerning tape position influence surgical outcome with particular reference to the position along the urethra. There is conflicting evidence on the importance of the mid-urethral position and there is also evidence that other factors such as the configuration of the tape under the urethra at rest and under strain and the proximity of the tape to the urethral mucosa may be as important in influencing outcome. Further research is required.
Smith
Anthony R B
AR
St Mary's Hospital, Manchester, UK. anthony.smith@cmft.nhs.uk
Koelbl
Heinz
H
D005260:Female; D006801:Humans; D053825:Suburethral Slings; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*