Retropubic Midurethral Synthetic Slings for Female Stress Urinary Incontinence

Abstract

Female stress urinary incontinence (SUI), defined as involuntary leakage on effort, exertion, sneezing, or coughing (Urology, 61(1):37–49, 2003), is a prevalent condition with significant impact on patient quality of life (QoL). About 18.3 million American women suffered from urinary incontinence in 2010, and almost 50 % of them reported SUI as the primary or sole symptom, with a financial burden of over US $12 billion a year (Curr Urol Rep, 12(5):370–6, 2011; Obstet Gynecol, 114(6):1278–83, 2009). This number is expected to increase substantially as the population ages. Worldwide, the prevalence of female SUI ranges from 5 to 61 %, and its incidence is estimated to be 4–11 % per year (Int Urogynecol J, 22(2):127–35, 2011; Incontinence: Fourth International Consultation on Incontinence, Paris, France, Health Publications Ltd., 2009, 35–112). Tension-free vaginal tape (TVT®; Gynecare, Ethicon, Somerville, NJ, USA) was the first retropubic midurethral synthetic sling (Int Urogynecol J, 7(2):81–6, 1996) proposed to address defective suburethral support, hypothesized to be responsible for the development of stress incontinence. Since then, the procedure has changed the perspective of SUI treatment and has become standard of care. It has several advantages, including a mini-invasive vaginal approach, short operation time, and hospital stay, combined with excellent short- and long-term results. [ABSTRACT FROM AUTHOR]