Midurethral sling complications

Herschorn, Sender

doi:10.5489/cuaj.4692

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…It is therefore logical to try a bulking agent in these patients and satisfying results have been achieved after mid-urethral sling failure [12,13]. Surgical failure rates after MUS procedures are variable and range from approximately 8 to 57% at five years of follow-up [11,12,14].…”

Section: Gr Up Smmentioning

confidence: 99%

Injectable Bulking Agents for the Treatment of Stress Urinary Incontinence

Lemperle¹,

Lemperle²

2017

SM Gerontol Geriatr Res

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Urethral Bulking Agents (UBAs) are injected locally as a minimally invasive procedure for Stress Urinary Incontinence (SUI) and are beneficial for properly selected patients. Many different materials have been developed and are available, although none so far meet all the requirements of an ideal agent. The first UBA was cross-linked bovine collagen (Contigen ® ), followed by autologous fat injections, solid silicone particles (Macroplastique ® ), microspheres covered with pyrolytic carbon (Durasphere ® ), calcium hydroxyapatite (Coaptite ® ), polyacrylamide hydrogel (Bulkamid ® ), and dextran/HA copolymer (Zuidex ® ). The latest product development is PDMS-U, a silicone gel bulking agent that polymerizes in situ (Urolastic ® ).The ideal urinary bulking agent could consist of permanent microspheres, which immediately elicit a modest foreign body reaction along with the production of fibro-vascular tissue, which encapsulate every single microsphere individually and prevent their migration from the injection site. Polymethylmethacrylate microspheres have a successful history as dermal fillers used world-wide and can be safely injected submucosally at the urinary sphincter under direct vision, rather than peri-urethrally into the muscle like most of the present agents.Overall, short-term clinical results with most of the currently used urinary bulking agents are encouraging; however, longer follow-up results are often disappointing and retreatment is required. Proper patient selection and a safe, biocompatible and non-migrating bulking agent that elicits permanent fibro-vascular tissue formation at the injection site are paramount to successful treatment of stress urinary incontinence.

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Section: Gr Up Smmentioning

confidence: 99%

Injectable Bulking Agents for the Treatment of Stress Urinary Incontinence

Lemperle¹,

Lemperle²

2017

SM Gerontol Geriatr Res

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“…2 Multiple primary reports and reviews have demonstrated that midurethral slings are safe, effective and associated with improved quality of life. 3,4 In the past decade, there has been significant public concern regarding mesh used for SUI and pelvic organ prolapse 3,5e7 following the FDA (U.S. Food and Drug Administration) and Health Canada warnings regarding the frequency and severity of complications in mesh-based POP surgery, specifically. 8e10 Mirroring these communications was a notable increase in litigation for both SUI and POP mesh-based procedures, which has forced several device companies to leave the marketplace and dissuaded patients from undergoing these procedures.…”

mentioning

confidence: 99%

“…8e10 Mirroring these communications was a notable increase in litigation for both SUI and POP mesh-based procedures, which has forced several device companies to leave the marketplace and dissuaded patients from undergoing these procedures. 3,6,7 One such concern includes a carcinogenic potential for pelvic mesh. 11 In the 1940s, various rat models reported the development of tumors after the implantation of thermoplastic materials.…”

mentioning

confidence: 99%

“…2 Multiple primary reports and reviews have demonstrated that midurethral slings are safe, effective and associated with improved quality of life. 3,4…”

mentioning

confidence: 99%

“…8–10 Mirroring these communications was a notable increase in litigation for both SUI and POP mesh-based procedures, which has forced several device companies to leave the marketplace and dissuaded patients from undergoing these procedures. 3,6,7…”

mentioning

confidence: 99%

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Stress Incontinence Surgery Does Not Cause Pelvic Malignancy: A Population-Based Cohort Study

Vigil

Wallis

Zhang³

et al. 2021

Journal of Urology

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Purpose: We sought to determine if stress urinary incontinence surgery (mesh or nonmesh) is associated with the development of pelvic malignancies later in life. Materials and Methods: We performed a retrospective cohort study between January 1, 2002 and October 31, 2015 of all women in Ontario, Canada without a history of pelvic malignancy who underwent an index stress incontinence surgery. The primary outcome was a composite of any pelvic malignancy (including urological and gynecological cancers) following stress incontinence surgery. Secondarily, we considered each cancer individually. A survival analysis using a Cox proportional-hazards model with a 3-level categorical exposure (mesh surgery, nonmesh surgery, and control) was performed. Patients were followed until death, emigration or the study end (October 31, 2017). Results: Of the women 74,968 underwent stress urinary incontinence surgery during the study period. There were 5,505,576 women in the control group. Over a median followup of 8.5 years (IQR, 5.5e11.9), 587 pelvic malignancies occurred in the surgery group. Women who underwent stress incontinence surgery had a reduced risk of pelvic malignancy independent of surgery type, compared to controls (Wald type 3 p <0.001; mesh HR, 0.68 [95% CI, 0.62e0.76]; p <0.0001; nonmesh HR, 0.37 [95% CI, 0.29e0.46]; p <0.0001). The individual pelvic cancers similarly demonstrated a reduced risk of malignancy following stress incontinence surgery. Conclusions: At a median followup of 8.5 years, women had no increased risk of pelvic malignancy following either mesh or nonmesh stress urinary incontinence surgery in a large population-based cohort.

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Mixed Urinary Incontinence: Strategic Approach

Weissbart

Smith

2021

Female Pelvic Medicine

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Midurethral sling complications

Cited by 4 publications

References 18 publications

Injectable Bulking Agents for the Treatment of Stress Urinary Incontinence

Injectable Bulking Agents for the Treatment of Stress Urinary Incontinence

Stress Incontinence Surgery Does Not Cause Pelvic Malignancy: A Population-Based Cohort Study

Mixed Urinary Incontinence: Strategic Approach

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