The Marlex sling operation for the treatment of recurrent stress urinary incontinence: A 16-year review

Morgan, J. Edwin; Farrow, G.A.; Stewart, Fiona

doi:10.1016/0002-9378(85)90017-1

Cited by 167 publications

(47 citation statements)

References 3 publications

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“…Repeat colposuspension and sling procedures involved 2.8-3.8% [23,24,29] and 0-1.7% [23,24,26] [23][24][25] of some kind of urgency or detrusor instability related problems, respectively. Voiding difficulties necessitated surgical interventions in 2-13.4% of the patients after sling procedures [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

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Tension-Free Vaginal Tape Procedure: An Effective Minimally Invasive Operation for the Treatment of Recurrent Stress Urinary Incontinence?

Kuuva

Nilsson²

2003

Gynecol Obstet Invest

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The aim of this study was to evaluate the results of tension-free vaginal tape (TVT) surgery in women with recurrent stress urinary incontinence (SUI). Fifty-one women with recurrent SUI were treated with TVT and followed prospectively for a minimum of 2 years according to a protocol. Twenty percent of the women had already undergone two previous continence procedures, whereas 80% had undergone only one. The mean follow-up period was 25.3 months. The objective cure rate was 89.6%, and the subjective cure rate 80.4%. No serious complications occurred. The majority of the patients were discharged in the afternoon of the operation day. No significant difference was observed between pre- and postoperative residual urine, maximal urethral closure pressure, and total and maximum voided urine volume values. However, the changes in urinary frequency, minimum voided volume, pad test results, and visual analog scale scores were highly significant. TVT appears to be a safe and suitable treatment for recurrent SUI.

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Section: Discussionmentioning

confidence: 99%

“…Voiding difficulties necessitated surgical interventions in 2-13.4% of the patients after sling procedures [24][25][26]. Retroperotineal abscesses [26] and sling erosions [25] are rare but significant complications after sling procedures. Both colposuspension and sling procedures predispose to genital organ prolapse [23,24].…”

Section: Discussionmentioning

confidence: 99%

Tension-Free Vaginal Tape Procedure: An Effective Minimally Invasive Operation for the Treatment of Recurrent Stress Urinary Incontinence?

Kuuva

Nilsson²

2003

Gynecol Obstet Invest

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“…Their popularity is related to the avoidance of a secondary harvesting site, decreased surgical time and similar efficacy in comparison with AS [1][2][3][4]. These factors have resulted in a substantial increase in the number of these procedures by both urologists and gynaecologists.…”

Section: Introductionmentioning

confidence: 99%

Disabling complications with slings for managing female stress urinary incontinence

et al. 2008

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OBJECTIVETo report an increase in the referral of patients with disabling complications after the failure of conservative therapy, their presentation, final surgical management and clinical outcome, following the use of non‐autologous slings (NAS), currently the primary surgical procedure for managing stress urinary incontinence (SUI) in women.PATIENT AND METHODSThirty‐eight patients (mean age 64 years) required surgical management for disabling complications after placing a NAS for SUI. Sling types were synthetic (25), xenografts (six) and allografts (four). Twenty (53%) patients presented with bladder outlet obstruction, 13 (34%) with sling erosion, three (8%) with worsened SUI, and two (5%) with unobstructive severe urgency and frequency.RESULTSThe sling was dissected and incised with no complication in 19 of 20 patients. One had a posterior urethral defect during sling dissection. Twelve patients (60%) acquired normal voiding and were continent. Among the 13 patients who had the sling dismantled and urethrolysis, two had recurrent or persistent SUI, two de‐novo urgency/frequency and one developed osteitis pubis. Three patients with disabling SUI received a pubovaginal sling placed proximal to the bladder neck, and had an overall improvement in their urinary control with no retention. Two unobstructed patients with urgency and frequency did not improve with anticholinergic medication and pelvic floor therapy, and are now candidates for botulinum toxin injection or neurostimulation.CONCLUSIONSThe complication rate with periurethral NAS for managing SUI in females is substantial. Patients with refractory urgency/frequency after the sling need a complete evaluation with cystoscopy and video‐urodynamics. Obstruction and erosion are the commonest problems and require surgical correction.

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“…Excessive haemorrhage requiring surgical drainage has been reported in 2.1% of pubovaginal sling procedures. 28 Leach et al 2 reported 6 cases out of 279 (2.1%) requiring transfusion after sling procedures. There have been few reports of retropubic haematoma formation and transfusion after TVT.…”

Section: Haemorrhage and Wound Haematomamentioning

confidence: 99%

Risks and benefits of sling procedures

Chaliha

Stanton²

2004

The Obstetric & Gynaecologis

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Over the past century over 150 operations have been described for the treatment of urodynamic stress incontinence. The spectrum of operative approaches that are used reflect its variety of causes. Classical sling procedures provide bladder neck support, permitting urethral compression or kinking with increases in intra‐abdominal pressure and decreasing voiding dysfunction. There are well‐documented complications associated with sling procedures. Modifications of operative technique and sling materials, in particular the tension‐free vaginal tape, have lowered complication rates and operative morbidity. This article discusses potential benefits and risks associated with different surgical options, to aid selection of the most appropriate treatment for any individual.

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The Marlex sling operation for the treatment of recurrent stress urinary incontinence: A 16-year review

Cited by 167 publications

References 3 publications

Tension-Free Vaginal Tape Procedure: An Effective Minimally Invasive Operation for the Treatment of Recurrent Stress Urinary Incontinence?

Tension-Free Vaginal Tape Procedure: An Effective Minimally Invasive Operation for the Treatment of Recurrent Stress Urinary Incontinence?

Disabling complications with slings for managing female stress urinary incontinence

Risks and benefits of sling procedures

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