Conference Coverage

Despite concerns, synthetic slings are still ‘standard of care’ in SUI


 

EXPERT ANALYSIS FROM PAGS

Transobdurator (TOT) slings offer benefits.

There’s less risk of bladder and vascular injury from the TOT procedure, which is easy to learn and teach, Dr. Ridgeway said. Research suggests the tension-free vaginal tape (TVT) approach is more likely to cause voiding dysfunction, she added.

But TOT is probably less effective in patients with SUI linked to intrinsic sphincter deficiency and in longer-term follow-up, she said. And there are cases of male sex partners injuring their penises during contact with TOT slings during intercourse.

Single-incision slings are up-and-coming options.

These slings offer promising results in short-term studies, but long-term results aren’t available yet. They may be a good option for cases of mild and occult SUI, she said.

Alternative treatments for SUI have limitations.

These include urethral bulking agents, which mainly lead to improvement rather than cure. Autologous fascial pubovaginal slings are another option, especially if patients don’t want a mesh-based treatment or have recurrent SUI following a synthetic mesh complication. However, she noted that research points to morbidity and de novo urinary urgency, she said.

The Pelvic Anatomy & Gynecologic Surgery Symposium was jointly provided by Global Academy for Medical Education and the University of Cincinnati. Global Academy and this news organization are owned by the same company.

Dr. Ridgeway disclosed consulting for Coloplast and having served as an independent contractor (legal) for Ethicon.

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