UROLOGICAL SURVEY
Fletcher SG, Zimmern PE
Female Pelvic Medicine, Reconstructive Surgery and Neurourology, UT South-Western Medical Center, Dallas, TX, USA
BJU Int. 2010; 105: 445-8
In this article, the author discusses the treatment options for women with bothersome stress urinary incontinence (SUI). He comments on the strong connection between the urethra and anterior vaginal wall and the complications related to the synthetic suburethral tapes. Further, the use of a vaginal wall support procedure with a pubovaginal sling and a mesh in the vaginal wall to treat UI are discussed.
Editorial Comment
An intellectual commentary discussing suburethral tape procedures, the potential reasons for their success as well as their complications. The authors note that based on the integral theory, the suburethral sling will help restore “deficient pubo-urethral ligaments to their normal anatomy (sic)”. They note that in their personal experience they have not identified a distinct pubourethral ligament. This observation has been discussed in previous editorials in this journal (1) and may explain the ability to maintain urinary continence after a suprameatal transvaginal urethrolysis (2). In addition, the article does quote a very candid if not surprising lower level of success with suburethral sling placement based on their Level 1 evidence.
This review is a worthwhile read for the surgeon interested in expanding both central and peripheral understanding of sub midurethral sling surgery.
Dr. Steven P. Petrou
Professor of Urology, Associate Dean
Mayo School of Graduate Medical Education
Jacksonville, Florida, USA
E-mail: petrou.steven@mayo.edu
-
1Petrou SP: Editorial Comment: What are the supportive structures of the female urethra? Int Braz J Urol. 2006; 32: 249-50.
-
2Petrou SP, Brown JA, Blaivas JG: Suprameatal transvaginal urethrolysis. J Urol. 1999; 161: 1268-71.
Neurology & Female Urology
Publication Dates
-
Publication in this collection
21 Oct 2010 -
Date of issue
Aug 2010
