Cadaveric Assessment of Synthetic Mid-Urethral Sling Placement

Abstract

Purpose: To determine if 3 types of mid-urethral synthetic slings are visually the same. Materials and Methods: A retropubic, obturator, and single incision sling was individually placed in three cadavers. Tension was set using a spacer (obturator and retropubic). Single incision sling (SIS) tension was set by visual inspection. Thirty physicians were asked to determine placement method, tension, and location of the 3 slings. Results: Physicians were composed of 5 urologists, 7 urogynecologist, and 18 general gynecologists, with an average of 53 slings performed per year. Conclusions: This study showed that after placement of a sling it is hard to tell how the sling was placed and that most physicians felt the SIS was tensioned the best and most likely at the mid-urethra. RetropubicObturator SIS % correctly identified sling 40% 43% 23%% thought tension was just right 33% 47% 73% % thought sling was at mid-urethra 50% 67% 83%

Comparison of clinical efficacy and urodynamic changes using single-incision slings (MiniArc® vs. Solyx™) for the treatment of female stress urinary incontinence

“…The technique for placing this sling has been standardized to permit reproducible placement into the obturator internus muscle, with optimized tension as demonstrated in a cadaver study by Serels. [ 9 ] In the literature, Solyx SIS was found to have a high postoperative continence rate of 95% with minimal perioperative or postoperative complications at a mean of 6.5 months follow-up,[ 8 ] which makes the Solyx tape an attractive alternative option for treatment of SUI. While these mini-tapes have reported noninferiority to transobturator slings in terms of safety, effectiveness, and objective cure rate for the treatment of SUI demonstrated in Maturana's randomized controlled trial in 2019,[ 10 ] there are few reports of their postoperative effects on the clinical outcomes and urodynamic changes.…”