Silastic sling for urethral sphincter incompetence in women

Stanton, Stuart L.; Brindley, G. S.; Holmes, David M.

doi:10.1111/j.1471-0528.1985.tb01459.x

Cited by 99 publications

(26 citation statements)

References 5 publications

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“…Each woman underwent 1.6±0.6 complete vaginal deliveries. Median preoperative 1-h pad test was 50 g (range, 2-144), median VLPP 42.5 (range, 25-60) and median MUCP 12 [8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Resultsmentioning

confidence: 99%

Results 1 year after the Reemex system was applied for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency

et al. 2007

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We present 1-year results obtained with Reemex for the cure of intrinsic sphincter deficiencies (ISDs). We recruited all patients with primary cases of stress urinary incontinence (SUI) due to an ISD (Valsalva leak-point pressure less than 60 cm or maximal urethral closure pressure less than 20 cm) who did not receive previous surgery. Thirty-eight patients were operated on. Postoperative pain was 3 (range, 1-5, visual analogue scale) at 24 h from surgery. Immediate regulation (the day after surgery) was necessary in three of 38 patients (7.9%), two for obstructive voiding difficulties and one for incontinence. Late regulation was necessary in three of 38 patients (7.9%), two for obstructive voiding difficulties (after 6 months) and one for incontinence (1 year). Symptoms resolved after the sling adjustment. Our results suggest that sling adjustments resolve postoperative failures and maintain the success rate of the Reemex system even in the midterm.

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Section: Resultsmentioning

confidence: 99%

Results 1 year after the Reemex system was applied for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency

et al. 2007

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“…Os mais diversos materiais naturais e sintéticos têm sido utilizados na confecção da faixa do sling, dentre os quais citam-se: derme porcina, fáscias cadavéricas, faixas de propileno, Vycrilâ, silicone e Marlexâ 5,6,13 . Um estudo utilizando corium suino mostrou permanência do material e ausência de complicações em 88% das 53 pacientes estudadas 14 .…”

Section: Discussionunclassified

“…Dessa forma, existe grande interesse por materiais biocompatíveis que possam substituir as faixas autólogas na realização do sling, como a derme suína, a "lyodura" (homólogo liofilizado de duramáter), as faixas com polietileno, o Dácron ® , o polipropileno, o Gore-Tex ® , além do pericárdio bovino e o pericárdio de canguru [3][4][5][6] . No entanto, esses materiais heterólogos e sintéticos têm mostrado índices mais elevados de insucesso e complicações como rejeição e erosão uretral subseqüente 7,8 .…”

Section: Introductionunclassified

Utilização de pericárdio bovino no sling pubovaginal para o tratamento da incontinência urinária de esforço

Cândido¹,

Triginelli²,

Filho³

et al. 2003

Rev. Bras. Ginecol. Obstet.

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IntroduçãoDesde o início do século passado, os procedimentos do tipo sling têm sido descritos no tratamento da incontinência urinária de esforço (IUE), sendo utilizada grande variedade de materiais, como: músculo piramidal, fáscia lata, músculo grácil e bulbocavernoso Apesar das várias modificações técnicas, a cirurgia de sling consiste na utilização de uma faixa posicionada inferiormente à uretra ou colo vesical e fixada superiormente na parede abdominal. Apresenta taxas de cura objetiva de 61 a 100% e de cura subjetiva de 73 a 93% no tratamento da IUE feminina 1 . As altas taxas de sucesso do sling suburetral no tratamento da IUE, associadas aos novos conceitos na fisiopatologia da IUE e ao desenvolvimento de técnicas menos invasivas com material sintético, têm ocasionado um ressurgimento do interesse pelo sling no tratamento da IUE feminina.A utilização de tecido não autólogo no sling pubovaginal tem como vantagens a diminuição do tempo operatório, a possibilidade de utilização de anestesia local, além de menor tempo de internação e convalescência das pacientes 1,3 . Dessa forma, existe grande interesse por materiais

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“…Simple urethral dilation has been suggested which might produce temporary relief but also progressive worsening of the obstruction due to periurethral fibrosis [5,6]. Transvaginal urethrolysis and transvaginal division of the sling have been described [7]. Ghoniem and Elgamasy [8] advanced this by incising the suburethral portion of the sling and then using a patch of vaginal epithelium to reunite the two ends.…”

Section: Discussionmentioning

confidence: 99%

A New Tension-Adjustment Technique for Sling Operation: An Animal Model

Kafalı

Verit²,

İriadam³

et al. 2004

Urol Int

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Objective: To investigate the effectiveness of a new tension-adjustment technique for postoperative voiding difficulties encountered after sling operations. Method: To test our new method, urethral obstruction was developed in 5 female dogs by modifying the sling operation by exerting more tension on a specially prepared polypropylene strip in which a gap had been developed. After filling the bladder with isotonic solution, detrusor contractions were induced by pelvic nerve stimulations, and urodynamic studies were performed to document the urethral obstruction. In each case Foley catheters were inserted into the bladder and left in place until the time of tension adjustment. Tension adjustment was performed in the 1st, 2nd, 3rd, 4th and 5th weeks postoperatively for dogs 1, 2, 3, 4, and 5, respectively. Results: On the day of tension adjustment, after filling the bladder with isotonic solution and removing the Foley catheter, none of the dogs, except dog 3, was able to produce a free flow of urine either spontaneously or provoked by detrusor contractions. The release of the prolene sutures was readily achieved in all cases except dog 5. In this case, sling takedown was achieved after surgical exploration in which the sling location was confirmed by following the prolene sutures and Hegar’s dilator. After identifying the sling, the gap was opened by cutting the prolene sutures, instead of a sling incision. Release of the prolene sutures resulted in a distinct drop in the urethra with decreased resistance of Hegar’s dilator. The improvement in voiding was confirmed by postoperative urodynamic studies and was immediate in all cases. Conclusion: Our new technique for postoperative voiding difficulties encountered after sling operation is simple, effective and avoids re-operation in the early postoperative period.

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Silastic sling for urethral sphincter incompetence in women

Cited by 99 publications

References 5 publications

Results 1 year after the Reemex system was applied for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency

Results 1 year after the Reemex system was applied for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency

Utilização de pericárdio bovino no sling pubovaginal para o tratamento da incontinência urinária de esforço

A New Tension-Adjustment Technique for Sling Operation: An Animal Model

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