Stress Urinary Incontinence (SUI) occurs when an increase in intra-abdominal pressure exceeds urethral closure pressure, resulting in the involuntary leakage of urine. This may occur with exertion, sneezing, or coughing.
Management options for SUI include conservative and surgical treatments. Midurethral sling placement has replaced other procedures (e.g., retropubic colposuspension, bladder neck slings) as the procedure of choice for many women.
The tension-free vaginal tape (TVT), introduced by Ulmsten in 1996, was the first synthetic retropubic midurethral sling. Since that time, variations of retropubic midurethral slings as well as midurethral transobturator slings have been introduced. A midurethral sling is a suburethral sling that is placed at the level of the midurethra in a tension-free manner. These slings are made of synthetic mesh.
The procedure takes about 20 minutes to perform and can be done with general, spinal or local sedation.
An alternative option to TVT and TOT is the Bard Adjust Sling
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