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Keywords:

  • integral theory;
  • musculoelastic closure;
  • pubourethral ligament;
  • ureterovesical junction;
  • urinary stress incontinence

Abstract

We analyzed our original experimental studies on which the midurethral sling was based with reference to FDA mesh warnings.

We concluded that

  • 1.
    Vascular/organ damage could be avoided by first penetrating the urogenital diaphragm.
  • 2.
    A non-stretch tape minimizes obstruction and urethral damage.
  • 3.
    A non-obstructive musculoelastic mechanism closes the urethra.
  • 4.
    The strength of neocollagen (>92.8 lbs/sq inch) indicates that little mesh is required for prolapse repair.
  • 5.
    Foreign body (mesh) reaction is different from infection and is related to volume implanted
  • 6.
    Urgency is potentially curable by repairing the suspensory ligaments
  • 7.
    “Minislings” are promising for incontinence and POP, but more development is required.

Neurourol. Urodynam. 32: 399–406, 2013. © 2012 Wiley Periodicals, Inc.