Conflict of Interest: Peter Petros is the co-inventor of the midurethral sling (“TVT” 1995) the posterior sling “Infracoccygeal Sacropexy” 1997) and the TFS tensioned sling (2005). John Papadimitriou author has no conflict of interest.
Version of Record online: 21 SEP 2012
Copyright © 2012 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 32, Issue 4, pages 399–406, April 2013
How to Cite
Petros, P. and Papadimitriou, J. (2013), Evolution of midurethral and other mesh slings – a critical analysis. Neurourol. Urodyn., 32: 399–406. doi: 10.1002/nau.22308
Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
Peter Petros and John Papadimitriou contributed to the conceptualization and writing of the manuscript.
- Issue online: 15 APR 2013
- Version of Record online: 21 SEP 2012
- Manuscript Accepted: 9 AUG 2012
- Manuscript Received: 3 JUL 2012
- integral theory;
- musculoelastic closure;
- pubourethral ligament;
- ureterovesical junction;
- urinary stress incontinence
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.