Surgical Treatment of Female Stress Urinary Incontinence: Midurethral Slings

Stress urinary incontinence (SUI) is the loss of urine caused by increased physical activity such as coughing or exercise. In this review, the anatomy and pathophysiology of SUI are discussed, particularly the presence of a hypermobile urethra. This specific anatomic finding allows the midurethral sling to be a viable surgical option. The evolution and different types of midurethral slings, including retropubic, transobturator, and single-incision slings, are described. We then discuss outcomes of the different types of slings in patients with SUI and special populations, including elderly and obese patients. Finally, we review the complications associated with midurethral slings. This review contains 7 figures, 3 tables, and 110 references. Keywords: complications, elderly, incontinence, intrinsic sphincter deficiency, meshexposure, midurethral sling, mixed incontinence, outcomes, retropubic sling, single-incision sling, stress urinary incontinence, transobturator sling