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Title: Making surgery safer through adequate communication with the stakeholders: vaginal slings.
Austin Authors: Elmer, Sandra;Brennan, Janelle;Mathieson, Rebecca;Norris, Briony;Carey, Marcus;Dowling, Caroline
Affiliation: Department of Urology, Eastern Health, 5 Arnold Street, Box Hill, Victoria, 3128, Australia
Eastern Health Clinical School, Monash University, Wellington Road, Clayton, Victoria, 3800, Australia
Department of Urogynaecology, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria, 3052, Australia
University of Melbourne, Parkville, Victoria, 3010, Australia
Department of Urology, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria, 3050, Australia
Department of Urology, Bendigo Health, 100 Barnard Street, Bendigo, Victoria, 3550, Australia
Bendigo Health Clinical School, University of Melbourne, Parkville, Victoria, 3010, Australia
Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Jun-2020 2019-07-04
Publication information: World Journal of Urology 2020; 38(6): 1351-1358
Abstract: In this review, we explore the evidence behind mid-urethral sling (MUS) surgery, review the rising reports of complications and the subsequent US Food and Drug Administration (FDA) and society statements, and evaluate risk perception and communication with patients, doctors, governing bodies, manufacturers and insurance companies. Our aim was to explore the pitfalls in communication that may be contributing to the decline in MUS use, and develop strategies to make MUS surgery safer. We searched the English language literature using PubMed for articles related to the management of stress urinary incontinence (SUI), MUS, safety and monitoring of transvaginal mesh (TVM), and reviewed all online FDA publications and international position statements regarding MUS for SUI. Polypropylene mesh has been used in MUS since the 1990s, with robust evidence to support its use. There has been a decline in the use of MUS ever since the FDA notifications. In response to the controversy surrounding TVM, position statements have been released portending the safety of, and advocating for the continued use of, MUS for the management of SUI. MUS is a viable, effective and safe treatment for SUI management. Physicians should obtain and document informed consent, be adequately trained, and monitor and report their outcomes using registries. With publication of registry results and ongoing health advocacy, the perception of the safety of MUS can improve and MUS can still be offered as a treatment option for SUI.
DOI: 10.1007/s00345-019-02859-8
ORCID: 0000-0002-7308-9451
PubMed URL: 31273442
Type: Journal Article
Subjects: Mid-urethral sling
Stress urinary incontinence
Transvaginal mesh
Appears in Collections:Journal articles

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