Sling surgery for stress urinary incontinence; the perfect solution?

Stress urinary incontinence (SUI) is the most observed type of urinary incontinence and is defined as the loss of urine following a rise in abdominal pressure. The TVT (Tension-free Vaginal Tape), a mid-urethral sling (MUS), was introduced in 1996 and soon became the gold standard in the surgical treatment of SUI. Over the last decade, numerous MUS devices have been introduced but only some were able to achieve similar results in comparison to the original TVT. The main question of this thesis is whether slings, old and new, for either male and female, can live up to the expectations of both patients and physicians by being both safe and effective in curing urinary incontinence. Secondly, the question is raised whether sling surgery is anatomically safe with regard to those nervous systems which are essential for the sexual function or may actually be responsible for iatrogenic neurological damage during placement. In this thesis we conclude that many slings were, or still are, freely available on the market without any proper pre-market research. Moreover sling surgery can have serious negative side-effects on sexual function that should be a standard part of the informed consent provided when opting for surgery.Chipsoft, Ferring, Astellas, Stichting Bekkenbodem 4all, Coloplast, Zambon b.v.LUMC / Geneeskund