Types of suburethral sling procedures to treat stress urinary incontinence in females

Midurethral sling

A vaginal surgery involving tension-free placement of a synthetic mesh strip or tape placed between the vagina and the urethra near the urethra midpoint

The synthetic mesh is usually a Type 1 monofilament, microporous polypropylene material

Retropubic midurethral sling

A midurethral sling that traverses the vagina, the retropubic space, the abdominal wall, and skin in the suprapubic area

The sling is most commonly inserted from "bottom-to-top" (vagina to abdominal wall) but can be inserted from "top-to-bottom" (abdominal wall to vagina)

Transobturator midurethral sling

A midurethral sling that traverses the vagina, bilateral obturator foramen, and the skin in the bilateral groin

May be inserted "in-to-out" through the vaginal incision, through the obturator foramen, and out through the groin skin, or may be inserted "out-to-in" through the groin incision, through the obturator foramen, and exit through the vaginal suburethral incision

Single-incision midurethral sling

A midurethral sling that requires only a vaginal incision using permanent anchors at the ends of the sling. It is shorter in length than a full-length retropubic or transobturator midurethral sling.

It may be anchored to the urogenital diaphragm in a retropubic "U" configuration or anchored flatter in the obturator internus muscle in a "H" of "Hammock configuration"

Pubovaginal sling

An abdominovaginal surgery that uses a length of fascia, tissue, or graft to support the urethra with an abdominal wall fixation site

Joint Report on Terminology for Surgical Procedures to Treat Stress Urinary Incontinence in Women. Female Pelvic Med Reconstr Surg 2020; 26:162.

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Types of suburethral sling procedures to treat stress urinary incontinence in females