Synthetic sling options for stress urinary incontinence

Various materials have been used in the treatment of stress urinary incontinence. Autologous materials such as muscle and fascia were first used to provide additional anatomic support to the periurethral and pelvic tissues; however, attempts to minimize the invasiveness of the procedures have led to the use of synthetic materials. We review the literature and describe different synthetic materials used for slings. We performed a comprehensive review of the literature on synthetic grafts used in slings using MEDLINE and resources cited in those peer-reviewed papers. Of all synthetic materials, the type I macroporous polypropylene meshes have demonstrated superiority in terms of efficacy and lower complication rates than other mesh types due to their structure and composition. The success of the graft appears to be independent of the placement technique. The ideal graft provides structural integrity and durability with minimal adverse reaction by the host tissue. Certain synthetic grafts used in pubovaginal slings can provide durability with minimal complications.