Abstract
Editorial Comment This paper discusses the use of a salvage spiral urethral sling in a very difficult to treat patient population, that is, females who have failed multiple vaginal operations for urinary incontinence. The authors provide an excellent technical analysis and state that when using this technique they are able to salvage approximately three out of four. Of interest is that they describe the use of both autologous fascia as well as synthetic graft. Operative tactics are described in the event of a bladder injury at the time of dissection (laterally placed spiral sling); this is very valuable in view of the potential for injury during the periurethral dissection in this patient population with a history of multiple surgeries. In addition, the authors discuss the use of this operation as opposed to the use of artificial urinary sphincter. Given the success rate of this operation mirrors that reported for artificial urinary sphincter in female patients, it has a potential to achieve a great deal of popularity in this very difficult to treat population (1).
Highlights
Salvage spiral sling techniques are a satisfactory alternative treatment for refractory stress urinary incontinence
When the bladder is perforated unilaterally, a lateral spiral sling can be used on the contralateral side
Editorial Comment This paper discusses the use of a salvage spiral urethral sling in a very difficult to treat patient population, that is, females who have failed multiple vaginal operations for urinary incontinence
Summary
Conclusions: Salvage spiral sling techniques are a satisfactory alternative treatment for refractory stress urinary incontinence. When synthetic material cannot be used, autologous tissue can provide similar results.
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