Surgical treatment of female stress incontinence:impact of changed views on polypropylene

The introduction of the tensionfree vaginal tape in 1995 drastically changed the landscape of surgical procedures for stress urinary incontinence (SUI). Because of the uncomplicated technique many urologists and gynecologists embraced the procedure with tripled the number of annual procedures in the beginning of this century. At the same time polypropylene was used for the development of surgical procedures of pelvic organ prolapse (POP). Especially the use of polypropylene for POP has caused many severe clinical complications. This caused a huge reduction of these kind of surgical procedures and it is performed nowadays only under strict conditions. At the same time the use of polypropylene for SUI was scrutinized and questioned. Nowadays, in the Ango-Saxon countries the use of polypropylene tapes for SUI is not recommended. This manuscript explores the role of polypropylene tapes for SUI. Questions that are dealt with are: How dangerous are polypropylene tapes anyway? What are the alternatives? Which factors contribute to a successful outcome of stress incontinence surgery

Sacral neuromodulation for lower urinary tract functional dysfunction:an update

Sacral neuromodulation is an approved treatment for overactive bladder and non-obstructive retention since the nineties of the last century. This article highlights the neuromodulation system, the indications for use, and the working mechanism, on the basis of current insights and recent publications. In addition, the new developments regarding surgery technique, surgical policy and the technical aspects of the system are being discussed