ABSTRACT

Slings have been the chosen option for most of the patients complaining stress urinary incontinence (SUI) for a long time. Synthetic slings have turned major surgeries into minimally invasive procedures and also reduce operative time and hospital stay as well as postoperative discomfort and the recovery period. Complex patients include those with multiple recurrences after the previous treatment attempts, specially using mesh, with dysfunctional voiding due to fixed urethra, and with previous urethral reconstructive surgery. Until recently, autologous material was mostly used for this subset based on two major concerns: risk of prosthetic implant infection and urethral erosion leading to pain and urethral fistulas [1]. Readjustable slings were proposed to allow for a safe and effective management of complex incontinence. In this chapter, we will focus on two most popular commercially available adjustable slings: safyre and remeex.