The midurethral sling (MUS) has largely been regarded as the “gold standard” in treatment of stress urinary incontinence (SUI). Recently the safety and use of the MUS has come under scrutiny following concerns about the use of mesh implants. The aim of this review was to detail the background to SUI which has led to the development of MUS, to highlight the issues surrounding the use of mesh under the current climate of mesh controversies and to provide an update on current evidence on the use of MUS.

We conducted a review of the literature looking at the efficacy and safety of MUS.

MUS has good rates of subjective cure in the short and into the longer term. The overall rates of complications are low including those associated with the use of mesh implants. When compared to other continence procedures, MUS is equally effective in regard to cure but has lower rates of complications and more favorable operative outcomes. The use of mesh has been supported by major Urogynaecological Societies along with the reports from government driven enquiries into the use of mesh.

Overall, MUS have been shown to be an effective and safe surgical treatment for management of stress urinary incontinence.

Neurourology and urodynamics. 2019 May 26 [Epub ahead of print]

Abigail A Ford, Visha Taylor, Joseph Ogah, Nikolaus Veit-Rubin, Vik Khullar, Guiseppe A Digesu

Imperial College Healthcare Trust, London, United Kingdom., University Hospital of Morecambe Bay, Cumbria, United Kingdom., Department of Obstetrics and Gynecology Medial University of Vienna, Vienna, Austria.