| May 2005 · Vol. 17, No. 5 PART 1 OF A SERIES
CONTROVERSIES IN PELVIC SURGERY UROGYNECOLOGY EXPERT PANEL
Which sling for which patient?
This roundtable is the first of a series on persistent questions in urogynecology. Future topics: lower urinary tract injury, hysterectomy routes, vaginal vault prolapse.
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IN THIS ARTICLE
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How preop evaluation guides the decision
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Intrinsic sphincter deficiency: What it is and what to make of it
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Why the Burch procedure isn’t obsolete
3 TECHNIQUES FOR STRESS INCONTINENCE
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Fast Track
“The tension-free vaginal tape is the only synthetic midurethral sling proven to be as effective as conventional repairs”
“As I gained experience, I tied slings looser and looser, without ever losing clinical efficacy”
“For their own protection, ObGyns should not do surgery for prolapse and incontinence if they do not have cystoscopy privileges”
“The best solution is to subspecialize to the point where all surgeons doing these procedures have sufficient experience”
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Mickey
Karram,
MD
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OUR EXPERT PANELISTS
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Mickey Karram, MD, the moderator of this discussion, is director of urogynecology at Good Samaritan Hospital in Cincinnati and professor of obstetrics and gynecology at the University of Cincinnati.
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Jerry Blaivas, MD, is clinical professor of urology, Weill Cornell Medical Center, New York City.
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Mark Walters, MD, is head of the section of urogynecology and reconstructive pelvic surgery, Cleveland Clinic Foundation, Cleveland.
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Slings abound, entering the market faster than research can evaluate every new modification as exhaustively as we would like. How should we determine what is best for a particular patient? That is the question we examine in this discussion—the first in a series of roundtables, Controversies in Pelvic Surgery.
Future topics in the series focus on other unsettled issues:
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