Mid-urethral slings represent a significant advance in the treatment of stress urinary incontinence, which levies a severe toll on the quality of life of millions of American women. This article examines the expanding family of mid-urethral slings and techniques that have defined the modern approach to anti-incontinence surgery.
Historical background
The most significant recent advance in sling surgery originated in the development of separate and novel theories to detail the etiology of SUI, forwarded by DeLancey (ie, the hammock theory) and Petros/Ulmsten (the integral theory).4 While a complete description of these respective theories is beyond the scope of this review, they describe a complex interaction between vaginal wall and periurethral ligamentous structures that act to prevent SUI. Indeed, these theories are varied and broad in their scope. Nonetheless, the clinical application of such concepts was seen in the subsequent repositioning of the sling to a more distal location beneath the urethra, and was appropriately described as the mid-urethral sling.
Prostate cancer genomic tests show prognostic value for progression, therapy benefit
April 22nd 2024"This preplanned ENACT trial biomarker analysis demonstrates the value of the Decipher score, AR-A score, and PAM50 genomic classifiers in identifying patients undergoing AS who are most likely to benefit from enzalutamide treatment," wrote the authors.
Updated data show survival benefit with adjuvant pembrolizumab in ccRCC
April 19th 2024“This is the first study to show a statistically significant and clinically meaningful survival improvement with any adjuvant therapy in kidney cancer, and this further supports adjuvant pembrolizumab as a standard of care after surgery in this disease setting,” says Toni K. Choueiri, MD.