[Use of slings in vaginal surgery]. / Protezele în chirurgia vaginala.

ABSTRACT

The use of slings in the cure of genital prolapse and urinary stress incontinence is justified by the large number of relapses after the classical surgical procedures, especially due to the poor quality of the perineal connective tissue. The ideal sling for vaginal surgery should have certain characteristics, i.e., resistance to infection, bio-stability, bio-compatibility, solidity, interstitial texture, porosity, elasticity, non-aggressive margins. The discussed techniques used in the cure of the stress urinary incontinence are the Tension-free Vaginal Tape (TVT), the Sparc-sling System, the Intra-vaginal sling-plasty tunneller (IVS), and Trans-obturator Tape (TOT). For the cystocele, the under-bladder meshes, either free or fixed to the abdominal wall or to TVT is recommended. For the rectocele, a posterior IVS with a tension-free inter-recto-vaginal prosthesis is suitable, while for the vaginal vault prolapse, hysterocele or isolated elitrocele we discuss the posterior IVS.