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Introduction: Since the banning of trans-vaginal meshes for pelvic organ prolapse treatment by the FDA in 2019, French authorities have been gradually regulating the use of prosthetic materials in urogynecology. The decision to fit a mid-urethral sling or a reinforcement implant for the cure of prolapse, as well as the management of complex genital prolapse and serious post-implant complications, must be the subject of multidisciplinary consultation and a shared medical decision. To comply with these regulations, multidisciplinary team meetings (MDTMs) have been set up. The aim of the study was to evaluate the impact of these meetings on patient management., Material: We carried out a retrospective study in a tertiary hospital in France on all cases presented in MDTM of urogynecology over the year 2022. MDTMs were held weekly, with a "Prosthesis MDTM" focusing on slings, sacrocolpo/hysteropexies and prosthetic complications, lead by the urology team, and a "Prolapse MDTM" focusing on pelvic organ prolapse and complex prolapses, lead by the gynecology team. We compared the initial proposal of the patient's referring physician versus the final proposal of the MDTM., Results: Three hundred and seventy-five cases were presented in our center in 2022: 188 in Prosthetic MDTM and 187 in Prolapse MDTM. The Prosthetic and Static MDTMs agreed with the initial proposal in 83 and 64% of cases respectively, while the therapeutic strategy was questioned in 12 and 36% of cases respectively., Conclusion: For almost a quarter (24%) of patients, the MDTM of urogynecology opted for a different management from that proposed by the referring physician. The presentation of cases to the MDTM is a legal obligation in specific indications. It also plays an educational role, enabling shared decision-making and responsibility, which is an asset in functional surgery., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Kadınlarda stres üriner inkontinans (SÜİ) yaygındır ve yaşam kalitesine önemli ölçüde olumsuz etkisi vardır. Yaşam tarzı değişiklikleri, fizik tedavi, planlı işeme rejimler gibi konservatif tedavi stratejileri başarısız olduğu zaman cerrahi standart yaklaşımdır. 1900 lerin başında tanımlanan ve uygulamaya başlayan invaziv cerrahi girişimlerden günümüzde uygulanmaya başlayan minimal invaziv sling operasyonlara kadar birçok yöntem denenmiştir. Midüretral sling güvenli oluşu, kolay uygulanması ve uzun dönem sonuçlarının diğer yöntemler kadar başarılı olması nedeniyle günümüzde en sık kullanılan yöntemdir. Farklı cerrahi işlemler tanımlanmış olmasına karşın, en uygun tekniği henüz mevcut görünmemektedir.

Midurethral slings have become the most popular surgical procedure for the correction of stress urinary incontinence in women. Urinary retention or obstructive voiding symptoms may arise from partial urethral obstruction as a result of oversuspension of the urethra or exaggerated tension. Fortunately, most cases of voiding dysfunction are transient and resolve spontaneously within days. Clean intermittent self-catheterization is the mainstay of conservative treatment. If symptoms persist, tape mobilization, incision or urethrolysis may be performed. Recurrent stress urinary incontinence may occur in a small group of patients, who may benefit from another incontinence treatment. [ABSTRACT FROM AUTHOR]

Purpose: To assess influence of miduretral sling (MUS) on patient's sexuality., Methods: A comprehensive literature review using Pubmed, Medline, Embase and Cochrane: "stress urinary incontinence", "sexual function", "anti-incontinence surgery", "minimaly invasive slings", "mid-urethral slings", "tension-free vaginal tape", "transobturator vaginal tape". Sixty-nine articles really dealt with the impact of MUS on sexuality., Results: The data were expressed as the median and interquartile range (IQR; 25th-75th percentile). After MUS surgery, 30% (21-37) patients had sexuality improvement, 8.5% (4.7-14) had sexuality impairment and 60% (53-73) didn't report change on their sexuality., Conclusion: MUS surgery didn't seem to impair significantly patient's sexuality., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)