Thoughts on midurethral synthetic slings.

Since the early 1900s, there have been many attempts to correct stress urinary incontinence (SUI) in women. Over the years, it became accepted that the most effective way to correct SUI involved a procedure that supports the urethra. This simple premise spurred major innovations in the 1970s and 1980s by Shlomo Raz and Tom Stamey, many of which proved difficult to reproduce and were not universally accepted. In the mid-1990s, however, Ulf Ulmsten and Peter Petros revolutionized treatment of SUI, using a synthetic sling at the midurethra in a tension-free fashion. The urologic and urogynecologic world forever changed. In the last decade, further innovations have been based on these principles. There are currently three main types of synthetic sling procedures, including the retro-pubic synthetic sling, the obturator synthetic sling, and the single-incision synthetic sling.