Evolution of midurethral and other mesh slings--a critical analysis.

We analyzed our original experimental studies on which the midurethral sling was based with reference to FDA mesh warnings. We concluded that: 1. Vascular/organ damage could be avoided by first penetrating the urogenital diaphragm. 2. A non-stretch tape minimizes obstruction and urethral damage. 3. A non-obstructive musculoelastic mechanism closes the urethra. 4. The strength of neocollagen (>92.8 lbs/sq inch) indicates that little mesh is required for prolapse repair. 5. Foreign body (mesh) reaction is different from infection and is related to volume implanted. 6. Urgency is potentially curable by repairing the suspensory ligaments. 7. "Minislings" are promising for incontinence and POP, but more development is required.