Abstract
Surgeons have performed multiple variations of the pubovaginal sling procedure in an attempt to achieve reproducible results. In this review, the potential mechanisms by which midurethral slings restore continence are discussed. Surgical techniques are described and the results of recently published data in the literature are presented. Two midurethral slings, which employ loosely woven polypropylene mesh, are the tension-free vaginal tape (Ethicon Inc., Sommerville, NJ) procedure and the SPARC Sling System (American Medical Systems, Minneapolis, MN). They are used in this article to illustrate important clinical concepts.