ABSTRACT

The aim is to critically review the Arc to Arc minisling (Palma's technique), a less invasive midurethral sling using bovine pericardium as the sling material. Methods: The Arc to Arc minisling, using bovine pericardium was the first published report of a minisling, in 1999. The technique was identical to the “tension-free tape” operation, midline incision and disssection of the urethra. The ATFP (white line) was identidied by blunt dissection, and the minisling was sutured to the tendineous arc on both sides with 2 polypropylene 00 sutures. Results: The initial results were encouraging, with 9/10 patients cured at the 6 weeks post-operative visit. However, infection and extrusion of the minisling resulted in sling extrusion and removal, with 5 patients remaining cured at 12 months . Critical analysis and conclusion: The Arc to Arc minisling was a good concept, but failed because of the poor technology available at that time. Further research using new materials and better technology has led to new and safer alternatives for the management of stress Urinary Incontinence.