Pressure transmission theory-The Rasputin of incontinence.

"How has the PTT survived?" Having provided a plausible explanation for all abdominal stress urinary incontinence operations since 100 years, PTT, unsurprisingly, like climate change today, had become an entrenched convention which abdicated the need for midurethral sling (MUS) surgeons to learn the very different functional surgical anatomy underlying the MUS. "Has the PTT progressed knowledge, or retarded it?" This lack of knowledge by the surgeons of how and why the MUS works could be held responsible for the large number of major complications reported by the TVT: including, transected urethras, obturator nerve damage, perforation of external iliac vessels, more than 20 deaths. The role of the sling is to strengthen the pubourethral neoligament to prevent the urethra opening out under stress, not to elevate it. Elevating the sling remains the major cause of the most frequent complication of the MUS today, postoperative urinary retention.