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RESULTS• Cure rate was 80% and improvement rate was 11%. Pain intensity was minimal on a visual analogue scale and transient urinary retention occurred in three patients, one requiring sling section.• De novo urgency was reported by 6% of women. Severe incontinence was less likely to be cured: 70% if > 5 pads per day (ppd); 94% if < 2ppd; 94% if 2-4ppd, P < 0.05).• There was no difference in success rates between the first 50 and the last 50 patients. BMI, ISD and age also did not influence success rate. CONCLUSION• Mini-Arc TM attained high success rates at 1 year follow-up. The procedure was easy to learn and was associated with very low and mild morbidity. Severe incontinence was identified as a risk factor for failure. KEYWORDSfemale stress urinary incontinence, midurethral sling, suburethral tape, Mini-Arc, mini-sling, single incision sling Study Type -Therapy (case series) Level of Evidence 4What's known on the subject? and What does the study add? Single-incision slings (SIS), requiring very limited intracorporeal dissection, have been recently introduced on the premise that they might increase safety of female stress urinary incontinence treatment. However, their success rate has been insufficiently evaluated.This is a large prospective series on Mini-Arc SIS, with data on 105 patients available at a mean follow-up of 12 months. Success rates are comparable while morbidity was lower and milder than that associated retropubic or transobturator slings. This study warrants a large-scale randomized comparative study between Mini-Arc and standard mid-urethral tapes, matured at longer follow-up time.

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Single-incision slings were introduced in the surgical treatment of female stress urinary incontinence (SUI) to lessen the morbidity associated with traditional midurethral slings. However, long-term reports on patient satisfaction are still scarce. This study describes the outcome of women treated with Mini-Arc at a mean follow-up of 45 months. In a previous report on 105 women with 15-month mean follow-up, 84 (80%) were found cured and 12 (11%) improved. Now, with a mean follow-up of 45 months, cured/improved patients were reassessed by telephone and completed Patient Global Impression of Improvement (PGI-I), Patient Global Impression of Severity (PGI-S), rated their improvement in a 0–100 scale, and answered if they would recommend the procedure. At 45-month follow-up, 73 women cured/improved were available for evaluation. Over 80% of the cured patients rated the improvement of SUI by the PGI-I as “very much better” or “much better,” reported their urinary tract condition to be “normal” on PGI-S, and described their improvement >70%. Ninety percent would recommend this procedure to a friend. The improved-patient population is very small (n = 7). This study shows that the majority of patients cured/improved after Mini-Arc placement maintain a high degree of satisfaction at a long-term evaluation.