Comparison of outcomes between single‐incision sling and transobturator sling for treating stress urinary incontinence: A 10‐year prospective study

Abstract

Aims: To evaluate and compare the clinical outcomes of the transobturator sling with the single-incision sling, for the treatment of stress urinary incontinence at a long-term follow-up. Methods: From October 2008 to October 2010, 94 patients who were enrolled and underwent either TVT-O, one of standard mid-urethral sling or TVT-S, one of single-incision mini-sling (SIMS) procedure. The study population was followed until February 2019. Surgical outcomes were analyzed by subjective and objective evaluations and Chinese version questionnaires. Data were analyzed by IBM 23.0 SPSS Statistics. The level of statistical significance was set at P < 0.05. Results: At the 10-year follow-up, 31(64.6%) TVT-O patients and 33(71.7%) TVT-S patients were still available. Objective cure and subjective satisfaction rate were not significantly different for TVT-O compared with TVT-S (P > 0.05).However, TVT-S showed a greater drop in success from the second to the tenth year compared with TVT-O (15.1% vs 0% and 9.2% vs 3.2%, respectively). Both groups experienced significantly improved quality of life in the TVT-O group and in the TVT-S group (P < 0.05). The total PISQ-12 scores at 10 years postoperatively of the TVT-O and TVT-S groups were 33.4(4.7) compared with 33.6(3.9) before surgery (P = 0.67 > 0.05) and 35.5(5.9) compared with 31.5(6.3) before surgery (P = 0.045 < 0.05).Conclusions: It is difficult to state that there is superiority of one sling over another sling without a significant difference. But TVT-O showed superior objective cure and subjective satisfaction rates and a less decline in success during 10 years compared with TVT-S.

Evaluation of the long-term effect and complication rate of single-incision slings for female stress urinary incontinence

“…These findings are consistent with Schweitzer et al [4]. In this study 2.5% of the total population had a sling exposure, which is comparable to other studies, with exposure rates for SIMS ranging between 0.0% and 3.5% [6,11,12]. This is also comparable with the exposure rate of 2.4% of patients with a TMUS and 2.1% of RMUS [13].…”

“…With a subjective improvement observed in three-quarters of patients and a subjective cure in about two-thirds, our results were less positive than the short term outcome one year after Ajust Ò and two years after Altis Ò placement [4,11]. This might be explained by the longer mean follow-up in the current study, as it is known that patient satisfaction rates decline over time [6,12]. Comparing these results with a meta-analysis of retropubic and TMUS, the RMUS has a significantly higher subjective improvement and cure rate: 97% (95% C.I.…”

“…The patient population was a non-selected population of women. The total number of included patients was 397, which, in comparison to other studies about SIMS, can be considered as a large cohort [4,6,11,12,18].…”

“…Transobturator mid-urethral slings (TMUS) have a lower risk of bladder injury, but are associated with thigh, groin and hip pain [3][4][5]. Singleincision midurethral slings (SIMS) have been available since 2006 [6]. These slings do not perforate the adductor muscles, and are experienced by patients as a less painful procedure, but are as effective as TMUS in curing SUI [3].…”

The Improvement of Urethral Function in the Rat Stress Urinary Incontinence Model by Electrical Stimulation Combined With Pelvic Floor Muscle Training To Activate VEGF and ERK 1/2

“…Studies have confirmed that moderate pudendal nerve electrical stimulation can promote cell activity, which is beneficial to urethral and vaginal tissue repair of SUI patients [4,5] . Electrical stimulation combined with pelvic floor training can effectively relieve the symptoms of SUI [6,7] , which is an efficient clinical treatment scheme for SUI. Nevertheless, its mechanism is still unclear, which further hinders the development of treatment research.…”