Single-incision mini-sling for the treatment of female stress urinary incontinence: Is it actually inferior to transobturator vaginal tape and tension-free vaginal tape?

Abstract

Objectives: The aim of the study was to report the extended long-term results of the use of single-incision mini-sling (SIMS), tension-free vaginal tape (TVT), and transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI) at the Department of Gynecology and Obstetrics of the University Medical Center Ljubljana. Materials and Methods: Enrolled women were evaluated by Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), Sandvik severity scale, Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) Short Form and data about diagnosis, procedures, complications, reoperations, postoperative results, and satisfaction with procedure were recorded. Results: In analyzed group of patients ( n = 357), 116 (32%) underwent SIMS procedure, 189 (53%) TOT, and 52 (15%) TVT. The SIMS, TOT, and TVT groups did not differ significantly from each other in PGI-S, PGI-I, Sandvik severity scale, UDI-6, IIQ-7, and ICIQ-UI Short Form or in postoperative complication rate. Repeat surgery was needed in 9.5% after SIMS, in 13.2% of TOT patients and in 23.1% of TVT patients ( P = 0.194). Urinary retention occurred in 9.5% of the SIMS patients, in 9.5% of the TOT patients, and in 13.5% of the TVT patients ( P = 0.682). Mesh erosion/inflammation occurred in 3.4% of the SIMS patients, in 6.3% of the TOT patients, and in 3.8% of the TVT patients ( P = 0.485). Conclusion: The efficacy and safety of SIMS, TOT, and TVT in the surgical treatment of SUI are comparable. The choice of the technique should be based on the relative pros and cons of techniques and the surgeon's experience.

Single-incision mini-slings versus standard synthetic mid-urethral slings for surgical treatment of stress urinary incontinence in women: The SIMS RCT

“…In 2020, a number of small observational-size studies reported on the short-term effectiveness of various types of SIMS. 175,176,[221][222][223][224][225] Most of the studies had small cohorts and some were not independent from the industry. One prospective cohort study, of 116 women receiving Altis, reported groin/hip/thigh pain (8%), dyspareunia (1%) and tape exposure (3.5%) at 12 months' follow-up, but, interestingly, no further new AEs at 24 months' follow-up.…”

Effectiveness of Magnetic Stimulation in the Treatment of Urinary Incontinence: A Systematic Review and Results of Our Study

“…Deciding on a conservative or surgical treatment approach depends predominantly on the type and severity of UI and on comorbidities. Conservative treatment should be exhausted first, and, before surgery is proposed, certain factors must be taken into account: the patient’s age, general condition, and health, prior surgeries, and especially the gynecological and lower urinary tract status [ 4 , 8 , 9 ]. Therefore, new conservative treatment methods are being sought.…”