Single-Incision Mini-Slings Versus Standard Midurethral Slings in Surgical Management of Female Stress Urinary Incontinence: An Updated Systematic Review and Meta-analysis of Effectiveness and Complications

Mostafa, Alyaa; Lim, Chou Phay; Hopper, Laura Rose; Madhuvrata, Priya; Abdel‐Fattah, Mohamed

doi:10.1016/j.eururo.2013.08.032

Cited by 153 publications

(133 citation statements)

References 49 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…Moreover, a recent systematic review and meta-analysis published by Mostafa el at. [48], demonstrating similar outcome for mini-slings and traditional MUS. However, most of the available RCTs reported only short-or intermediate-term follow-up data.…”

Section: Discussionmentioning

confidence: 70%

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

et al. 2017

Self Cite

View full text Add to dashboard Cite

CONTEXT: Retropubic (RT-TVT) and transobturator miurethral (TO-TVT) mid-urethral sling (MUS) are popular surgical treatments for female stress urinary incontinence (SUI). The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomized controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female SUI. EVIDENCE ACQUISITION:A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses. EVIDENCE SYNTHESIS:Twenty-eight RCTs were identified. In total, the meta-analyses CONCLUSIONS:The present analysis confirms the superiority of MUS over BC. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of 3 inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT. PATIENT SUMMARY:Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence. The available literature suggest that those slings are either more effective or safer than other older surgical procedures. Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra-and postoperative complications. TAKE-HOME MESSAGESThe present analysis confirms the superiority of MUS over Burch colposuspension. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT 4

show abstract

Section: Discussionmentioning

confidence: 70%

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Later, a randomized controlled trial, 15 which has evaluated the objective cure rate of MiniArc™ compared to the transobturator standard midurethral sling, Monarc™, concludes that MiniArc™ presents an objective cure rate that is not inferior to the other option (89% v. 91%, respectively; p: 0.65) nor subjective cure (83% v. 86%, respectively; p: 0.46) while post-operative pain is greater (p<0.01). Additionally, systematic reviews have been performed that confirm this fact: Mostafa et al 16 have compared the effectiveness of the single-incision minislings vs. TVT-O and similar slings, concluding that there is no significant difference in the objective cure rate (RR: 0.98; 95% CI: 0.94; 1.01 at 18.6 months) although MiniArc™ shows a shorter recovery time to return to daily activities (5.08 v. 7.20 days). The demonstration of equivalence in the effectiveness results is essential for the choice of the type of economic analysis.…”

Section: Discussionmentioning

confidence: 93%

Cost Effectiveness analysis of Surgical Treatment of Stress Urinary Incontinence Using Single-Incision Mini-Slings vs. Tension-Free Vaginal Obturator in Spain

Castañeda¹,

Sanz-Granda²,

Hidalgo³

et al. 2015

Surg Res Open J

View full text Add to dashboard Cite

“…Nowadays, there are a few SIMS available on the market, all of which are made of polypropylene. Yet, they differ, which may have an influence on biomechanical properties of tapes and on their respective cure rate [19,20,28]. Various success rates have been reported for SIMS during the last decade [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…Also, a smaller polypropylene tape is implanted [28]. The Ajust sling is the first SIMS, which just like TOT anchors to the obturator muscle or its membrane complex.…”

Section: Discussionmentioning

confidence: 99%

Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

Kluz¹,

Wlaźlak²,

Wróbel³

et al. 2017

Ginekol Pol

View full text Add to dashboard Cite

Objective: The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling -Ajust™. Material and methods:One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location. PFS-TV was performed under standardized conditions at rest and during maximum Valsalva maneuver.Results: This is a retrospective analysis of data from a total of 31 patients who attended a control visit between the 36 th and the 50 th month following the operation. Sixteen patients (51.6%) were cured. There were statistically significant differences in urethral mobility (p < 0.0007) and tape-urethra distance (p < 0.002) between cured and not-cured group. The difference in urethral length was not statistically significant. 77.8% of women with a hypermobile urethra was cured in contrast to 15.4% with a normobile urethra. Neither of the groups had a hypomobile urethra patient. There were no significant complications intra-or post-operatively. De novo urgency was observed in 1 patient only.Conclusions: Implantation of Ajust tape seems to be a safe mode of operative treatment for SUI in women. Our mid-term results suggest that long term effects might be worse compared to retropubic or transobturator tapes, especially at first operative experience with Ajust. Urethral mobility seems to be an important risk factor for treatment failure after Ajust implantation. It seems that patients that may benefit from Ajust most are women with urethral hypomobility but this needs to be verified with a prospective study.

show abstract

Single-Incision Mini-Slings Versus Standard Midurethral Slings in Surgical Management of Female Stress Urinary Incontinence: An Updated Systematic Review and Meta-analysis of Effectiveness and Complications

Cited by 153 publications

References 49 publications

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

Cost Effectiveness analysis of Surgical Treatment of Stress Urinary Incontinence Using Single-Incision Mini-Slings vs. Tension-Free Vaginal Obturator in Spain

Adjustable single incision sling Ajust — the effects of first operations controlled by pelvic floor sonography

Contact Info

Product

Resources

About