Single-incision sling system as primary treatment of female stress urinary incontinence: prospective 12 months data from a single institution


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Abstract

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.OBJECTIVE• To investigate the success and complication rates for Mini-ArcTM single incision sling in the treatment of female stress urinary incontinence (SUI).MATERIALS AND METHODS• A total of 119 female patients with pure SUI were enrolled in a prospective study. From these, 105 were available with a minimum follow-up of 6 months and a mean follow-up of 12 months.• Success, as determined by patient- reported outcomes, and complication rates, as well as impact of learning curve, body mass index (BMI), intrinsic sphincter deficiency (ISD), incontinence severity and age were investigated.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 <2 ppd; 94% if 2–4 ppd, 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-ArcTM 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.

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