Have mini-slings come of age?

To highlight the recent data published about mini-slings for management of female stress urinary incontinence, focusing on the past 12 months.

Mini-slings, implanted by single vaginal incision, have been increasingly used in recent years.

A significant number of new clinical trials have investigated the efficacy of single incision mini-slings (SIMS) in the past years. Meta-analyses have shown growing evidence supporting their use, but a number of limitations go against a wide, immediate, and unconditional diffusion of these techniques. First, the majority of the trials published investigated the TVT-Secur device, which is considered to be inferior to traditional slings and is no more used in clinical practice. All other SIMS have been tested in clinical trials but there is insufficient evidence to routinely recommend their use, mainly because long-term data are lacking. SIMS have to be considered as a heterogeneous group, and results obtained with one device cannot be translated to another. The safety profile of recently introduced SIMS seems good, with potential reduction of postoperative pain and faster recovery. However, further research is necessary to clearly establish their noninferiority regarding efficacy after 1 year compared to traditional transobturator tapes and TVT, and ascertain their benefits in daily clinical practice.