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Single-Incision Mini-Slings for Stress Urinary Incontinence in Women
Mohamed Abdel-Fattah1, David Cooper1, Tracey Davidson1
1From the University of Aberdeen, Aberdeen (M.A.-F., D.C., T.D., M.K., M.H., D.B., J. N'Dow, G.M.), University Hospital of Wales, Cardiff (K.B.), Oxford (J.W.), and the University of Edinburgh, Edinburgh (J. Norrie) - all in the United Kingdom.
The New England Journal of Medicine
|March 30, 2022
Summary
Newer single-incision mini-slings are as effective as standard midurethral slings for treating female stress urinary incontinence. Patient-reported success rates were similar at 15 and 36 months, with comparable safety profiles.
Area of Science:
- Urology
- Gynecology
- Surgical Innovation
Background:
- Synthetic midurethral slings were the standard surgical treatment for female stress urinary incontinence.
- Limited data exist comparing newer single-incision mini-slings with traditional midurethral slings.
Purpose of the Study:
- To compare the effectiveness and safety of single-incision mini-slings versus standard midurethral slings for female stress urinary incontinence.
- To determine if mini-slings are noninferior to midurethral slings.
Main Methods:
- A pragmatic, noninferiority, randomized trial involving 21 U.K. hospitals.
- 298 women received mini-slings, and 298 received midurethral slings.
- Patient-reported success was assessed at 15 and 36 months post-surgery.
Main Results:
- Mini-slings were noninferior to midurethral slings, with patient-reported success rates of 79.1% vs. 75.6% at 15 months.
- Success rates remained similar at 36 months (72.0% vs. 66.8%).
- Similar rates of groin/thigh pain; higher rates of tape/mesh exposure and re-operation with mini-slings; increased dyspareunia with mini-slings.
Conclusions:
- Single-incision mini-slings are noninferior to standard midurethral slings for patient-reported success in treating female stress urinary incontinence.
- Long-term outcomes and quality of life were generally similar, with specific differences in adverse events and sexual function.
