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Update on Single-Incision Slings.

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Single-incision slings (SIS) provide a minimally invasive treatment for stress urinary incontinence (SUI) with high cure rates and low complications. Further research is needed to confirm long-term effectiveness and cost-effectiveness.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Female Pelvic Medicine

Background:

  • Single-incision slings (SIS) are increasingly used for stress urinary incontinence (SUI).
  • Understanding their safety, efficacy, and economic impact is crucial for patient care.
  • SIS aim to reduce operative time, pain, and recovery compared to traditional slings.

Purpose of the Study:

  • To provide an updated evidence review on the safety, efficacy, and economic impact of SIS for SUI in women.
  • To synthesize current data on cure rates, complications, and cost-effectiveness.

Main Methods:

  • A structured literature review of randomized controlled trials, prospective studies, and meta-analyses was performed.
  • Databases searched included PubMed, Cochrane Library, and FDA 522 Postmarket Surveillance Studies.
  • Key outcome metrics were objective/subjective cure rates, complications, and economic evaluations up to December 2024.

Main Results:

  • Review of 28 publications since 2023 showed high subjective (73.3-94.2%) and objective (61.5-94%) cure rates for SIS.
  • Low rates of mesh complications (0-14.2%), reinterventions (0-16.3%), and de novo urgency (0-15%) were reported up to 36 months.
  • SIS demonstrated short-term cost savings, especially in outpatient settings, but long-term cost-effectiveness remains uncertain.

Conclusions:

  • Single-incision slings are effective and safe for SUI treatment, comparable to traditional slings.
  • They offer short operative times and rare perioperative complications.
  • Long-term data on durability and complications are necessary for definitive clinical guidance.