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Mini or Retropubic Sling in Women with Intrinsic Sphincter Deficiency at 12 Months-A Randomized Controlled Trial

Lin Li Ow1,2, James Wood Alexander3, Alison Leitch4

  • 1Monash Medical Centre, Pelvic Floor Unit, Monash Health, 365 Centre Road Bentleigh East, Victoria, 3165, Australia. owlinli@yahoo.com.

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Summary

Single-incision slings (SIS) and retropubic (RP) slings offer comparable cure rates for stress urinary incontinence (SUI) in women with intrinsic sphincter deficiency (ISD). Both surgical options demonstrate high success and low complication rates at 12 months.

Keywords:
Intrinsic Sphincter DeficiencyRandomized Controlled TrialRetropubic SlingSingle-Incision SlingStress Urinary Incontinence

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Area of Science:

  • Urology
  • Gynecology
  • Female Pelvic Medicine and Reconstructive Surgery

Background:

  • Stress urinary incontinence (SUI) significantly impacts women's quality of life.
  • Intrinsic sphincter deficiency (ISD) presents a specific challenge in SUI management.
  • Surgical interventions like slings are common treatments for SUI with ISD.

Purpose of the Study:

  • To compare the efficacy and safety of single-incision slings (SIS) versus retropubic (RP) slings for women with SUI and ISD.
  • To evaluate objective and subjective cure rates at 6 and 12 months post-surgery.
  • To assess complications and patient-reported outcomes for both surgical techniques.

Main Methods:

  • A multicenter randomized trial involving 112 women with SUI and ISD.
  • Participants were randomized to receive either an RP sling (58 women) or an SIS (54 women).
  • Primary outcome: objective cure rate (negative cough-stress test) at 12 months. Secondary outcomes: complications and patient-reported outcomes.

Main Results:

  • No significant difference in objective or subjective cure rates between SIS and RP groups at 12 months.
  • 74% of SIS patients and 69% of RP patients reported significant improvement.
  • Both methods showed comparable low rates of post-operative complications, with minor issues reported in both groups.

Conclusions:

  • Single-incision slings (SIS) and retropubic slings (RP) are both effective treatments for women with SUI and ISD.
  • Both surgical approaches demonstrate high success rates and low complication profiles at 12-month follow-up.
  • These findings support the use of both SIS and RP slings in managing SUI with ISD.