Three-year follow-up in patients with urinary stress incontinence treated with Altis® single-incision sling

Objetives: Compare the efficacy and post-surgical complications of single-incision sling (SIS) and transobturator band (TO) for the treatment of stress urinary incontinence (SUI) over 7 years’ follow up. Methods: This is a prospective observational study that included 289 women with SUI who went under surgical treatment, either TO (109) or SIS (180). Patients were evaluated pre- and postoperatively through anamnesis, physical examination and ultrasound. Epidemiological information, complications and surgical time were recorded. The primary outcomes were total continence, objective and subjective cure rates at 7-year follow-up. Statistics: T-Student or U-Mann-Whitney for quantitative variables, Chi-Square for qualitative variables. Results: The groups were similar regarding demographic and medical history parameters, except for age and arterial hypertension, which were higher in TO group, and that SIS patients were more physically active tan TO patients. The TO band compared to SIS associated with increased frequency repair of pelvic organ prolapse. Depending on the type of urinary incontinence, pure SUI was more frequent in SIS and mixed in TO. The duration of the surgery was shorter with SIS. During the 7-year follow up there were no differences in the objective cure, subjective cure and complication rates. Conclusion: After 7-years follow-up, no significant differences were found with regard to subjective and objective outcomes, and post-surgery complication rates between the single incisión sling and the transobturator band.

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The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm8081099 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1099

Author(s):

Hui-Hsuan Lau ◽

Sugarmaa Enkhtaivan ◽

Tsung-Hsien Su ◽

Wen-Chu Huang

Keyword(s):

Single Incision ◽

Obese Women ◽

Cure Rate ◽

Pad Test ◽

Single Incision Sling ◽

Wound Pain ◽

Urine Leakage ◽

Assess Quality ◽

Subjective Cure

Background: Being overweight or obese is a risk factor for incontinence and has negative impacts on the surgical outcomes. Compared with trans-obturator sling (TOS), single incision sling (SIS) is a new generation of anti-incontinence surgery. However, the data on SIS in overweight and obese women remains limited. Methods: This retrospective study analyzed the objective and subjective cure rate of overweight and obese women who underwent sling surgeries. Other evaluations included valid questionnaires to assess quality of life and 1-hour pad test to quantify urine leakage. Surgical characteristics and adverse events were also analyzed. Results: A total of 217 patients were analyzed with a median follow-up period of 37.3 months (range, 9–84 months). For overweight and obese patients, the objective and subjective cure rate were comparable (all p > 0.05). However, the SIS group had worse post-operative incontinence-related symptom distress (p < 0.001) and 1-hour pad test (p = 0.047). On the other hand, SIS had a shorter surgery time (p = 0.017) and lower pain score (p < 0.001). Conclusions: Compared with TOS, SIS had non-significant cure rates in the overweight and obese women. SIS had worse urine leakage and incontinence symptoms, but less surgical and wound pain in obese women. Thorough pre-operative counseling is necessary.

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