nach oben

Erschienen in:

01.03.2014 | Original Article

A cohort study comparing a single-incision sling with a retropubic midurethral sling

verfasst von: Annetta M. Madsen, Sherif A. El-Nashar, Joshua L. Woelk, Christopher J. Klingele, John B. Gebhart, Emanuel C. Trabuco

Erschienen in: International Urogynecology Journal | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

Despite established comparable efficacy between retropubic midurethral (RMUS) and transobturator slings, there are conflicting data regarding single-incision mini-slings (SIMS). This study tests the null hypothesis that the MiniArc® Single-Incision Sling is equivalent to the ALIGN® Urethral Support System for treatment of stress urinary incontinence (SUI).

Methods

Women who underwent a sling for SUI from 1 January 2008 through 31 December 2009 were identified (N = 324). A follow-up survey was mailed. Primary outcomes were treatment failure, defined as International Consultation on Incontinence Questionnaire (ICIQ) score >0 or additional anti-incontinence procedure, and stress-specific incontinence (SSI). Secondary outcomes included Patient Global Impression of Severity and Improvement (PGI-SI), satisfaction, de novo urge, and complications.

Results

The study included 202 women who returned the survey. The SIMS group had higher body mass index (BMI) (30.7 ± 6.5 vs 28.9 ± 6.0 kg/m², P = 0.052) and shorter follow-up (18.6 ± 11.5 vs 22.9 ± 14.6 months, P = 0.019). Treatment failure was higher in SIMS compared with RMUS (76.3 % vs 64.2 %) with adjusted odds ratio of 1.84 (95 % CI, 1.0, 3.5). The SIMS group was more likely to have postoperative SSI, with adjusted OR of 2.4 (95 % CI; 1.3–4.5). The RMUS group reported more improvement and satisfaction. Incidence of de novo urge and complications were similar between groups. Reoperation for mesh erosion was more likely in the RMUS group, while the SIMS had a higher reoperation rate for SUI.

Conclusions

Compared with retropubic ALIGN® Slings, MiniArc® Single-Incision Slings are less effective, with more postoperative incontinence, less patient-reported improvement, satisfaction, and higher reoperation rates for SUI.

Trabuco EC et al (2009) Medium-term comparison of continence rates after rectus fascia or midurethral sling placement. Am J Obstet Gynecol 200(3):300 e1–300 e6CrossRef

Ogah J, Cody DJ, Rogerson L (2011) Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women: a short version Cochrane review. NeurourolUrodyn 30(3):284–291

Barber MD et al (2012) Single-incision mini-sling compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 119(2 Pt 1):328–337PubMedCrossRef

Abdelwahab O, Shedid I, Al-Adl AM (2010) Tension-free vaginal tape versus secure tension-free vaginal tape in treatment of female stress urinary incontinence. Curr Urol 4:93–98 CrossRef

Amat ITL, Martinez Franco E, Lailla Vicens JM (2011) Contasure-Needleless compared with transobturator-TVT for the treatment of stress urinary incontinence. Int Urogynecol J 22(7):827–833

Andrada Hamer M, Larsson PG, Teleman P, Bergqvist CE, Persson J (2013) One-year results of a prospective randomized, evaluator-blinded, multicenter study comparing TVT and TVT Secur. Int Urogynecol J 24(2):223–229

Basu M, Duckett J (2010) A randomised trial of a retropubic tension-free vaginal tape versus a mini-sling for stress incontinence. BJOG 117(6):730–735PubMedCrossRef

Enzelsberger H et al (2010) MiniArc (R) versus Monarc (R)—a prospective randomized study of the treatment of female stress urinary incontinence with a follow-up of 2 years. Geburtshilfe Frauenheilkd 70(6):499–502CrossRef

Hinoul P et al (2011) A randomized, controlled trial comparing an innovative single incision sling with an established transobturator sling to treat female stress urinary incontinence. J Urol 185(4):1356–1362PubMedCrossRef

10.

Hota LS et al (2012) TVT-Secur (Hammock) versus TVT-Obturator: a randomized trial of suburethral sling operative procedures. Female Pelvic Med Reconstr Surg 18(1):41–45PubMedCentralPubMed

11.

Masata J et al (2012) Randomized trial of a comparison of the efficacy of TVT-O and single-incision tape TVT SECUR systems in the treatment of stress urinary incontinent women—2-year follow-up. Int Urogynecol J 23(10):1403–1412PubMedCrossRef

12.

Sivaslioglu AA et al (2012) A prospective randomized controlled trial of the transobturator tape and tissue fixation mini-sling in patients with stress urinary incontinence: 5-year results. J Urol 188(1):194–199PubMedCrossRef

13.

Tommaselli GA et al (2010) Efficacy and safety of TVT-O and TVT-Secur in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J 21(10):1211–1217PubMedCrossRef

14.

Wang YJ et al (2011) Comparison of three mid-urethral tension-free tapes (TVT, TVT-O, and TVT-Secur) in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J 22(11):1369–1374PubMedCrossRef

15.

Bianchi-Ferraro AM et al (2012) Single-incision sling compared with transobturator sling for treating stress urinary incontinence: a randomized controlled trial. Int Urogynecol J 24(9):1459–1465PubMedCrossRef

16.

Abrams P et al (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61(1):37–49PubMedCrossRef

17.

Avery K et al (2004) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. NeurourolUrodyn 23(4):322–330

18.

Shumaker SA et al (1994) Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group. Qual Life Res Int J Qual Life Asp Treat Care Rehab 3(5):291–306CrossRef

19.

Yalcin I, Bump RC (2003) Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 189(1):98–101PubMedCrossRef

20.

Abdel-Fattah M et al (2011) Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol 60(3):468–480PubMedCrossRef

21.

Kim JJ, Lee YS, Lee KS (2010) Randomized comparative study of the U- and H-type approaches of the TVT-Secur procedure for the treatment of female stress urinary incontinence: one-year follow-up. Kor J Urol 51(4):250–256CrossRef

22.

Liapis A, Bakas P, Creatsas G (2010) Comparison of the TVT SECUR System “hammock” and “U” tape positions for management of stress urinary incontinence. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 111(3):233–236CrossRef

23.

Basu M, Duckett J (2013) Three-year results from a randomised trial of a retropubic mid-urethral sling versus the Miniarc single incision sling for stress urinary incontinence. Int Urogynecol J DOI: 10.1007/s00192-013-2125-8

24.

Mostafa A et al (2012) A multicentre prospective randomised study of single-incision mini-sling (Ajust ®) versus tension-free vaginal tape-obturator (TVT-O™) in the management of female stress urinary incontinence: pain profile and short-term outcomes. Eur J Obstet Gynecol Reprod Biol 165(1):115–121PubMedCrossRef

25.

Oliveira R et al (2011) Exploratory study assessing efficacy and complications of TVT-O, TVT-Secur, and Mini-Arc: results at 12-month follow-up. Eur Urol 59(6):940–944PubMedCrossRef

26.

Palomba S et al (2012) A randomized controlled trial comparing three vaginal kits of single-incision mini-slings for stress urinary incontinence: Surgical data. Eur J Obstet Gynecol Reprod Biol 163(1):108–112PubMedCrossRef

27.

Lee JK et al (2011) Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis. BJOG 118(7):798–805PubMedCrossRef

28.

Gebhart JB et al (2008) Three-year outcomes of Uretex Urethral Support System for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1075–1079PubMed

29.

Barber MD et al (2008) Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 111(3):611–621PubMedCrossRef

30.

Richter HE et al (2010) Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 362(22):2066–2076PubMedCentralPubMedCrossRef

Titel: A cohort study comparing a single-incision sling with a retropubic midurethral sling
verfasst von: Annetta M. Madsen
Sherif A. El-Nashar
Joshua L. Woelk
Christopher J. Klingele
John B. Gebhart
Emanuel C. Trabuco
Publikationsdatum: 01.03.2014
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 3/2014
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2208-6

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

A cohort study comparing a single-incision sling with a retropubic midurethral sling