https://doi.org/10.4081/uij.2024.334

Short-term outcomes of mini-sling versus transobturator tape in the surgical management of women with stress urinary incontinence. A randomized controlled trial

Vol. 36 No. 1 (2024)
Submitted: 10 July 2024
Accepted: 29 November 2024
Published: 16 December 2024
Mini-sling, transobturator tape, stress urinary incontinence
Abstract Views: 899
PDF: 179
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Ahmed Emam
ahmed_emam@med.asu.edu.eg
https://orcid.org/0000-0002-7677-0461
Department of Urology, Ain Shams University, Cairo, Egypt.
Khaled Teama
Department of Urology, Ain Shams University, Cairo, Egypt.
Tarek Salem
https://orcid.org/0009-0004-0188-516X
Department of Urology, Ain Shams University, Cairo, Egypt.

The objective of this prospective randomized study was to assess the efficacy and safety of mini-sling in the management of female stress urinary incontinence (SUI) as compared to transobturator tape (TOT). A total of 42 female patients with SUI were included in this study. Patients were randomized into two equal groups, underwent either the TOT or the mini-sling procedure, and were followed up for 6 months. Compared to the TOT group, the mini-sling group had a statistically significant shorter operative time, less estimated blood loss, and a lower postoperative pain score. There was no statistically significant difference between both groups as regards postoperative fever, hospital stay, or vaginal erosion. The International Continence Index questionnaire showed a statistically significant improvement within each group after surgery, with the TOT group showing a statistically significant marginal improvement compared to the mini-sling group. Urodynamic testing showed no statistically significant difference between both groups regarding the first sensation of bladder filling, functional bladder capacity, maximal bladder capacity, postvoiding residual urine, and maximal flow rate. Both mini-slings and TOT were found to be safe and effective in treating female SUI with no clinically significant difference between both procedures.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21:5-26. DOI: https://doi.org/10.1007/s00192-009-0976-9
Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician 2013;87:543-50
Tran LN, Puckett Y. Urinary incontinence. Treasure Island (FL), USA: StatPearls; 2024.
Falah-Hassani K, Reeves J, Shiri R, et al. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J 2021;32:501-52. DOI: https://doi.org/10.1007/s00192-020-04622-9
Kowalik CG, Dmochowski RR, De EJB, Surgery for female SUI: the ICI algorithm. Neurourol Urodyn 2019;38:S21-7. DOI: https://doi.org/10.1002/nau.23879
Novara G, Ficarra V, Boscolo-Berto R, et al. Tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials of effectiveness. Eur Urol 2007;52:663-78. DOI: https://doi.org/10.1016/j.eururo.2007.06.018
Kim A, Kim S, Kim HG. Current overview of surgical options for female stress urinary incontinence. Int Neurourol J 2020;24:222-30. DOI: https://doi.org/10.5213/inj.2040052.026
Nambiar A, Cody JD, Jeffery ST, Aluko P. Single-incision sling operations for urinary incontinence in women. Cochrane Database Syst Rev 2017;7:CD008709. DOI: https://doi.org/10.1002/14651858.CD008709.pub3
FDA. He Stress urinary incontinence: surgical mesh considerations and recommendations. 2019. Available from: https://www.fda.gov/medical-devices/urogynecologic-surgi- cal-mesh-implants/stress-urinary-incontinence-surgical-mesh- considerations-and-recommendations.
Naumann G, Albrich S, Skala C, et al. Single-incision slings (SIS) – a new option for the surgical treatment of female stress urinary incontinence. Geburtshilfe Frauenheilkd 2012;72:125-31. DOI: https://doi.org/10.1055/s-0031-1298275
Cox A, Herschorn S, Lee L. Surgical management of female SUI: is there a gold standard? Nat Rev Urol 2013;10:78-89. DOI: https://doi.org/10.1038/nrurol.2012.243
Krhut J, Zachoval R, Smith PP, et al. Pad weight testing in the evaluation of urinary incontinence. Neurourol Urodynam 2014;33:507-10. DOI: https://doi.org/10.1002/nau.22436
Karantanis E, Fynes M, Moore KH, Stanton SL. Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2004;15:111-6. DOI: https://doi.org/10.1007/s00192-004-1123-2
Tienza A, Graham PL, Robles JE, et al. Daily pad usage versus the international consultation on incontinence questionnaire short form for continence assessment following radical prostatectomy. Int Neurourol J 2020;24:156-62. DOI: https://doi.org/10.5213/inj.1938116.058
Abdel-Fattah M, Ford JA, Lim CP, Madhuvrata P. 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 2011;60:468-80. DOI: https://doi.org/10.1016/j.eururo.2011.05.003
Mostafa A, Lim CP, Hopper L, et al. Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: an updated systematic review and meta-analysis of effectiveness and complications. Eur Urol 2014;65:402-27. DOI: https://doi.org/10.1016/j.eururo.2013.08.032
Maghawry Maghawry El-Sayed M, Abd El-Salam Wafa Y, El-Said Kamel A. Single-incision mini sling compared with transobturator sling for treating stress urinary incontinence in women. Al-Azhar Med J 2022;51:2197-216. DOI: https://doi.org/10.21608/amj.2022.258350
Karataş S, Tekelioğlu M, Çift T, et al. The comparison of adjustable single-incision mini-sling and transobturator tape for the treatment of stress urinary incontinence. Jarem 2020;10:36-40. DOI: https://doi.org/10.4274/jarem.galenos.2019.2544
Rudnicki M, von Bothmer-Ostling K, Holstad A, et al. Adjustable mini-sling compared with conventional mid-urethral slings in women with urinary incontinence. A randomized controlled trial. Acta Obstet Gynecol Scand 2017;96:1347-56. DOI: https://doi.org/10.1111/aogs.13205
Emami M, Momtazan A, Maghsoudi R, et al. Transobturator tape and mini-sling methods in stress urinary incontinence: Results of a randomized clinical trial. Urologia 2019;86:152-5. DOI: https://doi.org/10.1177/0391560319845255
Chang CP, Chang WH, Hsu YM, et al. Comparison of single-incision mini-slings (Ajust) and standard transobturator midurethral slings (Align) in the management of female stress urinary incontinence: a 1-year follow-up. Taiwan J Obstet Gynecol 2015;54:726-30. DOI: https://doi.org/10.1016/j.tjog.2015.10.007
Kokanali MK, Doğanay M, Aksakal O, et al. Risk factors for mesh erosion after vaginal sling procedures for urinary incontinence. Eur J Obstet Gynecol Reprod Biol 2014;177:146-50. DOI: https://doi.org/10.1016/j.ejogrb.2014.03.039
Maturana AP, Palos CC, Ghersel FR, et al. Randomized controlled trial comparing mini-sling with transobturator sling for the treatment of stress urinary incontinence. Int Urogynecol J 2020;31:1925-31. DOI: https://doi.org/10.1007/s00192-019-04145-y
Abdel-Fattah M, Cooper D, Davidson T, et al. Single-incision mini-slings versus standard synthetic mid-urethral slings for surgical treatment of stress urinary incontinence in women: the SIMS RCT. Health Technol Assess 2022;26:1-190. DOI: https://doi.org/10.3310/BTSA6148
Hasan MRA, AbdelMagid ME, Tagreda IA. Sub-urethral mini sling versus transobturator vaginal tape for treatment of female stress urinary incontinence, one year follow-up. Egypt J Hospital Med 2019;76:3176-83. DOI: https://doi.org/10.21608/ejhm.2019.35090

How to Cite

Emam, A., Teama, K., & Salem, T. (2024). Short-term outcomes of mini-sling <i>versus</i> transobturator tape in the surgical management of women with stress urinary incontinence. A randomized controlled trial. Urogynaecologia, 36(1). https://doi.org/10.4081/uij.2024.334
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.

An Open Access Publication is one that meets the following two conditions:

  1. the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.
  2. a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.