A Randomized Prospective Comparison of the Needleless Mini-sling "hammock" and "U-shape" Configurations for Management of Stress Urinary Incontinence: 60-month Follow-up Results

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2024 Jun 11

PMID 38861026

Authors

Ozan Dogan

Alper Basbug

Ecem Eren

Murat Yassa

Affiliations

Soon will be listed here.

Abstract

Objective: To compare needleless mini-slings placed in a retropubic (U-shape) or trans-obturator (hammock-shape) configuration for treating stress urinary incontinence at 60th month.

Methods: All surgeries, conducted by a senior surgeon, involved objective and subjective assessments preoperatively and at 6, 12, 18, and 60 months postoperatively using cough-stress tests, ICIQ-SF, PGI-I, and a Likert scale.

Results: After 60 months, no significant differences were found in cure rates, mesh complications, or reinterventions between U-shaped and hammock-shaped groups. However, a significant decrease in cure rates was observed at 18 and 60 months in both groups. Notable differences in ICIQ-SF, Likert scale, and PGI-I scores were seen in the hammock-shaped group, while the U-shaped group showed differences in ICIQ-SF and PGI-I scores, but not in the Likert scale.

Conclusion: Given the lack of significant differences, asserting the superiority of either retropubic (U-shape) or transobturatorly (hammock-shape) needleless mini-slings for treating stress urinary incontinence is challenging.

References

DAncona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold E, Goldman H . The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn. 2019; 38(2):433-477. DOI: 10.1002/nau.23897. View

Molden S, Lucente V . New minimally invasive slings: TVT Secur. Curr Urol Rep. 2008; 9(5):358-61. DOI: 10.1007/s11934-008-0062-8. View

Cornu J, Lizee D, Sebe P, Peyrat L, Ciofu C, Cussenot O . TVT SECUR single-incision sling after 5 years of follow-up: the promises made and the promises broken. Eur Urol. 2012; 62(4):737-8. DOI: 10.1016/j.eururo.2012.06.054. View

Oliveira R, Botelho F, Silva P, Resende A, Silva C, Dinis P . Exploratory study assessing efficacy and complications of TVT-O, TVT-Secur, and Mini-Arc: results at 12-month follow-up. Eur Urol. 2011; 59(6):940-4. DOI: 10.1016/j.eururo.2011.01.018. View

Lenz F, Doll S, Sohn C, Brocker K . Single-Incision Mini-Slings: Obturator Complex Pull-Out-Force Measurements. Gynecol Obstet Invest. 2016; 82(4):376-381. DOI: 10.1159/000449156. View

Palma P, Siniscalchi R, Maciel L, Bigozzi M, Dal Fabbro I, Riccetto C . Primary fixation of mini slings: a comparative biomechanical study in vivo. Int Braz J Urol. 2012; 38(2):258-65. DOI: 10.1590/s1677-55382012000200015. View

Dogan O, Basbug A, Ellibes Kaya A, Pulatoglu C, Yassa M . A randomized prospective comparison of the needleless mini-sling "hammock" and "U-shape" configurations for management of stress urinary incontinence: 18 month follow-up results. Arch Gynecol Obstet. 2018; 297(6):1483-1493. DOI: 10.1007/s00404-018-4755-z. View

Haylen B, Freeman R, Swift S, Cosson M, Davila G, Deprest J . An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female.... Neurourol Urodyn. 2010; 30(1):2-12. DOI: 10.1002/nau.21036. View

Yalcin I, Bump R . Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol. 2003; 189(1):98-101. DOI: 10.1067/mob.2003.379. View

10.

Lee K, Lee Y, Seo J, Na Y, Choo M, Kim J . A prospective multicenter randomized comparative study between the U- and H-type methods of the TVT SECUR procedure for the treatment of female stress urinary incontinence: 1-year follow-up. Eur Urol. 2010; 57(6):973-9. DOI: 10.1016/j.eururo.2010.02.018. View

11.

Sivaslioglu A, Unlubilgin E, Aydogmus S, Keskin L, Dolen I . 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. 2012; 188(1):194-9. DOI: 10.1016/j.juro.2012.02.2564. View

12.

Guillot-Tantay C, Van Kerrebroeck P, Chartier-Kastler E, Dechartres A, Tubach F . Long-term Safety of Synthetic Midurethral Sling Implantation for the Treatment of Stress Urinary Incontinence in Adult Women: A Systematic Review. Eur Urol Open Sci. 2023; 54:10-19. PMC: 10276216. DOI: 10.1016/j.euros.2023.05.013. View