A randomized, nonblinded extension study of single-incision versus transobturator midurethral sling in women with stress urinary incontinence

Schellart, René P.; Zwolsman, Sandra E.; Lucot, Jean-Philippe; Ridder, D.J.M.K. de; Dijkgraaf, Marcel G. W.; Roovers, Jan‐Paul W. R.

doi:10.1007/s00192-017-3362-z

Cited by 18 publications

(23 citation statements)

References 23 publications

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“…Few studies have reported medium-term outcomes of SIMS. [25][26][27] Overall, the various analyses of our trial demonstrated that objective cure of SUI favored TOT over a SIMS technique in the medium-term. Considering only the participants who completed 3-year follow-up which would best reproduce the treatment differences, cure reached 90.2% for TOT confirming the high success rate for MUS described by literature [21][22][23][24] while SIMS reached 68.3%.…”

Section: Discussionmentioning

confidence: 64%

Randomized controlled trial comparing single‐incision mini‐sling and transobturator midurethral sling for the treatment of stress urinary incontinence: 3‐year follow‐up results

Pascom

Djehdian

Bortolini

et al. 2018

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 64%

Randomized controlled trial comparing single‐incision mini‐sling and transobturator midurethral sling for the treatment of stress urinary incontinence: 3‐year follow‐up results

Pascom

Djehdian

Bortolini

et al. 2018

Neurourology and Urodynamics

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“…Data searches were performed in Google Scholar, PubMed, Medline, Embase, Scopus, Web of Science and the Cochrane Database of Systematic Reviews. Finally, 29 studies , including a total of 2 986 women, were selected for the meta‐analysis. An SIMS was defined as a midurethral sling placed through a single vaginal incision without skin incision, and included the Mini‐Arc, Contasure‐Needleless, Ophira, tissue fixation system (TFS) and Ajust.…”

Section: Methodsmentioning

confidence: 99%

“…Basu and Duckett , Schellart et al , Masata et al and Oliveira et al , published papers with in the same cohort of patients in different follow‐up years. In these cases, only objective and subjective cure rates were extracted from each paper for subgroup analysis based on the follow‐up period (Figs C and C).…”

Section: Methodsmentioning

confidence: 99%

Clinical outcome of single‐incision slings, excluding TVT‐Secur, vs standard slings in the surgical management of stress incontinence: an updated systematic review and meta‐analysis

Kim

Park

et al. 2018

BJU International

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The aim of the present paper was to assess and compare the long-term efficacy and safety of single-incision mini-slings (SIMSs), except tension-free vaginal tape (TVT)-Secur, with standard midurethral slings (SMUSs) for female stress urinary incontinence through an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing these two surgical methods. A literature review of all RCTs comparing SIMSs (Mini-Arc, Contasure-Needleless, Ophira, Tissue Fixation System and Ajust), except TVT-Secur, with SMUSs was performed. The Medline, Embase, Scopus, Web of Science and Cochrane Controlled Trial Register databases were reviewed. We retrieved 29 RCTs (including a total of 2 986 patients) that compared SIMSs, except TVT-Secur, with SMUSs. Meta-analysis of long-term results showed no significant difference in the patient-reported cure rate (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.44-1.60); however, we found that SMUSs had a significantly superior objective cure rate (OR 0.68, 95% CI 0.47-0.99; P = 0.04). SIMSs were associated with a significantly shorter operation time, lower immediate postoperative pain based on a visual analogue scale score, lower intra-operative blood loss, and lower postoperative voiding dysfunction. The meta-analysis showed clear evidence of the superiority of SMUSs over SIMSs, except TVT-Secur, in terms of the objective cure rate, after long-term follow-up; however, SIMSs were superior with respect to immediate postoperative pain, intra-operative blood loss, and postoperative voiding dysfunction.

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“…SIMS are less invasive compared to SMUS and can therefore more easily be performed in an outpatient setting under local analgesia. Moreover, although SIMS are very different from each other, some have been evaluated in randomized controlled trials and shown to be associated with shorter operative time, less postoperative pain yet, and noninferior cure rates of 85% in comparison to transobturator tapes (TOT) …”

Section: Introductionmentioning

confidence: 99%

“…Moreover, although SIMS are very different from each other, some have been evaluated in randomized controlled trials and shown to be associated with shorter operative time, less postoperative pain yet, and noninferior cure rates of 85% in comparison to transobturator tapes (TOT). 2,3 Urethral bulking agents (UBA) are an alternative option to treat SUI and can be performed in an outpatient setting using local analgesia. This can be seen as potentially beneficial to patients compared to MUS surgery.…”

Section: Introductionmentioning

confidence: 99%

How cure rates drive patients' preference for urethral bulking agent or mid‐urethral sling surgery as therapy for stress urinary incontinence

Casteleijn

Enklaar

Bouyahyaoui

et al. 2019

Neurourology and Urodynamics

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Aims To assess the patients' median‐accepted threshold of cure rate for urethral bulking agent (UBA) treatment compared to mid‐urethral sling (MUS) surgery for treatment of female stress urinary incontinence (SUI). Secondly, to determine the correlation between treatment trade‐off point and patient characteristics. Methods Women older than 18 years, with predominant SUI, seeking treatment, underwent a structured interview. The treatment trade‐off point was determined in scenario one: UBA vs transobturator standard MUS surgery (SMUS) performed under general/spinal anesthesia with one‐night hospital stay, and scenario 2: UBA compared to single‐incision MUS surgery (SIMS) performed under local analgesia (with sedation) in a daycare setting. The treatment trade‐off point was assessed by decreasing the cure rate of UBA from 85% to 10% with steps of 2% until the patient's treatment preference switched to SMUS/SIMS. Results One hundred and five patients were interviewed. Mean age was 52 years (SD, ±13.4). The median trade‐off point for scenarios 1 and 2 was 79% (interquartile range [IQR]: 69, 85) and 85% (IQR: 71, 85), respectively. Patients with longer duration of SUI symptoms were willing to trade more efficacy to prefer UBA treatment. Conclusions Patients with SUI are willing to trade a lower cure rate to prefer UBA over SMUS to avoid hospitalization and general anesthesia. When SIMS is performed in a daycare setting under local analgesia, the majority of patients with SUI are of the opinion that cure rates of UBA should be at least as high as SIMS to be worth considering. The treatment preference is not strongly correlated with the patients' characteristics.

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A randomized, nonblinded extension study of single-incision versus transobturator midurethral sling in women with stress urinary incontinence

Abstract: After a follow-up of 36 months, MiniArc (SIMS) is non-inferior to Monarc (SMUS) with respect to subjective and objective cure.

Cited by 18 publications

References 23 publications

Randomized controlled trial comparing single‐incision mini‐sling and transobturator midurethral sling for the treatment of stress urinary incontinence: 3‐year follow‐up results

Randomized controlled trial comparing single‐incision mini‐sling and transobturator midurethral sling for the treatment of stress urinary incontinence: 3‐year follow‐up results

Clinical outcome of single‐incision slings, excluding TVT‐Secur, vs standard slings in the surgical management of stress incontinence: an updated systematic review and meta‐analysis

How cure rates drive patients' preference for urethral bulking agent or mid‐urethral sling surgery as therapy for stress urinary incontinence

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