Medium-term results of Mini-arc for urinary stress incontinence in ambulatory patients under local anesthesia

Abstract

ObjectiveTo evaluate the medium-term outcome and patient's satisfaction after Single-incision mini-sling (SIMS) procedure done under local anesthesia in ambulatory set up for patients with stress urinary incontinence (SUI).Materials and MethodsThis is a retrospective cohort study, including all patients submitted to SIMS procedure for SUI with MiniArc (AMS, U.S.A) without concomitant surgery between January 2011 and March 2013. Patients were followed up during 12 months after surgery and once a year subsequently. Telephone interviews were conducted to evaluate patient satisfaction. Outcome masseurs included: SUI cure rate, urinary urge incontinence (UUI) cure rate in patients with mixed urinary incontinence (MUI), intra and post-operative complications and patient satisfaction.ResultsNinety-three patients were included with mean follow-up of 23 months. Fifty percent had MUI with predominant SUI. The cure rates of SUI (objective and subjective) were 89%. UUI was cured in 40% of patients. No major complications occur, neither voiding obstruction or groin pain. Telephone interviews conducted after 26 months on average revealed high satisfaction rate from the procedure (8.8 out of 10) and from the local anesthesia. Visual analog scale (VAS) rating was low during and after the procedure (2.38 and 2.69 respectively).ConclusionsThe SIMS procedure is safe and highly effective for SUI and it can be performed successfully under local anesthesia in an ambulatory setup.

A prospective observational cohort study of the Ajust® single incision sling performed under conscious sedation with local infiltration

“…This study shows that the Ajust® technique is as effective in the treatment of female SUI when administered under sedation with local infiltration, compared with general or spinal anesthesia. This result is comparable to other studies that have performed single incision mini‐slings under local anesthesia …”

“…There were no complications with sedation and/or local infiltration, and no conversions to general or spinal anesthesia were necessary. [4][5][6][7][8][9][10][11][12]18,19 The cough stress test during surgery, used to individualize the tension of the tape, did not enhance subjective or objective cure, nor lead to differences in de novo urge incontinence.…”

Learning curve for the single‐incision suburethral sling procedure for female stress urinary incontinence

“…The present study did not find any intraoperative complications, which is consistent with previous reports. For example, Levi et al . did not report any intraoperative complications among 93 women who had sling implantation in outpatient setting.…”

Single Incision Sling Procedure Done by the Dynamic Intraoperative Standing Sling Technique: A 2-Year Analysis

“…This is similar to the study by Levi et al who noticed that 40% of the 93 subjects who underwent MiniArc SIMUS procedure had complete resolution of the urgency. 30 Han et al in their study also noted a 68.8% cure rate for urgency and a 64.5% cure rate for urgency incontinence after the TVT-Secur SIMUS procedure. 31 The low incidence of voiding dysfunction and de novo urgency in this study indicate that the sling is not placed under any undue tension to achieve a DISST intraoperative success.…”