Mini Sling (Ophira) versus Pubovaginal Sling for Treatment of Stress Urinary Incontinence: A Medium-term Follow-up

Abstract

Sharifiaghdas F.; Nasiri M.; Mirzaei M.; Narouie B. Report / Vol. 116 (2015) No. 3, Mini Sling (Ophira) Key words: Mid-urethral mini sling -Autologous -Stress urinary incontinenceOphira Abstract: To compare two different procedures, mid-urethral mini sling (Ophira) and autologous rectus fascia sling, according to their medium-term subjective and objective outcome and satisfaction rates in the treatment of stress urinary incontinence in women. One hundred women with the main complaint of stress urinary incontinence were randomized to be treated with either mini sling (Ophira) or autologous rectus facia pubovaginal sling. Preoperative evaluation consisted of: physical examination, blood biochemistry urine analysis and culture, urinary tract ultrasound scan, conventional multi-channel urodynamic study, cystourethroscopy, cough induced stress test and Incontinence Impact Questionnaire (IIQ). The patients were objectively and subjectively re-evaluated at 1, 3, 6 and 12 postoperative months and the last visit and the collected data of more than one year follow-up were compared with preoperative assessments. Seventy two out of one hundred patients were followed for a mean time of 13.8 ± 4.4 months (12-20 months range). Objective cure rate, according to cough-induced stress test was recorded in 88.6% and 89.2% of the mini sling (Ophira) and the rectus facia sling group respectively (P=1.0). Postoperative mean IIQ score decreased to 42.7 ± 11.4 and 50.2 ± 11.1 in the mini sling (Ophira) 210) Prague Medicalhttp://dx

Risk Factor of De Novo Urgency and Urge Incontinence After Autologous Fascia Pubovaginal Sling

“…The downfalls of pubovaginal slings reported were wound infections, obstructive symptoms and de novo urgency incontinence. 12 The reported incidence for de novo urge and urge incontinence post autologous sling surgeries were 15–20% and 7.2%, respectively; 13 which is similar to the incidence of this study in urgency and urge incontinence as 21% (23/109). This study had identified previous POP repair and over-tight technique to be related to patients seeking for treatment for de novo urgency incontinence after surgery.…”

Resurgence of Autologous Fascial Slings in a Challenging Climate for Sling Surgery: A 20-Year Review of Comparative Data

“…18 Another cohort showed greater dyspareunia rates in minisling than in AFS at 12 months (11.4% vs 8.1%, P = 0.7). 17 However, these findings did not reach statistical significance in either study.…”

“…Bleeding, as defined by estimated blood loss exceeding 250 mL and/or requiring blood transfusion, occurred infrequently and was similar between AFS and TVT groups, 11,14 as well as between AFS and minisling groups 17 . Two studies showed longer postoperative catheterization time in AFS than in TVT and minisling groups, 11,17 whereas another study showed equivalent rates between AFS and TVT 15 …”

“…Hematoma and wound infection occurred more often in the AFS group than in the minisling group (21.6% vs 2.9%, P = 0.03). All were treated conservatively with either antibiotics, supportive care, and/or wound dressings 17 . Reoperation rate for SUI was only reported in the 3-arm study, occurring predominantly in xenograft slings than in the AFS or TVT group at 12-month and 10-year follow-up 13,16 …”

“…11,14 Contrary to the similarities seen in AFS and TVT slings, a significantly greater level of improvement was seen in AFS when compared with minisling at 12 months. 15,17 (Table 4)…”