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

Abstract

Objective: To evaluate 2-year outcome of subjects who underwent the single incision midurethral sling procedure by the Dynamic Intraoperative Standing Sling Technique (DISST). Design: A chart review was conducted on subjects who underwent the DISST from August 2013 through November 2016 and were considered intraoperative success. Materials and Methods: Subjects were contacted postoperatively to complete the medical, epidemiological, and social aspects of aging (MESA) questionnaire and satisfaction questions per routine follow-up. Primary outcome of cure was subjective success based on question, ''From the point of view of stress urinary incontinence, that is leaking if you cough, sneeze, laugh, or do other strenuous activities, are you satisfied with the outcome of surgery?'' answered affirmatively. Changes from baseline in MESA scores were determined. Complications were also recorded. Results: A total of 139 subjects underwent successful DISST and were at least 24 months postsurgery. The MiniArc (AMS, Minnetonka, MN) sling was used in 122 (87.8%) subjects whereas the Solyx (Boston Scientific, Marlborough, MA) sling was used in 17 subjects (12.2%). A total of 110 (79%) subjects were reached at 24 months. Success of the procedure was 94% with 6% failures and 1.4% retreatment. De novo urgency was noted in 5.5% subjects with none receiving retreatment. In total 47.5% of subjects noticed improvement in preoperative urgency. Voiding dysfunction necessitating sling release was noted in 1.4% subjects, and 88.5% of those with intrinsic sphincter deficiency were cured. Conclusion: Subjective outcomes after successful intraoperative DISST are excellent even after 2 years, and success is similar to our 1-year study.