Skip to main content
Top
Published in: International Urogynecology Journal 12/2013

01-12-2013 | Original Article

Three-year results from a randomised trial of a retropubic mid-urethral sling versus the Miniarc single incision sling for stress urinary incontinence

Authors: Maya Basu, Jonathan Duckett

Published in: International Urogynecology Journal | Issue 12/2013

Login to get access

Abstract

Introduction and hypothesis

There are limited long-term efficacy data on single-incision slings. The primary aim of this study was to evaluate the success rate of a single-incision sling versus a retropubic mid-urethral sling for cure of SUI at 3 years’ follow-up, in order to assess whether there is a deterioration in efficacy over time. The secondary aims were to assess re-operation rates for each procedure and to evaluate any differences in disease-specific quality of life.

Methods

This study was a 3-year questionnaire-based follow-up of a randomised controlled trial of the Miniarc single-incision sling versus the Advantage retropubic mid-urethral sling. Patients were considered failures if they documented stress incontinence on the symptom domain of the King’s Health questionnaire (KHQ) or had undergone repeat surgery for stress incontinence.

Results

Follow-up was available from 35 out of 38 women in the single-incision sling group (92.1 %) and from 26 out of 33 in the retropubic mid-urethral sling group (79.0 %). The overall 3-year failure rate was 20 out of 38 (52.6 %) in the single-incision sling group and 3 out of 33 (9.0 %) in the retropubic mid-urethral sling group (odds ratio 10.0, 95 % confidence interval 2.6–38.4). In the single-incision sling group, the failure rate increased from 40.5 % at 6 months to 52.6 % at 3 years with corresponding figures of 3 to 9 % in the retropubic mid-urethral sling group.

Conclusions

In this study, there was a significantly higher 3-year failure rate for the single-incision sling versus the retropubic mid-urethral sling. Both procedures had reduced efficacy over time.
Literature
1.
go back to reference Ward K, Hilton P, UK and Ireland TVT Trial Group (2008) Tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5 year follow up. BJOG 115:226–233PubMedCrossRef Ward K, Hilton P, UK and Ireland TVT Trial Group (2008) Tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5 year follow up. BJOG 115:226–233PubMedCrossRef
2.
go back to reference Song P, Kim Y, Kim H et al (2009) The 7-year outcome of the tension-free vaginal tape procedure for treating female stress urinary incontinence. BJU Int 104:1113–1117PubMedCrossRef Song P, Kim Y, Kim H et al (2009) The 7-year outcome of the tension-free vaginal tape procedure for treating female stress urinary incontinence. BJU Int 104:1113–1117PubMedCrossRef
3.
go back to reference Nilsson C, Falconer C, Rezapour M (2004) Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol 104:1259–1262PubMedCrossRef Nilsson C, Falconer C, Rezapour M (2004) Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol 104:1259–1262PubMedCrossRef
4.
go back to reference Nilsson C, Palva K, Rezapour M, Falconer C (2008) Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:1043–1047PubMedCrossRef Nilsson C, Palva K, Rezapour M, Falconer C (2008) Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:1043–1047PubMedCrossRef
5.
go back to reference Serati M, Ghezzi F, Cattoni E et al (2012) Tension-free vaginal tape for the treatment of urodynamic stress incontinence: efficacy and adverse effects at 10 year follow up. Eur Urol 61:939–946PubMedCrossRef Serati M, Ghezzi F, Cattoni E et al (2012) Tension-free vaginal tape for the treatment of urodynamic stress incontinence: efficacy and adverse effects at 10 year follow up. Eur Urol 61:939–946PubMedCrossRef
6.
go back to reference National Institute for Health and Clinical Excellence (2006) Urinary incontinence in women: NICE clinical guideline number 40. Audit criteria. HMSO, London National Institute for Health and Clinical Excellence (2006) Urinary incontinence in women: NICE clinical guideline number 40. Audit criteria. HMSO, London
7.
go back to reference Moore R, Mitchell G, Miklos J (2009) Single-center retrospective study of the technique, safety and 12-month efficacy of the Miniarc single-incision sling: a new minimally invasive procedure for treatment of female SUI. Surg Technol Int 18:175–181PubMed Moore R, Mitchell G, Miklos J (2009) Single-center retrospective study of the technique, safety and 12-month efficacy of the Miniarc single-incision sling: a new minimally invasive procedure for treatment of female SUI. Surg Technol Int 18:175–181PubMed
8.
go back to reference Gauruder Burmester A, Popken G (2009) The Miniarc sling system in the treatment of female stress urinary incontinence. Int Braz J Urol 35:334–341PubMedCrossRef Gauruder Burmester A, Popken G (2009) The Miniarc sling system in the treatment of female stress urinary incontinence. Int Braz J Urol 35:334–341PubMedCrossRef
9.
go back to reference Meschia M, Barbacini P, Ambrogi V, Pifarotti P, Ricci L, Spreafico L (2009) TVT-secur: a minimally invasive procedure for the treatment of primary stress urinary incontinence. One year data from a multi-centre prospective trial. Int Urogynecol J Pelvic Floor Dysfunct 20:313–317PubMedCrossRef Meschia M, Barbacini P, Ambrogi V, Pifarotti P, Ricci L, Spreafico L (2009) TVT-secur: a minimally invasive procedure for the treatment of primary stress urinary incontinence. One year data from a multi-centre prospective trial. Int Urogynecol J Pelvic Floor Dysfunct 20:313–317PubMedCrossRef
10.
go back to reference Oliveira R, Silva A, Pinto R, Silva J, Silva G, Guimaraes M et al (2009) Short term assessment of a tension-free vaginal tape for treating female stress urinary incontinence. BJU Int 104:225–228PubMedCrossRef Oliveira R, Silva A, Pinto R, Silva J, Silva G, Guimaraes M et al (2009) Short term assessment of a tension-free vaginal tape for treating female stress urinary incontinence. BJU Int 104:225–228PubMedCrossRef
11.
go back to reference Basu M, Duckett J (2010) A randomised trial of a retropubic tension free vaginal tape versus a mini-sling for stress incontinence. BJOG 117:730–735PubMedCrossRef Basu M, Duckett J (2010) A randomised trial of a retropubic tension free vaginal tape versus a mini-sling for stress incontinence. BJOG 117:730–735PubMedCrossRef
12.
go back to reference Schafer W, Abrams P, Liao L et al (2002) Good urodynamic practices: uroflowmetery, filling cystometry, and pressure flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef Schafer W, Abrams P, Liao L et al (2002) Good urodynamic practices: uroflowmetery, filling cystometry, and pressure flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef
13.
go back to reference Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29:75–82PubMedCrossRef Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29:75–82PubMedCrossRef
14.
go back to reference Moen M (2012) Randomized controlled trials in surgery: are we still missing something important? Int Urogynecol J 23:1321–1323PubMedCrossRef Moen M (2012) Randomized controlled trials in surgery: are we still missing something important? Int Urogynecol J 23:1321–1323PubMedCrossRef
15.
go back to reference Abdel-Fattah M, Ford J, Lim C, Madhuvrata P (2011) Single incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol 60:468–480PubMedCrossRef Abdel-Fattah M, Ford J, Lim C, Madhuvrata P (2011) Single incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol 60:468–480PubMedCrossRef
16.
go back to reference Han J, Park J, Choo M (2012) Efficacy of TVT Secur and factors affecting cure of female stress urinary incontinence: 3 year follow up. Int Urogynecol J 23:1721–1726PubMedCrossRef Han J, Park J, Choo M (2012) Efficacy of TVT Secur and factors affecting cure of female stress urinary incontinence: 3 year follow up. Int Urogynecol J 23:1721–1726PubMedCrossRef
17.
go back to reference Naumann G, Hagemeier T, Zachmann S et al (2013) Long term outcomes of the Ajust adjustable single incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 24:231–239PubMedCrossRef Naumann G, Hagemeier T, Zachmann S et al (2013) Long term outcomes of the Ajust adjustable single incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 24:231–239PubMedCrossRef
18.
go back to reference Oliveira R, Botelho F, Silva P, Resende E, Silva C, Dinis P, Cruz F (2011) Exploratory study assessing efficacy and complications of TVT-O, TVT- Secur and Miniarc: results at 12-month follow-up. Eur Urol 59:940–944PubMedCrossRef Oliveira R, Botelho F, Silva P, Resende E, Silva C, Dinis P, Cruz F (2011) Exploratory study assessing efficacy and complications of TVT-O, TVT- Secur and Miniarc: results at 12-month follow-up. Eur Urol 59:940–944PubMedCrossRef
19.
go back to reference De Ridder D, Berkers J, Deprest J, Verguts J, Ost D, Hamid D, Van der Aa F (2010) Single incision mini-sling versus a transobturator sling: a comparative study on Miniarc and Monarc slings. Int Urogynecol J 21:773–778PubMedCrossRef De Ridder D, Berkers J, Deprest J, Verguts J, Ost D, Hamid D, Van der Aa F (2010) Single incision mini-sling versus a transobturator sling: a comparative study on Miniarc and Monarc slings. Int Urogynecol J 21:773–778PubMedCrossRef
20.
go back to reference Sun M, Sun R, Li Y (2012) A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes. Int Urogynecol J 24:823–829PubMedCrossRef Sun M, Sun R, Li Y (2012) A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes. Int Urogynecol J 24:823–829PubMedCrossRef
21.
go back to reference Kennelly M, Moore R, Nguyen J, Lukban J, Siegal S (2012) Miniarc single-incision sling for treatment of stress urinary incontinence: 2 year clinical outcomes. Int Urogynecol J 23:1285–1291PubMedCrossRef Kennelly M, Moore R, Nguyen J, Lukban J, Siegal S (2012) Miniarc single-incision sling for treatment of stress urinary incontinence: 2 year clinical outcomes. Int Urogynecol J 23:1285–1291PubMedCrossRef
22.
go back to reference Lenz F, Doll S, Brocker K, Maier-Hein J, Sohn C (2009) Tensile strength of the membrane obturatoria in the use of minislings (abstract). Int J Urogynecol Pelvic Floor Dysfunct 20 [Suppl 2]:S220 Lenz F, Doll S, Brocker K, Maier-Hein J, Sohn C (2009) Tensile strength of the membrane obturatoria in the use of minislings (abstract). Int J Urogynecol Pelvic Floor Dysfunct 20 [Suppl 2]:S220
Metadata
Title
Three-year results from a randomised trial of a retropubic mid-urethral sling versus the Miniarc single incision sling for stress urinary incontinence
Authors
Maya Basu
Jonathan Duckett
Publication date
01-12-2013
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 12/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2125-8

Other articles of this Issue 12/2013

International Urogynecology Journal 12/2013 Go to the issue

Urogynecology Digest

Urogynecology digest