Evaluation of the efficacy of mini-sling in the treatment of stress urinary incontinence through patient-reported outcomes and transperineal ultrasonography.

Abstract

<h4>Objective</h4>Single-incision slings, such as Contasure-Needleless® (C-NDL), were developed to improve surgical treatment success in stress urinary incontinence (SUI). However, more evidence is needed to describe the outcomes of mini-sling procedures as an alternative to classical mid-urethral slings. The aim was to evaluate the short-term outcomes of the mini-sling procedure using C-NDL in the surgical treatment of SUI patients.<h4>Material and methods</h4>This was a single-center, prospective study including 24 patients with SUI who underwent C-NDL. Michigan Incontinence Severity Index (M-ISI) questionnaire, the Female Sexual Function Index, and the Patient Global Impression of Improvement (PGI-I) questionnaire were applied, as well as trans-perineal ultrasound evaluations at baseline, one month and six months postoperatively.<h4>Results</h4>The PGI-I index showed that 54.17% of participants described their post-operative recovery as "very much better" and 29.17% as "much better". Significant improvements were observed in all SUI and M-ISI-related results. No significant differences were detected in terms of FSFI. Complications were reported as <i>de novo</i> urgency in 4 (16.67%) patients, mesh erosion in 2 (8.33%) patients, and pelvic pain and infection in 1 patient each (4.17%). The mean distance of the mini-sling mesh to the urethra was found to be 5.51±2.3 mm at one month and 4.69±1.85 mm at six months after surgery (p=0.006). The mean urethral rotation angle was decreased following surgery (p<0.001). No significant differences were observed between patients with and without cure regarding any of the examined variables.<h4>Conclusion</h4>For SUI treatment, the C-NDL procedure is a safe and effective method with few complications and high subjective cure rates on short-term follow-up (6 months).