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Aims: To evaluate the medium term efficacy and safety of Altis and Solyx single incision slings (SIS) compared with tension-free vaginal tape (TVT) Abbrevo trans-obturator sling. We hypothesize that both SIS show little difference in efficacy and safety and perform similarly to TVT Abbrevo. Methods: We conducted an ambispective comparative cohort study of women with stress urinary incontinence who received a SIS in comparison to matched TVT Abbrevo subjects from a concurrent randomized controlled trial (RCT). Subjects were identified retrospectively, and prospectively invited for examination and questionnaires>12 months post-operatively. Exclusions included intrinsic sphincter deficiency, previous sling surgery, and others. Primary outcome was subjective cure [negative response to International Consultation Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) question 6, leakage during coughing/activity]. Secondary outcomes include objective cure (negative cough stress test), functional outcomes, and adverse events. Results: Between 2012 and 2018, a total of 113 women received one of two SIS surgeries; Solyx (n ​= ​50) followed by the Altis (n ​= ​63); 104 were available for final efficacy analysis. Mean follow-up was 21.7 (Altis), 46.0 (Solyx), and 29.0 (Abbrevo) months. Baseline characteristics were comparable between the groups. There was no significant differences in the subjective or objective cure rates between the groups, and no differences in functional outcomes such as patient global impression of improvement, and post-operative ICIQ-UI SF score. There was a low rate of mesh related complications and no differences seen between the groups. Conclusions: Despite being an underpowered study, Altis and Solyx SIS have favourable efficacy and safety profiles which are comparable to an established trans-obturator mid-urethral slings (MUS).

In the literature the rate of stress incontinence is reported between 29-75%. Compared to the established tension free vaginal tapes, the question arises, whether stabilization of the urethra can also be achieved by minimally invasive single incision slings. The aim of this retrospective analysis is to evaluate the cure rate after insertion of MicroGYNious sling. The study was carried out on 115 patients, who received a MicroGYNious sling. It was used both as a single operation for stress urinary incontinence and as a combined procedure. The degree of incontinence preoperatively and continence rate postoperatively with follow-ups (6 weeks, 6 months, one year, two years and three years) were recorded. Due to a high number of lost to follow-up after one year, only the data up to one year postoperative were included in the analysis. Preoperatively, grade I incontinence was found in 6.1%, grade II 35.7%, grade III 58.3% of the operated women. The continence rate was 96.7% postoperatively, 90 % after 6 weeks, 87.2 % after 6 months, 86.7% after one year. In terms of continence rates, the MicroGYNious sling shows similar results compared to the established procedures. Therefore, this sling provides a good treatment option for the stress urinary incontinence. These good results must be confirmed in prospective randomized trials.

In the literature the rate of stress incontinence is reported between 29-75%. Compared to the established tension free vaginal tapes, the question arises, whether stabilization of the urethra can also be achieved by minimally invasive single incision slings. The aim of this retrospective analysis is to evaluate the cure rate after insertion of MicroGYNious sling. The study was carried out on 115 patients, who received a MicroGYNious sling. It was used both as a single operation for stress urinary incontinence and as a combined procedure. The degree of incontinence preoperatively and continence rate postoperatively with follow-ups (6 weeks, 6 months, one year, two years and three years) were recorded. Due to a high number of lost to follow-up after one year, only the data up to one year postoperative were included in the analysis. Preoperatively, grade I incontinence was found in 6.1%, grade II 35.7%, grade III 58.3% of the operated women. The continence rate was 96.7% postoperatively, 90 % after 6 weeks, 87.2 % after 6 months, 86.7% after one year. In terms of continence rates, the MicroGYNious sling shows similar results compared to the established procedures. Therefore, this sling provides a good treatment option for the stress urinary incontinence. These good results must be confirmed in prospective randomized trials. [ABSTRACT FROM AUTHOR]

Purpose: Women with stress urinary incontinence (SUI) often require combined pelvic reconstructive surgeries because of shared risk factors of pelvic organ prolapse. The purpose of this study was to evaluate efficacies of Burch colposuspension, transobturator tape (TOT), and single-incision needleless (DynaMesh®-SIS minor) procedures in patients with SUI who also underwent combined pelvic reconstructive surgery or hysterectomy. Methods: We performed this retrospective cohort study that comprising 122 patients who either underwent Burch colposuspension (n:43), TOT (n:40), or SIS (n:39) procedures along with pelvic reconstructive surgery or hysterectomy between January 2010 and July 2018. During the clinical follow-up, we analyzed cure rates, and surgical success rates of SUI surgery, quality of life, and symptom severity by IIQ-7, UDI-6, SSI, SSQ-8, OAB-V8, and PGI-I scale scores. The primary outcome was surgical success, whereas secondary outcomes included complications and patient-reported outcomes in the quality of life. Results: We found that surgical success rates were higher in Burch group than SIS group and higher in TOT group than in SIS group (88.4% vs 61.5% and 87.5% vs 61.5%, p = 0.003). The quality of life was lower in SIS group than in Burch group. Conclusions: Both Burch and TOT are effective procedures in patients with SUI who require additional pelvic surgeries. Although surgical outcomes of SIS procedure in patients with SUI who underwent concomitant pelvic surgeries in our study were not promising, further studies with SIS are needed to clarify these observations. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the adjustable single‐incision sling (Ajust®) in the treatment of stress urinary incontinence (SUI), when placed under conscious sedation with local infiltration, using the cough test during surgery. Methods: In this multicenter observational study, 90 women who had moderate to severe SUI, were asked to have the Ajust® procedure performed under sedation with local infiltration with levobupivacain. This allowed for a perioperative cough test to adjust the sling to the urethra till continence was reached. The primary outcome of the study was subjective cure of stress incontinence at 1 year follow up. Secondary objectives were objective and subjective improvement, complications during and after the procedure, and postoperative pain scores. These results were compared with the results of a historical control group of 96 patients who received their Ajust® under general or regional (spinal) anesthesia. Results: At 6 weeks and 12 months, there were no statistical significant differences in the results for subjective cure (83.6% and 71.6% sedation group, 88.4% and 77.2% general/regional anesthesia group), objective cure (96% and 86.9% sedation group, 88.1% and 91.8% general/regional anesthesia group), de novo urgency (10.5% and 6.7% sedation group, 7.1% and 24.1% general/regional anesthesia group) and the patients global impression of improvement (96% and 89.2% sedation group, 91.4% and 84.4% general/regional anesthesia group). Conclusion: The performance of a cough test during the placement of an adjustable single‐incision sling for the treatment of SUI does not affect the functional outcome, and is therefore not necessary. [ABSTRACT FROM AUTHOR]

Objective: To ascertain whether low preoperational maximal urethral closure pressure (MUCP) affects the outcomes of single incision sling (SIS) procedures and changes MUCP values postsurgery. Material and methods: There were 112 (MUCP ≥ 40 cmH2O, n = 88; MUCP

Objective: To evaluate the clinical outcome among women who had undergone Miniarc™ in the treatment of stress urinary incontinence (SUI). Study design: In this retrospective study from March 2010 to December 2011 patients with clinically confirmed SUI and urodynamic stress incontinence (USI) underwent Single Incision Sling Procedure (SIS). Objective cure of SUI was defined as no urinary leakage on provocative filling cystometry and 1-hour pad test of 0.05). Conclusions: In conclusion, Miniarc™ was noted to have improvement in both subjective and objective clinical outcomes. Urethral indentation was noted and resolved by tape release on immediate post-operative voiding dysfunction.

Introduction: Single incision slings (SIS) were introduced in an attempt to decrease the complications associated with retropubic and transobturator slings. The TVT Abbrevo is a modification of the TVT-O with a reduced length and less immediate postoperative pain. The Miniarc SIS has been shown to be equivalent to outside-in transobturator sling, Monarc at 12 month follow-up.Objective: To evaluate objective and subjective outcomes of MiniArc SIS and TVT Abbrevo midurethral sling (MUS) in women with stress urinary incontinence.Methods: Female subjects who were assessed and referred for stress urinary incontinence surgery were eligible to participate in this study. Exclusion criteria included women with intrinsic sphincter deficiency previous failed midurethral or fascial sling, untreated detrusor overactivity or significant voiding dysfunction. Patients' randomisation was performed with computer-generated blocks of 4-8, with concealed allocation. Assuming an objective cure rate of 90% for TVT AbbrevoTMwith a power of 80%, a sample size of 79 in each arm was required to detect a clinical difference of 15%, using a one sided alpha of 0.05. The target recruitment number was 220 allowing for an attrition rate of 15%. Institution ethics approval (11261B) was obtained and the trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611001151921). Routine preoperative assessment was conducted for objective data, whilst patient reported outcome tools (PRO) were utilised for subjective outcomes. These include ICIQ UI SF, ICIQ OAB, IIQ7, EQ5D, PISQ12, PGIs & PGII. TVT AbbrevoTM or MiniarcTMwere performed in a standardized fashion, together with any concomitant prolapse surgery. Review was conducted at 6 weeks and at 6 and 12 months. Objective cure was defined as a negative cough stress test with a comfortably full bladder. Subjective cure was defined as no report of leakage with physical exertion. All Data was collected and outcomes were analysed statistically.Results: Between February 2011 and January 2016,a total of 246 women were randomized to receive MiniArc (121) or TVT Abbrevo (125). Baseline characteristics were clinically balanced in both groups. At 6 months subjective (94.4% vs 95.7% p=0.74) and Objective (92.9% vs 95.9% p=0.49) cure rates were high and not statistically different. At 12 months there were also no differences in subjective (73.6% vs 76.9% p=0.73) or objective (90.5% vs 96.0% p=0.21) cure rates. No differences were found in functional outcomes or when adjusted for potential confounding factors such as age, parity, BMI or menopausal status.Conclusion: We found no significant differences in subjective and objective cure rates at 6 and 12months between MiniArc and TVT Abbrevo. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Tension-free suburethral tapes have become the first-line surgical treatment for female stress urinary incontinence. Single-incision midurethral slings (SIMS) were introduced with the aim of offering similar efficacy with reduced morbidity, particularly postoperative pain. The objective of this study was to compare the effectiveness and complications of the Ajust™ SIMS and the Align™ transobturator tape sling. Methods: We performed a randomized controlled trial with a noninferiority design. Women with pure stress urinary incontinence or stress-predominant mixed urinary incontinence were eligible. The primary outcome was the cure/improvement rate at 1 year, defined according to combined objective and subjective criteria. Rate differences for cure/improvement with the two procedures were calculated along with their 95% confidence intervals. The Sandvik incontinence severity index and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were completed before surgery and at 1 year. Complications were also reported. Results: We randomized 30 women to the Ajust™ group and 28 to the Align™ group. At 1 year the cure/improvement rates were 93.3% in the Ajust™ group and 96.4% in the Align™ group. The rate difference for cure/improvement was of −3.1% (95% CI −14.4 % to 8.2%). The study was sufficiently powered to conclude the noninferiority of Ajust™ SIMS under the pre-established criteria. Three women in the Ajust™ group reported persistent thigh pain 1 year after surgery, but none in the Align™ group reported pain. Conclusions: At 1 year, the Ajust™ SIMS showed non-inferior effectiveness compared with the Align™ transobturator sling. Although not statistically significant, unexpectedly, more women reported persistent thigh pain in the Ajust™ group. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical outcome among women who had undergone Miniarc™ in the treatment of stress urinary incontinence (SUI). Study design In this retrospective study from March 2010 to December 2011 patients with clinically confirmed SUI and urodynamic stress incontinence (USI) underwent Single Incision Sling Procedure (SIS). Objective cure of SUI was defined as no urinary leakage on provocative filling cystometry and 1-hour pad test of <2 g. Subjective cure of SUI was the negative response to UDI-6. Assessment was done at baseline and after 1 year follow-up. Results Postoperative data was available for 85 women. Five women were not able to participate in the follow-up schedule and post-op questionnaire. The objective data for post-operative follow-up was available from 80 women. The average period of follow-up was 1.4 years (range 1.0 to 2.1). A total of 14 women had immediate post-operative urine retention at the first 24 hours and 6 cases were due to over-tensioning of the sling after ultrasound assessment. No case of bladder or bowel injury was recorded and no other major complications noted. Pre and post clinical findings revealed a significant improvement after 1 year follow-up based on the response to UDI-6, IIQ-7 (<0.001) and PISQ-1 (0.12). Urodynamic parameters revealed an increase in MUCP however the other urodynamic parameters had no statistical difference (p > 0.05). Conclusions In conclusion, Miniarc™ was noted to have improvement in both subjective and objective clinical outcomes. Urethral indentation was noted and resolved by tape release on immediate post-operative voiding dysfunction. [ABSTRACT FROM AUTHOR]

Objective To evaluate the ultrasound morphology and its clinical outcome among women who had undergone Miniarc™ vs Monarc™ in the treatment of stress urinary incontinence (SUI). Study design This was a prospective study on 140 patients with USI and undergone either Miniarc or Monarc surgery. From March 2010 to December 2011, patients with clinically SUI and urodynamic stress incontinence (USI) were included in the study. Objective cure of SUI was defined as no urinary leakage on provocative filling cystometry and 1-h pad test of <2 g. Subjective cure of SUI was the negative response to UDI-6. Introital ultrasound at one-year explored the sling and bladder neck's position, mobility, sling tension, percentile of urethra where the sling was located and urethral kinking. Results Postoperative data was available from 130 women. The ultrasound objective data for successful treatment post-operative follow-up was available from 119 women (46 Monarc, 73 Miniarc), the rest failed to follow-up. A bladder perforation was diagnosed in the Monarc group and 15 cases (7.1% of Monarc and 16.3% of Miniarc, p = 0.082) of urinary retention was reported due to over-tensioning of the sling, majority of cases came from the Miniarc group. At rest and during Valsalva, analogous distances of the bladder neck and sling as well as the center of the urethral core were similar for both procedures. In both groups, shortest (Us) and longest diameters (Ul) of the urethral core were comparable at Valsalva which was significantly shorter and longer, respectively, compared to the values at rest. Sling position and percentage of urethral kinking were similar. Statistical analysis failed to detect any significant difference between the two groups with regards to the objective and subjective cure ( p > 0.05). Conclusions In conclusion, a Miniarc and Monarc exhibit similar mechanism of action with comparable subjective and objective clinical outcomes. Majority of urethral impingement was noted in the Miniarc group. A higher maximum urethral closure pressure (MUCP), longer resting Ul, and shorter resting Us suggested these observations. Postoperative ultrasonographic evaluation may give a promising future perspective for the evaluation of sling tension. [ABSTRACT FROM AUTHOR]

Objective The primary outcome of this study was to evaluate the subjective and objective outcomes of an adjustable Single Incision Sling (Ajust™ C.R. Bard Inc., New Providence, NJ, USA) for the treatment of SUI, with a 2-year follow-up. The secondary outcome was to evaluate the safety of this procedure and the impact of this mini-sling on the filling and voiding phases of the bladder. Study design In our prospective multicenter study we included 95 females with a clinical symptomatic and urodynamic diagnosis of primary SUI, and unsuccessful previous conservative treatment. Cure rate was evaluated objectively, using a standardized cough stress test and subjectively using the patient global impression of improvement. The King's Health questionnaire was used to evaluate quality of life (QoL). Urgency was evaluated using the patient perception of intensity of urgency scale. Complications were assessed intra-, peri- and post-operatively. All patients underwent urodynamic studies pre-operatively and at 6 months. The McNemar chi-square test was used to compare categorical variables, the paired t -test for continuous parametric variables, and the Fisher exact test for continuous non-parametric variables. A logistic regression model and odds ratios (with 95 percent confidence intervals) were used to assess the independent prognostic value of four variables for the outcome (age, parity, body mass index and menopausal status). Results 92 Patients completed the 2-year follow-up. The objective cure rate was 83.7% and the subjective cure rate was 81.5%. De novo urgency was present in 9 patients (9.8%) and was associated with de novo urge incontinence in 6 patients (6.5%). Only 1 patient with de novo urge incontinence showed de novo detrusor overactivity. Regarding QoL, the King's Health Questionnaire indicated a statistically significant improvement in all domains except sleep. We observed no intraoperative complications. Post-operatively 1 patient referred pain in the right leg, 3 patients had mesh extrusions, 1 patient had recurrent urinary tract infections. Post-operative urodynamics showed a statistically significant increase of detrusor pressure at maximum flow and a reduction of maximum flow rate. No patients were obstructed according to the Blaivas and Groutz nomogram. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The aim was to compare the efficacy and safety of single-incision sling TVT-Secur (TVT-S) and transobturator midurethral sling (TVT-O) for the treatment of stress urinary incontinence (SUI) over 2 years' follow-up. Methods: This is a randomized controlled trial in which women with SUI were randomly assigned to have either TVT-O ( n = 56) or TVT-S ( n = 66). Exclusion criteria included: voiding dysfunction, detrusor overactivity, and pelvic organ prolapse beyond the hymen. The primary outcomes were objective and subjective cure rates at a follow-up visit at 24 months, defined as a negative stress test and pad test as well as absence of self-reported SUI symptoms. Secondary endpoints included quality of life assessment using the King's Health Questionnaire (KHQ), and complication and reoperation rates. Analysis was performed using intention to treat, and statistical significance was fixed at 5 % ( p < 0.05). Statistical methods used were Mann-Whitney, Student's t, Chi-squared, Fisher's, ANOVA, and McNemar's tests. Results: The groups were similar regarding demographic and clinical preoperative parameters. Objective cure rates for TVT-S and TVT-O groups were 77.3 % and 83.6 %, while subjective cure rates were 75.7 % and 80.3 % respectively, with no statistically significant differences between the techniques. There was a significant improvement in all KHQ domains in both groups ( p < 0.001). A few complications were observed in our study. The most common perioperative complication was thigh pain associated with TVT-O, while the long-term one was tape exposure observed in 5.3 % of TVT-O and in 7.5 % of TVT-S cases. Conclusion: The efficacy of the TVT-S was similar to that of the TVT-O after 2 years' assessment. This cohort will continue to be followed in order to maintain commitment to contributing data on long-term results. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To assess the potential impact of obesity on the success rate of single incision slings (SIS). Study design: This was a retrospective cohort study of women who underwent the SIS procedure for primary stress urinary incontinence. Women were divided into three different groups by body mass index (BMI) according to the WHO classification. The International Consultation on Incontinence-short form (ICIQ-SF), Women Irritative Prostate Symptoms Score (W-IPSS), Patient Global Impression of Severity (PGI-S) and Patient Global Impression of Improvement (PGI-I) questionnaires were used. Objective and subjective outcomes were the primary outcome measures of the study. SPSS software was used for data analysis. Results: 206 patients who underwent the SIS procedure were reviewed. At 1 year follow-up there were 196 women available for the analysis: 69 were normal weight subjects, 91 overweight and 36 obese. Patients in all BMI groups reported a significant improvement in their condition. Nevertheless there was a trend towards lesser objective efficacy of SIS with increasing body weight, with a significant difference between obese women and normal subjects: 75% vs 91.3%, p =0.049; OR 3.74 (95% CI 1.19–11.76). Analysis of the ICIQ-SF and PGI-I showed significant lower mean±SD improvement in obese women when compared with their normal or overweight counterparts, together with a significantly lower number of obese patients reporting themselves as very much improved or much improved. Conclusions: Single incision slings seem to be an effective treatment regardless of BMI, but obese women had nearly 4 times the odds of objective failure as compared to normal weight women. [Copyright &y& Elsevier]

Introduction and hypothesis: The aim of this study was to evaluate the functional outcome of a single-incision sling procedure for the treatment of female stress urinary incontinence (SUI) and to correlate the cure rate with a pelvic floor ultrasound examination Methods: Fifty-seven patients treated with a single-incision sling procedure between January 2009 and September 2010 were included in the study. Functional outcome was evaluated as objective cure rate assessed with stress test and subjective cure rate determined by the International Consultation on Incontinence-Short Form and Patient Global Impression of Improvement scores. Women underwent perineal ultrasound examination by a combined 2D translabial and 3D transvaginal approach to assess bladder neck and tape mobility, tape position along the urethral axis, and tape anchorage. According to the position of self-fixating tips, we divided patients into group A (both tips crossed the obturator membrane), group B (only one tip crossed the obturator membrane) and group C (none of the tips crossed the obturator membrane). Objective cure rate and type of anchorage were compared with all ultrasound parameters. Results: At an average follow-up of 13 months objective cure rate was 87.7 % with a significant subjective improvement. A significant difference in tape mobility was noted between group A and group C. Bladder neck mobility significantly increased in failures. Sling was significantly closer to mid-urethra in cured than in failures. Conclusions: In 77 % of patients MA didn't reach the obturator membrane on both sides. This feature conditioned significantly bladder neck mobility but not the efficacy of the procedure. Tape position seems to be the most important factor for success. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effectiveness and assess the changes in sexual function and quality of life after placement of a single-incision sling for the treatment of female stress urinary incontinence. Study design: A prospective study of women diagnosed with stress urinary incontinence. The single-incision sling was implanted and patients were followed postoperatively for 6 months. The postoperative rate of continence, complications, changes in sexual function, and patient-reported quality of life were evaluated. Female Sexual Function in sexually active patients was evaluated before and after the single-incision sling procedure using the Female Sexual Function Index. From January 2009 to November 2011, 73 patients were enrolled and underwent the procedure to implant the MiniArc® or Ajust® single-incision sling. Results: Overall, 93.2% of the patients who successfully received a single-incision sling demonstrated total restoration of continence (83.6%) or improved continence (9.6%) at the 6-month postoperative visit. Improvements were seen in the quality of life scores related to global bladder feeling (87.7%) and the Female Sexual Function Index (preoperative score 23.86±5.67 vs postoperative score 27.25±4.66 [P <0.0001]). Conclusion: Single-incision sling treatment for stress urinary incontinence led to improvements in continence and sexual function at 6 months of postoperative follow-up. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this prospective cohort study was to compare effectiveness, morbidity, quality of life (QoL) and sexual function in women treated with tension-free vaginal tape (TVT) versus single-incision sling (SIS) in the treatment of female stress urinary incontinence (SUI). Methods: Retropubic TVT sling or SIS was implanted in local anesthesia and patients were followed post-operatively for 6 months. Evaluation was performed to assess post-operative rate of continence, complications, changes in sexual function and patient reported quality of life. Female sexual function was evaluated before and after sling procedure using Female Sexual Function Index (FSFI) in sexually active patients. Results: From January 2009 to December 2011, 150 patients were enrolled and underwent a procedure to implant the retropubic TVT ( n = 75) or the MiniArc and Ajust SIS ( n = 75). Overall, 93.3 % of the patients who successfully received SIS demonstrated total restoration (84 %) or improvement of continence (9.3 %) at the 6 month post-operative study visit. In TVT group we found 88 % total continence and 6.7 % improvement, respectively. Improvements were seen in the QoL scores related to global bladder feeling (89.3 %) in SIS group and 96 % for TVT. Post-operative FSFI score improves significantly and were comparable in both groups (SIS pre-operative 24.30 ± 4.56 to 27.22 ± 4.66 ( P < 0.001) post-operative; TVT 24.63 ± 6.62 to 28.47 ± 4.41, respectively). Conclusions: The SIS procedure appears to be as effective in improving incontinence-related quality of life and sexual function as the TVT through 6 months of post-operative follow-up. No differences in complications and sexual function were demonstrated between the groups. [ABSTRACT FROM AUTHOR]

To review the most recent studies comparing single incision slings (SISs) with conventional mid-urethral slings (CMUSs) for treatment of female stress urinary incontinence (SUI). A search in Pubmed and ISI Web of Knowledge was made using words referred to SUI and SISs. Only randomized clinical trials (RCTs) described in full-length papers published after the meta-analysis by Abdel-Fattah and co-workers (Eur Urol ;60(3):468-480) were considered. Six studies were identified, including a quasi-RCT. TVT-Secur was compared against CMUSs in three papers. Contasure-Needleless and Tissue Fixation System (TFS) were compared with a CMUS in one study each. Miniarc and TVT-Secur were compared against a CMUS in one trial. One additional study compared three SISs (Miniarc, TVT-Secur, Ajust). RCTs with Miniarc, TVT-Secur placed in the vertical position, Contasure-Needleless and TFS, show success rates similar to CMUSs. Consistently, complications favour SISs. These studies support the use of some SISs to treat female SUI. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Data on the Ajust™, a new single-incision sling procedure for female stress urinary incontinence (SUI) management, remain scarce and limited to a 1-year follow-up. Our goal was to assess the efficacy of this procedure after a 1-year follow-up. Methods: This prospective evaluation involved 95 consecutive patients implanted with Ajust at a single centre. All patients had SUI on urodynamics due to urethral hypermobility, 33 % had preoperative overactive bladder (OAB) symptoms and none had detrusor overactivity. Ninety-two patients were treated on an outpatient basis, and 3 patients had general anaesthesia. Postoperative assessment was conducted at 1, 6, 12 months, and yearly thereafter. The main outcome measure was pad usage. Secondary parameters were self-reported SUI episodes, OAB symptoms, data of clinical examination, satisfaction using the Patient Global Impression of Improvement (PGI-I) scale, postoperative pain, and adverse events. Results: After a mean follow-up of 21 ± 6 months (12-32), 76 out of 95 patients used no pads or one dry security pad, showing a success rate of 80 %. Seventy-nine out of 95 patients had no more SUI-related leakage. Only 6 patients experienced late recurrence of SUI after 6 months' follow-up. Perioperative complications included 1 case of vaginal hematoma, 1 case of acute urinary retention, 2 cases of urinary tract infection, all managed conservatively. Half of the patients had no pain after day 1, free of medications. Late complications were vaginal erosion in 1 case, and pain during exertion in 2 cases. Conclusions: The Ajust single incision transobturator sling is a safe and effective procedure, with durable results after 1 year. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: To evaluate the efficacy and safety of the minimally invasive Ajust™ system in the treatment of stress urinary incontinence. Methods: This was a prospective multicentre study. All patients with primary urodynamic stress urinary incontinence were prospectively selected to receive the Ajust™ procedure. The International Consultation on Incontinence-Short Form (ICI-SF), Women Irritative Prostate Symptoms Score (W-IPSS), PGI-S, and PGI-I questionnaires were used to evaluate the impact of incontinence and voiding dysfunction on QoL and to measure patient's perception of incontinence severity and improvement. Results: From January 2009 to October 2009, 111 consecutive subjects were enrolled in the study. At 6 months, 102 were available for outcomes analysis. The subjective and objective cure rates were 85.7% and 91.4%, respectively. The ICI-SF and W-IPSS questionnaires showed a statistical significant improvement in symptom scores. Conclusions: In the short-term follow-up, the Ajust™ system was effective in restoring continence in more than 85% of subjects with a highly significant improvement in QoL. [ABSTRACT FROM AUTHOR]