Minimally invasive sling surgery in patients with stress urinary incontinence

Kupriyanov Yu.A., Tupikina N.V., Kasyan G.R., Gvozdev M.Yu., Godunov B.N., Pushkar' D.Yu.

Objective: The objective was to perform comparative evaluation the results of treatment of patients suffering from stress urinary incontinence (SUI), using a variety of mini-slings and standard suburethral slings.

Materials and Methods: A prospective cohort study included 130 patients who underwent sling surgery for SUI which includes usage of synthetic suburethral transobturator sling – TVT-O (n = 36) (Eticon), or mini-slings: Ophira (Promedon) (n = 30) or TVT-Secur (Eticon) (n = 34) or Mini-Arc (AMS) (n = 30). A comparative assessment of the efficacy and safety data surgical techniques (holding cough test and completed questionnaires to assess quality of life) was conducted during 1, 12 and 36 months of postoperative period.

Results: during the first month of foolow-up statistical analysis didn't found any significant differences in the effectiveness of the studying methods. At 1 and 3 months of the postoperative period a statistically significant decrease in the efficiency of techniques TVT-Secur was noted with a larger percentage of re-operated patients compared with results of other operations – Ophira, Miniarc and TVT-O (47% vs 13%, 16.7%, 11%, p < 0.05, respectively). Over 1, 12 and 36 months of follow-up there was a decreased efficiency techniques Mini-Arc (96,7% vs 90% vs 80%) and Ophira (100% vs 87,5% vs 79%), but it was not statistically significant and was comparable with the results of the TVT-O technique (94,4% vs 91,3% vs 85%).

Conclusion: Besides of results of TVT-Secur operation, a prospective cohort study of the efficacy and safety of minimally invasive sling surgery in patients suffering of SUI showed similar results in comparison with the results of the application of suburethral synthetic loop transobturator access.

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