Tsia-Shu Lo1, Sandy Chua2, Chuan Chi Kao3, Ma Clarissa Uy-Patrimonio4, Rami Ibrahim5, Yiap Loong Tan6. 1. Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China; Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China. Electronic address: 2378@cgmh.org.tw. 2. Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Cebu Velez General Hospital, Cebu City, Philippines. 3. Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China. 4. Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, Philippines. 5. Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Al-Bashir Hospital, Amman, Jordan. 6. Department of Obstetrics and Gynecology, Kuching Specialist Hospital, KPJ Healthcare Group, Kuching, Sarawak, Malaysia.
Abstract
STUDY OBJECTIVE: To evaluate the effectiveness and safety of the MiniArc single-incision sling in the treatment of urodynamic stress incontinence (USI) through 5 years. DESIGN: Retrospective observational study (Canadian Task Force classification II-2). SETTING: Tertiary referral center. PATIENTS: Eighty-five patients with USI without needing concurrent procedures who underwent anti-incontinence surgery using the MiniArc SIMS from February 2010 to December 2011. INTERVENTIONS: Anti-incontinence surgery. MEASUREMENTS AND MAIN RESULTS: Objective cure was defined as no demonstrable leakage of urine on the cough stress test and 1-hour pad test weight <2 g. Subjective cure was based on negative response to Urinary Distress Inventory question 3, no leakage on coughing, sneezing, or laughing. Most patients were postmenopausal, overweight, and multiparous. Postoperative USI significantly improved (p < .001) through 3 years, and the 1-hour pad test showed significant improvement through 5 years (p < .001). Although 13 patients had recurrence of USI, no repeat surgery was done. The cumulative cure rates may show a declining trend of cure, yet subjective cure was 80.0% and objective cure 84.7%, with age as a significant risk factor for sling failure. CONCLUSION: MiniArc maintains its effectiveness and safety in treatment of USI through 5 years with high objective and subjective cure rates and low incidence of complications.
STUDY OBJECTIVE: To evaluate the effectiveness and safety of the MiniArc single-incision sling in the treatment of urodynamic stress incontinence (USI) through 5 years. DESIGN: Retrospective observational study (Canadian Task Force classification II-2). SETTING: Tertiary referral center. PATIENTS: Eighty-five patients with USI without needing concurrent procedures who underwent anti-incontinence surgery using the MiniArc SIMS from February 2010 to December 2011. INTERVENTIONS: Anti-incontinence surgery. MEASUREMENTS AND MAIN RESULTS: Objective cure was defined as no demonstrable leakage of urine on the cough stress test and 1-hour pad test weight <2 g. Subjective cure was based on negative response to Urinary Distress Inventory question 3, no leakage on coughing, sneezing, or laughing. Most patients were postmenopausal, overweight, and multiparous. Postoperative USI significantly improved (p < .001) through 3 years, and the 1-hour pad test showed significant improvement through 5 years (p < .001). Although 13 patients had recurrence of USI, no repeat surgery was done. The cumulative cure rates may show a declining trend of cure, yet subjective cure was 80.0% and objective cure 84.7%, with age as a significant risk factor for sling failure. CONCLUSION: MiniArc maintains its effectiveness and safety in treatment of USI through 5 years with high objective and subjective cure rates and low incidence of complications.