Single incision slings： Are they ready for real life？

摘要

cqvip:AIM: To review of the efficacy and safety outcomes of different single incision slings(SIS) systems, also in comparison with traditional slings.METHODS: A literature search was conducted in Pub Med/MEDLINE database. The research was restricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence(SUI). The studies had to assess efficacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The final selection included 19 papers fulfilling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS: Four different SIS systems were analysed: Ajust®, Ophira®, Altis® and Mini Arc®. The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings(MUS) in terms of objective cure(all P > 0.005). Only one paper showed a statistically lower success rate in Mini Arc® vs Advantage® slings(40% vs 90%) and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to compare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust® and Mini Arc®, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported longterm pain complains.CONCLUSION: SIS showed similar efficacy to that of traditional slings but lower short-term pain, complication and failure rates.