Initial Outcomes of a Stabilized Adjustable Minisling for Female Urinary Stress Incontinence

Abstract

Study Objective: To assess the short-term efficacy of the stabilized and adjustable minisling, Minitape (Mpathy Medical Inc) in a group of women with urodynamically proven stress incontinence (USI).Design: Retrospective cohort series.Setting: 2 private surgical centers (urogynecology,urology), with single-physician care.Patients: 76 consecutive women.Intervention: 76 consecutive women who underwent the Minitape procedure for USI of whom 9 had mixed incontinence and 22 had intrinsic sphincter deficiency(ISD). One had previously undergone incontinence surgery. 62 underwent simultaneous concomitant pelvic surgery. 8 had Minitape placed retropubically and 68 by the subfascial or transobturator route. Minitape is an 8 cm mesh tape constructed of ultralightweight polypropylene mesh with a closed knit contruction and 100 micron interstitial pores.Measurements and Main Results: Patients were assessed at a mean of 21 weeks postoperatively. 74 of 76 (97%) patients were dry and therefore symptomatically cured. One more became dry after postoperative adjustment.There were no major tape-related complications. One bladder perforation occurred with a retropubic needle passage. An MRSA urinary infection occurred in a woman taking steroids for Addison's Disease. Evidence of high effectiveness of unstabilized minislings is lacking. This series of stabilized minislings, albeit early, demonstrates high cure rates and the possibility of early postoperative sling adjustment to add a further increment of clinical effectiveness.Conclusion: In a heterogeneous group of women with USI and a high proportion of ISD, Minitape shows a high early efficacy with a low complication profile. Postoperative tape adjustment is feasible. These results suggest at least benchmark effectiveness, associated with full length slings. Longer term follow-up and controlled trials are planned to further assess Minitape and to determine whether postoperative adjustment can give sustained superior results. Study Objective: To assess the short-term efficacy of the stabilized and adjustable minisling, Minitape (Mpathy Medical Inc) in a group of women with urodynamically proven stress incontinence (USI). Design: Retrospective cohort series. Setting: 2 private surgical centers (urogynecology,urology), with single-physician care. Patients: 76 consecutive women. Intervention: 76 consecutive women who underwent the Minitape procedure for USI of whom 9 had mixed incontinence and 22 had intrinsic sphincter deficiency(ISD). One had previously undergone incontinence surgery. 62 underwent simultaneous concomitant pelvic surgery. 8 had Minitape placed retropubically and 68 by the subfascial or transobturator route. Minitape is an 8 cm mesh tape constructed of ultralightweight polypropylene mesh with a closed knit contruction and 100 micron interstitial pores. Measurements and Main Results: Patients were assessed at a mean of 21 weeks postoperatively. 74 of 76 (97%) patients were dry and therefore symptomatically cured. One more became dry after postoperative adjustment.There were no major tape-related complications. One bladder perforation occurred with a retropubic needle passage. An MRSA urinary infection occurred in a woman taking steroids for Addison's Disease. Evidence of high effectiveness of unstabilized minislings is lacking. This series of stabilized minislings, albeit early, demonstrates high cure rates and the possibility of early postoperative sling adjustment to add a further increment of clinical effectiveness. Conclusion: In a heterogeneous group of women with USI and a high proportion of ISD, Minitape shows a high early efficacy with a low complication profile. Postoperative tape adjustment is feasible. These results suggest at least benchmark effectiveness, associated with full length slings. Longer term follow-up and controlled trials are planned to further assess Minitape and to determine whether postoperative adjustment can give sustained superior results.