Abstract
PurposeThe 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).MethodsRetropubic 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.ResultsFrom 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).ConclusionsThe 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.
Highlights
Urinary incontinence is a prevalent disorder reported by up to 25 % in women and is highly correlated with impairment of quality of life (QoL) and sexual dysfunction [1, 2]
Purpose The objective of this prospective cohort study was to compare effectiveness, morbidity, quality of life (QoL) and sexual function in women treated with tensionfree vaginal tape (TVT) versus single-incision sling (SIS) in the treatment of female stress urinary incontinence (SUI)
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
Summary
Urinary incontinence is a prevalent disorder reported by up to 25 % in women and is highly correlated with impairment of quality of life (QoL) and sexual dysfunction [1, 2]. Curing of incontinence without generating new side effects (e.g., pain, mesh erosion) may lead to an improvement of sexual function. Today the minimally invasive mid-urethral slings have become a standard surgical procedure for surgical treatment of stress urinary incontinence (SUI) in women and has resulted in a rapid increase in the number of surgeries performed throughout the last 15 years. Single-incision slings (SIS) with anchor fixation in the musculus obturatorius internus fascia or membrane, such as the MiniArcÒ and AjustÒ sling, represent the most recent advancement in the treatment of SUI. This minimally invasive procedure leads to less complications with comparable results to conventional slings [3]. Few long-term data are available; 2-year follow-up data from the MiniArc and Ajust system demonstrate continence for 82–93 % [4,5,6,7] of all patients; no severe side effects were seen
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