Sling For Stress Urinary Incontinence Research Articles

Long-term re-procedure rate after mid-urethral slings for stress urinary incontinence

Introduction and hypothesisLong-term safety concerns have risen over the mid-urethral sling operation (MUS) for stress urinary incontinence (SUI), which in some countries has led to litigations and even suspending MUS insertions. We examined the long-term re-procedure rate after MUS operations. The main outcome was re-procedures for SUI. The secondary outcome was surgical interventions due to complications.MethodsWe analysed a retrospective population cohort of 3531 women with MUS operations in 2000–2006 and followed them up until 31 December 2016. Data were collected from a national hospital register and from hospital patient records.ResultsThe median follow-up time was 13 years (IQR 11.6–14.8) for the 3280 women with a retropubic MUS (RP-MUS) and 11 years (IQR 10.3–11.9) for the 245 women with a transobturator MUS (TO-MUS). The cumulative number of re-procedures for SUI was 16 (0.5%) at 1 year, 66 (1.9%) at 5 years, 97 (2.8%) at 10 years and 112 (3.2%) at 17 years. This risk was higher after TO-MUS than after RP-MUS operations (OR 3.6, 95% CI 2.5–5.2, p < 0.001). The cumulative number of any long-term re-procedure was 43 (1.2%) at year 1, 105 (3.0%) at year 5, 144 (4.1%) at year 10 and 163 (4.6%) at year 17.ConclusionsRe-procedures occur up to 17 years after primary MUS insertion, but their incidence is low after the first few postoperative years. Re-procedures for recurrent SUI are more common after TO-MUS than RP-MUS.

SC26 - Influence of detrusor underactivity on outcomes of women treated with middle urethral sling for stress urinary incontinence

SC26 - Influence of detrusor underactivity on outcomes of women treated with middle urethral sling for stress urinary incontinence

Osteochondroma of the Pubic Symphysis Involved With Aberrantly Placed Minisling: A Case Report

Osteochondromas are benign bone tumors that rarely involve the pubic symphysis. This case report describes a 41-year-old woman with a pubic symphyseal osteochondroma associated with an aberrantly placed single incision sling. After an outside surgeon placed a single incision midurethral sling for stress urinary incontinence, she developed pelvic pain, dyspareunia and vaginal mesh sling exposure. Imaging demonstrated a 2.6 centimeter calcified mass posterior to the pubic symphysis. The patient underwent excision of the mass and the eroded mesh sling via vaginal and abdominal approaches. Pathology demonstrated osteochondroma aggregated around mesh. This is a rare case of a single incision sling placed aberrantly into a pubic symphyseal osteochondroma that required excision.

Long-term Physical Activity Levels and Physical Functioning Outcomes After Midurethral Sling.

The objective of this study was to describe changes in leisure physical activity (PA) levels and physical functioning (PF) in women 60 months or more after midurethral sling for stress urinary incontinence (SUI). This is a long-term follow-up study of a previously published prospective study of women undergoing outpatient midurethral sling for SUI from 2009 to 2011. Women completed questionnaires for incontinence, PA, and PF at baseline, 6, 12, and 60 months or more postoperatively. Women were categorized as having sedentary, insufficient, or sufficient leisure PA levels by metabolic equivalents (MET min/week on the International Physical Activity Questionnaire). Physical functioning was measured from the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System. Physical activity and PF levels were compared preoperatively and at 60 months or more. Statistical tests were applied as appropriate with a P < 0.05 considered significant. Of the 85 women enrolled in the primary study, contact was made with 49, and 35 completed surveys. The follow-up range was 5.8 to 8 years (median, 6.8). Baseline mean age was 49.8 (SD, 8) years. Urinary Impact Questionnaire scores were lower at 60 months or more postprocedure (33.33 vs 0, P < 0.001), with no differences at 6, 12, and 60 months or more. At baseline, 31.3% of patients had sedentary, 12.5% had moderate, and 56.3% had sufficient leisure PA levels. On long-term follow-up, this improved to 21.9% sedentary, 12.5% moderate, and 65.6% sufficient leisure PA levels. Physical functioning also improved (mean, 44.95 vs 53.18 points; P < 0.001). Midurethral sling procedures are associated with modest improvements in leisure PA levels and significant improvements in PF 60 months or more after surgery.

Committee Opinion No. 387-Mid-Urethral Slings for Stress Urinary Incontinence.

Committee Opinion No. 387-Mid-Urethral Slings for Stress Urinary Incontinence.

Translabial Ultrasound in Midurethral Sling (Mesh) Visualization and Erosion Detection in Women With Stress Urinary Incontinence: A Retrospective Pilot Study.

Sling erosion is a significant complication of midurethral sling (mesh) placement for stress urinary incontinence, a common pelvic floor disorder. The goal of this retrospective case-control pilot study was to evaluate the performance of translabial ultrasound (TLUS) and magnetic resonance imaging in diagnosing mesh erosion. Therefore, women who underwent surgery in the setting of prior failed midurethral sling for stress urinary incontinence were identified from the hospital database. The case subcohort comprised all women with intraoperatively documented erosion, and the control subcohort comprised an equal number of randomly selected patients without erosion. The data consisted of selected clinical parameters, the presence of erosion at surgery (reference standard) and at cystourethroscopy, and dual-reader preoperative TLUS consensus interpretation for mesh location (intraluminal, mural, and extramural) and erosion (defined as intraluminal or mural mesh location). Odds ratios were calculated for the selected clinical parameters. Of the 198 women identified, 15 (8%) had mesh erosion at surgery into the lower urinary tract. The sensitivity, specificity, and accuracy of TLUS and cystourethroscopy in detecting erosion in the combined group of cases and controls (30 women) were 93%, 88%, and 90%, as well as 67%, 100%, and 83%, respectively (TLUS Cohen κ = 0.85). Thus, TLUS may be a good diagnostic tool in diagnosing mesh erosion. Only 7 of 30 women had pelvic magnetic resonance examination, and mesh fragments were not visualized. Case-control comparison of the selected clinical parameters was not statistically significant.

Impact of the mid-urethral sling for stress urinary incontinence on female sexual function and their partners’ sexual activity

ObjectiveTo assess the impact of the transobturator mid-urethral sling (MUS) procedure on female sexual function and their partners’ sexual activity. Materials and methodsSexually active women with stress urinary incontinence who underwent a transobturator MUS procedure at the Department of Obstetrics and Gynecology of two medical centers were prospectively enrolled. All participants and their partners were required to complete questionnaires before surgery and 3 months after surgery. ResultsEighteen women undergoing both the transobturator tape (TOT) procedure (n = 14) and the tension-free vaginal tape obturator (TVT-O) procedure (n = 4) were enrolled. The female sexual function index scores did not differ between the baseline and postoperative data. However, the overactive bladder symptom scores improved significantly 3 months after surgery. Patients also had an improvement in their arousal score after TOT procedures; however, there was no between-group difference in the post-treatment changes in the arousal scores. Thirteen partners completed their questionnaires at both the baseline and postoperative phases. Fifty-four percent (7/13) of partners stated that sexual intercourse improved after surgery, and 46% (6/13) described no change after surgery. In addition, no change in pain level due to vaginal narrowing or dryness after surgery was observed. Only one partner noticed the tape during intercourse and complained of pain due to the tape. ConclusionAlthough most female sexual function remains unchanged after the transobturator MUS procedure, a significant percentage of partners in the study felt that their sexual activity improved after surgery.

Influence of age, BMI and parity on the success rate of midurethral slings for stress urinary incontinence.

AimsOur aim was to evaluate, in a second data analysis of the prospective randomized controlled trial conducted by Austrian Urogynaecology Working Group, the effect of age, BMI and parity at the time of surgery on short- and long-term outcomes of women primarily treated for SUI (stress urinary incontinence) with midurethral slings.MethodsIn the original study 554 patients received randomly a retropubic (TVT) or a transobturator midurethral (TVT-O) sling procedure. 480 (87%) and 277 (50%) patients were available for a follow-up efficacy evaluation at 3 months and 5 years respectively.ResultsHigher age and BMI at surgery appear to lead to a larger probability to have a positive stress test 5 years after surgery, but not after 3 months. Older patients seem to have a worse perception of improvement 5 years after surgery as compared to younger ones, as described by the PGI-I score. Age and BMI do not affect significantly the quality of life of women surgically treated for SUI, as reflected by the results of King´s Health Questionnaire. Parity does not seem to have any effect on objective and subjective surgical outcomes.ConclusionsHigher age and BMI at surgery have a detrimental influence on the objective cure rate at 5 years after midurethral sling surgery; higher age also has a negative influence on subjective long-term outcomes. However, these demographic parameters do not influence significantly the quality of life of patients after anti-incontinence surgery. Parity does not show any significant influence on success rate of midurethral sling.

Refined nomogram incorporating standing cough test improves prediction of male transobturator sling success.

To develop a decision aid in predicting sling success, incorporating the Male Stress Incontinence Grading Scale (MSIGS) into existing treatment algorithms. We reviewed men undergoing first-time transobturator sling for stress urinary incontinence (SUI) from 2007 to 2016 at our institution. Patient demographics, reported pads per day (PPD), and Standing Cough Test (SCT) results graded 0-4, according to MSIGS, were assessed. Treatment failure was defined as subsequent need for >1 PPD or further procedures. Parameters associated with failure were included in multivariable logistic models, compared by area under the receiver-operating characteristic curves. A nomogram was generated from the model with greatest AUC and internally validated. Overall 203 men (median age 67 years, IQR 63-72) were evaluated with median follow-up of 45 months (IQR 11-75 months). A total of 185 men (91%) were status-post radical prostatectomy and 29 (14%) had pelvic radiation history. Median PPD and SCT grade were both two. Eighty men (39%) failed treatment (use of ≥1 PPD or subsequent anti-incontinence procedures) at a median of 9 months. History of radiation (P = 0.03), increasing MSIGS (P < 0.0001) and increasing preoperative PPD (P < 0.0001) were associated with failure on univariate analysis. In a multivariable model with AUC 0.81, MSIGS, and PPD remained associated (P = 0.002 and <0.0001 respectively, and radiation history P = 0.06), and was superior to models incorporating PPD and radiation alone (AUC 0.77, P = 0.02), PPD alone (AUC 0.76, P = 0.02), and a cutpoint of >2 PPD alone (AUC 0.71, P = 0.0001). MSIGS adds prognostic value to PPD in assessing success of transobturator sling for treatment of SUI.

No incision and tension-free vaginal sling for stress urinary incontinence: The role of knotless barbed suture

Midurethral mesh sling is the most performed incontinence procedure. This hypotheses propose knotless barbed suture could be positioned as a tension-free trans-vaginal sling under the mid-urethra without vaginal incision. Knotless suture sling support and stabilize mid-urethra when intraabdominal pressure increase. This procedure is designed to replace midurethral mesh sling operation, aiming at reducing complications. It is completed in a similar way with retropubic mesh sling procedure, and less invasive. This involve the passage of fine needle from suprapubic skin to midurethral vaginal wall, and knotless suture passing through in fine needle as a U shape. The foundational promises for this hypothesis pertain to two clinical facts: midurethral sling procedure is a gold standard treatment, and the knotless suture offer superior tissue holding or fixation strength originated from the unique barbed design.

Association Between the Amount of Vaginal Mesh Used With Mesh Erosions and Repeated Surgery After Repairing Pelvic Organ Prolapse and Stress Urinary Incontinence

Mesh, a synthetic graft, has been used in pelvic organ prolapse (POP) repair and stress urinary incontinence (SUI) to augment and strengthen weakened tissue. Polypropylene mesh has come under scrutiny by the US Food and Drug Administration. To examine the rates of mesh complications and invasive reintervention after the placement of vaginal mesh for POP repair or SUI surgery. This investigation was an observational cohort study at inpatient and ambulatory surgery settings in New York State. Participants were women who underwent transvaginal repair for POP or SUI with mesh between January 1, 2008, and December 31, 2012, and were followed up through December 31, 2013. They were divided into the following 4 groups based on the amount of mesh exposure: transvaginal POP repair surgery with mesh and concurrent sling use (vaginal mesh plus sling group), transvaginal POP repair with mesh and no concurrent sling use (vaginal mesh group), transvaginal POP repair without mesh but concurrent sling use for SUI (POP sling group), and sling for SUI alone (SUI sling group). The primary outcome was the occurrence of mesh complications and repeated invasive intervention within 1 year after the initial mesh implantation. A time-to-event analysis was performed to examine the occurrence of mesh erosions and subsequent reintervention. Secondary analyses of an age association (<65 vs ≥65 years) were conducted. The study identified 41 604 women who underwent 1 of the 4 procedures. The mean (SD) age of women at their initial mesh implantation was 56.2 (13.0) years. The highest risk of erosions was found in the vaginal mesh plus sling group (2.72%; 95% CI, 2.31%-3.21%) and the lowest in the SUI sling group (1.57%; 95% CI, 1.41%-1.74%). The risk of repeated surgery with concomitant erosion diagnosis was also the highest in the vaginal mesh plus sling group (2.13%; 95% CI, 1.76%-2.56%) and the lowest in the SUI sling group (1.16%; 95% CI, 1.03%-1.31%). The combined use of POP mesh and SUI mesh sling was associated with the highest erosion and repeated intervention risk, while mesh sling alone had the lowest erosion and repeated intervention risk. There is evidence for a dose-response relationship between the amount of mesh used and subsequent mesh erosions, complications, and invasive repeated intervention.

A Large Retrospective Series of Pregnancy and Delivery After Midurethral Sling for Stress Urinary Incontinence.

The aim of this study was to review the complete medical course, including safety, efficacy, and medical decision making, of patients who delivered a pregnancy after the placement of midurethral sling (MUS) within a large health maintenance organization. We conducted a retrospective case series of patients within the Northern and Southern California Permanente Medical Group who were identified based on procedural codes for placement of MUS for stress urinary incontinence. Electronic medical records with MUS code were referenced against records of live births within the health care system. Demographic and clinical data were abstracted through extensive, standardized physician review of the electronic medical records of all identified patients. Twenty-six patients were identified and included in analysis. Sixteen patients had a retropubic MUS, and 10 had a transobturator MUS. Twenty-one of 26 patients reported subjective resolution of urinary incontinence after MUS. Fourteen of the 25 first deliveries after MUS were cesarean section (CS). Of these, 5 CS were elective primary for the indication of previous MUS, 5 were elective repeat CS, and the remaining 4 were for fetal indications. Eleven patients had spontaneous vaginal deliveries. There were no MUS-related pregnancy complications. One patient developed recurrent stress urinary incontinence postpartum, for which she underwent repeat MUS within a year resulting in cure of incontinence. This case series corroborates previous series demonstrating the safety and durability of MUS after subsequent pregnancy.

Long-term patient satisfaction after retropubic and transobturator mid-urethral slings for female stress urinary incontinence.

The aim of this study was to report long-term patient outcomes after retropubic and transobturator mid-urethral slings for female stress urinary incontinence. Women who underwent mid-urethral sling for stress urinary incontinence between 2000 and 2010 were invited to participate in a survey regarding their overall improvement. Patients' outcomes were assessed using the International Consultation on Incontinence Questionnaire - Short Form and the Global Response Assessment Scale. The questionnaires were completed by 330 patients. Their median age at the time of surgery was 54.8 years (±12.9) and the median follow-up period was 11.9 years (±6.4). Retropubic and transobturator approaches were performed in 128 (38.8%) and 202 (61.2%) patients, respectively. The International Consultation on Incontinence Questionnaire - Short Form score dropped from an average of 14 (±4.1) to 6.4 (±6) with no significant difference between the two groups. The Global Response Assessment Scale showed an 9% greater improvement in the retropubic (66.4%) over the transobturator (57.4%) approach. De novo overactive bladder was the commonest long-term reported adverse event, affecting 18/330 patients (5.5%). Voiding dysfunction that required surgical correction following the retropubic approach occurred in three patients (2.3%). Mid-urethral slings for the management of female stress urinary incontinence had good and durable long-term effects. Although the retropubic approach gave better results, they were not significantly different than those of the transobturator approach.

The Role of Obesity in Success and Complications in Patients Undergoing Retropubic Tension-Free Vaginal Tape Surgery.

The aim of this study was to examine the impact of obesity on the success rate of and complications from retropubic tension-free vaginal tape (TVT) midurethral slings for stress urinary incontinence (SUI). A retrospective, cohort study was performed on patients with retropubic TVT surgery between 2008 and 2014. Demographic, outcome, and complication data were obtained from electronic medical records and analyzed using logistic regression, analysis of variance, and multivariate regression analysis. Short-term (1-2 weeks) and long-term (2 months) outcomes were measured. Two hundred twenty-seven patients were included; 100 (44%) were of normal weight, 71 (31%) were overweight, and 56 (24%) were obese. Overall SUI cure rates were high, although the obese group had a lower cure rate. Compared with normal weight, overweight patients had a 2.43 times higher odds (P = 0.14) of short-term complaints of persistent SUI, whereas obese patients had a 3.56 times higher odds (P = 0.03). Similar failure rates were seen at 2 months among the groups. Odds of intraoperative complications did not differ between overweight and normal weight (odds ratio [OR], 0.64; P = 0.319) and obese and normal weight (OR, 0.90; P = 0.83) patients. Postoperative complications did not differ between overweight and normal weight (OR, 0.40; P = 0.27) and obese and normal weight (OR, 1.45; P = 0.54) patients. Obese women undergoing retropubic TVT surgery had a 3.56 increased odds of short-term complaints of SUI compared with normal weight patients, but 2-month failure rates were similar. Obese and overweight patients were equally likely to have complications from TVT.

The effect of major depression on quality of life after surgery for stress urinary incontinence: a secondary analysis of the Trial of Midurethral Slings

Depression has been associated with symptom amplification, functional impairment, and lower incontinence-specific quality of life in women with urinary incontinence. Although depression has been shown to impact both subjective and objective outcomes after many different surgeries, there are limited data on the effects of major depression on postoperative outcomes after antiincontinence surgery. The purpose of this study was to determine whether major depression affects urinary incontinence severity and quality of life after midurethral sling surgery. This was a secondary analysis of the Trial of Midurethral Slings. Participants were assigned randomly either to a retropubic or transobturator sling for stress urinary incontinence. Each was classified as having major depression or not by the validated depression screening Patient Health Questionnaire-9. Pre- and postoperative urinary incontinence severity (which was assessed by the International Consultation on Incontinence Questionnaire), urinary incontinence-specific quality of life (which was assessed by the Incontinence Impact Questionnaire and the Urinary Distress Inventory), and sexual function (which was assessed by the Prolapse/Urinary Incontinence Sexual Questionnaire) was compared between groups at baseline and at 12 months. Five hundred twenty-six patients were included: 79 patients (15%) had major depression before surgery; 447 patients (85%) did not. Baseline incontinence severity was higher in women with major depression than in those without (International Consultation on Incontinence Questionnaire, 14.7 ± 4.1 vs 12.9 ± 4.0; P < .001). Similarly, baseline quality of life and sexual function were worse in depressed women than in nondepressed women (Incontinence Impact Questionnaire, 235.6 ± 95.8 vs 134.8 ± 89.8; P < .001; Urinary Distress Inventory, 162.7 ± 46 vs 128.6 ± 41.3; P < .001; and Prolapse/Urinary Incontinence Sexual Questionnaire-12, 27.2 ± 7.3 vs 33.9 ± 6.4; P < .001). After adjustment for differences between groups, baseline major depression did not negatively affect 12-month incontinence severity or quality of life. However, at 12 months after surgery, despite significant improvement in sexual function scores in depressed women, the 12-month scores were still significantly worse in the major depression group (Prolapse/Urinary Incontinence Sexual Questionnaire-12, 34.1 ± 7.1 vs 37.7 ± 6.1; P<.001); multivariable analysis showed independent association of baseline major depression with 12-month sexual function. At 12 months, 83% of those women (66/79) with baseline major depression were no longer depressed. Women with major depression who are planning surgery for stress urinary incontinence have worse quality of life than nondepressed women. However, women with major depression improve significantly more than those without major depression such that, at 12months postoperatively, incontinence severity and quality of life are notdifferent between groups. Sexual function is worse before and after theoperation for depressed women.

A randomized clinical trial of how to best position retropubic slings for stress urinary incontinence: Development of a study protocol for the mid-urethral sling tensioning (MUST) trial.

The goal of this trial is to compare two techniques for tensioning retropubic midurethral slings: a Mayo scissor between the tape and urethra vs. a Babcock clamp creating a measured loop underneath the urethra. The primary outcome is a composite of abnormal bladder function at 12 months post surgery. Abnormal bladder function is defined as bothersome stress incontinence or worsening over active bladder symptoms, a positive cough stress test, re-treatment of stress urinary incontinence, post-operative urinary retention requiring either catheterization beyond 6 weeks or surgical intervention. Secondary outcomes include the duration of post operative urinary retention, quality of life scores, and physical examination. This article describes the rationale and design of this clinical trial, which will be of interest to those who care for patient with pelvic floor disorders such as stress urinary incontinence.

10 Long term follow-up of transvaginal retropubic mid urethral sling for stress urinary incontinence in an historic cohort of 500 women

10 Long term follow-up of transvaginal retropubic mid urethral sling for stress urinary incontinence in an historic cohort of 500 women

What to Do With Recurrent Prolapse After Vaginal Mesh Failure?

Study ObjectiveTo show that in selected cases laparoscopic sacrocolpopexy can be used for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. MethodsStep-by-step examination of the technique using an educative video. Institutional review board approval was obtained. SettingThe authors describe two clinical cases of treatment of recurrent pelvic organ prolapse, after a vaginal mesh surgery, using laparoscopic sacrocolpopexy. PatientsA 56-year old patient (para 3, gravida 2) presented with the sentation of bulging in the vagina. On physical examination, the patient had a grade 2-3 vaginal apical prolapse and a stage 4 rectocele. She had a slight mesh contraction but no vaginal extrusion and no pain were reported. Eleven years before, she had a vaginal total hysterectomy for pelvic organ prolapse correction and one year before she had a vaginal prolapse repair using a synthetic mesh. A laparoscopic sacrocolpopexy with bilateral ooforectomy was performed. The second case is of a 54-year old patient (para 2, gravida 2) that presented stress urinary incontinence. On physical examination, the patient had a grade 3 uterine prolapse and grade 2 cystocele. Eleven years before she had a vaginal prolapse repair using a synthetic mesh and a miduretral sling for stress urinary incontinence. Two years before, she had the miduretal sling removed for recurrent urinary infections and dysuria. A laparoscopic sub-total hysterectomy with salpingectomy and ovarian conservation, sacrocolpopexy and a Burch colposuspension was performed. Measurements and Main ResultsThe procedures and postoperative recovery were uneventful. No minor or major complications occurred. The patients were discharged three days after surgery. ConclusionLaparoscopic sacrocolpopexy is a promising approach for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. It appears to be feasible, safe, and effective.

Long-term efficacy of the trans-obturator and retropubic mid-urethral slings for stress urinary incontinence: update from a randomized clinical trial.

To report the extended long-term results of the use of tension-free vaginal tape(TVT) and trans-obturator tape (TOT) for the treatment of female stress urinary incontinence (SUI). A prospective, multicentre randomized clinical trial comparing the use of TVT and TOT was used to evaluate 87 patients. The inclusion criteria were stress or mixed UI associated with urethral hyper mobility (the stress component was clinically predominant), while the exclusion criteria were previous anti-incontinence surgery and/or pelvic organ prolapse. The objective cure criteria were a negative provocative stress test and a negative 1-h pad test, with no further treatment for SUI. The subjective cure criteria were a 3-day voiding diary, quality-of-life questionnaires (UDI6-IIQ7), and patient satisfaction on a scale from 0 to 10. Eighty-seven patients were evaluated (47 TOT and 40 TVT) at a median follow-up of 100 months. Subjective and objective cure rates were 59.6 and 70.2 % in the TOT group and 75 and 87.5 % in the TVT group. The mid-to-long-term trend was a decreasing continence rate in patients who underwent TOT, compared with a stable rate for TVT. The Kaplan-Meier survival curve showed that continence rate decreased for up to 25 months after surgery, with stabilization thereafter for the TVT group while continuing to drop in the TOT group, with no inter-group difference. The patients in both groups were highly satisfied at long-term follow-up. The overall continence rate worsened for both groups within 25 months. While the results tend to stabilize in the TVT group, a further decline in the TOT was observed.

Bandelette sous-urétrale en ambulatoire chez la femme : revue de la littérature

The aim of this study was to assess efficacy, complication and feasibility of outpatient suburethral slings for stress urinary incontinence in women. A systematic review of the literature was done from the Pubmed data-base by searching following keywords: suburethral sling, midurethral sling, TVT, TOT, outpatient surgery, day surgery. Seventy-eight percent to 88% of patients were continent postoperatively, and 6.8 to 12% of patients were significantly improved. No major complication occurred and minor complications were observed in 7.2 to 19.8% of patients. Eighty to 86.6% of patients experienced no complication. Seventy percent to 100% of patients were discharged on post operative day 0. The satisfaction rate was 89.4 to 95%. Outpatient suburethral sling for stress urinary incontinence is suitable, effective, with a low complication rate, and with a high rate of satisfaction.