Single-incision slings for the treatment of stress urinary incontinence: efficacy and adverse effects at 10-year follow-
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ORIGINAL ARTICLE
Single-incision slings for the treatment of stress urinary incontinence: efficacy and adverse effects at 10-year follow-up Matteo Frigerio 1 & Rodolfo Milani 1 & Marta Barba 2 & Luca Locatelli 2 & Giuseppe Marino 2 & Gianluca Donatiello 2 & Federico Spelzini 3 & Stefano Manodoro 4 Received: 30 June 2020 / Accepted: 13 August 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis Single-incision slings are not considered a first-choice surgical treatment owing to a lack of data about long-term outcomes. We aimed to assess the long-term results of urinary incontinence treatment after single-incision sling implantation at 10 years’ follow-up and to investigate possible deterioration over time. Methods This retrospective study analyzed women with subjective and urodynamically proven stress urinary incontinence who underwent single-incision sling procedure. The objective cure rate was assessed with a 300-ml stress test. The subjective cure rate was determined by the Patient Global Impression of Improvement (PGI-I) questionnaire. International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire scores and self-answered patient-satisfaction scales were collected to assess symptom severity. Findings were compared with short-term outcomes in the same patients, available through our previous database, in order to detect possible outcome deterioration over time. Results The records of 60 patients were analyzed. Nine patients (15%) were lost to follow-up. A total of 51 patients completed the evaluation, with a mean follow-up of 10.3 ± 0.7 years. Objective and subjective cure resulted 86.3% and 88.2% respectively. Mean PGI-I scores and ICIQ-SF were 1.5 ± 1.0 and 3.2 ± 4.8 respectively. Patients’ satisfaction scored 8.6 ± 2.6 out of 10. No long-term complications occurred. Comparison of short-term (2.6 ± 1.4 years after surgery) and long-term follow-up did not show a significant deterioration of outcome over time. Conclusions Single-incision slings were shown to be a procedure with a great efficacy and safety profile at very long-term follow-up. Cure rates and functional outcomes did not show any deterioration over time compared with short-term results. Keywords Complications . Functional outcomes . Long-term follow-up . Quality of life . Single-incision sling . Stress urinary incontinence
Introduction Stress urinary incontinence (SUI) is a common condition defined as any involuntary leakage of urine with activity such as laughing, coughing, and sneezing [1]. SUI is estimated to affect up to 50% of women in developed countries, with a lifetime
* Stefano Manodoro [email protected] 1
ASST Monza, San Gerardo Hospital, Monza, Italy
2
University of Milano-Bicocca, Monza, Italy
3
AUSL Romagna, Infermi Hospital, Rimini, Italy
4
ASST Santi Paolo e Carlo, Ospedale San Paolo, via Antonio di Rudini, Milan, Italy
risk of requiring surgery of about 4% [2, 3]. Surgical treatment is indicated when conservative management fails [4]. Many typ
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