Evaluation of the long-term effect and complication rate of single-incision slings for female stress urinary incontinence.

To evaluate the long-term outcomes of single-incision midurethral slings (SIMS) in real-life practice.
This retrospective, single-arm, patient cohort study was performed in a large Dutch teaching hospital, including 397 consecutive women who underwent a SIMS-procedure between 2009 and 2018. Data were obtained through questionnaires and patient record study. Subjective improvement was the primary outcome, defined as a Patient Global Impression of Improvement (PGI-I) of ‘(very) much better’. Secondary outcomes were subjective cure rate (defined as a negative Urogenital Distress Inventory – item 4 ‘Do you experience involuntary urine leakage related to physical activity, coughing or sneezing?’), complication rate and sling failure (defined as the need for additional research or treatment for persisting stress urinary incontinence (SUI)). All data was analysed with a statistical significance level of 5%.
The mean follow-up time was 54 months. All patients received SIMS (Ajust® or Altis®). Of all respondents, 75% reported a (very) much improved burden of disease. The subjective cure rate was 61%. In 93 patients a total of 120 complications were registered. In 10% of patients a sling failure was observed, 76% of these failures appeared in the first two years post-surgery.
This study showed that, in real life practice, SIMS are both effective and safe over a long period of time.

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