A prospective study of a single-incision sling at the time of robotic sacrocolpopexy

Int Urogynecol J. 2014 Nov;25(11):1541-6. doi: 10.1007/s00192-014-2432-8. Epub 2014 Jun 4.

Abstract

Introduction and hypothesis: The objective of this study was to evaluate the efficacy and safety of the Miniarc Precise® single-incision sling (American Medical Systems, Minnetonka, MN, USA) placed at the time of a robotic sacrocolpopexy.

Methods: This was a prospective study of a single-incision suburethral sling placed at the time of robotic sacrocolpopexy in women with stress urinary incontinence (SUI) and pelvic organ prolapse. Primary outcome measure was cure at 1 year, defined objectively by a negative cough stress test (CST) and subjectively by a score of "0 or 1" on question 17 of the Pelvic Floor Distress Inventory (PFDI-20): "Do you experience urine leakage related to coughing/sneezing/laughing?" Secondary outcome measures included the change in Urinary Distress Inventory (UDI-6) and Urinary Impact Questionnaire (UIQ-7) scores at 1 year. All sling-related complications were reported. Paired Student's t test and the Wilcoxon signed-rank test were used for statistical analysis.

Results: One hundred and one patients were included between August 2010 and July 2012. One-year follow-up was available for 97 out of 101 patients (96 %). Objective cure was 90 % and subjective cure was 87 %. Baseline UDI-6 scores improved from 34.8 ± 25.1 to 6.7 ± 11.2 at 1 year (p < 0.001). Similarly, UIQ-7 scores improved from 21.1 ± 22.8 to 2.4 ± 8.2 at 1 year (p < 0.001). There were no intraoperative cystotomies, no mesh erosions, no sling revisions, and no cases of urinary retention. The retreatment rate for persistent SUI was 8 % (8 out of 97).

Conclusions: The addition of a single-incision suburethral sling at the time of robotic sacrocolpopexy in women with SUI resulted in an 87 % cure rate at 1 year.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Pelvic Organ Prolapse / complications
  • Pelvic Organ Prolapse / surgery
  • Prospective Studies
  • Reoperation
  • Robotic Surgical Procedures
  • Sacrum / surgery
  • Severity of Illness Index
  • Suburethral Slings*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence, Stress / complications
  • Urinary Incontinence, Stress / surgery*
  • Vagina / surgery