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DOI: 10.1055/s-0031-1298275
Single-Incision Slings (SIS) – a New Option for the Surgical Treatment of Female Stress Urinary Incontinence
Single-Incision-Schlingen (SIS) – neue Entwicklungen in der operativen Behandlung der Belastungsinkontinenz der FrauPublication History
received 23 October 2011
revised 11 December 2011
accepted 1 02 December 2011
Publication Date:
05 March 2012 (online)
![](https://www.thieme-connect.de/media/gebfra/201202/lookinside/thumbnails/10.1055-s-0031-1298275-1.jpg)
Abstract
The new development of single-incision slings (SIS) for the treatment of female stress urinary incontinence offers comparable results with only minimal side effects and will find wide acceptance in modern incontinence surgery. This mini-sling is inserted over a single vaginal incision and fixed on both sides to the pelvic wall tissue with special anchors, without passing through the groin and avoiding a blind tape passage. Compared with the established sub-urethral tapes, there are comparable success rates with fewer complications. Randomised prospective studies are needed to evaluate whether, in the long run, the benefits of the single incision technique can be correlated with satisfying continence results.
Zusammenfassung
Die Neuentwicklung von Single-Incision-Schlingen (SIS) bei der operativen Therapie der Belastungsinkontinenz der Frau ist mit vergleichbaren Kontinenzraten und nur geringsten Nebenwirkungen verbunden und kann in Zukunft breite Anwendung in der Inkontinenztherapie finden. Diese minimalinvasiven Schlingen werden über eine singuläre vaginale Inzision eingebracht und bds. an der Beckenwand über verschiedene Haltesysteme verankert. Bei gleicher Wirkung durch suburethralen Bandsupport wird hier jedoch eine Blindpassage wie bei den bekannten retropubischen oder transobturatorischen Systemen vermieden. Im Vergleich zu den etablierten suburethralen Schlingen zeigen sich in den ersten Untersuchungen äquivalente Erfolgsraten und deutlich geringere Nebenwirkungen. Hierzu müssen prospektive Studien die Wertigkeit im Vergleich zu den etablierten Verfahren noch belegen.
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References
- 1 Nilsson CG, Palva K, Rezapour M et al. Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J 2008; 19: 1043-1047
- 2 Ward KL, Hilton P. UK and Ireland TVT Trial Group. Tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5-year follow up. BJOG 2008; 115: 226-233
- 3 Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 2002; 81: 72-77
- 4 Tamussino KF, Hanzal E, Kölle D et al. Tension-free vaginal tape operation: results of the Austrian registry. Obstet Gynecol 2001; 98 (5 Pt 1) 732-736
- 5 Latthe PM, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 2007; 114: 522-531
- 6 Latthe PM, Singh P, Foon R et al. Two routes of transobturator tape procedures in stress urinary incontinence: a meta-analysis with direct and indirect comparison of randomized trials. BJU Int 2010; 106: 68-76
- 7 Palma PCR. “Sling” tendineovaginal de pericárdio bovino. Experiència inicial. J Bras Ginec 1999; 109: 93-97
- 8 Palma PCR, Riccetto CLZ, Herrmann V et al. Tendinous vaginal support (T.V.S.) using the porcine small intestine submucosa (SIS): a promising anatomical approach for urinary stress incontinence. J Urol 2001; 165: 5 (A)
- 9 Palma P, Riccetto CLZ, Fraga R et al. Long term follow-up of the tendineus urethral support: an anatomical approach for stress urinary incontinence. Actas Urol Esp 2007; 31: 759-762
- 10 Palma P, Riccetto CLZ, Reges R et al. Arcus to arcus microsling: technique and preliminary results. Int Urogynecol J 2008; 19: 1133-1136
- 11 Petros PE, Richardson PA. Midurethral tissue fixation system sling – a ‘micromethod’ for cure of stress incontinence – preliminary report. Aust N Z J Obstet Gynaecol 2005; 45: 372-375
- 12 Petros PE, Richardson PA. Midurethral tissue fixation system (TFS) sling for cure of stress incontinence – 3 year results. Int Urogynecol J 2008; 19: 869-871
- 13 Sivaslioglu AA, Unlubilgin E, Aydogmus S et al. A prospective randomized controlled trial of the transobturator tape and tissue fixation system minisling in 80 patients with stress urinary incontinence – 3 year results. Pelviperineology 2010; 29: 56-59
- 14 Debodinance P, Amblard J, Lucot JP et al. TVT-Secur: prospective study and follow-up at 1 year about 154 patients. J Gynecol Obstet Biol Reprod 2009; 38: 299-303
- 15 Kim JJ, Lee YS, Lee KS et al. Randomized comparative study of the U- and H-type approaches of the TVT-Secur procedure for the treatment of female stress urinary incontinence: one-year follow-up. Korean J Urol 2010; 51: 250-256
- 16 Liapis A, Bakas P, Creatsas G. Comparison of the TVT-Secur system “hammock” and “U” tape positions for management of stress urinary incontinence. Int J Gynaecol Obstet 2010; 111: 233-236
- 17 Tommaselli GA, Di Carlo C, Gargano V et al. Efficacy and safety of TVT-O and TVT-Secur in the treatment of female stress urinary incontinence: 1-year follow-up. Int Urogynecol J 2010; 21: 1211-1217
- 18 Cornu JN, Sébe P, Peyrat L et al. Midterm prospective evaluation of TVT-Secur reveals high failure rate. Eur Urol 2010; 58: 157-161
- 19 Khandwala S, Jayachandran C, Sengstock D. Experience with TVT-Secur sling for stress urinary incontinence: a 141 case analysis. Int Urogynecol J 2010; 21: 767-772
- 20 Oliveira R, Botelho F, Silva P et al. Exploratory study assessing efficacy and complications of TVT-O, TVT-Secur and MiniArc: results at 12 month follow-up. Eur Urol 2011; 59: 940-944
- Resende A, Oliveira R, Botelho F et al. Mid-term follow-up of a randomized trial comparing TVT-O®, TVT-Secur® and Mini-Arc®. 26th Annual Congress of the European Association of Urology; March 18–22, 2011 Vienna, Abstract
- 22 Tincello D, Lucente V, Khandwala S et al. One year results from a world-wide registry of TVT-Secur® in women with stress urinary incontinence (SUI). ICS/IUGA Meeting 2010. Neurourol Urodyn 2010; 29 Abstract 160
- 23 Han J, Lee HN, Park CM et al. The durability of efficacy of the TVT-SECUR procedure for treatment of female stress urinary incontinence: two-year follow-up. ICS/IUGA Meeting 2010. Neurourol Urodyn 2010; 29 Abstract 738
- 24 Walsh CA. TVT-Secur mini-sling for stress urinary incontinence: a review of outcomes at 12 months. BJU Int 2011; 108: 652-657
- 25 Kennelly MJ, Moore R, Nguyen JN et al. Prospective evaluation of a single incision sling for stress urinary incontinence. J Urol 2010; 184: 604-609
- 26 Kennelly M, Moore R, Siegel S et al. Two years prospective evaluation of the MiniArc® single incision sling for treatment of stress urinary incontinence. J Urol 2011; 185 CD Abstract 1335
- 27 De Ridder D, Berkers J, Deprest J et al. Single incision mini-sling versus a transobturator sling: a comparative study on MiniArc® and Monarc® slings. Int Urogynecol J 2010; 21: 773-778
- 28 Enzelsberger H, Cemer I, Enzelsberger S et al. MiniArc® versus Monarc® – a prospective randomized study of the treatment of female stress urinary incontinence with a follow-up of 2 years. Geburtsh Frauenheilk 2010; 70: 499-502
- 29 Oliveira R, Botelho F, Silva P et al. Single-incision sling system as primary treatment of female stress urinary incontinence: prospective 12 months data from a single institution. BJU Int 2011; 108: 1616-1621
- 30 Pickens RB, Klein FA, Mobley JD et al. Single-incision mid-urethral sling for treatment of female stress urinary incontinence. Urology 2011; 77: 321-324
- Pickens RB, Stewart AF, White WM et al. Long term follow-up data on the MiniArc™ single incision sling system for the treatment of stress urinary incontinence. 75th Annual Meeting of the South Eastern Section of the American Association of Urology; March 17 – 20, 2011, Abstract
- 32 Naumann G, Hagemeier T, Zachmann S et al. Ajust™ fully adjustable single incision sling for the treatment of stress urinary incontinence: 1 year follow-up on a new minimal-invasive treatment for female SUI. ICS/IUGA Meeting 2010. Neurourol Urodyn 2010; 29 Abstract 751
- 33 Naumann G, Hagemeier T, Zachmann S et al. Ajust™ fully adjustable single incision sling for the treatment of stress urinary incontinence: 24 months follow-up on a new minimal-invasive treatment for female SUI. Int Urogynecol J 2012; in press
- 34 Meschia M, Barbacini P, Baccichet R et al. Short-term outcomes with the Ajust™ system: a new single incision sling for the treatment of stress urinary incontinence. Int Urogynecol J 2011; 22: 177-182
- 35 Abdel-Fattah M, Agur W, Abdel-All M et al. Prospective multi-centre study of adjustable single-incision mini-sling (Ajust®) in the management of stress urinary incontinence in women: 1-year follow-up study. BJU Int 2011; 26 DOI: 10.1111/j.1464-410X.2011.10471.x.
- 36 Palma P, Riccetto CLZ, Castro R et al. Safety and efficacy of Ophira mini sling system in an outpatient basis: one-year follow up of a multicentre international clinical trial. ICS/IUGA Meeting 2010. Neurourol Urodyn 2010; 29 Abstract 751
- 37 Jeffery S, Acharyya R, Algar M et al. Mini-sling procedures in stress urinary incontinence: a systematic review of efficacy and complications. ICS/IUGA Meeting 2010. Neurourol Urodyn 2010; 29: 811-812
- 38 Abdel-Fattah M, Ford JA, Lim CP et al. Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol 2011; 60: 468-480
- 39 Serels S, Douso M, Short G. Preliminary findings with the Solyx single-incision sling system in female stress urinary incontinence. Int Urogynecol J 2010; 21: 557-561
- 40 Amat I, Tardiu L, Martínez Franco E et al. Contasure-Needleless® compared with transobturator-TVT® for the treatment of stress urinary incontinence. Int Urogynecol J 2011; 22: 827-833
- 41 Navazo R, Moreno J, Hidalgo C et al. Contasure Needleless: a single incision TOT for the surgical treatment of stress urinary incontinence. Arch Esp Urol 2009; 62: 719-723