Mira Gon Lucas, Zanettini Riccetto Cassio Luis, Citatini de Campos Caio Cesar, Iamashita Voris Brunno Raphael, Reis Leonardo O, Rodrigues Palma Paulo Cesar
Department of Urology, University of Campinas, Unicamp, Brazil.
Department of Urology, University of Campinas, Unicamp, Brazil,
Urol Int. 2019;102(3):326-330. doi: 10.1159/000496560. Epub 2019 Jan 30.
To evaluate mini-sling long-term results and correlate them to failure predictors. Many studies show comparable results among different single-incision slings developed as an attempt to reduce complications while keeping good results, but there is a lack of evidence about mini-slings outcomes in the long term.
This prospective, single-center study evaluated 40 patients for long-term outcomes after mini-sling placement. Objective cure was defined as leakage of less than 1 g in 1-hour pad-test and no leakage at Valsalva maneuver. An objective improvement was defined as leakage of a maximum 50% of the preoperative test. Subjective continence was considered as a zero score at International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Patients were also evaluated for comorbidities and previous surgeries.
The mean age was 56 (±9.3) years, the mean ICIQ-SF score was 16 (±2.98) before surgery and 3.5 (± 5) at last follow-up, showing sustained improvement in the long term, mean 100 (84-109) months follow-up. The objective results show 67.5% of success, 17.5% of improvement, and 15% of failure. Age and parity were not related to outcomes (p = 0.33), but previous surgeries increase failure rate with 5.66 OR (p = 0.04). Success, improvement, and failure rates were 85, 10, and 5% for treatment-naive patients versus 50, 25, and 25% for patients with previous surgeries, respectively.
Mini-sling Ophira shows good long-term results with low complications rates in patients without previous anti-incontinence surgery. Randomized trials are necessary to compare mini-slings results to other mid-urethral slings in recurred stress urinary incontinence.
评估迷你吊带的长期效果，并将其与失败预测因素相关联。许多研究表明，不同的单切口吊带在减少并发症的同时保持良好效果方面取得了可比的结果，但缺乏关于迷你吊带长期结果的证据。
这项前瞻性单中心研究评估了40例患者在放置迷你吊带后的长期结果。客观治愈定义为1小时尿垫试验漏尿量少于1克，以及在瓦尔萨尔瓦动作时无漏尿。客观改善定义为漏尿量最多为术前试验的50%。主观尿失禁被视为在国际尿失禁咨询问卷简表（ICIQ-SF）上得分为零。还对患者的合并症和既往手术情况进行了评估。
平均年龄为56（±9.3）岁，术前平均ICIQ-SF评分为16（±2.98），末次随访时为3.5（±5），显示长期持续改善，平均随访100（84-109）个月。客观结果显示成功率为67.5%，改善率为17.5%，失败率为15%。年龄和产次与结果无关（p=0.33），但既往手术会使失败率增加，比值比为5.66（p=0.04）。初治患者的成功率、改善率和失败率分别为85%、10%和5%，而既往有手术史的患者分别为50%、25%和25%。
对于未接受过抗尿失禁手术的患者，Ophira迷你吊带显示出良好的长期效果和低并发症发生率。有必要进行随机试验，以比较迷你吊带与其他中尿道吊带在复发性压力性尿失禁中的效果。
