Comparison of Clinical Efficacy and Urodynamic Changes Using Single-incision Slings (MiniArc vs. Solyx™) for the Treatment of Female Stress Urinary Incontinence.

OBJECTIVE

To compare the clinical efficacy and urodynamic parameter changes between the MiniArc and the Solyx sling for the treatment of female urodynamic stress incontinence (USI).

MATERIALS AND METHODS

One-hundred and thirty (MiniArc = 79, BS-Solyx = 51) patients were included in this study. Cough stress test (ST), pad test (PT), Incontinence Impact short form Questionnaire (IIQ-7), Urogenital Distress Inventory six-item questionnaire (UDI-6), Sexual Questionnaire-Short Form (PIS-Q), and urodynamic parametric changes were assessed to determine objective and subjective outcomes following the procedure. Objective cure was defined as negative ST and PT <2 g and subjective cure was defined as "No" to the answer of UDI-6 Question #3. Predictors of surgical failure were also determined.

RESULTS

All Solyx users, as opposed to 91.1% of MiniArc patients, obtained objective cure at postoperative 3 months ( = 0.042). No significant difference in subjective cure rates (93.7% vs. 90.2% at 3-months ( = 0.513); 89.9% vs. 80.4% at 1 year for Solyx and MiniArc patients, respectively ( = 0.126)) and improvement scores in UDI-6 and IIQ-7 were observed. The Solyx group incurred more urgency (17.6% vs. 6.3% at 3 months ( = 0.042); 23.5% vs. 7.6% at 1 year ( = 0.01)). Both procedures yielded significant decrements in maximal urethral closure pressure ( < 0.001) and average flow rate ( = 0.015). The preoperative PT and sling type were strong predictors of surgical failure, where the Solyx tape reported lower odds (odds ratio = 0.174, = 0.02) compared to the MiniArc sling.

CONCLUSION

Single-incision mini-slings are safe and effective treatment for female USI. The Solyx SIS demonstrated superiority over the MiniArc in this study based on its higher objective cure rate and lower risk for surgical failure.