Single Incision Mini-sling versus Trans- Obturator mid urethral Sling (TOT) in Treatment of Stress Urinary Incontinence: Randomized Controlled Trail

Abstract

The International Continence Society (ICS) define the stress urinary incontinence as any involuntary leakage of urine during increase abdominal pressure in absence of detrusor contraction or an over distended bladder, e.g.; (during cough, sneezing, laughing, or lifting heavy objects). This study was conducted at Ain-shams maternity hospital on 100 patients with genuine stress urinary incontinence (SUI) diagnosed by urodynamic. They were divided by randomization into two groups: Each group included 50 patients, Group I with SIMS done for them by using surgeon tailored mesh from mesh used in herniorrhaphy and Group II with TVT-O done for them. Our aim in this study was to compare single incision mini sling (SIMS) and trans-obturator suburethral tape (TVT-O) for surgical treatment of genuine stress urinary incontinence (SUI) as regard success rate and complications after six month follow up. All patients were subjected to complete history taking, general and gynecological examination, urodynamic tests, urine analysis, urine culture, random blood sugar, stress test, PVR measurement, quality of life (QoL) questionnaire. Postoperative evaluation was carried out after 1, 3 and 6 months. Cure is defined objectively by the negative stress test in the lithotomy position and subjectively by a satisfaction question. Improvement is defined as ≥50% decrease in symptoms based on the questionnaire’s results. The SIMS operation had a shorter surgical duration, less intraoperative bleeding, less post-operative pain and less post-operative hospital stay than the TVT-O.