Comparing single-incision and transobturator slings in women with stress incontinence and intrinsic sphincter deficiency

This study compared the effectiveness and safety of single-incision slings (SIS) and transobturator slings (TOS) in women with stress urinary incontinence (SUI) and sphincter deficiency. Researchers suggested that SIS and TOS had similar surgical outcomes in these patients.

SUI is common in adult women. It involves the leakage of urine from the bladder due to the pressure that certain physical movements such as coughing, sneezing, and exercising put on the bladder. Sling procedures are treatments for SUI that help keep closed the bladder neck.

The bladder sphincter is a small muscle that guards or closes the bladder. Sphincter deficiency happens when this muscle is unable to put enough closing pressure to retain urine in the bladder. Patients with SUI and sphincter deficiency have a more severe type of disorder and have a higher risk of sling failure.

SIS consists of applying a tape or mesh beneath the urethra (urinary tube) through a vaginal opening. This will support the bladder and stop the leakage of urine. TOS consists of the same procedure but applied through the obturator muscle (in the pelvis area).

Prior studies showed the effectiveness of both SIS and TOS. However, it is still not clear which treatment is best for women with SUI and sphincter deficiency.

This study included information about 109 patients. Of these, 37 underwent SIS, and 72 underwent TOS. The main outcomes measured were cure rates and side effects. The average follow-up time was 21 months for SIS and 24 months for TOS.

For both groups, the SUI symptoms improved after surgery. The cure rate of women treated with SIS or TOS was 76% in both groups. 

There were no significant differences in side effects between both treatments. However, SIS was associated with a shorter surgery time (16.4 minutes) when compared to TOS (27.3 minutes). Also, SIS was associated with decreased pain after surgery.

This study concluded that both SIS and TOS have similar functional outcomes in women with SUI and sphincter deficiency.

This study was based on medical records and therefore data might be missing. Moreover, this study included a limited number of participants. Further randomized studies with a bigger population are needed.