In a nutshell
This study evaluated the long-term effectiveness and complication rates of the Altis® sling (Coloplast) use in women with predominant stress urinary incontinence (SUI). The data showed favorable results for long-term safety and effectiveness, and improved quality of life (QoL) in these patients.
SUI is a common type of urinary incontinence in women that involves involuntary urine leakage during activities that require physical effort and exertion or while sneezing or coughing.
Surgical treatment options like mid-urethral slings (MUS) involve sling placement around the urethra (the tube that passes urine out of the bladder) for repositioning to prevent leaks. MUS methods include retropubic tension-free transvaginal tape (RP-TVT) and transobturator tape (TOT) procedures. RP-TVT uses a small vaginal cut and two small openings above the pubic bone. TOT uses a small vaginal cut and an opening on each side of the vaginal skin folds. These techniques are associated with bladder injury, and groin and thigh pain.
Single-incision slings (SIS) like the Altis® sling (Coloplast) are less invasive. New generation slings use shorter tape length and modified fixation and avoid hip joint muscle penetration to minimize side effects. Although there is some evidence of a high short-term success rate with SIS, limited data are available for long-term success rates.
Methods & findings
This study included 145 adult women with SUI. Altis® slings were implanted in patients. Patients were evaluated for treatment success before and after surgical treatment. The average follow-up was 8 years.
There was a 73.3% overall treatment success rate. 66.1% of patients were cured (no more urine leakage). 70.4% of patients reported that they were better or very much better.
1.5% of patients had vaginal prolapse (the top of the genital organs collapse into the vagina). 2.3% of patients had urinary obstruction (cannot pass urine out of the bladder). 15.3% of patients had new cases of urgency and 1.5% of patients had pain associated with sexual intercourse.
The bottom line
The study indicated that the Altis® sling use in women with SUI produced good results with few, mild complications and high patient satisfaction in the long-term.
The fine print
This study was based on medical record data. There was no comparison group. The last follow-up was based on a telephone interview rather than a physical evaluation. This may have influenced the results.
Published By :
International urogynecology journal
Aug 02, 2021
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