Which type of surgery is best for stress urinary incontinence?

This study compared single-incision mini slings (SIMS) and transobturator slings (TOT) for the management of stress urinary incontinence. Results from this study show that transobturator slings provided better outcomes than single-incision mini slings.

Stress urinary incontinence (SUI) defined as the uncontrolled leakage of urine, from coughing, or sneezing. SUI is a condition that can lower the quality of life by increasing urination frequency. One of the main forms of treatment for SUI is surgery. There are a number of different surgical procedures, but transobturator slings (TOT) are considered to be the most effective. However, there have also been complications with TOT that have led to pain and damage to the pelvic area. Single-incision mini slings (SIMS) were created to provide the same positive outcomes as TOT, but reduce the associated risks. To date, there have been very few studies comparing the outcomes of SIMS to TOT, and there is still debate about which procedure is better.

Over a three year period, this study followed 130 women who received either a SIMS or TOT. Study participants were over the age of 18, and did not have other significant medical issues. Success was measured by the lack of urination upon coughing, patient reported satisfaction, and quality of life scales.

After three years 82 patients, 41 with TOT and 41 with SIMS, completed the study. It was found that women who had the TOT (90%) had better control of stress urinary incontinence upon coughing than women who had SIMS (68%). Women in the TOT group also had significantly higher quality of life than women in the SIMS group. Overall satisfaction was similar between the two groups.

This study found that TOT objectively provided better relief for stress urinary incontinence than SIMS, but satisfaction rates were similar between the two groups.

This research project had a large number of individuals drop out, which could have led to errors in results. This study ran statistic tests to account for these errors, but they may not have been accurate.

Consult your physician about different types of treatment for stress urinary incontinence.