Comparison of clinical efficacy and urodynamic changes using single-incision slings (MiniArc® vs. Solyx™) for the treatment of female stress urinary incontinence
Fook Chin Chiang1, Ryan Sun2, Yu- Jun Chang3, Yi- Ing Li4, Mou- Jong Sun5
1 Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Changhua Christian Hospital, Changhua; Department of Obstetrics and Gynecology, Cheng Ching Hospital, Taichung, Taiwan
2 Department of Surgery, Section of Urology, University of Manitoba, Winnipeg, Canada
3 Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan
4 Center for Urinary Incontinence and Voiding Dysfunction, Changhua Christian Hospital, Changhua, Taiwan
5 Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Changhua Christian Hospital; Center for Urinary Incontinence and Voiding Dysfunction, Changhua Christian Hospital, Changhua, Taiwan
Dr. Mou- Jong Sun
No. 135, Nanxiao Street, Changhua City, Changhua County 500
Source of Support: None, Conflict of Interest: None
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 n = 79, BS-Solyx n = 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 (P = 0.042). No significant difference in subjective cure rates (93.7% vs. 90.2% at 3-months (P = 0.513); 89.9% vs. 80.4% at 1 year for Solyx and MiniArc patients, respectively (P = 0.126)) and improvement scores in UDI-6 and IIQ-7 were observed. The Solyx group incurred more de novo urgency (17.6% vs. 6.3% at 3 months (P = 0.042); 23.5% vs. 7.6% at 1 year (P = 0.01)). Both procedures yielded significant decrements in maximal urethral closure pressure (P < 0.001) and average flow rate (P = 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, P = 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.