Efficacy of needle retractor device in single-incision slings for treatment of stress urinary incontinence

Single-incision slings demonstrated overall similar effectiveness and less pain and recovery time compared to standard tapes. Efficacy rates vary widely among different commercial kits and may be affected by device characteristics. The aim was to evaluate the impact needle removal device of single-incision sling on objective, subjective and functional outcomes.

This was a retrospective study. Single-incision sling without needle removal device (group A) were compared to same single-incision sling with needle removal device (group B) in terms of complications, objective, subjective and functional outcomes.

A total of 191 patients were analyzed: 51 in group A and 140 in group B. Estimated blood loss, operative time and overall complications were not different. No bladder perforation or other intraoperative complications were observed. At 12- months follow-up visit objective cure rate resulted similar irrespective of the presence of the needle retractor lever (Group A=84.3%, Group B=87.1%; p=.61). Subjective outcomes evaluated as International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score, ICIQ-SF score improvement and Patient Global Impression of Improvement score were similar between groups. De novo onset of overactive bladder syndrome resulted more frequent in Group A (Group A=19.6%, Group B=7.9%; p=.02) while voiding symptoms were reported without differences between groups.

The current study showed that the presence of a needle retractor device to avoid unintentional tip displacement for single-incision sling had no impact on objective and subjective postoperative continence. However, a reduced rate of de novo overactive bladder syndrome was observed after implantation of single-incision sling with needle retractor.

Minerva ginecologica. 2018 Sep 26 [Epub ahead of print]

Stefania Palmieri, Stefano Manodoro, Alice Cola, Federico Spelzini, Rodolfo Milani, Matteo Frigerio

ASST Monza, San Gerardo Hospital, Monza, Italy., AUSL Romagna, Infermi Hospital, Rimini, Italy - ., AUSL Romagna, Infermi Hospital, Rimini, Italy.