Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Obstetrics and Gynaecology Department, Ayrshire & Arran NHS, Ayrshire; Obstetrics and Gynaecology Department, Borders General Hospital, Melrose; Obstetrics and Gynaecology Department, Greater Glasgow Health Board, Glasgow; Obstetrics and Gynaecology Department, NHS Lanarkshire, Wishaw, UK.
Study Type - Therapy (individual cohort) Level of Evidence 2b.
What's known on the subject? and What does the study add? A number of SIMS have been introduced into clinical practice in 2006 and has been so far shown to be inferior to standard mid urethral-slings. Adjustable SIMS (Ajust) have been recently introduced into clinical practice however with little evidence on its safety and efficacy in surgical treatment of female SUI. SIMS-Ajust® is associated with low rates of postoperative pain and peri-operative morbidity and is both feasible and acceptable under local anaesthesia. The patient reported success rate at 1-year is 80%.
To determine whether an adjustable single-incision mini-sling (SIMS, Ajust® ) is safe and effective in the management of female stress urinary incontinence (SUI) at 12 months follow-up. To determine whether it is feasible to be performed under local anesthesia (LA).
The present study is a multicentre prospective cohort study in which 90 female patients underwent SIMS-Ajust® using a standardized insertion technique. The last 45 women were offered the procedure under LA. All patients completed their 12-month follow-up.
The patient-reported success rate, using Patient Global Impression of Improvement (PGI-I), was 80% at 12 months follow-up and a further 6% (n= 5) reported themselves to be 'improved'. In all, 32/45 (71%) patients agreed to undergo the procedure under LA while one patient required conversion to general anaesthetic. There was no organ damage or requirement for blood transfusion. Significantly lower rates of blood loss (P= 0.025) and postoperative voiding difficulties (P= 0.026) were seen in the LA group. The re-operation rate for SUI was 6% at 12 months.
SIMS (Ajust) appears to be a safe procedure, which is feasible under LA. SIMS (Ajust) have an 80% patient-reported success rate at 12 months follow-up.
Written by:
Abdel-Fattah M, Agur W, Abdel-All M, Guerrero K, Allam M, Mackintosh A, Mostafa A, Yousef M. Are you the author?
Reference: BJU Int. 2011 Aug 26. Epub ahead of print.
doi: 10.1111/j.1464-410X.2011.10471.x
PubMed Abstract
PMID: 21883844
UroToday.com Stress Urinary Incontinence Section
