PMID- 37214065
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230523
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 4
DP  - 2023 Apr
TI  - Single Incision Mini-Sling Versus Mid-Urethral Sling (Transobturator/Retropubic) 
      in Females With Stress Urinary Incontinence: A Systematic Review and 
      Meta-Analysis.
PG  - e37773
LID - 10.7759/cureus.37773 [doi]
LID - e37773
AB  - Stress urine incontinence (SUI) is most common in middle-aged women and the 
      second most common in those over 75. SUI causes significant discomfort and 
      suffering for patients and has a considerable financial impact on the healthcare 
      system. Conservative approaches are recommended as the first step in treatment. 
      However, surgery is often necessary to improve a patient's quality of life due to 
      the high failure rate of conservative treatments. A thorough literature review of 
      studies published before March 2023 was conducted on the safety and effectiveness 
      of single-incision mini slings (SIMS) and standard mid-urethral slings (MUS). 
      PubMed, Embase, Cochrane Library, and Elsevier's ScienceDirect were used to 
      retrieve the studies. Two reviewers independently searched and evaluated the data 
      based on inclusion and exclusion criteria. Review Manager 5.4 software was used 
      for meta-analysis. Included were seventeen studies involving 3,503 female SUI 
      patients without intrinsic sphincter deficiency (ISD) or mixed urinary 
      incontinence. According to the results of our meta-analysis, the clinical 
      efficacy of SIMS is comparable to that of MUS in terms of objective cure rate 
      (RR: 0.99; 95% CI: 0.95 to 1.03, p: 0.66, I2: 29%). In contrast, it increases the 
      post-procedure International Consultation on Incontinence Questionnaire (ICIQ) 
      score (WMD: 0.08; 95% CI: -0.08 to 0.08). CI: -0.02 to 0.18, p: 0.11, I2: 55%) 
      and improves the PGI-I score to a greater extent (RR: 1.04; 95% CI: 0.96 to 1.08, 
      p: 0.36, I2: 76%). In contrast, there is no difference between the two groups 
      regarding patient satisfaction (RR: 0.96; 95% CI: 0.92 to 1.01, p: 0.16, I2: 0%) 
      and Sandvik score reduction (RR: 0.98; 95% CI: 0.94 to 1.02, p: 0.35, I2: 0%). In 
      conclusion, single-incision mid-urethral slings (SIMS) are as effective as 
      mid-urethral slings (MUS) for treating pure stress urinary incontinence (SUI) 
      without intrinsic sphincter deficiency (ISD), with a shorter operation time. 
      However, the SIMS procedure has a higher incidence of dyspareunia. At the same 
      time, bladder perforation, mesh-related complications, pelvic/groin pain, urinary 
      tract infection (UTI), worsening urgency, dysuria, and pain score are less likely 
      to occur with SIMS. Only the decrease in pelvic/groin pain was statistically 
      significant.
CI  - Copyright (c) 2023, Patel et al.
FAU - Patel, Tirath
AU  - Patel T
AD  - Surgery, American University of Antigua, St John, ATG.
FAU - Sugandh, Fnu
AU  - Sugandh F
AD  - Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK.
AD  - Medicine, Civil Hospital Karachi, Sukkur, PAK.
FAU - Bai, Shuaita
AU  - Bai S
AD  - Medicine and Surgery, Peoples University of Medical & Health Science, Nawabshah, 
      PAK.
FAU - Varrassi, Giustino
AU  - Varrassi G
AD  - Pain Medicine, Paolo Procacci Foundation, Rome, ITA.
FAU - Devi, Anjuli
AU  - Devi A
AD  - Medicine and Surgery, Ziauddin University, Karachi, PAK.
FAU - Khatri, Mahima
AU  - Khatri M
AD  - Medicine and Surgery, Dow University of Health Sciences, Karachi, Karachi, PAK.
FAU - Kumar, Satesh
AU  - Kumar S
AD  - Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, 
      PAK.
FAU - Dembra, Deepak
AU  - Dembra D
AD  - Surgery, Ghulam Muhammad Mahar Medical College, Sukkur, PAK.
FAU - Dahri, Samiullah
AU  - Dahri S
AD  - Medicine, Dow University of Health Sciences, Karachi, PAK.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230418
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10194431
OTO - NOTNLM
OT  - mid-urethral sling
OT  - sims
OT  - single incision mini-sling
OT  - stress urinary incontinence
OT  - sui
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/05/22 13:04
MHDA- 2023/05/22 13:05
PMCR- 2023/04/18
CRDT- 2023/05/22 12:06
PHST- 2023/03/31 00:00 [received]
PHST- 2023/04/18 00:00 [accepted]
PHST- 2023/05/22 13:05 [medline]
PHST- 2023/05/22 13:04 [pubmed]
PHST- 2023/05/22 12:06 [entrez]
PHST- 2023/04/18 00:00 [pmc-release]
AID - 10.7759/cureus.37773 [doi]
PST - epublish
SO  - Cureus. 2023 Apr 18;15(4):e37773. doi: 10.7759/cureus.37773. eCollection 2023 
      Apr.