Mini-slings noninferior to mid-urethral slings for stress urinary incontinence in women

Single-incision mini-slings are noninferior to mid-urethral slings for women with stress urinary incontinence, according to a study published in the March 31 issue of the New England Journal of Medicine.

Mohamed Abdel-Fattah, M.D., from the University of Aberdeen in the United Kingdom, and colleagues compared mini-slings to mid-urethral slings among women at 21 U.K. hospitals during 36 months of follow-up in a pragmatic, noninferiority, randomized trial. A total of 298 women were randomly assigned to receive mini-slings and 298 were randomly assigned to mid-urethral slings.

The researchers found that success was reported by 79.1 and 75.6 percent of patients in the mini-sling and mid-urethral sling groups, respectively, at 15 months (adjusted risk difference, 4.6 percentage points; 95 percent confidence interval [CI], −2.7 to 11.8; P < 0.001 for noninferiority). Success was reported by 72 and 66.8 percent of patients, respectively, at the 36-month follow-up (adjusted risk difference, 5.7 percentage points; 95 percent CI, −1.3 to 12.8). The percentage of patients with groin or thigh pain at 36 months was 14.1 and 14.9 percent for those with mini-slings and mid-urethral slings, respectively; the percentage with tape or mesh exposure was 3.3 and 1.9 percent, respectively, during the 36-month follow-up. The groups had similar outcomes with respect to quality of life and sexual function, apart from dyspareunia, which was reported by 11.7 and 4.8 percent in the mini-sling and mid-urethral sling groups, respectively.

"Adjustable anchored mini-slings were noninferior to tension-free mid-urethral slings with respect to patient-reported success at 15 months, and the between-group difference remained similar at 36 months," the authors write.

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