EVALUATION OF NEEDLELESS MIDURETHRAL MINI-SLING PROCEDURE IN MANAGEMENT OF FEMALE STRESS URINARY INCONTINENCE
Nader Adel Abdel-Sattar, Ahmed Fahim Abdelrahim and Gamal Ibrahim Selmy
Urology Department, Faculty of Medicine. Al-Azhar University
Objective: To evaluate needleless Mini-Sling procedure in treatment of female SUI, As regards; safety and efficacy by subjective and objective measures. Patients and methods: Forty four adult female patients presenting to outpatient clinic of Al-Azhar University Hospitals from January 2016 to June 2018 with stress urinary incontinence or mixed urinary incontinence with predominant stress. Pregnancy, neurological insult that may affect continence of urine, patients with advanced uterine or vaginal prolapse, postmicturition residual volume >100 ml, overactive bladder, hypocompliant bladder, and patients with bladder pathology (Contracted bladder or stone) were excluded. Pre- and postoperative evaluation included subjective assessment of International Consultation on Incontinence Questionnaire - Urinary Incontinence - Short Form (ICIQ-UI-SF), ultrasound and urodynamic studies when necessary. Surgical outcomes and complications were evaluated Results: The mean age of included women was 44.73±8.50 years. The subjective cure rate for minisling procedure increased from 84.1% at 1 week to 88.6% at 12 months, which was associated with an increase in the objective cure rate from 93.2% at 1 week to 95.5% at 12 months. Regarding adverse outcomes, 3 patients developed de novo voiding difficulty, all resolved on medical treatment by 3 months after surgery. There were 6 cases of de-novo urge incontinence, all resolved on medical treatment by 6 months after surgery. There was one case of vaginal mesh erosion managed by surgical debridement and rectus fascial sling. Conclusion: This technique is simple, safe, effective, and economical for treating SUI.