[Mini-sling for management of stress urinary incontinence in women: a literature review]

Abstract

Aim: To conduct a review about the use of single incision mini-slings (SIMS) to manage non-neurogenic stress urinary incontinence in women.

Methods: Literature search in Pubmed/MEdline database until june 2013. TVT-Secur™ was excluded because this device is not anymore marketed.

Results: Ajust™ and Mini-Arc™ were the two main SIMS evaluated in the literature. Studies about Mini-Arc™ generated heterogeneous results, with a success rate between 44% and 91% after 1 year. Ajust™ was the most promising device with 80% efficacy after mid-term follow-up. All evaluated SIMS had a low rate of immediate complications. Two randomized controlled trials comparing SIMS and traditional mid-urethral slings were identified, as well as one meta-analysis; they all concluded to non-superiority or inferiority for the mini-sling versus traditional slings.

Conclusion: Due to short follow-up, limited evidence and heterogeneous data, SIMS are not yet standard of care and further research is warranted.

Keywords: Anesthésie locale; Incontinence urinaire d’effort; Literature review; Local anesthesia; Mini-bandelettes; Mini-slings; Revue de la littérature; Single vaginal incision.