Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 May 18;18(1):44.
doi: 10.1186/s12894-018-0357-0.

Adjustable single-incision mini-slings (Ajust®) versus other slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications

Fuding Bai  1 , Jimin Chen  1 , Zhewei Zhang  1 , Yichun Zheng  1 , Jiaming Wen  1 , Xiawa Mao  1 , Nan Zhang  2
Affiliations
Meta-Analysis

Adjustable single-incision mini-slings (Ajust®) versus other slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications

Fuding Bai et al. BMC Urol. .

Abstract

Background: Adjustable single-incision mini-sling (SIMS) is a new category of SIMS for stress urinary incontinence (SUI). The aim of this study was to compare the efficacy and safety of adjustable single-incision mini-sling with other slings.

Methods: Literature search in databases such as Pubmed, and Conchrane Library was performed up to December, 2015. The outcomes including cure rate, operation time, postoperative pain score and complications were reanalyzed. The pooled relative risk (RR) and mean difference (MD) with their 95% confidence interval (95% CI) were calculated by RevMan v5.0.

Results: Eight studies with 1093 SUI female patients were included. There was no significant difference between adjustable SIMS and other slings (transobturator slings and MiniArc) in patients subjective cure rate and objective cure rate. In addition, adjustable SIMS was associated with a significantly shorter operative time and lower postoperative pain score when comparing adjustable SIMS with transobturator tape (MD = - 1.35; 95%CI: -2.24 to - 0.46, P = 0.003). For the complications, there was also no significant difference between adjustable SIMS and transobturator slings.

Conclusions: Adjustable SIMS had equally efficacy for SUI compared with transobturator slings and MiniArc. However, the significantly shorter operative time and lower postoperative pain score than transobturator tape supported the clinical application of adjustable SIMS.

Keywords: Ajust; Meta-analysis; MiniArc; Single-incision mini-slings; Transobturator slings.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of study selection in the meta-analysis
Fig. 2
Fig. 2
Risk of bias assessed by the Cochrane Collaboration’s tool. a Methodological quality item of all included studies; b Methodological quality item for each included study. +: low risk of bias; “?”: unclear risk of bias; “-”: high risk of bias
Fig. 3
Fig. 3
The forest plots of meta-analysis for patients subjective cure rate and objective cure rate. a patients subjective cure rate of adjustable SIMS versus transobturator slings; b patients subjective cure rate of adjustable SIMS versus TVT-O; c patients subjective cure rate of adjustable SIMS versus MiniArc; d objective cure rate of adjustable SIMS versus transobturator slings; e objective cure rate of adjustable SIMS versus TVT-O; f objective cure rate of adjustable SIMS versus MiniArc
Fig. 4
Fig. 4
The forest plots of meta-analysis for operation details. a operation time of adjustable SIMS versus transobturator slings; b operation time of adjustable SIMS versus TVT-O; c comparison of adjustable SIMS versus TVT-O in postoperative pain score at the first day after operation; d comparison of adjustable SIMS versus TVT-O in postoperative pain score at the fourth day after operation
Fig. 5
Fig. 5
The forest plots of meta-analysis for postoperative complications. a comparison of adjustable SIMS versus TVT-O in groin pain; b comparison of adjustable SIMS versus transobturator slings in repeated continence surgery; c comparison of adjustable SIMS versus TVT-O in postoperative voiding difficulties; d comparison of adjustable SIMS versus transobturator slings in vaginal tape erosion; e comparison of adjustable SIMS versus TVT-O in vaginal tape erosion; f comparison of adjustable SIMS versus transobturator slings in de novo urgency and/or worsening of preexisting surgery; g comparison of adjustable SIMS versus TVT-O in de novo urgency and/or worsening of preexisting surgery
See this image and copyright information in PMC

References

    1. Donkelaar CST, Rosier PFWM, Kort LMOD: 990 international continence society definition of detrusor underactivity; analysis of clinical parameters and comparison with contractility grading methods. Eur Urol Suppl 2016, 15(3):e975-e975.
    1. Kavia R, Rashid T, Ockrim J. Stress urinary incontinence. J Clin Urol. 2013;6(6):377–390. doi: 10.1177/2051415813510115. - DOI
    1. Fritel X, Fauconnier A, Bader G, Cosson M, Debodinance P, Deffieux X, Denys P, Dompeyre P, Faltin D, Fatton B. Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol. 2010;151(1):14–19. doi: 10.1016/j.ejogrb.2010.02.041. - DOI - PubMed
    1. Fong ED, Nitti VW. REVIEW ARTICLE: mid-urethral synthetic slings for female stress urinary incontinence. BJU Int. 2010;106(5):596–608. doi: 10.1111/j.1464-410X.2010.09544.x. - DOI - PubMed
    1. Nilsson C, Palva K, Aarnio R, Morcos E, Falconer C. Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J. 2013;24(8):1265–1269. doi: 10.1007/s00192-013-2090-2. - DOI - PubMed

MeSH terms