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. 2025 Jan;36(1):135-145.
doi: 10.1007/s00192-024-05971-5. Epub 2024 Nov 13.

Effectiveness and Safety of Shorter Incontinence Slings

Kjersti Rimstad  1   2 , Sissel Hegdahl Oversand  3   4 , Marie Ellström Engh  5   6 , Rune Svenningsen  3   4   6
Affiliations

Effectiveness and Safety of Shorter Incontinence Slings

Kjersti Rimstad et al. Int Urogynecol J. 2025 Jan.

Abstract

Introduction and hypothesis: Traditional slings, tension-free vaginal tape obturator inside-out (TVT-O) and tension-free vaginal tape (TVT), have well-documented continence outcomes but can cause serious complications. This study was aimed at evaluating whether slings with less synthetic material, Ajust™ and TVT-O Abbrevo™ (TVT-A), have comparable 6- to 12-month failure and complication rates, including risk of prolonged postoperative pain, compared with traditional slings.

Methods: A registry study from the Norwegian Female Incontinence Registry (NFIR) including 611 Ajust™, 2,772 TVT-A, and 18,612 traditional slings was carried out. Preoperative, surgical, and 6- to 12-month follow-up data from the period 2009-2021 were used. Objective failure was defined as ≥ 1-g leakage on standardized cough-jump stress test. Subjective failure was defined as stress index-score ≥ 3 on a validated questionnaire. Prolonged postoperative pain was defined as lasting > 3 months.

Results: At first follow-up after 6-12 months, the groups differed significantly. Objective failure rates were as follows: Ajust™ 15.4%, TVT-A 13.5%, and traditional slings 7.3%, p < 0.01. Subjective failure rates were as follows: Ajust™ 23.4%, TVT-A 23.8%, and traditional slings 18.8%, p < 0.01. Shorter slings had fewer overall complications (Ajust™ 4.9% vs TVT-A 6.5% vs traditional slings 9.3%, p < 0.01), but did not have less prolonged postoperative pain (TVT-A: 1.4% vs Ajust™ 0.8% vs traditional slings 0.7%, p < 0.01 < 0.01). All presented outcomes remained significant after adjusting for differences at baseline.

Conclusions: Shorter slings have inferior subjective and objective continence outcomes at 6-12 months, but fewer overall complications except for prolonged postoperative pain.

Keywords: Follow-up studies; Persistent postsurgical pain; Registries; Stress urinary incontinence; Suburethral slings; Transobturator suburethral tape.

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Conflict of interest statement

Declarations. Ethics Statement: This paper is in line with the IUGA Code of Ethics and Professional Conduct. The study was approved by the Regional Committee for Medical and Health Research Ethics in the Southeast Norway (22/397503). Conflicts of Interest: K. Rimstad: no conflicts of interest; S.H. Oversand: part-time position (20%) at the Norwegian Female Incontinence Registry; M.E. Engh: no conflicts of interest; R. Svenningsen: speaker fees from Astellas and a part-time (10%) position at the Norwegian Female Incontinence Registry.

Figures

Fig. 1
Fig. 1
Flow chart of exclusion criteria FAST 1. (NFIR Norwegian Female Incontinence Registry, TOT outside-in transobturator tape, TVT-O tension-free vaginal tape obturator, TVT-A TVT-O Abbrevo™). TVT and TVT-O were grouped together as traditional slings
See this image and copyright information in PMC

References

    1. Ford AA, Rogerson L, Cody JD, Aluko P, Ogah JA. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7):CD006375. - PMC - PubMed
    1. Ebbesen MH, Hunskaar S, Rortveit G, Hannestad YS. Prevalence, incidence and remission of urinary incontinence in women: longitudinal data from the Norwegian HUNT study (EPINCONT). BMC Urol. 2013;13:27. - PMC - PubMed
    1. Charalambous STA. Impact of urinary incontinence on quality of life. Pelviperineology. 2009;28:51–3.
    1. Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol. 1995;29(1):75–82. - PubMed
    1. Delorme E, Droupy S, de Tayrac R, Delmas V. Transobturator tape (Uratape): a new minimally-invasive procedure to treat female urinary incontinence. Eur Urol. 2004;45(2):203–7. - PubMed

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