Mini-sling Ophira in treatment of stress urinary incontinence: experience of the Urology Clinic of A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Abstract

Background: The invention of the sling interventions in urology made a big step forward in the cure of stress urinary incontinence. Nevertheless, with high success outcomes came high rates of complications, that requested evolvement of urologists’ surgical skills. Therefore, a decrease of interaction with a tissue can provide a less damaging effect and sustainable effect of the mid-urethral sling surgery. This study evaluates the effectiveness of the most commonly used mini-sling Ophira in our practice. Methods: The study included patients who underwent this surgical intervention in the period from February 2010 to July 2012. A total of 68 patients took part in the study. The mean age of the patients was 58,7 years (range, 31–85 years). All patients were invited for follow-up visits: 1 month, 1 year after surgery. Results: After 1 month after surgery, a negative cough test was recorded in 58 patients (85.3%). Fifty-nine patients (86.8%) had no residual volume. 3 patients (4.4%) reported pelvic pain after surgery. In 5 patients (7.4%), signs of overactive bladder appeared. 49 patients (72.1%) were pleased with the result of the surgery, 13 patients (19.1%) were satisfied with the results of the surgery, 6 patients (8.8%) were dissatisfied with the results of treatment. After 12 months after the surgery, a negative cough test was observed in 55 patients (87.3%). We did not observe any recurrence of urinary incontinence. Two patients (3.2%) had a residual volume of fewer than 100 mL. Two patients (3.2%) had overactive bladder syndrome. 1 patient (1.6%) still had pelvic pain. 50 patients (79.4%) were pleased with the result of the surgery, 9 patients were satisfied with the treatment results (14.3%), 4 patients (6.3%) were dissatisfied with the treatment results. Conclusions: This tape can be implanted in patients with recurrent urinary incontinence after previous surgeries, where obturator or retropubic route was used. With the right choice of patients for this operation, adequate preoperative assessment, and planning, as well as direct performance of the intervention according to its steps, mini-sling Ophira provides high success efficiency and a low rate of complications in the surgical treatment of stress urinary incontinence.