ABSTRACT
Objectives: The aim of this thesis is to determine the clinical effectiveness, safety
and cost-effectiveness of Single Incision needleless Mini-Slings compared with
tension-free Standard Mid-urethral Sling in the surgical management of female
stress urinary incontinence, but with less side effects. Methods: The
study will be conducted in Zagazig University Hospitals. From 2018 to Sept.
2019, 40 cases were enrolled in the study and were randomized by envelope
technique at the time of surgery to either a trans-obturator vaginal tape (TOT)
or Needleless anti-incontinence procedure. The patients will be divided into 2
groups: Group 1 patient treated by standard sling (TOT). Group 2 those treated
by mini-sling. Parameters in perioperative period such as operating time,
intraoperative hemorrhage volume, length of stay in hospital, intraoperative
complications, and postoperative pain of each patient were recorded. The sample
size was calculated to be 40 cases (20 cases will be treated by standard
slings, 20 case will be treated by mini-sling). Results: A total of 40
patients assessed for eligibility were randomized into Needleless groups. There
were no significant differences in age, body mass index, process, parity, pad
test or the assessment of preoperative quality of life between the two groups.
In the perioperative period, statistically significant differences between the
two groups were found in operating time, intraoperative hemorrhage volume,
groin pain scores at 24 h after operation and length of stay in hospital (P
< 0.001). After two weeks of follow-up, a statistically significant
difference between the two groups was found in groin pain/femori-bus internus
pain scores, but there were no significant differences in cure rates, pad test,
complications or ICIQ-SF. After 1 year, there were no significant differences
between the Needleless and TOT groups in cure rates, pad test, groin pain or
ICIQ-SF (P > 0.05). Both groups registered a significant improvement in the
quality of life (P < 0.001), but there were no significant differences
between the two groups (P > 0.05). Conclusion: We conclude that
compared with the TOT surgery, single-incision Needleless sling in the
treatment of female stress urinary incontinence is simpler and quicker and has
less hemorrhage during surgery as well as faster recovery and it also can
obviously reduce the inguinal region pains after operation and shorten hospital
stays. In summary, single-incision Needleless sling is a kind of convenient,
safe and effective minimally invasive surgery for urinary incontinence.