3-year follow up of a single incision sling procedure performed under local anesthesia in an office setting.
OBJECTIVES: To assess the 3-year success of placing a single-incision midurethral sling (SIMS) using the Dynamic Intraoperative Standing Sling Technique (DISST) in an office setting under local anesthesia.
METHODS: This is a prospective case series of 20 women who underwent in-office single incision midurethral sling (SIMS) procedure by the Dynamic Intraoperative Standing Sling Technique (DISST) from July 2019 to February 2020. This is an extension of our pilot study (11) and all twenty patients were evaluated at a mean follow-up of 34.3 months. Success was defined as a composite score of objective success (negative standing cough test at bladder fullness), subjective success based on the modified PGI-I score of "very much better" or "much better", and no retreatment for stress urinary incontinence. Secondary objectives were adverse events, de novo overactivity of the bladder (OAB), recurrent urinary tract infections, voiding dysfunction, pain/dyspareunia, and influence on sexual function.
RESULTS: The composite success rate was 95% (95% CI [75.1, 99.9]) at the 36-month follow-up. The significant improvement in MESA scores was maintained over the study period. There were no cases of de novo urgency, mesh exposure, post-op voiding dysfunction or recurrent UTI's. There were no cases of de novo dyspareunia.
CONCLUSIONS: Single incision midurethral slings placed by the DISST technique under local anesthesia in an office setting has shown sustained efficacy over a three year period with no decrease in cure. Subjects remained dry and reported excellent improvement in symptoms and quality of life at the 36- month follow-up visit.
Baratono J, Khandwala S, Childers K. 3-year follow up of a single incision sling procedure performed under local anesthesia in an office setting. Urology. 2023 Aug 12:S0090-4295(23)00689-1. doi: 10.1016/j.urology.2023.08.006. Epub ahead of print. PMID: 37579852.