title: [Place of the mini-sling in the treatment of female stress urinary incontinence].
abstract: OBJECTIVE
  Evaluate the place of sub-urethral mini-slings in the treatment of female stress urinary incontinence.
  
  
  METHODS
  Review of the literature on 43 publications (comparative and prospective studies) more than 6443 patients who underwent for the treatment of urinary incontinence, a mini-strip type TVT®, TVT-S®, MiniArc®, Ajust®, Needleless®, Solyx®, or Ophira® in comparison to the conventional urethral sling. The comparison used objective (cough stress test and pad weight test) and subjective criteria (quality of life questionnaire). The papers have also studied the complication associated with these new techniques.
  
  
  RESULTS
  The overall effectiveness of this surgery varied between 40 to 84% for TVT-S®, 69 to 92% for MiniArc®, 80 to 91% for Ajust®, 87% for Needleless®, 95% for Solyx® and 85% for Ophira®. The efficacy on incontinence was higher with the TVT® TVT-S® and the MiniArc® (P=0.01 to 0.05). TVT-O® efficacy was higher than TVT-S® (P<0.01 and P=0.02). Conventional slings seems to be more efficient than TVT-S® and MiniArc® mini-slings. Ajust® mini-sling seems to be as efficient as MiniArc® and TVT-S® mini-sling and TVT-O®. It showed a decrease in the intensity of postoperative pain (P<0.001), faster return to normal activities (P=0.025) and use of a common local anesthetic to the adjustable mini-sling.
  
  
  CONCLUSIONS
  It seems that the adjustable mini-sling is currently the best compromise in terms of effectiveness and complications if the choice had to be among the mini-sling in the treatment of stress urinary incontinence.
authors: Département de gynécologie-obstétrique, centre hospitalier Dunkerque, GCS Flandre-Maritime, avenue de la Polyclinique, 59760 Grande-Synthe, France.
authors: C
authors: C
authors: Castellier
authors: G
authors: G
authors: Doucède
authors: P
authors: P
authors: Debodinance
mesh_terms: D005260:Female; D006801:Humans; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: Chirurgie de l’incontinence urinaire; Incontinence urinaire de la femme; Mini-bandelettes sous-urétrales; Mini-slings; Single-incision mini-sling; Stress urinary incontinence; Surgery of stress incontinence