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Introduction and Hypothesis <p>This study assesses the efficacy of the single-incision sling (SIS) versus the retropubic (RP) sling for women with urodynamic stress&#xa0;incontinence and intrinsic sphincter deficiency (ISD) - mini RISD.</p> Methods <p>This was a multicenter randomized trial of women with stress urinary incontinence (SUI) and ISD. The primary outcome was objective cure rate (negative clinical cough-stress test) at 6 and 12&#xa0;months. The secondary outcomes were immediate and short-term complications and patient-reported outcomes at 6 and 12&#xa0;months based on the International Consultation on Incontinence Urinary Incontinence Short Form, International Consultation on Incontinence Overactive Bladder, and Patient Global Impression of Improvement.</p> Results <p>Between 2016 and 2022, a total of 112 eligible women were randomized: 58 received an RP sling and 54 received an SIS. All 112 women (100%) had a 6-month follow-up, and 108 women (96%) completed a 12-month follow-up. At 12&#xa0;months, there was no difference in the objective and subjective cure rates. 74% in the SIS and 69% in the RP group reported improvement as “very much better or much better” (relative risk 0.91 [95% CI 0.62–1.3], <i>p</i> = 0.63). There was no difference in the post-operative complications. However, one SIS was removed for groin pain associated with pre-pubic placement; a further 2 patients in the RP group and 1 in the SIS group had sling loosening and 1 in the SIS group had sling division. Overall repeat surgery was RP sling for 2 women with recurrent SUI and 1 mesh excision for exposure in the RP group. Five women had repeat continence surgery (4 RP sling and 1 fascial sling) in the SIS group.</p> Conclusions <p>For women with intrinsic sphincter deficiency, both RP slings and SIS had high success rates, with low complication rates at 12&#xa0;months.</p>

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Mini or Retropubic Sling in Women with Intrinsic Sphincter Deficiency at 12 Months—A Randomized Controlled Trial (Mini RISD)

  • 期刊论文

  • 发表日期：

    2025年11月29日

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  • Lin Li Ow,
  • James Wood Alexander,
  • Alison Leitch,
  • Christine Murray,
  • Joseph Lee,
  • Peter L. Dwyer,
  • Anna Rosamilia

摘要

Introduction and Hypothesis

This study assesses the efficacy of the single-incision sling (SIS) versus the retropubic (RP) sling for women with urodynamic stress incontinence and intrinsic sphincter deficiency (ISD) - mini RISD.

Methods

This was a multicenter randomized trial of women with stress urinary incontinence (SUI) and ISD. The primary outcome was objective cure rate (negative clinical cough-stress test) at 6 and 12 months. The secondary outcomes were immediate and short-term complications and patient-reported outcomes at 6 and 12 months based on the International Consultation on Incontinence Urinary Incontinence Short Form, International Consultation on Incontinence Overactive Bladder, and Patient Global Impression of Improvement.

Results

Between 2016 and 2022, a total of 112 eligible women were randomized: 58 received an RP sling and 54 received an SIS. All 112 women (100%) had a 6-month follow-up, and 108 women (96%) completed a 12-month follow-up. At 12 months, there was no difference in the objective and subjective cure rates. 74% in the SIS and 69% in the RP group reported improvement as “very much better or much better” (relative risk 0.91 [95% CI 0.62–1.3], p = 0.63). There was no difference in the post-operative complications. However, one SIS was removed for groin pain associated with pre-pubic placement; a further 2 patients in the RP group and 1 in the SIS group had sling loosening and 1 in the SIS group had sling division. Overall repeat surgery was RP sling for 2 women with recurrent SUI and 1 mesh excision for exposure in the RP group. Five women had repeat continence surgery (4 RP sling and 1 fascial sling) in the SIS group.

Conclusions

For women with intrinsic sphincter deficiency, both RP slings and SIS had high success rates, with low complication rates at 12 months.