Mini-Arc for the Treatment of Female Stress Urinary Incontinence: Long-Term Prospective Evaluation by Patient Reported Outcomes

Single-incision slings were introduced in the surgical treatment of female stress urinary incontinence (SUI) to lessen the morbidity associated with traditional midurethral slings. However, long-term reports on patient satisfaction are still scarce. This study describes the outcome of women treated with Mini-Arc at a mean follow-up of 45 months. In a previous report on 105 women with 15-month mean follow-up, 84 (80%) were found cured and 12 (11%) improved. Now, with a mean follow-up of 45 months, cured/improved patients were reassessed by telephone and completed Patient Global Impression of Improvement (PGI-I), Patient Global Impression of Severity (PGI-S), rated their improvement in a 0–100 scale, and answered if they would recommend the procedure. At 45-month follow-up, 73 women cured/improved were available for evaluation. Over 80% of the cured patients rated the improvement of SUI by the PGI-I as “very much better” or “much better,” reported their urinary tract condition to be “normal” on PGI-S, and described their improvement >70%. Ninety percent would recommend this procedure to a friend. The improved-patient population is very small . This study shows that the majority of patients cured/improved after Mini-Arc placement maintain a high degree of satisfaction at a long-term evaluation. 1. Introduction According to the European Association of Urology Guidelines on Urinary Incontinence, concerning the treatment of female stress urinary incontinence (SUI), the retropubic insertion of a midurethral synthetic sling (MUS) gives equivalent patient-reported cure of SUI at 12 months, when compared to colposuspension [1]. These guidelines also report that midurethral synthetic sling inserted by either the transobturator (TO) or retropubic (RP) route gives equivalent patient-reported outcome at 12 months [1]. With an obvious trending towards less and less invasive surgical options, single-incision vaginal slings (SIS) have emerged. They require very limited intracorporeal dissection, proposing to further increase safety of suburethral slings, without jeopardizing the success rates reported by conventional RP and TO access [2]. These SIS outcomes are comparable with conventional MUS at short-term follow-up [3–5]. Although sparse, two-year follow-up studies are available and seem to maintain steady success rates over this time [6, 7]. Longer follow-up time reports are needed, to ensure that, in the long run, these SIS offer constant success rates. The objective of this study is to describe the outcome of women treated with Mini-Arc at a mean follow-up of 45