Comparative effectiveness of adjustable and non-adjustable synthetic slings in female stress urinary incontinence.

Introduction. Stress incontinence is the most common type of urinary incontinence in women, the gold standard for surgical treatment of which is the installation of synthetic mesh endoprostheses. However, the failure rate reaches 10-15% and urinary incontinence or obstructive uropathy recurs. In this regard, it is promising to install adjustable slings, which allows you to change the degree of tension of the loop in the early postoperative period, preventing the development of complications. Purpose. To compare the effectiveness of non-adjustable and adjustable mesh endoprostheses in women with stress urinary incontinence in terms of effectiveness and safety. Materials and methods. The study was prospective, non-randomized. Women with stress urinary incontinence. Groups were formed based on the type of urethral sling used. The first group included 40 patients who had a non-adjustable mesh endoprosthesis installed using a transobturator approach. The second group – 42 women with an adjustable sling. In the postoperative period, a comparative assessment of the treatment effectiveness of both methods was carried out. Results. The success rate of using a non-adjustable sling was 85,0%. The use of an adjustable endoprosthesis demonstrated higher efficiency, in 97,6% the desired result was achieved (р=0,04), in 10 cases, adjustment of the prosthesis was required in the postoperative period, in one patient (2,4%) the adjustment had no effect and reinstallation of the loop was required. Conclusion. The data obtained prove that the ability to adjust the degree of tension of the loop in the early postoperative period significantly increases the percentage of successful treatment cases, reducing the likelihood of repeated surgical interventions.