Intraoperative adjustable sub-urethral mini-sling in patients with stress urinary incontinence

Stress urinary incontinence (SUI) occurs in 20–30% of young women and 40% of elderly and senile women, which causes a significant decline in the quality of life of these patients. Despite the application of various operative techniques, the recurrence rate is high, and the question of ensuring long-term positive outcomes of intervention and reducing the risk of postoperative complications remains open. Objective. To study the efficacy and safety of the developed original technique for surgical treatment of SUI in women of reproductive, pre- and postmenopausal ages using a sub-urethral mini-sling made of mesh “titanium silk” with bilateral fixation and intraoperative regulation of loop tension. Patients and methods. The results of treatment of 15 patients with SUI aged 36–72 years using the original technique – Timesh-ligature sub-urethral mini-sling with intraoperative regulation of loop tension and bilateral fixation – were examined. Dynamic follow-up was carried out within 6–36 months. Results. Comprehensive clinical examination in early and late postoperative periods revealed complete absence of SUI in all patients. Gynecological examination, transperineal and transvaginal ultrasound showed no displacement of pelvic organs and titanium implant. There were no Mesh-associated complications during the follow-up period. Conclusion. The original technique – Timesh-ligature sub-urethral mini-sling with bilateral fixation and intraoperative regulation of loop tension – increases the efficacy of surgical treatment of SUI in women, reduces the risk of Mesh-associated complications and disease recurrences. Key words: stress urinary incontinence in women, surgical correction, intraoperative adjustable sub-urethral mini-sling, early and late postoperative outcomes