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I-Stop® for Treatment of Stress Urinary Incontinence: High Satisfaction Rate and Low Morbidity

Received: 15 June 2021     Accepted: 29 June 2021     Published: 9 July 2021
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Abstract

Objective: The objective of this study was to investigate patient satisfaction and stress urinary incontinence (SUI) cure rates in females who underwent a midurethral I-Stop® sling insertion. It is well established in current literature that midurethral sling insertion is a highly efficacious treatment for female SUI. The challenge with sling insertion is to find a product that addresses SUI caused by both urethral hypermobility and intrinsic sphincter deficiency (ISD). Thus, this study aims to highlight the success of an I-Stop® midurethral slings for treatment of SUI in females with ISD and urethral hypermobility, while demonstrating low patient morbidity. Methods: Three hundred females who underwent midurethral I-Stop® sling insertion from August 2011 through December 2019 were included in this retrospective chart review. Females with diagnosed SUI and ISD were included in this study. Females with ISD underwent retropubic sling insertion approach while all other patients diagnosed with SUI underwent a transobturator (TO) approach. Patients scheduled follow-up visits 2-, 6-, 12-, and 24-weeks post-procedure and then yearly thereafter. Statistical analysis was completed with a paired t-test. Results: This retrospective review yielded 300 females who underwent sling insertion with a mean age of 66.6 years and median follow up of 37 months. Satisfaction rate was rated 4 or 5 on a 5-point Likert scale by 91.7% of patients, and SUI correction rate was 95%. Highest satisfaction rates were reported by patients in the 65–75-year-old age group. No statistical significance was identified between any of the variables analyzed with the exception of reported SUI after sling insertion and satisfaction rate, p=0.048. Nine patients (3.0%) required sling lysis secondary to inability to void or difficulty voiding resulting in elevated post-void residual values >200cc. Ten patients had sling exposure requiring revision. No vaginal, urethral, or vesical perforations, and no persistent pain post-procedure was reported. Conclusion: Midurethral I-Stop® sling insertion results in high patient satisfaction and SUI cure rates while maintaining low post-operative complications.

Published in International Journal of Clinical Urology (Volume 5, Issue 2)
DOI 10.11648/j.ijcu.20210502.11
Page(s) 58-63
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Stress Urinary Incontinence, Midurethral Sling, Incontinence, Transobturator Sling, Retropubic Sling

References
[1] Sivaslioglu AA, Unlubilgin E, Aydogmus S, et al. A prospective randomized controlled trial of the transobturator tape and tissue fixation mini-sling in patients with stress urinary incontinence: 5-year results. J Urol. 2012; 188 (1): 194-199.
[2] Ross S, Tang S, Eliasziw M, et al. Transobturator tape versus retropubic tension-free vaginal tape for stress urinary incontinence: 5-year safety and effectiveness outcomes following a randomised trial. Int Urogynecol J. 2016; 27 (6): 879-886.
[3] Krauth JS, Rasoamiaramanana H, Barletta H, et al. Sub-urethral tape treatment of female urinary incontinence--morbidity assessment of the trans-obturator route and a new tape (I-STOP): A multi-centre experiment involving 604 cases. Eur Urol. 2005; 47 (1): 102-107.
[4] Considerations about surgical mesh for SUI. fda.gov. https://www.fda.gov/medical-devices/urogynecologic-surgical-mesh-implants/considerations-about-surgical-mesh-sui. Updated April 16, 2019. Accessed February 21, 2021.
[5] Nazemi TM, Kobashi KC, Govier FE. Synthetic sling options for stress urinary incontinence. Curr Bladder Dysfunct Rep. 2007; 2 (2): 79-85.
[6] Amid, PK. Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia. 1997; 1 (1): 15–21.
[7] Ogah J, Cody DJ, Rogerson L. Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women: a short version Cochrane review. Neurourol Urodyn. 2011; 30 (3): 284-291.
[8] Jijon A, Hegde A, Arias B, et al. An inelastic retropubic suburethral sling in women with intrinsic sphincter deficiency. Int Urogynecol J. 2013; 24 (8): 1325-1330.
[9] Ulrich D, Tammaa A, Hölbfer S, et al. Ten-year followup after tension-free vaginal tape-obturator procedure for stress urinary incontinence. J Urol. 2016; 196 (4): 1201-1206.
[10] Glass A, Durbin-Johnson B, Rothschild J, et al. SEAPI incontinence classification system: 1-year postoperative results following midurethral sling placement. Female Pelvic Med Reconstr Surg. 2020; 26 (11): 671-676.
[11] Gomelsky A. Midurethral sling: is there an optimal choice?. Curr Opin Urol. 2016; 26 (4): 295-301.
[12] Mallett VT, Brubaker L, Stoddard AM, et al. The expectations of patients who undergo surgery for stress incontinence. Am J Obstet Gynecol. 2008; 198 (3): 308. e1-308. e6.
[13] Nettleman, MD. Patient satisfaction--what's new?. Clin Perform Qual Health Care. 1998; 6 (1): 33-37.
[14] Lo TS, Shailaja N, Tan YL, et al. Outcomes and failure risks in mid-urethral sling insertion in elderly and old age with urodynamic stress incontinence. Int Urogynecol J. 2020; 31 (4): 717-726.
[15] Shin JH, Choo MS. De novo or resolved urgency and urgency urinary incontinence after midurethral sling operations: How can we properly counsel our patients?. Investig Clin Urol. 2019; 60 (5): 373-379.
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  • APA Style

    Melanie Crites-Bachert, Bradley Loomis. (2021). I-Stop® for Treatment of Stress Urinary Incontinence: High Satisfaction Rate and Low Morbidity. International Journal of Clinical Urology, 5(2), 58-63. https://doi.org/10.11648/j.ijcu.20210502.11

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    ACS Style

    Melanie Crites-Bachert; Bradley Loomis. I-Stop® for Treatment of Stress Urinary Incontinence: High Satisfaction Rate and Low Morbidity. Int. J. Clin. Urol. 2021, 5(2), 58-63. doi: 10.11648/j.ijcu.20210502.11

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    AMA Style

    Melanie Crites-Bachert, Bradley Loomis. I-Stop® for Treatment of Stress Urinary Incontinence: High Satisfaction Rate and Low Morbidity. Int J Clin Urol. 2021;5(2):58-63. doi: 10.11648/j.ijcu.20210502.11

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  • @article{10.11648/j.ijcu.20210502.11,
      author = {Melanie Crites-Bachert and Bradley Loomis},
      title = {I-Stop® for Treatment of Stress Urinary Incontinence: High Satisfaction Rate and Low Morbidity},
      journal = {International Journal of Clinical Urology},
      volume = {5},
      number = {2},
      pages = {58-63},
      doi = {10.11648/j.ijcu.20210502.11},
      url = {https://doi.org/10.11648/j.ijcu.20210502.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20210502.11},
      abstract = {Objective: The objective of this study was to investigate patient satisfaction and stress urinary incontinence (SUI) cure rates in females who underwent a midurethral I-Stop® sling insertion. It is well established in current literature that midurethral sling insertion is a highly efficacious treatment for female SUI. The challenge with sling insertion is to find a product that addresses SUI caused by both urethral hypermobility and intrinsic sphincter deficiency (ISD). Thus, this study aims to highlight the success of an I-Stop® midurethral slings for treatment of SUI in females with ISD and urethral hypermobility, while demonstrating low patient morbidity. Methods: Three hundred females who underwent midurethral I-Stop® sling insertion from August 2011 through December 2019 were included in this retrospective chart review. Females with diagnosed SUI and ISD were included in this study. Females with ISD underwent retropubic sling insertion approach while all other patients diagnosed with SUI underwent a transobturator (TO) approach. Patients scheduled follow-up visits 2-, 6-, 12-, and 24-weeks post-procedure and then yearly thereafter. Statistical analysis was completed with a paired t-test. Results: This retrospective review yielded 300 females who underwent sling insertion with a mean age of 66.6 years and median follow up of 37 months. Satisfaction rate was rated 4 or 5 on a 5-point Likert scale by 91.7% of patients, and SUI correction rate was 95%. Highest satisfaction rates were reported by patients in the 65–75-year-old age group. No statistical significance was identified between any of the variables analyzed with the exception of reported SUI after sling insertion and satisfaction rate, p=0.048. Nine patients (3.0%) required sling lysis secondary to inability to void or difficulty voiding resulting in elevated post-void residual values >200cc. Ten patients had sling exposure requiring revision. No vaginal, urethral, or vesical perforations, and no persistent pain post-procedure was reported. Conclusion: Midurethral I-Stop® sling insertion results in high patient satisfaction and SUI cure rates while maintaining low post-operative complications.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - I-Stop® for Treatment of Stress Urinary Incontinence: High Satisfaction Rate and Low Morbidity
    AU  - Melanie Crites-Bachert
    AU  - Bradley Loomis
    Y1  - 2021/07/09
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijcu.20210502.11
    DO  - 10.11648/j.ijcu.20210502.11
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 58
    EP  - 63
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20210502.11
    AB  - Objective: The objective of this study was to investigate patient satisfaction and stress urinary incontinence (SUI) cure rates in females who underwent a midurethral I-Stop® sling insertion. It is well established in current literature that midurethral sling insertion is a highly efficacious treatment for female SUI. The challenge with sling insertion is to find a product that addresses SUI caused by both urethral hypermobility and intrinsic sphincter deficiency (ISD). Thus, this study aims to highlight the success of an I-Stop® midurethral slings for treatment of SUI in females with ISD and urethral hypermobility, while demonstrating low patient morbidity. Methods: Three hundred females who underwent midurethral I-Stop® sling insertion from August 2011 through December 2019 were included in this retrospective chart review. Females with diagnosed SUI and ISD were included in this study. Females with ISD underwent retropubic sling insertion approach while all other patients diagnosed with SUI underwent a transobturator (TO) approach. Patients scheduled follow-up visits 2-, 6-, 12-, and 24-weeks post-procedure and then yearly thereafter. Statistical analysis was completed with a paired t-test. Results: This retrospective review yielded 300 females who underwent sling insertion with a mean age of 66.6 years and median follow up of 37 months. Satisfaction rate was rated 4 or 5 on a 5-point Likert scale by 91.7% of patients, and SUI correction rate was 95%. Highest satisfaction rates were reported by patients in the 65–75-year-old age group. No statistical significance was identified between any of the variables analyzed with the exception of reported SUI after sling insertion and satisfaction rate, p=0.048. Nine patients (3.0%) required sling lysis secondary to inability to void or difficulty voiding resulting in elevated post-void residual values >200cc. Ten patients had sling exposure requiring revision. No vaginal, urethral, or vesical perforations, and no persistent pain post-procedure was reported. Conclusion: Midurethral I-Stop® sling insertion results in high patient satisfaction and SUI cure rates while maintaining low post-operative complications.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • 360 Pelvic Health Institute, A Division of The Center for Men’s and Women’s Urology, Gresham, USA

  • 360 Pelvic Health Institute, A Division of The Center for Men’s and Women’s Urology, Gresham, USA

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