In the Continence Market there are different types of surgical solutions. Slings are the most common treatment option to treat this disorder. The most complete and successful treatment option are the re-adjustable slings, for Male and for Female Incontinence.
But if lifetime re-adjustability is not surgeon’s treatment option, traditional sling procedures are also able to solve urinary incontinence.
Non-Adjustable slings and Single Incision
For the non-adjustable slings, there are three surgical procedures: the retropubic (also known as TVT), the transobturator (TOT or TVT-O) and the Single Incision.
The retropubic slings passes behind the pubic bone paraurethraly and requires one vaginal incision and two sikn incisions at the lower abdomen. Perforation of the bladder may occur during needle passage. Transobturator slings have the same number of incisions, but the sling is passed through the obturator muscle, and the groin, with the risk of suffering post op groin pain.
These two surgical procedures are widely used to treat stress urinary incontinence. But there are more and better alternatives:
The Single Incision TOT sling
The Single Incision, as its name suggests, requires only a small incision at the vaginal area to place the sling into the patient’s body. Normally when people talk about single incision, they think of Mini Slings, a short sling of aprox. 6.5 cm length. A shorter sling provides less area of urethral suppport and shows a preliminary results as low as 44% of patients really cured after one year of follow-up and 24% with some improvement1.
Single incision sling does not always mean Mini Sling. A Spanish company, Neomedic International, developed a long single incision sling that have the advantages of a single incision technique but maintaining the TOT results. The Needleless System is a 11.4 cm sling with a patented pocket possitioning system at both ends that not only provides a better urethral support, but also the possibility of being readjusted during surgery.
Its simple design, permits the adjustment of the sling’s position in both directions during operation (see the video below). The Needleless System offers all the benefits of Mini Slings (a short intervention with no skin incisions), but with the same results as traditional TOT procedures. The Needleless sling is known as the Single Incision TOT.2
Needleless System offers the patient and the doctor the same results as TOT’s (better than Minislings) and less risk of groin pain like mini slings (higher in TOT’s).
To complete this explanation, here you can see a Needleless Sling intervention to treat Female Stress Urinary Incontinence.
1 The Mini Arc sling for female stress urinary incontinence: clinical results after 1-year follow-up. Hogewoning CR, Ruthe IM, Bekker MD, Hogewoning CJ, Putter H, Deruiter MC, Peiger RC, Elzevier HW.
2 Surgical Treatment of Stress Urinary Incontinence in women with a Single Incision TOT Technique. Three years of follow-up. Baya G. (Fundació Hospital Althaia, Manresa (Spain); Janin P. (Clinique Pole Sante Leonard Da Vinci, Pole,Dours (France).