Assessing the Clinical Effectiveness of the Mini-Sling Procedure in Women with Urinary Incontinence

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Abstract

Background/Objectives: Urinary incontinence (UI) significantly affects women’s quality of life, and minimally invasive surgical options have gained increasing interest. Mini-sling procedures were developed to reduce operative time, minimize tissue dissection, and lower perioperative morbidity compared with traditional mid-urethral slings. Despite increasing use, real-world data on postoperative satisfaction, objective cure, and mesh-related complications remain limited. This study aimed to evaluate the clinical effectiveness and safety profile of the mini-sling procedure in women with UI. Methods: We conducted a retrospective cohort study including 186 women who underwent mini-sling surgery between January 2019 and January 2024. Outcomes included mesh erosion, time to healing, and 6-month postoperative cough stress and pad test results. Although the study design was retrospective, the 6-month evaluations—including objective tests and patient satisfaction scores—were collected prospectively as part of the clinic’s standardized follow-up protocol. Results: More than half of patients (58.1%) had symptoms for over five years, and 83.9% presented with stress UI. All patients had positive preoperative cough stress and pad tests and received postoperative estriol therapy. At six months, 63.4% reported the highest satisfaction score (5). Pad test positivity decreased from 100% preoperatively to 5.4% postoperatively. Reoperation was required in two patients (1.1%). Mesh erosion occurred in 25.8% of cases but resolved completely within three months in all patients. Conclusions: Mini-sling surgery demonstrated high short-term effectiveness and patient satisfaction. Although mesh erosion was relatively common, complete healing within three months supports an acceptable safety profile.

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