Re: Single-incision Mini-slings for Stress Urinary Incontinence in Women.

In this pragmatic, noninferiority, randomized trial, Abdel-Fattah et al compared the efficacy and safety of newer sin-gle-incision mini-slings (SIMS; mainly Ajust from C.R. Bard and Altis from Coloplast) to traditional mid-urethral slings (MUS; retropubic or transobturator) in women with pre-dominant symptoms of stress urinary incontinence. After randomization, a total of 298 patients for each group were assigned to receive SIMS or MUS in 21 UK hospitals. The authors showed that the patient-reported subjective suc-cess, assessed using the Patient Global Impression -Improve-ment questionnaire, was noninferior in the SIMS group in comparison to the MUS group (79.1% vs 75.6%) at 15-mo follow-up. These data remained similar in the two groups at 36-mo follow-up. The rates of mesh exposure and dys-pareunia and the percentage of women who underwent fur-ther surgery for any reason were higher in the SIMS group than in the MUS group.