Vol.:(0123456789) 1 3 Archives of Gynecology and Obstetrics https://doi.org/10.1007/s00404-018-4755-z GENERAL GYNECOLOGY A randomized prospective comparison of the needleless mini‑sling “hammock” and “U‑shape” confgurations for management of stress urinary incontinence: 18 month follow‑up results Ozan Dogan 1  · Alper Basbug 2,5  · Aski Ellibes Kaya 2,6  · Cigdem Pulatoglu 3  · Murat Yassa 4 Received: 4 January 2018 / Accepted: 14 March 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Objective To compare the efcacy of needleless mini-sling placed either retropubic (U-shape) or trans-obturator (hammock- shape) to treat stress urinary incontinence. Setting One hundred and twenty six women were randomized in a 2:1 ratio to receive hammock-shaped or U-shaped of Contasure-NDL. Methods All surgical procedures were performed by one senior surgeon experienced in anti-incontinence surgery with mesh. Cough-stress test was considered for objective outcome. Subjective outcomes consisted of International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I) and three-item Likert scale to measure satisfaction. Assessments were performed preoperatively and at postoperative 6th, 12th and 18th month. Results The objective cure rates at postoperative 6th and 12th month were signifcantly lower in U-shape group compared to hammock-shape group (85.4 vs. 96.4%; p = 0.034) and was comparable with hammock-shape group at 18 th month post- operative (90.2 vs. 96.4%, respectively; p = 0.216). The subjective cure rates at postoperative 6th, 12th and 18th month were similar between groups (90.2/90.2/100% vs. 96.4/96.4/96.4%, respectively; p > 0.05). Median of total ICIQ-SF scores was signifcantly lower in hammock-shaped group (1.62 ± 2.92) compared to U-shape (3.80 ± 2.64) at 18th month (p < 0.001). The rate of patients reported as very satisfed or satisfed to the Likert scale was 90.2% in U-shape group and 96.4% in hammock group. Patients’ responses to PGI-I were majorly distributed to “much better” and “very much better” with a mean score of 1.93 ± 2 in U-shape and 1.33 ± 1 in hammock group at 18th month of follow-up (p < 0.001). Conclusion U-shape placement of needleless single-incision mini-sling mimicking the retropubic route did not satisfy in achieving the patient’s goal when compared to hammock-shape placement. Keywords Midurethral sling · Mini-slings · Single-incision tapes · Stress urinary incontinence · Tension-free vaginal tape · Urinary incontinence * Ozan Dogan ozandogan02@hotmail.com Alper Basbug dralper123@gmail.com Aski Ellibes Kaya askiellibes@hotmail.com Cigdem Pulatoglu cigdempulatoglu@gmail.com Murat Yassa murat.yassa@gmail.com 1 Department of Obstetrics and Gynecology, Health Sciences University, Sisli Hamidiye Etfal Research and Training Hospital, Binbasi Refkbey sk, No: 9/5 Sisli, Istanbul, Turkey 2 Department of Obstetrics and Gynecology, Duzce University Faculty of Medicine, Duzce, Turkey 3 Department of Obstetrics and Gynecology, Bayburt Government Hospital, Singah mh, Ibni Sina cd., Bayburt Devlet Hastanesi Lojmani, F blok, D:1, 69000 Bayburt, Turkey 4 Department of Obstetrics and Gynecology, Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital, Sarikanaryasokak, Menekse apt. No.6/36 Kadikoy, Istanbul, Turkey 5 Kultur mahallesi Mehmet Akif caddesi No 31/6, Istanbul, Turkey 6 Arapciftligi mahallesi 2871.sok no:1/1 Guleryuz evleri, Duzce, Istanbul, Turkey