Local anesthesia for single incision slings has shown a good objective and subjective cure rate in women with stress urinary incontinence. The aim of the present study was to verify the efficacy and safety of local anesthesia during Altis® single incision placement.
One hundred sixty-six consecutive patients (83 patients for each group: local resp. spinal anesthesia) were selected from our database for this retrospective study among women who underwent an Altis® implantation for SUI from September 2016 to June 2021, after unsuccessful previous conservative treatment. Primary endpoints were objective and subjective cure rates; secondary endpoint was the evaluation of complications linked to this procedure.
A total of 155 included patients completed our 12 months follow-up. Baseline characteristics were similar between the groups. Operative time (percentage difference of 50%; p < 0.05) and the Intraoperative Difficulty Scale resulted lower in spinal patients. No differences were found between populations in terms of objective (cough stress test and urodynamics) and subjective (PGI-I and FSDS questionnaires) cure rate and postoperative complications.
Local anesthesia for Altis® implantation could be considered a safe alternative to spinal anesthesia and an effective opportunity to avoid general anesthesia, increasing the possibility of outpatient implantation of this sling system.
Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy. 2023 Jun 04 [Epub ahead of print]
Andrea Morciano, Giuseppe Marzo, Dario Caliandro, Michele Carlo Schiavi, Alessia Giaquinto, Carlo Rappa, Marzio Angelo Zullo, Andrea Tinelli, Giovanni Scambia, Mauro Cervigni
Panico Pelvic Floor Center, Department of Gynaecology and Obstetrics, Pia Fondazione 'Card. G. Panico', Tricase, Lecce, Italy., Department of Gynaecology and Obstetrics, 'Sandro Pertini' Hospital, Roma, Italy., Department of Clinical Pathology, 'Santa Caterina Novella' Hospital, Galatina, Lecce, Italy., Pelvic Floor Unit, 'Villa Angela' Clinic, Napoli, Italy., Department of Surgery-Week Surgery, 'Campus Biomedico' University, Roma, Italy., Department of Gynaecology and Obstetrics, 'Veris Delli Ponti' Hospital, Scorrano, Lecce, Italy., Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario 'A. Gemelli' - IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy., Department of Urology, 'La Sapienza' University, ICOT-Latina, Italy.