Experience of Solyx™ Single-Incision Sling System in a Urogynaecology Centre

Objectives: Stress urinary incontinence (SUI) is a common condition known to affect up to 35% of women worldwide and can greatly impact quality of life. Solyx™ is a Single Incision Sling (SIS) System used to treat female SUI via a minimally invasive technique with potentially fewer complications. This study describes our two-year experience with the Solyx™ SIS for the treatment of female SUI.

Methods: We retrospectively analysed the data of 26 women who underwent Solyx™ SIS surgery from November 2017 to December 2019 by a single surgeon. The pre-operative parameters, intra-operative details, and 1, 6, 12 and 24 months follow-up data were collected.

Results: The average age was 60.2 years old with a mean parity of 2.5. Over 90% of women had a previous vaginal/instrumental delivery. Concomitant procedures were performed in 24 patients (92.3%) and were namely vaginal hysterectomy (73.1%), anterior pelvic floor repair (76.9%), posterior pelvic floor repair (84.6%), sacrospinous ligament fixation (46.2%), vaginal mesh augmentation (11.5%) and abdominal hysterectomy (3.8%). The average surgery duration was 113.5 minutes with an average blood loss of 214.6 ml. Four women had major intraoperative complications, namely haemorrhage requiring transfusion, bladder perforation, right ureteric injury, and prominent submucosal stitch felt on rectal examination. There were no significant intra-operative complications related specifically to the insertion of Solyx™ SIS. Mean hospital stay was 4.1 days. Twenty-three women (88.5%) required an indwelling catheter (IDC) for a mean duration of 4.2 days. One woman's IDC was prophylactically kept for 16 days because of intraoperative bladder perforation. Two women (7.7%) required readmission for voiding dysfunction. All women attended their 1- and 6-month follow-up appointments while 25 women (96.2%) attended their 12- and 24-month appointments. Subjective cure rate was noted in 96.0%, 96.2%, 100.0% and 100.0% of patients at 1, 6, 12 and 24 months respectively. Urodynamic study was repeated at 6 months post-surgery and showed an objective cure rate of 86.4% with no leak. Vaginal tape extrusion was noted in 1 woman at 6 months. De novo urgency/urge incontinence was reported in 1, 2 and 3 women at 1, 6 and 24 months respectively. One woman reported thigh pain at 1 month, while 1 and 2 women reported dyspareunia at 6 and 24 months respectively.

Conclusions: The short to medium term outcomes for Solyx™ SIS were comparable to other mid-urethral sling procedures in existing literature. This study showed Solyx™ SIS to be efficacious with good safety profile. A longer follow-up data on a larger population to further evaluate outcomes and make definitive conclusions is required.