Woman confidently leaping across a light bridge, symbolizing support for urinary incontinence.

Mini-Slings: Are They the Right Choice for Your SUI?

Avery Sinclair in Health & Wellness November 2025 • 3 min read.

"Understanding unique issues, effectiveness, and considerations to make informed decisions about single-incision mini-slings (SIMS) for stress urinary incontinence (SUI)."

Stress urinary incontinence (SUI) affects millions of women, significantly impacting their quality of life. While various treatments exist, synthetic midurethral slings (MUS) have become a popular and effective option due to their minimally invasive nature. Over the years, many studies have delved into the efficacy and outcomes of both retropubic and transobturator approaches, solidifying MUS as a widely used treatment for SUI.

More recently, single-incision mini-slings (SIMS) have emerged as an alternative, offering a potentially less invasive approach that could even be performed in an ambulatory office setting. These third-generation synthetic slings are designed with the goal of reducing complications. SIMS are shorter in length, typically around 8-10 cm compared to the 40 cm of most MUS, and require only a single vaginal incision. By anchoring just beyond the vagina, SIMS avoid blind passage through the retropubic and obturator spaces.

This article explores the unique aspects of single-incision mini-slings, offering a comprehensive look at their efficacy, patient selection, potential complications, and long-term outcomes. Understanding these factors is crucial for both patients and practitioners in navigating the evolving landscape of SUI treatment.

Preoperative Considerations: Is a Mini-Sling Right for You?

Woman confidently leaping across a light bridge, symbolizing support for urinary incontinence.

Before considering a mini-sling, it's essential to understand who makes an ideal candidate. While many women with SUI, particularly those who have not found relief through conservative measures like pelvic floor therapy and lifestyle changes, may be suitable, certain factors need careful evaluation. Not all mini-slings are made equal. The now discontinued TVT-Secur™ mini-sling, for instance, showed lower cure rates compared to retropubic approaches.

Several conditions and considerations can impact the success of mini-slings. These include:

Prior Incontinence Surgery: Women with previous incontinence procedures may experience lower success rates with mini-slings.
Conditions Affecting Healing: Tobacco use, diabetes, and pelvic radiation therapy can increase the risk of complications like mesh erosion.
Urethral Hypermobility: The degree of urethral mobility is a crucial factor. Women with fixed urethras (limited mobility) may have a higher risk of sling failure.

It's also vital to address any urge incontinence (UI) component before considering a mini-sling. Treating UI with conservative methods or medication may eliminate the need for SUI surgery altogether. Some research suggests that age and obesity might influence outcomes. While one study indicated that elderly patients may not benefit as much from SIMS, another suggests that obesity is not necessarily an exclusionary factor. These conflicting findings highlight the need for individualized assessments.

The Future of Mini-Slings

Single-incision mini-slings represent an evolving approach to SUI treatment. Ongoing research is crucial to better understand their long-term efficacy, identify the ideal patient profile, and optimize surgical techniques. As our understanding grows, mini-slings have the potential to offer a less invasive and effective solution for women seeking relief from stress urinary incontinence.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/978-3-319-49855-3_18, Alternate LINK

Title: Mini-Slings: Unique Issues

Journal: Complications of Female Incontinence and Pelvic Reconstructive Surgery

Publisher: Springer International Publishing

Authors: Dina A. Bastawros, Michael J. Kennelly

Published: 2017-01-01

Everything You Need To Know

How do single-incision mini-slings (SIMS) differ from traditional midurethral slings (MUS) in the treatment of stress urinary incontinence (SUI)?

Single-incision mini-slings (SIMS) offer a potentially less invasive approach to treating stress urinary incontinence (SUI) compared to traditional midurethral slings (MUS). They involve a shorter sling (8-10 cm) and only a single vaginal incision, avoiding blind passage through retropubic and obturator spaces. This design aims to reduce complications associated with longer MUS procedures.

Who are the ideal candidates for single-incision mini-slings (SIMS), and what factors should be carefully evaluated before considering this treatment option?

Ideal candidates for single-incision mini-slings (SIMS) are typically women with SUI who haven't found relief through conservative treatments. However, factors like prior incontinence surgery, conditions affecting healing (e.g., tobacco use, diabetes, pelvic radiation therapy), and the degree of urethral hypermobility must be carefully evaluated before considering this approach. Fixed urethras, in particular, may lead to a higher risk of sling failure. Addressing any existing urge incontinence (UI) is also important before surgery.

How can the TVT-Secur™ mini-sling inform the effectiveness of other single-incision mini-slings (SIMS) for stress urinary incontinence (SUI)?

The now discontinued TVT-Secur™ mini-sling had lower cure rates compared to retropubic approaches. This highlights the importance of understanding that not all single-incision mini-slings (SIMS) are the same and that their effectiveness can vary. This is why ongoing research and careful patient selection are critical for the successful implementation of mini-slings in SUI treatment.

How do conditions such as tobacco use, diabetes, and pelvic radiation therapy impact the success and potential complications of single-incision mini-slings (SIMS)?

Conditions that impair healing, such as tobacco use, diabetes, and pelvic radiation therapy, can increase the risk of complications like mesh erosion with single-incision mini-slings (SIMS). These conditions can compromise tissue integrity and vascularity, potentially leading to poorer outcomes after sling placement. Managing these underlying health issues is crucial to optimizing the success of SUI treatment.

Do age and obesity affect the outcomes of single-incision mini-slings (SIMS) in treating stress urinary incontinence (SUI), and how should these factors be considered in patient selection?

While studies present conflicting data, age and obesity may influence the outcomes of single-incision mini-slings (SIMS). Some research suggests that elderly patients might not benefit as much, while other studies indicate that obesity may not be an absolute contraindication. Individualized assessments are therefore crucial in determining the suitability of SIMS for each patient. Considering these factors in conjunction with a patient's overall health profile is essential for informed decision-making.