Benefits and risks

Information for the public

When NICE looked at the evidence, it decided that there was not enough long-term evidence to support single-incision short sling mesh insertion being routinely recommended to treat stress urinary incontinence in women. The 12 studies that NICE looked at involved a total of 8,971 women.

Generally, they showed that this procedure is similar to other types of slings and tape procedures in terms of reducing incontinence in the short term, and has the following benefits:

less daily incontinence pad use
improvement in symptoms of stress urinary incontinence
less need for medicines for incontinence 12 months after the procedure
return to normal activities and work sooner than women who had different procedures
improved quality of life.

The studies showed that the risks of single-incision short sling mesh insertion included:

pain, including groin pain, but less often than with other procedures
bleeding during the procedure, with pelvic bruising in 1 woman
erosion, which is when the mesh wears through body tissues so that it pokes through the vaginal wall or, less commonly, through the wall of the urethra, bladder or bowel; often surgery was needed
overactive bladder symptoms, and difficulty or pain when passing urine
damage to the bladder or vagina during surgery
urinary tract infections.

These risks were only found in a small number of patients (about 1% to 3%). NICE also received 22 questionnaires from women who had had the procedure (most within 2 years). Nineteen reported positive outcomes on quality of life but 6 still had some leakage. Two women went on to have another procedure.

If you want to know more about the studies, see the guidance. Ask your health professional to explain anything you don't understand.