Development of a minimal invasive surgical procedure for stress urinary incontinence

Stress urinary incontinence (SUI) is a prevalent and bothersome condition. In patients with moderate to severe SUI, midurethral sling surgery, as compared to first line physiotherapy, results in higher rates of subjective improvement and objective cure. Several types of mid-urethral slings have been developed. Single-incision midurethral slings (SIMS) have been developed to decrease surgery-related discomfort, without compromising efficacy. SIMS are very different from each other and should not be evaluated as a single category of slings, like retropubic of transobturator midurethral slings. Altis®(Coloplast, Minneapolis) SIS has unique design characteristics that provide solutions for many clinical challenges specific for repeatable and reliable surgical correction of SUI. Although quantification of the added value from each technical characteristic is not realistic, it is clear that the high cure rate and consistent outcomes are a reflection of unique and intentional engineering. In this manuscript we explain how designing technical characteristics of a mid-urethral sling to meet clinical needs, results in a unique engineered medical device, that has discriminatory performance in the surgical treatment of stress urinary incontinence. For physicians it is important to understand the background of a product design in order to optimize the clinical use of it.