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Objective: Evaluate the place of sub-urethral mini-slings in the treatment of female stress urinary incontinence., Material and Methods: Review of the literature on 43 publications (comparative and prospective studies) more than 6443 patients who underwent for the treatment of urinary incontinence, a mini-strip type TVT®, TVT-S®, MiniArc®, Ajust®, Needleless®, Solyx®, or Ophira® in comparison to the conventional urethral sling. The comparison used objective (cough stress test and pad weight test) and subjective criteria (quality of life questionnaire). The papers have also studied the complication associated with these new techniques., Results: The overall effectiveness of this surgery varied between 40 to 84% for TVT-S®, 69 to 92% for MiniArc®, 80 to 91% for Ajust®, 87% for Needleless®, 95% for Solyx® and 85% for Ophira®. The efficacy on incontinence was higher with the TVT® TVT-S® and the MiniArc® (P=0.01 to 0.05). TVT-O® efficacy was higher than TVT-S® (P<0.01 and P=0.02). Conventional slings seems to be more efficient than TVT-S® and MiniArc® mini-slings. Ajust® mini-sling seems to be as efficient as MiniArc® and TVT-S® mini-sling and TVT-O®. It showed a decrease in the intensity of postoperative pain (P<0.001), faster return to normal activities (P=0.025) and use of a common local anesthetic to the adjustable mini-sling., Conclusion: It seems that the adjustable mini-sling is currently the best compromise in terms of effectiveness and complications if the choice had to be among the mini-sling in the treatment of stress urinary incontinence., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objective: To evaluate the results at 1 year of a mini invasive sub urethral sling, not requiring no more a single incision., Patients and Methods: Prospective study of 72 patients with isolated stress urinary incontinence. The procedures were performed on an outpatient under local anesthesia. Pain was assessed using the visual analogue scale. All patients were checked at 2 months and 1 year of intervention., Results: Stress urinary incontinence for 58 patients, 14 for mixed incontinence and sphincter deficiency for five. As per procedure, the average pain was 3.7/10, at the end of the intervention, 0.5/10. Peroperative complications were: one episode involving bleeding over 100ml, one vasovagal episode, and one procedure failure. At 2 months follow-up, the authors recorded: de novo urge incontinence (n=2), de novo dysuria (n=1), sling exposure (n=1), urinary infection (n=1) and noticeable side ties (n=4). Control at 1 year, another patient filed an eviction of the anchor of the tape with Stall thereof. Two patients reported having moderate pain. The objective results at 1 year of 68 patients were 69.1% cured, 20.6% improved and 10.3% failed. Three patients were re-operated and two of them are cured., Conclusion: The results of this simplified tape are worse than those of classic sub-urethral tape; however, no comparative study has been completed and the specific indications of these techniques are not specified., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate the efficacy and complications of this new sub-urethral tape procedure with a follow up of 12 months., Materials and Methods: Prospective, multicenter study of 154 patients operated for stress urinary incontinence with the TVT Secur. Patients were operated between 24 July 2006 and 18 December 2007 and were all controlled at 2 months and 118 at 1 year. No associated surgical procedure was performed., Results: One hundred five patients had pure stress incontinence with 12 of them presenting an intrinsic sphincter deficient. Forty-nine had a mixed urinary incontinence with 12 of them having ISD. Preoperatively, 69 patients complained of urgency and 12 of micturation disorder. Anaesthesia was local for 97 patients (63%). Per operative complications were five hemorrhages, one bladder injury, one vaginal wound, 21 patients had post-void residual volume (100 to 200ml) and one groin pain. We noted two exposed tapes, one granuloma, one ITU and seven lateral vaginal bands. Among the patients with urge at baseline, 61.2% were cured at 2 months and 75.5% at 1 year. De novo urge appeared in 12.8% at 2 months and 12.3% at 1 year. De novo micturation disorder was found in 9.5% at 2 months and 3.7% at 1 year. The cured patients at 1 year were 70.3%, improved 11% and fails 18.7%. The cured rate remains same between 2 months and 1 year. The improved patients (24%) at 2 months remain 11% at 1 year. The recurrence rate was 12,8% at 1 year., Conclusion: The results are inferior to TVT or TVT-O procedures. We probably must selected the patients for this procedure.

Objectives: To present a new mini-invasive tape requiring only a single incision, to assess the complications and short-term results., Materials and Methods: Prospective study of 72 patients with stress urinary incontinence. Were selected for the study patients with stress urinary incontinence with or without intrinsic sphincter deficiency and mixed urinary incontinence with a predominance of leaks to the effort. Patients were evaluated at 2 months of the intervention., Results: Isolated stress urinary incontinence for 58 patients, mixed incontinence for 14 and intrinsic sphincter deficiency for five. The complications per procedure revealed one bleeding over 100ml, one malaise vagal and a failure of the procedure. At 2 months, the authors found: two urgenturies de novo, one de novo micturition disorder, one erosion, one urinary tract infection and four lateral vaginal bands. The early objective results are overall 75.7% of dry patients (79.6% for pure SUI, 66.6% for IUE with ISD and 61.5% for mixed incontinence). The overall failure rate was 2.9%., Conclusion: The results of this simplified tape are worse than those of TVT and transobturator tapes.

Objectives: To present a new minimal invasive suburethral tape device derivative of the classic TVT, to describe the technique of laying, to evaluate complications and results to short term., Materials and Methods: Prospective multicentric study of 110 patients presenting a stress urinary incontinence and benefiting from the laying of TVT Secur without associated operation. The tape is identical to that old-fashioned retropubic and obturator TVT, smaller, laying in "U" or in "hammock" without orifice of exit, to avoid complications due to crossed spaces of the other techniques. The device and the technique of laying are described by authors. The originality of the TVT Secur resides in the mechanism of insertion of the tape to a metallic divice. All patients have been controlled at two months and complications with notably pains (quotation VAS) as well as objective results have been reported., Results: Pure and isolated stress urinary incontinence for 71 patients, mixed incontinence for 39 and sphincter deficient for 23. Preoperative urgency for 49 patients and dysuria for 10 of them. The method "hammock" has been used in 85.5% of cases. The type of anaesthesia has been pure local for 69.1% (0 to 98.8% for the different centers) with an average operative time of 8'30". Under local anaesthesia, the average per operative pain was quoted 2.8/10, and 0.7 at the end of intervention. Peroperative complications have revealed a wound of bladder, a vaginal wound and four bleeding of more than 100ml. In immediate continuations a total retention yielding to 24h and 13 postmicturition residual between 100 and 200ml have been mentioned. At two months, authors have observed the following: de novo urgency in 19.6%, de novo dysuria in 13.2%, one tape exposition, one granuloma, one urinary infection and seven perceptible lateral cords without pain. Thirteen patients have signalled to have had moderated pains on a duration of four to 30 days. Early objective results are globally 70.4% of dry patients (83% for pure isolated SUI, 72.2% for SUI with deficient sphincter, 50% for mixed incontinence). The pure local anaesthesia was recommended by 98% of patients., Conclusion: The diminution of complications ahead not to be made to the detriment of results, it is necessary to envisage multicentric studies with standardized modifications. The indications of this new device will have to be defined.

Objective: To search if the prosthetic kits bring an interest, other that financier., Materials and Method: Authors have counted 5 firms presenting the varied kits. The Prolift kit with synthetic pre- cut mesh made of polypropylene, standardized needle, cannulas and protective devices of recovery of mesh arms in 3 versions, anterior, posterior and total. Perigee and Apogee systems in a synthetic version (IntePro) and a biological version (InteXen ++LP) matched of specific needles for the different obturator passages and infra coccygeus. The Avaulta kit declines in a biosynthetic version and a hybrid version with a specific needle for its anterior kit and an other for its posterior kit. The Biomesh Soft system presents a polypropylène mesh posed on a multi pattern sheet to carve following dots with a share of 3 needles according to the type of arm passage ended by a recuperator thread. The Nazca POP Repair System, in its anterior version claims to be able to correct in the same time a urinary incontinence by pre-pubic arms. The polypropylene mesh is perforated and is had with the help a needle for its anterior and posterior kit. Authors have been interested in the research of studies on prosthesis with and without kit., Results: The Prolift kit contains the alone prosthesis having been evaluated without (TVM) and with kit. Authors remind results of two studies, understanding 684 cases without kit and 110 cases with kit. The rate of early per and postoperative complications has been decreased half, the rate of mesh exposure decreased from 11,3 to 4,7%. Studies on Perigee and Apogee IntePro kits, whose meshe and the procedure are similar to the Prolift seem to obtain from results equal. The Biological version has not made the object of study. For the Avauta kit, alone the mesh in plate not pre-cut has been well studied as for its tolerance for the biosynthetic version. Nothing on the hybrid version. No study is found for the Biomesh Soft kit and Nazca POP repair system., Discussion: The cost of these kits, varying 1 to 4, is to take in consideration and to put in scale with the returned service. Alone TVM/Prolift allows to advance in a reply. The utilization of needles, presents in all the kits, but especially devices facilitating the passage and the recovery of prosthesis arms, presents solely in the Prolift kit, reduce the utilization of valves and the risk of tear tissues during their job. The improvement of techniques by elements of the kit make that the surgical procedure become mini invasive., Conclusion: The full kits allow a best security of procedures, facilitate the surgical gesture and limit complications. It is necessary to remain vigilant in the evaluation of these new materials "ready to wear" and to require pre clinic and clinic studies before their distribution.

Reported cases of angular pregnancy, which by definition corresponds to pregnancy developing in a uterine horn, are rare. Etiologies as well as the diagnostic and therapeutic strategies are discussed. The anatomic modifications resulting from uterine fibromyoma and affecting embryo nidation in the uterine cavity of the uterus are the leading cause of angular pregnancy. The course of pregnancy depends on the evolution of the fibromyoma. Treatment therefore depends on the clinical course. Early diagnosis is essential for conservative treatment. In the case presented here, angular pregnancy was diagnosis following development of aseptic necrobiosis, the most common complication of fibromyosma.