Among the current controversy regarding the use of mesh in SUI surgeries, there is a dire need for further studies on the safety of mesh in sling surgery in our region as the available studies have a short follow-up time and a low sample size. This study aimed to evaluate the safety of MUS in terms of long-term postoperative complications, and its effect on QoL, and to assess the subjective cure and overall success rate over the past 10 years.

This was a retrospective observational study of 345 women who underwent TVT, TOT, and TVT-O for stress urinary incontinence at the XY institute from January 2013 to December 2023. The main outcomes were the safety and efficacy of MUS, assessed as overall surgical success and subjective cure rate. The secondary outcome was an improvement in quality of life (QoL) assessed by using incontinence impact questionnaire-7 – short form (IIQ-7) and urogenital distress inventory-6 – short form (UDI-6).

At 12- and 30-months follow-up, the Objective cure of MUS was 94.2% and 93.6%, respectively. The QoL the mean satisfaction score assessed by using UDI-6 and IIQ-7 was significantly improved after surgery (p<0.01). The mesh-related complications at postoperative one, 12, and 30 months were 3.4%, 2.6%, and 1.1 %. In univariate analysis, age, BMI, and menopausal women were significantly associated with objective failure (p < 0.05), while transobturator MUS and pelvic organ prolapse were the factors associated with overall surgical failure of the MUS at 30 months postoperative period in multivariate analysis.

Results from the current study have revealed that MUS surgeries are a very safe and effective procedure for SUI treatment. The objective cure rate was 94.2%, and 97.7% of patients reported incontinence cured or improved at 12 months postoperative follow-up. Similarly, 30 months after surgery, the objective cure rate was 93.6%, while the overall surgical success was 96.5% with no significant difference observed over time.

The mid-urethral sling surgery is a safe and effective procedure for the treatment of stress urinary incontinence and is associated with a low frequency of mesh-related complications at 10 years follow-up.