Transperineal Ultrasound Comparison of Longitudinal Sling Position and Dynamic Sling Configuration After Altis and MiniStop Single-Incision Mini-Slings for Stress Urinary Incontinence

Background/Objectives: Direct imaging comparisons of single-incision mini-slings are limited. This study compared six-month three-dimensional transperineal ultrasound (TPUS) findings after Altis and MiniStop surgery. Methods: This retrospective cohort included 174 women with stress urinary incontinence who underwent Altis (n = 118) or MiniStop (n = 56) surgery. Sling position along the urethral length was expressed as a percentage from the bladder neck (0%) to the external urethral meatus (100%), with 20–60% defined as the midurethral region. TPUS also assessed sling-to-urethra distance, coronal sling angles, and sling kinking. Clinical outcomes and complications were evaluated as secondary outcomes. Results: Slings were located within the midurethral region in 82.2% of Altis and 50.0% of MiniStop patients (p < 0.001). Coronal sling angles were smaller in the Altis group at rest and during straining (both p < 0.001). Sling-to-urethra distance and sling kinking did not differ significantly. Baseline leakage severity was greater in the Altis group, whereas concomitant pelvic reconstruction was more common in the MiniStop group. Questionnaire scores decreased within both groups. Recurrence occurred in 5.1% and 7.1%, respectively. Conclusions: Six-month TPUS identified distinct postoperative sling positions and coronal configurations in the two cohorts, with Altis slings more frequently located within the study-defined midurethral region. These findings characterize anatomical differences in the context of baseline and procedural differences and provide a basis for investigating their relationship with clinical outcomes.