Meta-Analysis
doi: 10.1002/14651858.CD001754.pub5.
Traditional suburethral sling operations for urinary incontinence in women
Affiliations
- PMID: 31990055
- PMCID: PMC7027385
- DOI: 10.1002/14651858.CD001754.pub5
Item in Clipboard
Meta-Analysis
Traditional suburethral sling operations for urinary incontinence in women
Cochrane Database Syst Rev.
.
Abstract
Background: Stress urinary incontinence constitutes a significant health and economic burden to society. Traditional suburethral slings are surgical operations used to treat women with symptoms of stress urinary incontinence.
Objectives: To assess the effectiveness of traditional suburethral sling procedures for treating stress urinary incontinence in women; and summarise the principal findings of relevant economic evaluations.
Search methods: We searched the Cochrane Incontinence Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), as well as MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP); we handsearched journals and conference proceedings (searched 27 February 2017) and the reference lists of relevant articles. On 23 January 2019, we updated this search; as a result, several additional reports of studies are awaiting classification.
Selection criteria: Randomised or quasi-randomised trials that assessed traditional suburethral slings for treating stress or mixed urinary incontinence.
Data collection and analysis: At least two review authors independently extracted data from included trials and assessed risk of bias. When appropriate, a summary statistic was calculated: risk ratio (RR) for dichotomous data, odds ratio (OR) for continence and cure rates that were expected to be high, and mean difference (MD) for continuous data. We adopted the GRADE approach to assess the quality of evidence.
Main results: A total of 34 trials involving 3244 women were included. Traditional slings were compared with 10 other treatments and with each other. We did not identify any trials comparing suburethral slings with no treatment or sham treatment, conservative management, anterior repair, or laparoscopic retropubic colposuspension. Most trials did not distinguish between women having surgery for primary or recurrent incontinence. One trial compared traditional slings with bladder neck needle suspension, and another trial compared traditional slings with single-incision slings. Both trials were too small to be informative. Traditional suburethral sling operation versus drugs One small trial compared traditional suburethral sling operations with oxybutynin to treat women with mixed urinary incontinence. This trial did not report any of our GRADE-specific outcomes. It is uncertain whether surgery compared with oxybutynin leads to more women being dry (83% vs 0%; OR 195.89, 95% confidence interval (CI) 9.91 to 3871.03) or having less urgency urinary incontinence (13% vs 43%; RR 0.29, 95% CI 0.09 to 0.94) because the quality of this evidence is very low. Traditional suburethral sling versus injectables One small trial compared traditional slings with suburethral injectable treatment. The impact of surgery versus injectables is uncertain in terms of the number of continent women (100% were dry with a traditional sling versus 71% with the injectable after the first year; OR 11.57, 95% CI 0.56 to 239.74), the need for repeat surgery for urinary incontinence (RR 0.52, 95% CI 0.05 to 5.36) or the occurrence of perioperative complications (RR 1.57, 95% CI 0.29 to 8.49), as the quality of evidence is very low. Traditional suburethral sling versus open abdominal retropubic colposuspension Eight trials compared slings with open abdominal retropubic colposuspension. Moderate-quality evidence shows that the traditional suburethral sling probably leads to more continent women in the medium term (one to five years) (69% vs 59% after colposuspension: OR 1.70, 95% CI 1.22 to 2.37). High-quality evidence shows that women were less likely to need repeat continence surgery after a traditional sling operation than after colposuspension (RR 0.15, 95% CI 0.05 to 0.42). We found no evidence of a difference in perioperative complications between the two groups, but the CI was very wide and the quality of evidence was very low (RR 1.24, 95% CI 0.83 to 1.86). Traditional suburethral sling operation versus mid-urethral slings Fourteen trials compared traditional sling operations and mid-urethral sling operations. Depending on judgements about what constitutes a clinically important difference between interventions with regard to continence, traditional suburethral slings are probably no better, and may be less effective, than mid-urethral slings in terms of number of women continent in the medium term (one to five years) (67% vs 74%; OR 0.67, 95% CI 0.44 to 1.02; n = 458; moderate-quality evidence). One trial reported more continent women with the traditional sling after 10 years (51% vs 32%: OR 2.22, 95% CI 1.07 to 4.61). Mid-urethral slings may be associated with fewer perioperative complications (RR 1.74, 95% CI 1.16 to 2.60; low-quality evidence). One type of traditional sling operation versus another type of traditional sling operation Nine trials compared one type of traditional sling operation with another. The different types of traditional slings, along with the number of different materials used, mean that trial results could not be pooled due to clinical heterogeneity. Complications were reported by two trials - one comparing non-absorbable Goretex with a rectus fascia sling, and the second comparing Pelvicol with a rectus fascial sling. The impact was uncertain due to the very low quality of evidence.
Authors' conclusions: Low-quality evidence suggests that women may be more likely to be continent in the medium term (one to five years) after a traditional suburethral sling operation than after colposuspension. It is very uncertain whether there is a difference in urinary incontinence after a traditional suburethral sling compared with a mid-urethral sling in the medium term. However, these findings should be interpreted with caution, as long-term follow-up data were not available from most trials. Long-term follow-up of randomised controlled trials (RCTs) comparing traditional slings with colposuspension and mid-urethral slings is essential. Evidence is insufficient to suggest whether traditional suburethral slings may be better or worse than other management techniques. This review is confined to RCTs and therefore may not identify all of the adverse effects that may be associated with these procedures. A brief economic commentary (BEC) identified three eligible economic evaluations, which are not directly comparable due to differences in methods, time horizons, and settings. End users of this review will need to assess the extent to which methods and results of identified economic evaluations may be applicable (or transferable) to their own setting.
Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
LS: none known. HR: none known. MIO: none known. JDC: none known. PA: none known. CG: none known.
Figures
PRISMA study flow diagram ‐ search for clinical effectiveness studies.
PRISMA study flow diagram ‐ search for economic evaluations for the BEC.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Comparison 3 Traditional suburethral sling operation versus drugs, Outcome 1 Number of continent women within 1 year (any definition).
Comparison 3 Traditional suburethral sling operation versus drugs, Outcome 2 Urge urinary symptoms, urgency urinary incontinence.
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 1 Number of continent women within 1 year (any definition).
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 2 Number of continent women at 1 to 5 years (any definition).
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 3 Repeat surgery for urinary incontinence.
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 4 Number of women cured after first year (women's observations).
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 5 Number of women satisfied (women's observations).
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 6 Number of women with urinary incontinence within first year (clinician's observations).
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 7 Urinary tract infection.
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 8 De novo detrusor overactivity (urodynamic diagnosis).
Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 9 Voiding dysfunction.
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 1 Number of continent women within 1 year (any definition).
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 2 Number of continent women at 1 to 5 years (any definition).
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 3 CURE: number of women cured after first year (women's observations).
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 4 Length of hospital stay (hours).
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 5 Perioperative surgical complications.
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 6 Urinary urgency symptoms, urgency urinary incontinence.
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 7 Detrusor overactivity (urodynamic diagnosis).
Comparison 6 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 8 Voiding dysfunction after 3 months.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 1 Number of continent women within 1 year (any definition).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 2 Number of continent women at 1 to 5 years (any definition).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 3 Number of continent women after 5 years (any definition).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 4 Repeat surgery for urinary incontinence.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 5 Number of women cured after first year (women's observations).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 6 Number of women satisfied (women's observations).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 8 Number of women with urinary incontinence at 1 to 5 years (clinician's observations).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 9 Number of women with urinary incontinence after 5 years (clinician's observations).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 10 Duration of operation (minutes).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 11 Length of hospital stay (days).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 12 Time to catheter removal (days).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 14 Number of women requiring treatment for pelvic organ prolapse.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 15 Perioperative surgical complications.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 16 Bladder perforation.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 17 Urinary tract infection.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 18 Number of women with recurrent UTIs at > 5 years.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 19 Urinary urgency symptoms, urgency urinary incontinence.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 20 Detrusor overactivity (urodynamic diagnosis).
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 21 Voiding dysfunction after 3 months.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 22 Long‐term voiding dysfunction > 5 years.
Comparison 7 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 23 Condition‐specific measures to assess quality of life.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 1 Number of continent women within 1 year (any definition).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 2 Number of continent women at 1 to 5 years (any definition).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 3 Number of continent women after 5 years (any definition).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 4 Repeat surgery for urinary incontinence.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 5 Number of women cured after first year (women's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 6 Number of women improved or cured within 1 year (women's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 7 Number of women improved or cured at 1 to 5 years (women's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 8 Number of women improved or cured after 5 years (women's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 9 Number of women satisfied (women's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 10 Pad test of quantified leakage (mean weight of urine lost).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 11 Number of women with urinary incontinence within first year (clinician's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 12 Number of women with urinary incontinence at 1 to 5 years (any definition) (clinician's observations).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 13 Duration of operation (minutes).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 14 Length of hospital stay (days).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 15 Time to catheter removal (days).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 16 Perioperative surgical complications.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 17 Bladder perforations.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 18 Urethral injury.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 19 Vaginal bleeding.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 20 Urinary tract infection.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 21 Voiding dysfunction.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 22 Urinary urgency symptoms, urgency urinary incontinence.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 23 De novo detrusor overactivity (urodynamic diagnosis).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 24 Long‐term adverse effects (release of sling required).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 25 Long‐term adverse effects (wound pain at 6 months).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 26 Long‐term adverse effects (vaginal mesh or graft exposure).
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 27 Condition‐specific measures to assess quality of life: UDI‐6.
Comparison 9 Traditional suburethral sling operation versus mid‐urethral sling or tape, Outcome 28 Condition‐specific measures to assess quality of life: IIQ‐7.
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 1 Number of continent women at 1 to 5 years (any definition).
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 2 Number of women cured after first year (women's observations).
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 3 Number of women satisfied (women's observations).
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 4 Number of women with urinary incontinence (clinician's observations) within first year.
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 5 Bladder perforation.
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 6 Urinary urgency symptoms, urgency urinary incontinence.
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 7 Pain with intercourse (dyspareunia).
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 8 Long‐term adverse effects (vaginal mesh or graft exposure).
Comparison 10 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 9 Condition‐specific measures to assess quality of life: IIQ score.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 1 Number of continent women within 1 year (any definition).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 2 Number of continent women at 1 to 5 years (any definition).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 3 Number of continent women after 5 years (any definition).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 4 Repeat surgery for urinary incontinence.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 5 Number of women cured after first year (women's observations).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 6 Number of women improved or cured within first year (women's observations).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 7 Number of women improved or cured at 1 to 5 years (women's observations).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 8 Number of women satisfied (women's observations).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 9 Pad test of quantified leakage (mean weight of urine lost) within 1 year.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 10 Pad test of quantified leakage (mean weight of urine lost) at 1 to 5 years.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 11 Duration of operation (minutes).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 12 Blood loss (mL).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 13 Length of hospital stay (days).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 14 Perioperative surgical complications.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 15 Bladder perforation.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 16 Urinary tract infection.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 17 Vaginal bleeding.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 18 Long‐term adverse effects (wound pain).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 19 Voiding dysfunction.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 20 Urinary urgency symptoms, urgency urinary incontinence.
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 21 Detrusor overactivity (urodynamic overactivity).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 22 Long‐term adverse effects (release of sling required).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 23 Long‐term adverse effects (vaginal mesh or graft exposure).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 24 Condition‐specific measures to assess quality of life (ICI‐Q short form UI score at 1 year).
Comparison 11 One type of traditional sling operation versus another type of traditional sling operation, Outcome 25 Condition‐specific measures to assess quality of life (ICI‐Q short form UI score at 1 to 5 years).
Comparison 12 Traditional suburethral sling operation versus drugs, Outcome 1 Number of women with urinary incontinence (worse, unchanged, or improved) within first year (women's observations).
Comparison 12 Traditional suburethral sling operation versus drugs, Outcome 2 Urge urinary symptoms, urgency urinary incontinence.
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 1 Number of women with urinary incontinence (worse, unchanged, or improved) within first year (women's observations).
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 2 Number of women with urinary incontinence (worse, unchanged, or improved) after first year (women's observations).
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 3 Number of women with urinary incontinence (clinician's observations) within first year.
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 4 CURE: number of women cured after first year (women's observations).
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 5 Voiding dysfunction.
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 6 De novo detrusor overactivity (urodynamic diagnosis).
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 7 Urinary tract infection.
Comparison 13 Traditional suburethral sling operation versus injectables, Outcome 8 Repeat surgery for urinary incontinence.
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 1 Number with incontinence (worse, unchanged, or improved) within first year (women's observations).
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 2 Number with incontinence (worse, unchanged, or improved) after first year (women's observations).
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 3 CURE: number of women cured after first year (women's observations).
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 4 Length of hospital stay (hours).
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 5 Perioperative surgical complications.
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 6 Urge urinary symptoms, urgency urinary incontinence.
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 7 Voiding dysfunction after 3 months.
Comparison 14 Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal), Outcome 8 Detrusor overactivity (urodynamic diagnosis).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 1 Number of women with urinary incontinence (worse, unchanged, or improved) within first year (women's observations).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 3 Number of women with urinary incontinence (worse, unchanged, or improved) at 1 to 5 years (women's observations).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 5 Number of women with urinary incontinence (worse, unchanged, or improved) at > 5 years (women's observations).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 6 CURE: number of women cured at > 1 year (women's observations).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 7 Number of women not satisfied at > 5 years.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 10 Number of women with urinary incontinence (clinician's observations) at 1 to 5 years.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 11 Number of women with urinary incontinence (clinician's observations) at > 5 years.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 12 Duration of operation (minutes).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 13 Time to catheter removal (days).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 14 Length of hospital stay (days).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 16 Perioperative surgical complications.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 17 Bladder perforation.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 18 Urinary tract infection.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 19 Number of women with recurrent UTIs at > 5 years.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 20 Urge urinary symptoms, urgency urinary incontinence.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 21 Detrusor overactivity (urodynamic diagnosis).
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 22 Voiding dysfunction after 3 months.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 23 Long‐term voiding dysfunction > 5 years.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 24 Number of women requiring treatment for pelvic organ prolapse.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 25 Repeat surgery for urinary incontinence.
Comparison 15 Traditional suburethral sling operation versus open abdominal retropubic colposuspension, Outcome 26 Condition‐specific measures to assess quality of life.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 1 Number of women with urinary incontinence (worse, unchanged, or improved) within first year (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 2 Number not improved (worse or unchanged) within first year (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 3 Number of women with urinary incontinence (worse, unchanged, or improved) at 1 to 5 years (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 4 Number not improved (worse or unchanged) after first year (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 5 Number of women with urinary incontinence after 5 years (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 6 Number with incontinence not improved after 5 years (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 7 CURE: number of women cured at > 1 year (women's observations).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 8 Repeat surgery for urinary incontinence.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 9 Number of women not satisfied.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 10 Pad test of quantified leakage (mean weight of urine loss).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 11 Number of women with urinary incontinence (clinician's observations) within first year.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 12 Number of women with urinary incontinence (clinician's observations) after first year.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 13 Duration of operation (minutes).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 14 Length of hospital stay (days).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 15 Time to catheter removal (days).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 16 Perioperative surgical complications.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 17 Bladder perforations.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 18 Urethral injury.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 19 Vaginal bleeding.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 20 Urinary tract infection.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 21 Voiding dysfunction.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 22 De novo detrusor urgency or urge symptoms.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 23 De novo detrusor overactivity (urodynamic diagnosis).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 24 Long‐term adverse effects (release of sling required).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 25 Long‐term adverse effects (wound pain at 6 months).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 26 Long‐term adverse effects (vaginal mesh or graft exposure).
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 27 Condition‐specific measures to assess quality of life: UDI‐6.
Comparison 16 Traditional suburethral sling operation versus a mid‐urethral sling or tape, Outcome 28 Condition‐specific measures to assess quality of life: IIQ‐7.
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 1 Number of women with urinary incontinence in the medium term (1 to 5 years).
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 2 Number of women not satisfied within first year.
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 3 Number of women with urinary incontinence (clinician's observations) within first year.
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 4 CURE: number of women cured at > 1 year (women's observations).
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 5 Bladder perforation.
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 6 Urge urinary symptoms, urgency urinary incontinence.
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 7 Pain with intercourse (dyspareunia).
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 8 Long‐term adverse effects (vaginal mesh or graft exposure).
Comparison 17 Traditional suburethral sling operation versus a single‐incision sling (mini‐sling), Outcome 9 Condition‐specific measures to assess quality of life: IIQ score.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 1 Number of women with urinary incontinence (worse, unchanged, or improved) within first year (women's observations).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 2 Number not improved (worse or unchanged) within first year (women's observations).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 3 Number of women with urinary incontinence (worse, unchanged, or improved) at 1 to 5 years (women's observations).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 4 Number not improved (worse or unchanged) after first year (women's observations).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 5 Number of women with urinary incontinence (worse, unchanged, or improved) after 5 years (women's observations).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 6 CURE: number of women with urinary incontinence > 1 year (women's observations).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 7 Number of women not satisfied.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 8 Pad test of quantified leakage (mean weight of urine loss) at 1 year.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 9 Pad test of quantified leakage (mean weight of urine loss) at 1 to 5 years.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 10 Duration of operation (minutes).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 11 Blood loss (mL).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 12 Length of hospital stay (days).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 13 Perioperative surgical complications.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 14 Bladder perforation.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 15 Urinary tract infection.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 16 Vaginal bleeding.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 17 Long‐term adverse effects (wound pain).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 18 Voiding dysfunction.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 19 Long‐term adverse effects (release of sling required).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 20 De novo detrusor urgency or urge symptoms or detrusor overactivity.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 21 Repeat surgery for urinary incontinence at first year.
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 22 Long‐term adverse effects (vaginal mesh or graft exposure).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 23 Condition‐specific measures to assess quality of life (ICI‐Q short form UI score at 1 year).
Comparison 18 One type of traditional sling operation versus another type of traditional sling operation, Outcome 24 Condition‐specific measures to assess quality of life (ICI‐Q short form UI score at 1 to 5 years).
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References
References to studies included in this review
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Al‐Azzawi 2014 {published data only}
Albo 2007 {published data only}
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Bai 2005 {published data only}
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Barbalias 1997 {published data only}
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Choe 2000 {published data only}
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Demirci 2001 {published data only}
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Enzelsberger 1996 {published data only}
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Fischer 2001 {published data only}
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Guerrero 2008 {published data only}
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Helmy 2012 {published data only}
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Henriksson 1978 {published data only}
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Hilton 1989 {published data only}
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Kondo 2006 {published data only}
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Lucas 2000 {published data only}
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- Guerrero K, Watkins A, Emery S, Wareham K, Stephenson T, Logan V, et al. A randomised controlled trial comparing two autologous fascial sling techniques for the treatment of stress urinary incontinence in women: short, medium and long‐term follow‐up. International Urogynecology Journal 2007;18(11):1263‐70. [sr‐incont23957] - PubMed
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Maher 2005 {published data only}
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Okulu 2013 {published data only}
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- Okulu E, Kayigil O, Aldemir M, Onen E. The use of three types of synthetic mesh materials in the surgery for stress incontinence: the clinical results (Abstract number 765). International Urogynecology Journal and Pelvic Floor Dysfunction 2011;22(2 Suppl):S1024‐5. [sr‐incont62216]
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Osman 2003 {published data only}
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- Osman T. Stress incontinence surgery for patients presenting with mixed incontinence and a normal cystometrogram. BJU International 2003;92:964‐8. [sr‐incont16660] - PubMed
Pacetta 2005 {published data only}
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Sand 2000 {published data only}
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- Culligan PJ, Winkler HA, Blackhurst DW, Sand PK. A prospective randomized study of modified Burch retro pubic urethropexy and suburethral sling for genuine stress incontinence and low pressure urethra (Abstract). Proceedings of the International Continence Society (ICS), 28th Annual Meeting, 1998 Sept 14‐17, Jerusalem, Israel. 1998:133. [sr‐incont5689]
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Sharifiaghdas 2008 {published data only}
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Sharifiaghdas 2015 {published data only}
Shin 2001 {published data only}
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- Shin MS, Kim JH, Koh JS, Jung JH. Comparison of the results of sling procedure using autologous dermal graft patch and cadaveric fascia lata as a sling material for stress urinary incontinence (Abstract). Proceedings of the International Continence Society (ICS), 31st Annual Meeting, 2001 Sept 18‐21, Seoul, Korea. 2001:Abstract number 313. [sr‐incont14477]
Silva Filho 2006 {published data only}
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- Silva‐Filho AL, Candido EB, Noronha A, Triginelli SA. Comparative study of autologous pubovaginal sling and synthetic transobturator (TOT) SAFYRE sling in the treatment of stress urinary incontinence. Archives of Gynecology and Obstetrics 2006;273(5):288‐92. [sr‐incont21600] - PubMed
Song 2004 {published data only}
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- Song YF, Huang HJ, Xu B, Hao L. Comparative study of tension‐free vaginal tape and fascia lata for stress urinary incontinence [Chinese]. Chung‐Hua Fu Chan Ko Tsa Chih [Chinese Journal of Obstetrics and Gynecology] 2004;39(10):658‐61. [sr‐incont20768] - PubMed
Tcherniakovsky 2009 {published data only}
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- Tcherniakovsky M, Fernandes CE, Bezerra CA, Roy CA, Wroclawski ER. Comparative results of two techniques to treat stress urinary incontinence: synthetic transobturator and aponeurotic slings. International Urogynecology Journal 2009;20(8):961‐6. [sr‐incont32120] - PubMed
Teixeira 2008 {published data only}
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- Teixeira M, Pinto AR, Montalvao M, Candoso B. Systemic and local inflammatory response in collagen vs. polypropylene tapes for stress urinary incontinence: is there any difference? (Abstract number 527). Proceedings of the 38th Annual Meeting of the International Continence Society (ICS), 2008 Oct 20‐24, Cairo, Egypt. 2008. [sr‐incont31878]
Teleb 2011 {published data only}
Viseshsindh 2003 {published data only}
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- Viseshsindh W, Kochakarn W, Waikakul W, Roongruangsilp U. A randomized controlled trial of pubovaginal sling versus vaginal wall sling for stress urinary incontinence. Journal of the Medical Association of Thailand 2003;86(4):308‐15. [sr‐incont15733] - PubMed
Wadie 2005 {published data only}
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- Wadie B, Henawy A. Does urethral pressure measurement correlate to the outcome of incontinence surgery? (Abstract number 546). Proceedings of the 37th Annual Meeting of the ICS, 2007 Aug 20‐24, Rotterdam, The Netherlands. 2007. [sr‐incont26689]
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- Wadie BS, Edwan A, Nabeeh A. Autologous fascial sling verus polypropylene tape at short term follow up, a prospective randomized study (Abstract number 636). Proceedings of the International Continence Society (ICS), 35th Annual Meeting, 2005 Aug 28‐Sep 2, Montreal, Canada. 2005. [sr‐incont21100]
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- Wadie BS, Edwan A, Nabeeh AM. Autologous fascial sling vs polypropylene tape at short‐term followup: a prospective randomized study. Journal of Urology 2005;174(3):990‐3. [sr‐incont20796] - PubMed
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- Wadie BS, Mansour A, El‐Hefnawy AS, Nabeeh A, Khair AA. Minimum 2‐year follow‐up of mid‐urethral slings, effect on quality of life, incontinence impact and sexual function. International Urogynecology Journal 2010;21(12):1485‐90. [sr‐incont41437] - PubMed
Zargham 2013 {published data only}
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- Zargham M, Alizadeh F, Tadayyon F, Khorrami M‐H, Nouri‐Mahdavi K, Gharaati MR, et al. Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes. Journal of Research in Medical Sciences 2013;18(7):588‐93. [sr‐incont59874] - PMC - PubMed
References to studies excluded from this review
Amat 2007 {published data only}
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- Amat LL, Franco EM, Saavedra AH, Martinez AV. Needleless (R): A new technique for correction of urinary incontinence. Randomized controlled trial compared with TVT‐O (R). Preliminary results (Abstract number 225). International Urogynecology Journal and Pelvic Floor Dysfunction 2007;18(Suppl 1):S128. [27329]
Atherton 2000 {published data only}
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- Atherton MJ, Stanton SL. TVT and colposuspension: comparisons and contrasts of possible mechanisms (Abstract). Neurourology and Urodynamics 2000;19(4):396‐8.
Aurunkalaivanan 2001 {published data only}
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- Arunkalaivanan AS, Barrington JW. Comparison of porcine pubovaginal sling (Pelvicol) vs tension free vaginal tape (TVT) in the surgical management of stress incontinence (Abstract). International Urogynecology Journal 2001;12(Suppl 3):S21. - PubMed
Barrington 2003 {published data only}
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- Barrington JW. Pelvicol implant vs TVT ‐ a randomised prospective study. Proceedings of the BARD Satellite Symposium to the International Continence Society Annual Meeting, 7 Oct. 2003; Vol. 8.
Brandt 2009 {published data only}
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- Brandt FT, Lorenzato F, Albuquerque CDC, Machado AS, Poca AC, Viana RA. Tension‐free vaginal tape versus lata fascia sling: the importance of transvulvar ultrasound in the assessment of relevant anatomical parameters in treatment of women with stress urinary incontinence. Indian Journal of Urology 2009;25(1):62‐7. [sr‐incont42535] - PMC - PubMed
Bruschini 2005 {published data only}
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- Bruschini H, Nunes R, Truzzi JC, Simonetti R, Cury J, Ortiz V, et al. Low cost polypropylene sling procedure for correction of stress urinary incontinence: a possible solution for developing countries? (Abstract number 360). Proceedings of the International Continence Society (ICS), 35th Annual Meeting, 2005 Aug 28‐Sep 2, Montreal, Canada. 2005. [21055]
Choe 2001 {published data only}
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- Choe JM. Sling surgery performed with and without preoperative urodynamics: a comparative outcomes analysis. Proceedings of the International Continence Society (ICS), 31st Annual Meeting, 2001 Sept 18‐21, Seoul, Korea. 2001:Abstract number 175.
Chong 2003 {published data only}
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- Chong C, Bane A, Corstiaans A. Intraoperative division of tensionless vaginal tape (TVT) ‐ prospective randomized trial (Abstract). Singapore Journal of Obstetrics and Gynaecology 2003;34(Suppl 1):55.
Corcos 2001 {published data only}
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- Corcos J, Collet JP, Shapiro S, Herschorn S, Radomski SB, Schick E, et al. Multicenter randomized clinical trial comparing surgery and collagen injections for treatment of female stress urinary incontinence. Urology 2005;65(5):898‐904. [20346] - PubMed
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- Corcos J, Collet JP, Shappiro S, Schick E, Macramallah E, Tessier J, et al. Surgery vs collagen for the treatment of female stress urinary incontinence (SUI): results of a multicentric randomized trial (Abstract). Journal of Urology 2001;165(5 Suppl):198.
Darai 2007 {published data only}
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References to studies awaiting assessment
Abou Hashem 2017 {published data only}
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