What do systematic reviews say?

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

Obturator medial‐to‐lateral approach showed no clear difference in subjective cure (short term ≤ 1 year) compared with obturator lateral‐to‐medial approach (low certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 1 [0.96, 1.06]
  6 studies · 759 participants
  Low

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

Obturator medial‐to‐lateral approach showed no clear difference in subjective cure (medium term, 1 to 5 years) compared with obturator lateral‐to‐medial approach (low certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 1.06 [0.91, 1.23]
  2 studies · 235 participants
  Low

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

Obturator medial‐to‐lateral approach showed no clear difference in bladder or urethral perforation compared with obturator lateral‐to‐medial approach (moderate certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 0.38 [0.07, 1.92]
  6 studies · 794 participants
  Moderate

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

Obturator medial‐to‐lateral approach probably leads to higher voiding dysfunction (short and medium term, up to 5 years) compared with obturator lateral‐to‐medial approach (moderate certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 1.74 [1.06, 2.88]
  8 studies · 1121 participants
  Moderate

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

Obturator medial‐to‐lateral approach showed no clear difference in de novo urgency or urgency incontinence (short term, up to 12 months) compared with obturator lateral‐to‐medial approach (low certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 1.01 [0.46, 2.2]
  3 studies · 357 participants
  Low

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

It is very uncertain whether obturator medial‐to‐lateral approach changes groin pain compared with obturator lateral‐to‐medial approach (very low certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 1.15 [0.75, 1.76]
  6 studies · 837 participants
  Very low

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

It is very uncertain whether obturator medial‐to‐lateral approach changes vaginal tape erosion (short and medium term, up to 5 years) compared with obturator lateral‐to‐medial approach (very low certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 0.42 [0.16, 1.09]
  7 studies · 1087 participants
  Very low

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

Obturator medial‐to‐lateral approach showed no clear difference in repeat incontinence surgery (short term, up to 12 months) compared with obturator lateral‐to‐medial approach (low certainty).

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  RR 0.64 [0.32, 1.3]
  2 studies · 532 participants
  Low
• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach

• Mid‐urethral sling operations for stress urinary incontinence in women 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 46 participants
  Very low