Cochrane · systematic review · CD001754
Traditional suburethral sling operations for urinary incontinence in women
Saraswat, L, Rehman, H, Omar, MI, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
56
current version
GRADE rated
23
No studies
33
Included studies
NR
No studies 33 · 58.9%Ungraded 0 · 0%Very low 15 · 26.8%Low 5 · 8.9%Moderate 2 · 3.6%High 1 · 1.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyTraditional suburethral sling operation versus no treatment or sham operation
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs no treatment or sham operation | no estimate extracted | NR | No studies |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs no treatment or sham operation | no estimate extracted | NR | No studies |
Perioperative surgical complications Traditional suburethral sling operation vs no treatment or sham operation | no estimate extracted | NR | No studies |
Long‐term adverse effects Traditional suburethral sling operation vs no treatment or sham operation | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs no treatment or sham operation | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus conservative management
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs conservative management | no estimate extracted | NR | No studies |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs conservative management | no estimate extracted | NR | No studies |
Perioperative surgical complications Traditional suburethral sling operation vs conservative management | no estimate extracted | NR | No studies |
Long‐term adverse effects Traditional suburethral sling operation vs conservative management | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs conservative management | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus drugs
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs drugs | no estimate extracted | NR | No studies |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs drugs | no estimate extracted | NR | No studies |
Perioperative surgical complications Traditional suburethral sling operation vs drugs | no estimate extracted | NR | No studies |
Long‐term adverse effects Traditional suburethral sling operation vs drugs | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs drugs | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus injectables
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs injectables | OR 11.57 [0.56, 239.7] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Repeat surgery for urinary incontinence ‐ urodynamic stress incontinence (only) Traditional suburethral sling operation vs injectables | RR 0.52 [0.05, 5.36] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Perioperative surgical complications Urinary tract infection ‐ stress urinary incontinence (symptoms only) Traditional suburethral sling operation vs injectables | RR 1.57 [0.29, 8.49] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Long‐term adverse effects Traditional suburethral sling operation vs injectables | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs injectables | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus anterior repair
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs anterior repair | no estimate extracted | NR | No studies |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs anterior repair | no estimate extracted | NR | No studies |
Perioperative surgical complications Traditional suburethral sling operation vs anterior repair | no estimate extracted | NR | No studies |
Long‐term adverse effects Traditional suburethral sling operation vs anterior repair | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs anterior repair | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus bladder neck needle suspension (abdominal and vaginal)
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs bladder neck needle suspension (abdominal and vaginal) | OR 3.86 | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs bladder neck needle suspension (abdominal and vaginal) | no estimate extracted | NR | No studies |
Perioperative surgical complications ‐ urodynamic stress incontinence (only) Traditional suburethral sling operation vs bladder neck needle suspension (abdominal and vaginal) | RR 4.5 [1.28, 15.81] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Long‐term adverse effects Traditional suburethral sling operation vs bladder neck needle suspension (abdominal and vaginal) | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs bladder neck needle suspension (abdominal and vaginal) | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus open abdominal retropubic colposuspension
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs open abdominal retropubic colposuspension | OR 1.7 [1.22, 2.37] | 4 studies · 687 participants | Moderate Downgraded: risk of bias |
Repeat surgery for urinary incontinence‐stress urinary incontinence (symptoms only) Traditional suburethral sling operation vs open abdominal retropubic colposuspension | RR 0.15 [0.05, 0.42] | 1 study · 450 participants | High |
Perioperative surgical complications Traditional suburethral sling operation vs open abdominal retropubic colposuspension | RR 1.24 [0.83, 1.86] | 4 studies · 792 participants | Very low Downgraded: risk of bias, imprecision |
Long‐term adverse effects Number of women with recurrent UTIs at > 5 years Traditional suburethral sling operation vs open abdominal retropubic colposuspension | RR 1.02 [0.57, 1.82] | 1 study · 453 participants | Low Downgraded: risk of bias, imprecision |
Condition‐specific quality of life Health status measures ‐ Incontinence Impact Questionnaire (IIQ) Traditional suburethral sling operation vs open abdominal retropubic colposuspension | no estimate extracted | 1 study · 453 participants | Low Downgraded: risk of bias, imprecision |
Traditional suburethral sling operation versus laparoscopic colposuspension
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs laparoscopic colposuspension | no estimate extracted | NR | No studies |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs laparoscopic colposuspension | no estimate extracted | NR | No studies |
Perioperative surgical complications Traditional suburethral sling operation vs laparoscopic colposuspension | no estimate extracted | NR | No studies |
Voiding dysfunction Traditional suburethral sling operation vs laparoscopic colposuspension | no estimate extracted | NR | No studies |
Long‐term adverse effects Traditional suburethral sling operation vs laparoscopic colposuspension | no estimate extracted | NR | No studies |
Condition‐specific quality of life Traditional suburethral sling operation vs laparoscopic colposuspension | no estimate extracted | NR | No studies |
Traditional suburethral sling operation versus a mid‐urethral sling or tape
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs a mid‐urethral sling or tape | OR 0.67 [0.44, 1.02] | 6 studies · 445 participants | Moderate Downgraded: risk of bias |
Repeat surgery for urinary incontinence ‐ urodynamic stress incontinence (only) Traditional suburethral sling operation vs a mid‐urethral sling or tape | no estimate extracted | 1 study · 136 participants | Low Downgraded: risk of bias, imprecision |
Perioperative surgical complications Traditional suburethral sling operation vs a mid‐urethral sling or tape | RR 1.74 [1.16, 2.6] | 4 studies · 293 participants | Low Downgraded: risk of bias, imprecision |
Long‐term adverse effects Release of sling required Traditional suburethral sling operation vs a mid‐urethral sling or tape | RR 2.53 [0.87, 7.35] | 3 studies · 326 participants | Very low Downgraded: risk of bias, imprecision |
Condition‐specific quality of life IIQ‐7 ‐ stress urinary incontinence (symptoms only) Traditional suburethral sling operation vs a mid‐urethral sling or tape | no estimate extracted | 1 study · 63 participants | Very low Downgraded: risk of bias, imprecision |
Traditional suburethral sling operation versus a single‐incision sling (mini‐sling)
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) Traditional suburethral sling operation vs a single‐incision sling (mini‐sling) | OR 1 [0.23, 4.36] | 1 study · 70 participants | Very low Downgraded: risk of bias |
Repeat surgery for urinary incontinence Traditional suburethral sling operation vs a single‐incision sling (mini‐sling) | no estimate extracted | NR | No studies |
Perioperative surgical complications ‐ bladder perforation Traditional suburethral sling operation vs a single‐incision sling (mini‐sling) | RR 3 [0.13, 71.22] | 1 study · 70 participants | Very low Downgraded: risk of bias |
Long‐term adverse effects Traditional suburethral sling operation vs a single‐incision sling (mini‐sling) | no estimate extracted | NR | No studies |
Condition‐specific quality of life IIQ Traditional suburethral sling operation vs a single‐incision sling (mini‐sling) | no estimate extracted | 1 study · 70 participants | Very low Downgraded: risk of bias |
One type of traditional sling operation versus another traditional sling operation
Population: women with urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of continent (dry) women (any definition) in the medium term (1 to 5 years) One type of traditional sling operation vs another traditional sling operation | no estimate extracted | 7 studies · 749 participants | Very low Downgraded: imprecision, inconsistency |
Repeat surgery for urinary incontinence at first year Fascial sling vs Pelvicol sling One type of traditional sling operation vs another traditional sling operation | RR 0.04 [0, 0.61] | 1 study · 113 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Perioperative surgical complications One type of traditional sling operation vs another traditional sling operation | no estimate extracted | 3 studies · 239 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Long‐term adverse effects Vaginal mesh or graft exposure One type of traditional sling operation vs another traditional sling operation | no estimate extracted | 3 studies · 421 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Condition‐specific quality of life ICI‐Q short form UI score at 1 to 5 years One type of traditional sling operation vs another traditional sling operation | no estimate extracted | 1 study · 282 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Traditional suburethral slings compared to injectable treatment for stress urinary incontinence
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
4.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral slings vs injectable treatment | RR 0.42 [0.09, 1.93] | 1 study · 43 participants | Very low Downgraded: risk of bias, inconsistency |
4.2 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral slings vs injectable treatment | RR 0.12 [0.01, 2.02] | 1 study · 27 participants | Low Downgraded: risk of bias, inconsistency |
4.4 Voiding dysfunction Traditional suburethral slings vs injectable treatment | RR 4.19 [0.51, 34.5] | 1 study · 43 participants | Low Downgraded: risk of bias, inconsistency |
Traditional suburethral sling operation compared to open abdominal retropubic suspension for stress urinary incontinence
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
5.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 0.4 [0.11, 1.41] | 4 studies · 147 participants | Low Downgraded: risk of bias, imprecision |
5.3 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 0.75 [0.62, 0.9] | 5 studies · 715 participants | Moderate Downgraded: risk of bias |
5.14 Peri‐operative surgical complications Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 1.31 [1.14, 1.51] | 4 studies · 792 participants | Moderate Downgraded: risk of bias |
5.15 Bladder perforation Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 0 [0, 0] | 1 study · 655 participants | Moderate Downgraded: risk of bias |
5.18 Voiding dysfunction after three months Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 6.08 [3.1, 11.95] | 5 studies · 853 participants | Moderate Downgraded: risk of bias |
5.21 Repeat incontinence surgery ‐ not reported Traditional suburethral sling operation vs open abdominal retropubic suspension | no estimate extracted | NR | No studies |
Traditional suburethral sling operation compared to bladder neck (needle) suspension for stress urinary incontinence
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
6.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 0.5 [0.05, 4.67] | 1 study · 20 participants | Very low Downgraded: risk of bias, inconsistency |
6.2 Number with incontinence (worse, unchanged or improved) after the first year (women's observations) Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 0.33 [0.04, 2.69] | 1 study · 20 participants | Very low Downgraded: risk of bias, inconsistency |
6.4 Peri‐operative surgical complications Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 4.5 [1.28, 15.81] | 1 study · 20 participants | Low Downgraded: risk of bias, inconsistency |
6.6 Voiding dysfunction after three months ‐ urodynamic stress incontinence (only) Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 2 [0.47, 8.56] | 1 study · 20 participants | Very low Downgraded: risk of bias, inconsistency |
Traditional suburethral sling operation compared to minimally invasive synthetic slings for stress urinary incontinence
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
9.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 0.97 [0.78, 1.2] | 8 studies · 693 participants | High |
9.3 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 1.23 [0.91, 1.66] | 4 studies · 382 participants | Low Downgraded: risk of bias, imprecision |
9.11 Peri‐operative surgical complications Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 1.59 [1.03, 2.44] | 3 studies · 243 participants | Low Downgraded: risk of bias |
9.12 Bladder perforations Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 0.62 [0.34, 1.11] | 7 studies · 563 participants | Moderate Downgraded: risk of bias, imprecision |
9.16 Voiding dysfunction Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 1.6 [0.94, 2.71] | 5 studies · 375 participants | Moderate Downgraded: risk of bias, imprecision |
Traditional suburethral sling operation compared to another traditional suburethral sling for stress urinary incontinence
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
10.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs another traditional suburethral sling | RR 0.89 [0.66, 1.19] | 3 studies · 307 participants | Moderate Downgraded: risk of bias, imprecision |
10.3 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral sling operation vs another traditional suburethral sling | RR 0.89 [0.72, 1.1] | 4 studies · 379 participants | Moderate Downgraded: risk of bias |
10.8 Peri‐operative surgical complications Traditional suburethral sling operation vs another traditional suburethral sling | RR 0.93 [0.65, 1.33] | 2 studies · 213 participants | Low Downgraded: imprecision |
10.12 Voiding dysfunction Traditional suburethral sling operation vs another traditional suburethral sling | RR 1.16 [0.65, 2.07] | 1 study · 165 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Traditional suburethral slings compared to injectable treatment for stress urinary incontinence
Population: patients with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
4.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral slings vs injectable treatment | RR 0.42 [0.09, 1.93] | 1 study · 43 participants | Very low Downgraded: risk of bias, inconsistency |
4.2 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral slings vs injectable treatment | RR 0.12 [0.01, 2.02] | 1 study · 27 participants | Low Downgraded: risk of bias, inconsistency |
4.4 Voiding dysfunction Traditional suburethral slings vs injectable treatment | RR 4.19 [0.51, 34.5] | 1 study · 43 participants | Low Downgraded: risk of bias, inconsistency |
Traditional suburethral sling operation compared to open abdominal retropubic suspension for stress urinary incontinece
Population: patients with stress urinary incontinece
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
5.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 0.4 [0.11, 1.41] | 4 studies · 147 participants | Low Downgraded: risk of bias, imprecision |
5.3 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 0.75 [0.62, 0.9] | 5 studies · 715 participants | Moderate Downgraded: risk of bias |
5.14 Peri‐operative surgical complications Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 1.31 [1.14, 1.51] | 4 studies · 792 participants | Moderate Downgraded: risk of bias |
5.15 Bladder perforation Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 0 [0, 0] | 1 study · 655 participants | Moderate Downgraded: risk of bias |
5.18 Voiding dysfunction after three months Traditional suburethral sling operation vs open abdominal retropubic suspension | RR 6.08 [3.1, 11.95] | 5 studies · 853 participants | Moderate Downgraded: risk of bias |
5.21 Repeat incontinence surgery ‐ not reported Traditional suburethral sling operation vs open abdominal retropubic suspension | no estimate extracted | NR | No studies |
Traditional suburethral sling operation compared to bladder neck (needle) suspension for stress urinary incontinence
Population: patients with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
6.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 0.5 [0.05, 4.67] | 1 study · 20 participants | Very low Downgraded: risk of bias, inconsistency |
6.2 Number with incontinence (worse, unchanged or improved) after the first year (women's observations) Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 0.33 [0.04, 2.69] | 1 study · 20 participants | Very low Downgraded: risk of bias, inconsistency |
6.4 Peri‐operative surgical complications Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 4.5 [1.28, 15.81] | 1 study · 20 participants | Low Downgraded: risk of bias, inconsistency |
6.6 Voiding dysfunction after three months ‐ urodynamic stress incontinence (only) Traditional suburethral sling operation vs bladder neck (needle) suspension | RR 2 [0.47, 8.56] | 1 study · 20 participants | Very low Downgraded: risk of bias, inconsistency |
Traditional suburethral sling operation compared to minimally invasive synthetic slings for stress urinary incontinence
Population: stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
9.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 0.97 [0.78, 1.2] | 8 studies · 693 participants | High |
9.3 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 1.23 [0.91, 1.66] | 4 studies · 382 participants | Low Downgraded: risk of bias, imprecision |
9.11 Peri operative surgical complications Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 1.59 [1.03, 2.44] | 3 studies · 243 participants | Low Downgraded: risk of bias |
9.12 Bladder perforations Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 0.62 [0.34, 1.11] | 7 studies · 563 participants | Moderate Downgraded: risk of bias, imprecision |
9.16 Voiding dysfunction Traditional suburethral sling operation vs minimally invasive synthetic slings | RR 1.6 [0.94, 2.71] | 5 studies · 375 participants | Moderate Downgraded: risk of bias, imprecision |
9.21 Hospital costs (US Dollars) Traditional suburethral sling operation vs minimally invasive synthetic slings | no estimate extracted | 1 study · 44 participants | Low Downgraded: risk of bias |
Traditional suburethral sling operation compared to another traditional suburethral sling for stress urinary incontinence
Population: patients with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
10.1 Number with incontinence (worse, unchanged or improved) within the first year (women's observations) Traditional suburethral sling operation vs another traditional suburethral sling | RR 0.89 [0.66, 1.19] | 3 studies · 307 participants | Moderate Downgraded: risk of bias, imprecision |
10.3 Number with incontinence (worse, unchanged or improved) after first year (women's observations) Traditional suburethral sling operation vs another traditional suburethral sling | RR 0.89 [0.72, 1.1] | 4 studies · 379 participants | Moderate Downgraded: risk of bias |
10.8 Peri operative surgical complications Traditional suburethral sling operation vs another traditional suburethral sling | RR 0.93 [0.65, 1.33] | 2 studies · 213 participants | Low Downgraded: imprecision |
10.12 Voiding dysfunction Traditional suburethral sling operation vs another traditional suburethral sling | RR 1.16 [0.65, 2.07] | 1 study · 165 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |