Cochrane · systematic review · CD006375
Mid‐urethral sling operations for stress urinary incontinence in women
Ford, AA, Rogerson, L, Cody, JD, et al. · Cochrane Database of Systematic Reviews · 2017 · 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
43
current version
GRADE rated
31
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 12 · 27.9%Very low 3 · 7%Low 9 · 20.9%Moderate 17 · 39.5%High 2 · 4.7%
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
Show all 3 versionsTransobturator (TOR) compared to retropubic (RPR) route for stress urinary incontinence in women
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure (Short term < 1 year) Transobturator (TOR) vs retropubic (RPR) route | RR 0.98 [0.96, 1] | 36 studies · 5514 participants | Moderate Downgraded: risk of bias |
Subjective cure (medium term, 1 to 5 years) Transobturator (TOR) vs retropubic (RPR) route | RR 0.97 [0.92, 1.03] | 5 studies · 683 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Subjective cure (long term, > 5 years) Transobturator (TOR) vs retropubic (RPR) route | RR 0.95 [0.87, 1.04] | 4 studies · 714 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Bladder or urethral perforation Transobturator (TOR) vs retropubic (RPR) route | RR 0.13 [0.08, 0.2] | 40 studies · 6372 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Voiding dysfunction (short and medium term, up to 5 years) Transobturator (TOR) vs retropubic (RPR) route | RR 0.53 [0.43, 0.65] | 37 studies · 6217 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
De novo urgency or urgency incontinence (short term, up to 12 months) Transobturator (TOR) vs retropubic (RPR) route | RR 0.98 [0.82, 1.17] | 31 studies · 4923 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Groin pain Transobturator (TOR) vs retropubic (RPR) route | RR 4.62 [3.09, 6.92] | 18 studies · 3226 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Suprapubic pain Transobturator (TOR) vs retropubic (RPR) route | RR 0.29 [0.11, 0.78] | 4 studies · 1105 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Vaginal tape erosion (short and medium term, up to 5 years) Transobturator (TOR) vs retropubic (RPR) route | RR 1.13 [0.78, 1.65] | 31 studies · 4743 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Repeat incontinence surgery (short term, within 12 months) Transobturator (TOR) vs retropubic (RPR) route | RR 1.64 [0.85, 3.16] | 9 studies · 1402 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Repeat incontinence surgery (long term, > 5 years) Transobturator (TOR) vs retropubic (RPR) route | RR 8.79 [3.36, 23] | 4 studies · 695 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Transobturator (TOR) vs retropubic (RPR) route | no estimate extracted | 11 studies · 11 participants | Ungraded |
Retropubic bottom‐to‐top approach compared to retropubic top‐to‐bottom approach for stress urinary incontinence in women
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure (short term, ≤ 1 year) Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 1.1 [1.01, 1.2] | 3 studies · 492 participants | Moderate Downgraded: risk of bias |
Subjective cure (medium term, 1 to 5 years) Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | no estimate extracted | 0 studies · 0 participants | Ungraded |
Subjective cure long term: > 5 years Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | no estimate extracted | 0 studies · 0 participants | Ungraded |
Bladder or urethral perforation Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 0.55 [0.31, 0.98] | 5 studies · 631 participants | Moderate Downgraded: risk of bias, imprecision |
Voiding dysfunction Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 0.4 [0.18, 0.9] | 5 studies · 631 participants | Moderate Downgraded: risk of bias, imprecision |
De novo urgency or urgency incontinence Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 0.84 [0.52, 1.34] | 4 studies · 547 participants | Low Downgraded: risk of bias, imprecision |
Vaginal tape erosion Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 0.27 [0.08, 0.95] | 4 studies · 569 participants | Moderate Downgraded: risk of bias, imprecision |
Repeat incontinence surgery short term Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | no estimate extracted | 0 studies · 0 participants | Ungraded |
Repeat incontinence surgery long term Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life (IIQ scores) Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | no estimate extracted | 1 study · 84 participants | Ungraded |
Obturator medial‐to‐lateral approach compared to obturator lateral‐to‐medial approach for stress urinary incontinence in women
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure (short term ≤ 1 year) Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1 [0.96, 1.06] | 6 studies · 759 participants | Low Downgraded: risk of bias |
Subjective cure (medium term, 1 to 5 years) Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.06 [0.91, 1.23] | 2 studies · 235 participants | Low Downgraded: risk of bias, imprecision |
Subjective cure Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | no estimate extracted | 0 studies · 0 participants | Ungraded |
Bladder or urethral perforation Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 0.38 [0.07, 1.92] | 6 studies · 794 participants | Moderate Downgraded: risk of bias, imprecision |
Voiding dysfunction (short and medium term, up to 5 years) Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.74 [1.06, 2.88] | 8 studies · 1121 participants | Moderate Downgraded: risk of bias, imprecision |
De novo urgency or urgency incontinence (short term, up to 12 months) Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.01 [0.46, 2.2] | 3 studies · 357 participants | Low Downgraded: risk of bias, imprecision |
Groin pain Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.15 [0.75, 1.76] | 6 studies · 837 participants | Very low Downgraded: risk of bias, imprecision |
Vaginal tape erosion (short and medium term, up to 5 years) Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 0.42 [0.16, 1.09] | 7 studies · 1087 participants | Very low Downgraded: risk of bias, imprecision |
Repeat incontinence surgery (short term, up to 12 months) Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 0.64 [0.32, 1.3] | 2 studies · 532 participants | Low Downgraded: risk of bias, imprecision |
Repeat incontinence surgery Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | no estimate extracted | 1 study · 46 participants | Very low Downgraded: risk of bias, imprecision |
Monofilament compared to multifilament tapes for stress urinary incontinence in women
Population: women with stress urinary incontinence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure (short term ≤ 1 year) Monofilament vs multifilament tapes | RR 1.07 [0.98, 1.16] | 4 studies · 505 participants | Moderate Downgraded: risk of bias |
Subjective cure (medium term: 1 to 5 years) Monofilament vs multifilament tapes | no estimate extracted | 0 studies · 0 participants | Ungraded |
Subjective cure (long term: > 5 years) Monofilament vs multifilament tapes | no estimate extracted | 0 studies · 0 participants | Ungraded |
Bladder or urethral perforation Monofilament vs multifilament tapes | RR 0.76 [0.29, 1.99] | 4 studies · 496 participants | Moderate Downgraded: risk of bias |
Voiding dysfunction Monofilament vs multifilament tapes | RR 2.2 [0.98, 4.92] | 3 studies · 400 participants | Low Downgraded: risk of bias, imprecision |
De novo urgency or urgency incontinence Monofilament vs multifilament tapes | RR 1.09 [0.66, 1.82] | 4 studies · 496 participants | Low Downgraded: risk of bias, imprecision |
Vaginal tape erosion Monofilament vs multifilament tapes | RR 0.43 [0.16, 1.14] | 3 studies · 396 participants | High |
Repeat incontinence surgery (short term ≤ 1 year) Monofilament vs multifilament tapes | no estimate extracted | 0 studies · 0 participants | Ungraded |
Repeat incontinence surgery (long term > 5 years) Monofilament vs multifilament tapes | no estimate extracted | 0 studies · 0 participants | Ungraded |
Quality of life scores ICIQ Monofilament vs multifilament tapes | no estimate extracted | 1 study · 96 participants | High |