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
Current version onlyTransobturator (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 |
Transobturator (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 |
Cost effectiveness of intervention Transobturator (TOR) vs retropubic (RPR) route | no estimate extracted | 1 study · 1 participants | Ungraded |
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 |
Cost effectiveness of intervention 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 |
Cost effectiveness of intervention 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 |
Cost effectiveness of intervention 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 |
Minimally invasive synthetic suburethral sling operation compared to traditional slings for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months Minimally invasive synthetic suburethral sling operation vs traditional slings | RR 1.03 [0.94, 1.13] | 8 studies · 599 participants | Moderate Downgraded: risk of bias |
Denovo urgency or urgency incontinence Minimally invasive synthetic suburethral sling operation vs traditional slings | RR 0.36 [0.16, 0.79] | 3 studies · 236 participants | Moderate Downgraded: risk of bias |
Voiding Dysfunction Minimally invasive synthetic suburethral sling operation vs traditional slings | RR 0.75 [0.38, 1.48] | 3 studies · 254 participants | Moderate Downgraded: risk of bias |
Peri‐operative complications Minimally invasive synthetic suburethral sling operation vs traditional slings | RR 1.09 [0.23, 5.21] | 1 study · 142 participants | Low Downgraded: risk of bias, imprecision |
Bladder or urethral perforation Minimally invasive synthetic suburethral sling operation vs traditional slings | RR 2.15 [0.75, 6.16] | 4 studies · 401 participants | Moderate Downgraded: risk of bias |
Minimally invasive synthetic suburethral sling operation compared to open colposuspension for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months Minimally invasive synthetic suburethral sling operation vs open colposuspension | RR 0.96 [0.9, 1.03] | 6 studies · 729 participants | Moderate Downgraded: risk of bias |
Objective cure within 12 months Minimally invasive synthetic suburethral sling operation vs open colposuspension | RR 1.04 [0.94, 1.14] | 3 studies · 468 participants | High |
Denovo urgency or urgency incontinence Minimally invasive synthetic suburethral sling operation vs open colposuspension | RR 0.69 [0.38, 1.24] | 4 studies · 360 participants | Moderate Downgraded: risk of bias |
Voiding Dysfunction Minimally invasive synthetic suburethral sling operation vs open colposuspension | RR 0.62 [0.37, 1.03] | 6 studies · 704 participants | Ungraded |
Peri‐operative complications Minimally invasive synthetic suburethral sling operation vs open colposuspension | RR 0.78 [0.61, 1] | 5 studies · 653 participants | Ungraded |
Bladder or urethral perforation Minimally invasive synthetic suburethral sling operation vs open colposuspension | RR 4.24 [1.71, 10.52] | 6 studies · 753 participants | Moderate Downgraded: risk of bias |
Minimally invasive synthetic suburethral sling operation compared to laparoscopic colposuspension for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 1.11 [0.99, 1.24] | 6 studies · 434 participants | Moderate Downgraded: risk of bias |
Objective cure within 12 months Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 1.15 [1.06, 1.24] | 6 studies · 513 participants | Moderate Downgraded: risk of bias |
Objective cure within 12 months ‐ Lap (mesh) vs TVT Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 1.51 [1.17, 1.95] | 1 study · 121 participants | Ungraded |
Denovo urgency or urgency incontinence Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 0.31 [0.1, 0.99] | 2 studies · 169 participants | High |
Voiding Dysfunction Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 0.74 [0.33, 1.64] | 5 studies · 435 participants | High |
Peri‐operative complications ‐ Lap(sutures) vs TVT Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 0.87 [0.49, 1.54] | 7 studies · 350 participants | Moderate Downgraded: risk of bias |
Bladder or urethral perforation Minimally invasive synthetic suburethral sling operation vs laparoscopic colposuspension | RR 2.91 [0.96, 8.86] | 4 studies · 366 participants | High |
Retropubic bottom‐to‐top approach versus retropubic top‐to‐bottom approach for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months 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 |
Objective cure within 12 months Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 1.06 [1.01, 1.11] | 5 studies · 636 participants | Ungraded |
Denovo 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 | Moderate Downgraded: risk of bias |
Voiding dysfunction Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 0.4 [0.18, 0.9] | 5 studies · 631 participants | Ungraded |
Peri‐operative complications Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | RR 0.98 [0.53, 1.84] | 4 studies · 507 participants | Moderate Downgraded: imprecision |
QoL Specific Retropubic bottom‐to‐top approach vs retropubic top‐to‐bottom approach | no estimate extracted | 1 study · 84 participants | Moderate Downgraded: imprecision |
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 |
Obturator medial‐to‐lateral approach versus obturator lateral‐to‐medial approach for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1 [0.86, 1.16] | 2 studies · 160 participants | Low Downgraded: risk of bias |
Objective cure within 12 months Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 0.95 [0.86, 1.04] | 2 studies · 214 participants | Low Downgraded: risk of bias |
Denovo urgency or urgency incontinence Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.19 [0.53, 2.71] | 3 studies · 260 participants | Very low Downgraded: risk of bias, imprecision |
Voiding dysfunction Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.3 [0.23, 7.51] | 2 studies · 214 participants | Very low Downgraded: risk of bias, imprecision |
Peri‐operative complications Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 1.3 [0.23, 7.51] | 2 studies · 214 participants | Very low Downgraded: risk of bias, imprecision |
QoL Specific Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | no estimate extracted | 1 study · 46 participants | Low Downgraded: risk of bias |
Bladder or urethral perforation Obturator medial‐to‐lateral approach vs obturator lateral‐to‐medial approach | RR 0.3 [0.03, 2.82] | 2 studies · 189 participants | Very low Downgraded: risk of bias, imprecision |
Monofilament compared to multifilament minimally invasive synthetic suburethral slings for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months Monofilament vs multifilament minimally invasive synthetic suburethral slings | RR 1.08 [0.98, 1.19] | 3 studies · 409 participants | Moderate Downgraded: risk of bias |
Objective cure within 12 months Monofilament vs multifilament minimally invasive synthetic suburethral slings | RR 1.15 [1.02, 1.3] | 2 studies · 309 participants | Moderate Downgraded: risk of bias |
Denovo urgency or urgency incontinence Monofilament vs multifilament minimally invasive synthetic suburethral slings | RR 1.17 [0.67, 2.04] | 3 studies · 400 participants | Moderate Downgraded: risk of bias |
Voiding dysfunction Monofilament vs multifilament minimally invasive synthetic suburethral slings | RR 2.2 [0.98, 4.92] | 3 studies · 400 participants | Moderate Downgraded: risk of bias |
Peri‐operative complications Monofilament vs multifilament minimally invasive synthetic suburethral slings | RR 1.16 [0.36, 3.69] | 2 studies · 279 participants | Low Downgraded: risk of bias, imprecision |
QoL Specific Monofilament vs multifilament minimally invasive synthetic suburethral slings | no estimate extracted | 0 studies · 4 participants | Ungraded |
Bladder or urethral perforation Monofilament vs multifilament minimally invasive synthetic suburethral slings | RR 0.76 [0.29, 1.99] | 3 studies · 400 participants | Ungraded |
Transobturator (TOR) compared to retropubic (RPR) route minimally invasive synthetic suburethral slings for stress urinary incontinence in women
Population: patients with stress urinary incontinence in women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subjective cure within 12 months Transobturator (TOR) vs retropubic (RPR) route minimally invasive synthetic suburethral slings | RR 1 [0.96, 1.05] | 10 studies · 1381 participants | Moderate Downgraded: risk of bias |
Objective cure within 12 months Transobturator (TOR) vs retropubic (RPR) route minimally invasive synthetic suburethral slings | RR 0.96 [0.93, 0.99] | 17 studies · 2434 participants | Moderate Downgraded: risk of bias |
Denovo urgency or urgency incontinence Transobturator (TOR) vs retropubic (RPR) route minimally invasive synthetic suburethral slings | RR 1.08 [0.75, 1.56] | 14 studies · 1685 participants | Moderate Downgraded: risk of bias |
Voiding Dysfunction Transobturator (TOR) vs retropubic (RPR) route minimally invasive synthetic suburethral slings | RR 0.63 [0.44, 0.89] | 14 studies · 2085 participants | Moderate Downgraded: risk of bias |
Peri‐operative complications Transobturator (TOR) vs retropubic (RPR) route minimally invasive synthetic suburethral slings | RR 1.03 [0.79, 1.33] | 13 studies · 1802 participants | Moderate Downgraded: risk of bias |
Bladder or urethral perforation Transobturator (TOR) vs retropubic (RPR) route minimally invasive synthetic suburethral slings | RR 0.14 [0.07, 0.26] | 18 studies · 2674 participants | Moderate Downgraded: risk of bias |