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Treatment of stress urinary incontinence--midurethral slings: top-down, bottom-up, "outside-in," or "inside-out".
Clin Obstet Gynecol. 2007 Jun; 50(2):362-75.CO

Abstract

Two randomized trials have reported no differences in efficacy between suprapubic arc and tension-free vaginal tape at 2 years. There are no long-term studies comparing the inside-out and outside-in transobturator (TOT) approach, although short-term data show no difference in cure rates or complications. The short-term efficacy of TOT midurethral slings is comparable with the retropubic slings; however, preliminary evidence suggests that TOT slings may have a lower success rate compared with retropubic slings for the treatment of intrinsic sphincter deficiency. The risk of bladder injury may be the least with the "inside-out" approach, whereas retropubic techniques have a higher risk of cystotomy as compared with the TOT approach. Four randomized controlled trials comparing the retropubic and TOT approaches show no differences in rate of de novo urgency, retention, frequency, nocturia, or incomplete voiding.

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Authors+Show Affiliations

Silva WA
Department of Obstetrics and Gynecology, St Francis Hospital, Federal Way, Washington, USA. wazsilva@comcast.net

MeSH

FemaleHumansPostoperative ComplicationsProstheses and ImplantsRandomized Controlled Trials as TopicSuburethral SlingsTreatment OutcomeUrinary Incontinence, StressUrologic Surgical Procedures

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17513924

Citation

Silva, William Andre. "Treatment of Stress Urinary Incontinence--midurethral Slings: Top-down, Bottom-up, "outside-in," or "inside-out"." Clinical Obstetrics and Gynecology, vol. 50, no. 2, 2007, pp. 362-75.
Silva WA. Treatment of stress urinary incontinence--midurethral slings: top-down, bottom-up, "outside-in," or "inside-out". Clin Obstet Gynecol. 2007;50(2):362-75.
Silva, W. A. (2007). Treatment of stress urinary incontinence--midurethral slings: top-down, bottom-up, "outside-in," or "inside-out". Clinical Obstetrics and Gynecology, 50(2), 362-75.
Silva WA. Treatment of Stress Urinary Incontinence--midurethral Slings: Top-down, Bottom-up, "outside-in," or "inside-out". Clin Obstet Gynecol. 2007;50(2):362-75. PubMed PMID: 17513924.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of stress urinary incontinence--midurethral slings: top-down, bottom-up, "outside-in," or "inside-out". A1 - Silva,William Andre, PY - 2007/5/22/pubmed PY - 2007/7/4/medline PY - 2007/5/22/entrez SP - 362 EP - 75 JF - Clinical obstetrics and gynecology JO - Clin Obstet Gynecol VL - 50 IS - 2 N2 - Two randomized trials have reported no differences in efficacy between suprapubic arc and tension-free vaginal tape at 2 years. There are no long-term studies comparing the inside-out and outside-in transobturator (TOT) approach, although short-term data show no difference in cure rates or complications. The short-term efficacy of TOT midurethral slings is comparable with the retropubic slings; however, preliminary evidence suggests that TOT slings may have a lower success rate compared with retropubic slings for the treatment of intrinsic sphincter deficiency. The risk of bladder injury may be the least with the "inside-out" approach, whereas retropubic techniques have a higher risk of cystotomy as compared with the TOT approach. Four randomized controlled trials comparing the retropubic and TOT approaches show no differences in rate of de novo urgency, retention, frequency, nocturia, or incomplete voiding. SN - 0009-9201 UR - https://www.unboundmedicine.com/medline/citation/17513924/Treatment_of_stress_urinary_incontinence__midurethral_slings:_top_down_bottom_up_"outside_in"_or_"inside_out"_ L2 - https://dx.doi.org/10.1097/GRF.0b013e31804a840c DB - PRIME DP - Unbound Medicine ER -