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Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices.
Eur Urol. 2008 Feb; 53(2):288-308.EU

Abstract

OBJECTIVES

To evaluate the complication rates of tension-free midurethral slings compared with other surgical treatments for stress urinary incontinence, including other tension-free midurethral slings.

METHODS

A systematic review of the literature using MEDLINE, EMBASE, and Web of Science was performed in January 2007. Meta-analysis was conducted by using the Review Manager software 4.2.

RESULTS

Our search identified 33 randomized controlled trials reporting data on complication rates. Our meta-analysis showed that complication rates were similar after tension-free vaginal tape (TVT) and Burch colposuspension, with the exclusion of bladder perforation, which was more common after TVT (p=0.0001), and reoperation rate, which was significantly higher after Burch colposuspension (p=0.02). TVT and pubovaginal sling were followed by similar complication rates. With regards to the comparisons among retropubic tapes, TVT and intravaginal slingplasty had similar complication rates, whereas suprapubic arc sling (SPARC) was complicated by higher rates of voiding lower urinary tract symptoms (LUTS) (p=0.02) and reoperations (p=0.04). Comparing retropubic and transobturator tapes, the occurrence of bladder perforations (p=0.007), pelvic haematoma (p=0.03), and storage LUTS (p=0.01) was significantly less common in patients treated by transobturator tapes.

CONCLUSIONS

Tension-free slings were followed by lower risk of reoperation compared with Burch colposuspension, whereas pubovaginal sling and tension-free midurethral slings had similar complication rates. With regards to different tension-free tapes, voiding LUTS and reoperations were more common after SPARC, whereas bladder perforations, pelvic haematoma, and storage LUTS were less common after transobturator tapes. The quality of many evaluated studies was limited.

Authors+Show Affiliations

Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

18031923

Citation

Novara, Giacomo, et al. "Complication Rates of Tension-free Midurethral Slings in the Treatment of Female Stress Urinary Incontinence: a Systematic Review and Meta-analysis of Randomized Controlled Trials Comparing Tension-free Midurethral Tapes to Other Surgical Procedures and Different Devices." European Urology, vol. 53, no. 2, 2008, pp. 288-308.
Novara G, Galfano A, Boscolo-Berto R, et al. Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol. 2008;53(2):288-308.
Novara, G., Galfano, A., Boscolo-Berto, R., Secco, S., Cavalleri, S., Ficarra, V., & Artibani, W. (2008). Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. European Urology, 53(2), 288-308.
Novara G, et al. Complication Rates of Tension-free Midurethral Slings in the Treatment of Female Stress Urinary Incontinence: a Systematic Review and Meta-analysis of Randomized Controlled Trials Comparing Tension-free Midurethral Tapes to Other Surgical Procedures and Different Devices. Eur Urol. 2008;53(2):288-308. PubMed PMID: 18031923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. AU - Novara,Giacomo, AU - Galfano,Antonio, AU - Boscolo-Berto,Rafael, AU - Secco,Silvia, AU - Cavalleri,Stefano, AU - Ficarra,Vincenzo, AU - Artibani,Walter, Y1 - 2007/11/08/ PY - 2007/08/27/received PY - 2007/10/30/accepted PY - 2007/11/23/pubmed PY - 2008/5/14/medline PY - 2007/11/23/entrez SP - 288 EP - 308 JF - European urology JO - Eur Urol VL - 53 IS - 2 N2 - OBJECTIVES: To evaluate the complication rates of tension-free midurethral slings compared with other surgical treatments for stress urinary incontinence, including other tension-free midurethral slings. METHODS: A systematic review of the literature using MEDLINE, EMBASE, and Web of Science was performed in January 2007. Meta-analysis was conducted by using the Review Manager software 4.2. RESULTS: Our search identified 33 randomized controlled trials reporting data on complication rates. Our meta-analysis showed that complication rates were similar after tension-free vaginal tape (TVT) and Burch colposuspension, with the exclusion of bladder perforation, which was more common after TVT (p=0.0001), and reoperation rate, which was significantly higher after Burch colposuspension (p=0.02). TVT and pubovaginal sling were followed by similar complication rates. With regards to the comparisons among retropubic tapes, TVT and intravaginal slingplasty had similar complication rates, whereas suprapubic arc sling (SPARC) was complicated by higher rates of voiding lower urinary tract symptoms (LUTS) (p=0.02) and reoperations (p=0.04). Comparing retropubic and transobturator tapes, the occurrence of bladder perforations (p=0.007), pelvic haematoma (p=0.03), and storage LUTS (p=0.01) was significantly less common in patients treated by transobturator tapes. CONCLUSIONS: Tension-free slings were followed by lower risk of reoperation compared with Burch colposuspension, whereas pubovaginal sling and tension-free midurethral slings had similar complication rates. With regards to different tension-free tapes, voiding LUTS and reoperations were more common after SPARC, whereas bladder perforations, pelvic haematoma, and storage LUTS were less common after transobturator tapes. The quality of many evaluated studies was limited. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/18031923/Complication_rates_of_tension_free_midurethral_slings_in_the_treatment_of_female_stress_urinary_incontinence:_a_systematic_review_and_meta_analysis_of_randomized_controlled_trials_comparing_tension_free_midurethral_tapes_to_other_surgical_procedures_and_different_devices_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(07)01413-3 DB - PRIME DP - Unbound Medicine ER -