Medium-term and Long-term Outcomes Following Placement of Midurethral Slings for Stress Urinary Incontinence: a Systematic Review and Metaanalysis

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2015 May 21

PMID 25990203

Citations 21

Authors

Giovanni A Tommaselli

Costantino Di Carlo

Carmen Formisano

Annamaria Fabozzi

Carmine Nappi

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: Questions regarding the long-term efficacy and safety of midurethral slings (MUS) are still unresolved, notwithstanding the widespread use of these procedures. The objective of this review was to evaluate the long-term outcomes of retropubic MUS (RP-MUS) procedures and the medium-term outcomes of transobturator MUS (TO-MUS) procedures.

Methods: MEDLINE, EMBASE, NLH, ClinicalTrials.gov, and Google Scholar databases were searched up to June 2014 with restriction to English language and using the search terms: "stress urinary incontinence", "midurethral sling", "tension-free tape", "transobturator tape", and "follow-up". Studies with a follow-up of 36 months for TO-MUS and 60 months for RP-MUS were searched. Only studies comparing a RP-MUS or TO-MUS with another synthetic sling were included. Data from 49 studies were included. Data were expressed as odds ratios (OR) with 95 % confidence intervals (CI) and combined using the Mantel-Haenszel fixed effects model. Differences in the proportions were evaluated using the chi-squared test.

Results: RP-MUS had similar objective cure rates (OR 1.15, 95 % CI 0.75 - 1.76) but higher subjective cure rates than TO-MUS (OR 1.76, 95 % CI 1.08 - 2.86). No differences were observed between outside-in (TOT) and inside-out (TVT-O) and between TO-MUS and minisling. Bladder injuries were more frequent (OR 7.01, 95 % CI 2.94 - 17.90) and vaginal erosions were less frequent for RP-MUS (OR 0.24, 95 % CI 0.07 - 0.84). Vaginal injuries were more common with TOT than with TVT-O (OR 7.96, 95 % CI 1.15 - 157.9). Pain-related complications were more common with TO-MUS than with minimally invasive tapes (OR 8.75; 95 % CI 9.02 - 57.90).

Conclusions: MUS have similar objective cure rates in the long term and medium term. TO-MUS is associated with a lower subjective cure rate than RP-MUS.

Citing Articles

The Impact of Pelvic Organ Prolapse on the Long-Term Outcomes of Transobturator Tape (TOT) Procedures-A Retrospective Study.

Hillmeyer A, Kennes L, Strauss M, Lube K, Stickeler E, Najjari L J Clin Med. 2025; 14(1.

PMID: 39797242 PMC: 11721789. DOI: 10.3390/jcm14010159.

Long-Term Outcomes of Tension-Free Vaginal Tape Obturator: Efficacy and Safety at Long-Term Follow-Up.

Braga A, Papadia A, Gamarra E, Caccia G, Campitiello M, Torella M J Clin Med. 2024; 13(19).

PMID: 39407759 PMC: 11476623. DOI: 10.3390/jcm13195699.

The True Impact of Voiding Dysfunctions after Transobturator Sub-Urethral Tape Procedures: A Systematic Review of Literature.

Plotti F, Rampello S, Terranova C, De Cicco Nardone C, Luvero D, Montera R J Clin Med. 2024; 13(16).

PMID: 39200904 PMC: 11355201. DOI: 10.3390/jcm13164762.

Late-presenting with a tumor-like mass giant cell reaction related to retropubic midurethral sling.

Kaufman R, Vu A, Ufondu O, Powell M, Lanzer J, Terris M Urol Case Rep. 2023; 50:102468.

PMID: 37719190 PMC: 10504477. DOI: 10.1016/j.eucr.2023.102468.

Complications following retropubic versus transobturator midurethral synthetic sling placement.

Sears S, Rhodes S, McBride C, Shoag J, Sheyn D Int Urogynecol J. 2023; 34(10):2389-2397.

PMID: 37133561 DOI: 10.1007/s00192-023-05553-x.

References

Park Y, Kim D . Randomized controlled study of MONARC® vs. tension-free vaginal tape obturator (TVT-O®) in the treatment of female urinary incontinence: comparison of 3-year cure rates. Korean J Urol. 2012; 53(4):258-62. PMC: 3332137. DOI: 10.4111/kju.2012.53.4.258. View

Novara G, Artibani W, Barber M, Chapple C, Costantini E, Ficarra V . Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol. 2010; 58(2):218-38. DOI: 10.1016/j.eururo.2010.04.022. View

Waltregny D, de Leval J . New surgical technique for treatment of stress urinary incontinence TVT-ABBREVO from development to clinical experience. Surg Technol Int. 2012; 22:149-57. View

Celebi I, Gungorduk K, Ark C, Akyol A . Results of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence: a 5-year follow-up study. Arch Gynecol Obstet. 2008; 279(4):463-7. DOI: 10.1007/s00404-008-0805-2. View

Latthe P, Foon R, Toozs-Hobson P . Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG. 2007; 114(5):522-31. DOI: 10.1111/j.1471-0528.2007.01268.x. View

Moher D, Liberati A, Tetzlaff J, Altman D . Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther. 2009; 89(9):873-80. View

Svenningsen R, Staff A, Schiotz H, Western K, Kulseng-Hanssen S . Long-term follow-up of the retropubic tension-free vaginal tape procedure. Int Urogynecol J. 2013; 24(8):1271-8. DOI: 10.1007/s00192-013-2058-2. View

Latthe P, Singh P, Foon R, Toozs-Hobson P . Two routes of transobturator tape procedures in stress urinary incontinence: a meta-analysis with direct and indirect comparison of randomized trials. BJU Int. 2009; 106(1):68-76. DOI: 10.1111/j.1464-410X.2009.09051.x. View

Goktolga U, Atay V, Tahmaz L, Yenen M, Gungor S, Ceyhan T . Tension-free vaginal tape for surgical relief of intrinsic sphincter deficiency: results of 5-year follow-up. J Minim Invasive Gynecol. 2008; 15(1):78-81. DOI: 10.1016/j.jmig.2007.09.001. View

10.

Nambiar A, Cody J, Jeffery S . Single-incision sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2014; (6):CD008709. DOI: 10.1002/14651858.CD008709.pub2. View

11.

Athanasiou S, Grigoriadis T, Zacharakis D, Skampardonis N, Lourantou D, Antsaklis A . Seven years of objective and subjective outcomes of transobturator (TVT-O) vaginal tape: why do tapes fail?. Int Urogynecol J. 2013; 25(2):219-25. DOI: 10.1007/s00192-013-2186-8. View

12.

Tommaselli G, DAfiero A, Carlo C, Formisano C, Fabozzi A, Nappi C . Tension-free vaginal tape-O and -Secur for the treatment of stress urinary incontinence: a thirty-six-month follow-up single-blind, double-arm, randomized study. J Minim Invasive Gynecol. 2013; 20(2):198-204. DOI: 10.1016/j.jmig.2012.11.008. View

13.

Tan P, Yang L, Ou R, Tang P, Yang W, Huang J . Effectiveness and complication rates of tension-free vaginal tape, transobturator tape, and tension-free vaginal tape-obturator in the treatment of female stress urinary incontinence in a medium- to long-term follow up. Meta-analysis of randomized.... Saudi Med J. 2014; 35(1):20-32. View

14.

Heidler S, Ofner-Kopeinig P, Puchwein E, Pummer K, Primus G . The suprapubic arch sling procedure for treatment of stress urinary incontinence: a 5-year retrospective study. Eur Urol. 2009; 57(5):897-901. DOI: 10.1016/j.eururo.2009.09.036. View

15.

Schierlitz L, Dwyer P, Rosamilia A, Murray C, Thomas E, De Souza A . Three-year follow-up of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency. Obstet Gynecol. 2012; 119(2 Pt 1):321-7. DOI: 10.1097/AOG.0b013e31823dfc73. View

16.

Costantini E, Lazzeri M, Zucchi A, Di Biase M, Porena M . Long-term efficacy of the transobturator and retropubic midurethral slings for stress urinary incontinence: single-center update from a randomized controlled trial. Eur Urol. 2014; 66(3):599-601. DOI: 10.1016/j.eururo.2014.04.004. View

17.

Ankardal M, Heiwall B, Lausten-Thomsen N, Carnelid J, Milsom I . Short- and long-term results of the tension-free vaginal tape procedure in the treatment of female urinary incontinence. Acta Obstet Gynecol Scand. 2006; 85(8):986-92. DOI: 10.1080/00016340600753091. View

18.

Canete P, Ortiz E, Domingo S, Cano A . Transobturator suburethral tape in the treatment of stress urinary incontinence: efficacy and quality of life after 5 year follow up. Maturitas. 2012; 74(2):166-71. DOI: 10.1016/j.maturitas.2012.10.021. View

19.

Ballester M, Bui C, Frobert J, Grisard-Anaf M, Lienhart J, Fernandez H . Four-year functional results of the suburethral sling procedure for stress urinary incontinence: a French prospective randomized multicentre study comparing the retropubic and transobturator routes. World J Urol. 2011; 30(1):117-22. DOI: 10.1007/s00345-011-0668-1. View

20.

Kuuva N, Nilsson C . Long-term results of the tension-free vaginal tape operation in an unselected group of 129 stress incontinent women. Acta Obstet Gynecol Scand. 2006; 85(4):482-7. DOI: 10.1080/00016340600604989. View