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Patient-reported outcomes have shown that TOT is not inferior to TVT, but both produce lower success rates than studies using objective measures.

Summary. Conventional sling materials have numerous disadvantages. A reinforced Silastic sling is described and its use reported in 30 patients. There was an 83% symptomatic and objective cure of stress incontinence. The advantages of this material include its consistent strength, adjustability and ease of removal.

Fifty-six patients with the "urge syndrome" were reviewed between 1 and 5 years after in-patient treatment by bladder training. There was an overall initial cure/improvement rate of 85%. The best long-term results were obtained in those with objectively stable bladders before treatment. Forty-three per cent of patients with reduced detrusor compliance and idiopathic instability relapsed after initial improvement. Those with primary instability or with associated degenerative disease responded poorly to treatment.