Background:The current body of evidence is limited regarding the long-term outcomes of different modalities for stress urinary incontinence (SUI). We conducted this systematic review and network meta-analysis to compare the long-term follow-up outcomes of mid-urethral slings (MUS), Burch colpo-suspension, pubo-vaginal sling (PVS), anterior colporrhaphy with Kelly's plication, and laser therapy in the treatment of SUI. Aim of the work:The current work aimed to compare the long-term follow-up outcomes of the following modalities in the management of SUI: MUS, Burch colpo-suspension, PVS, SIMS, anterior colporrhaphy with Kelly's plication, bulking agents, and laser therapy. Methods:In this systematic review and network meta-analysis, we included prospective and retrospective studies that assessed the long-term outcomes of modalities for the management of SUI. We performed an online, bibliographic, search in four bibliographic databases: Cochrane Central Register of Controlled Trials (CENTRAL), Medline via PubMed, Web of Science, and Scopus.Results: A total of 42 studies were included. For the subjective cure rate, five different interventions were compared; pooling direct and indirect comparisons revealed an advantage of tension-free vaginal tape (TVT) intervention over TVT-obturator (TVT-O), laparoscopic Burch colpo-suspension, trans-obturator tape (TOT), and TVT-sling (TVT-S). Concerning objective cure rate, the pooling direct and indirect comparisons showed an obvious advantage of TOT, followed by TVT, and then TVT-O, Burch lap, and TVT-S. For repeated surgery, four different interventions were compared, and the comparisons revealed an advantage of TVT intervention over TVT-O, PVS, and TOT. The comparisons revealed the advantage of TVT and TVT-O over other procedures for lower urinary symptoms and postoperative complications.Conclusion: MUS appears to be the most effective and safe procedure for SUI at long-term follow-up. However, these findings should be interpreted with caution as there is scarcity in the published reports assessing long-term outcomes of other modalities, especially PVS and laser therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.