O534 Use of a Preventive Sling Surgery for the Simultaneous Correction of Latent Stress Urinary Incontinence During the Cystocele Repair: 2 Years Follow‐up

Busacchi, Paolo; Paganotto, M.

doi:10.1016/s0020-7292(12)60964-3

Cited by 3 publications

(7 citation statements)

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“…We excluded eight studies because of study design, six after reading the full text 17,19,[31][32][33][34] and two after communication with the author. 35,36 The remaining 15 publications describing seven RCTs were included, reporting on 1115 women. 5,10,11,[23][24][25][26][27][37][38][39][40][41][42][43] …”

Section: Study Selectionmentioning

confidence: 99%

Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta‐analysis of randomised trials

Ploeg

Steen

Rengerink

et al. 2014

BJOG

109

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Objectives The combination of prolapse surgery with an incontinence procedure can reduce the incidence of stress urinary incontinence (SUI) after surgery, but may increase adverse events. We compared the effectiveness and safety of prolapse surgery versus combined prolapse and incontinence surgery in women with pelvic organ prolapse.Design and setting Pubmed, EMBASE, DARE, the Cochrane Library and the register of Current Controlled Trials were searched for randomised trials (restricted to Burch colposuspension and midurethral sling as incontinence procedure) from 1995 to 2013 limited to the English literature.Methods Two reviewers selected eligible articles and extracted the data. Pooling for SUI was based on three patient groups: (1) women with coexisting SUI; (2) women asymptomatic for SUI; and (3) women with occult SUI. For adverse events, pooling was based on incontinence procedure.Main outcome measures The primary outcome was SUI. The secondary outcomes were treatment for SUI, bladder storage symptoms, obstructive voiding and adverse events.Results Seven trials were included. Pooling for women with coexisting SUI was possible for objective SUI with two studies and showed no difference. Statistical (I 2 = 95%) and clinical heterogeneity was, however, high. The largest study showed a lower incidence of persisting SUI (5% versus 23%) and treatment for this (0% versus 57%) in women who underwent prolapse repair with a midurethral sling. The second study did not find a difference in women undergoing a sacrocolpopexy with or without Burch colposuspension. In asymptomatic women, combination surgery resulted in a lower incidence of de novo subjective SUI (two studies; 24% versus 41%; relative risk [RR], 0.6; 95% confidence interval [CI], 0.3-0.9; I 2 = 36%) and the need for subsequent anti-incontinence surgery (three studies; 2% versus 7%; RR, 0.4; 95% CI, 0.2-0.8; I 2 = 13%). For the outcome objective SUI, pooling was possible for five studies, but statistical heterogeneity was high (I 2 = 82%) and the difference was not statistically significant. In the subgroup of women with occult stress incontinence, we found a lower incidence of objective SUI after combination surgery (two studies; 22% versus 52%; RR, 0.4; 95% CI, 0.3-0.8; I 2 = 32%). There were no differences in bladder storage symptoms, urgency incontinence or long-term obstructive voiding symptoms. Adverse events (two studies; 15% versus 10%; RR, 1.6; 95% CI, 1.0-2.5; I 2 = 0%) and prolonged catheterisation (three studies; 6% versus 1%; RR, 4.5; 95% CI, 1.5-13.3; I 2 = 0%)were more frequent after vaginal prolapse repair with a midurethral sling.Conclusions Combination surgery reduces the risk of postoperative stress incontinence, but short-term voiding difficulties and adverse events were more frequent after combination surgery with a midurethral sling.Keywords Burch colposuspension, meta-analysis, midurethral sling, pelvic organ prolapse, review, stress urinary incontinence.Please cite this paper as: van der Ploeg JM, van der Steen A, Oude Rengerink K, va...

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Section: Study Selectionmentioning

confidence: 99%

Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta‐analysis of randomised trials

Ploeg

Steen

Rengerink

et al. 2014

BJOG

109

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“…Altogether, the review included trials of four different types of anti-incontinence procedures: midurethral sling (retropubic and transobsturator), Burch colposuspension, needle colposuspension, and cystopexy with posterior pubourethral ligaments plication. [10][11][12][13][14][15][16][17][18][19] Kelly plications were not considered an anti-incontinence procedure.…”

Section: Resultsmentioning

confidence: 99%

“…[11][12][13]20 In terms of midurethral slings, the literature shows a reduction in the incidence of UI and a necessity of surgical treatment for UI postoperatively. 6,11,12,[15][16][17][18][19][20] It was not possible to perform a meta-analysis with the studies by Fuentes 14 and by Busacchi et al 15 because their outcomes were different. On the other hand, Burch colposuspension showed more complications and no difference in the incidence of UI postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…urethral sling was the only anti-incontinence procedure that reduced postoperative SUI. [11][12][13][14][15] Regarding transobturator slings, it was not possible to conduct a meta-analysis of the studies by Fuentes 14 and by Busacchi et al 15 In addition, during the correction of stage 3 and 4 prolapses in patients considered asymptomatic from the voiding point of view, it is essential to weigh all the advantages and adverse effects of performing an anti-incontinence procedure. In this sense, Wei et al 11 showed that the placement of a tension-free medium urethral sling in asymptomatic patients took a rate increased the incidence of intra-and postoperative complications.…”

Section: ããmentioning

confidence: 99%

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Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis—Brazilian Guidelines

Matsuoka

Castro

Baracat

et al. 2019

Rev Bras Ginecol Obstet

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Objective To evaluate if performing anti-incontinence procedures during surgical anterior and/or apical prolapse correction in women with asymptomatic urinary incontinence (UI) may prevent stress urinary incontinence (SUI) postoperatively. Methods We have performed a systematic review of articles published in the PubMed, Cochrane Library, and Lilacs databases until March 31, 2016. Two reviewers performed the data collection and analysis, independently. All of the selected studies were methodologically analyzed. The results are presented as relative risk (RR), with a 95% confidence interval (CI). Results After performing the selection of the studies, only nine trials fulfilled the necessary prerequisites. In the present review, 1,146 patients were included. Altogether, the review included trials of three different types of anti-incontinence procedures. We found that performing any anti-incontinence procedure at the same time of prolapse repair reduced the incidence of SUI postoperatively (RR = 0.50; 95% CI: 0.28–0.91). However, when we performed the analysis separately by the type of anti-incontinence procedure, we found different results. In the subgroup analysis with midurethral slings, it is beneficial to perform it to reduce the incidence of SUI (RR = 0.08; 95% CI: 0.02–0.28). On the other hand, in the subgroup analysis with Burch colposuspension, there was no significant difference with the control group (RR = 1.47; 95% CI: 0.28–7.79]). Conclusion Performing any prophylactic anti-incontinence procedure at the same time as prolapse repair reduced the incidence of SUI postoperatively. The Burch colposuspension did not show any decrease in the incidence of SUI postoperatively.

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“…16,17 Alguns autores recomendam que se realize, concomitantemente, a cirurgia de Burch, ao passo que outros indicam slings de uretra média, como sling transobturatótio e sling retropúbico. [16][17][18][19] Meschia e colaboradores realizaram ensaio clínico comparando os resultados do sling retropúbico e plicatura da fáscia endopélvica em mulheres com IUO e prolapso genital, demonstrando uma incidência de IUE de, respectivamente, de 4 % versus 36% (p<0,01). 18 Entretanto, apesar dos vários estudos publicados, a realização concomitante do tratamento cirúrgico do prolapso genital e incontinência urinária ainda é controverso.…”

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Avaliação do impacto do tratamento da incontinência urinária oculta na correção de prolapso genital estádio 3 e 4: revisão sistemática e metanálise

Locali¹

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O534 Use of a Preventive Sling Surgery for the Simultaneous Correction of Latent Stress Urinary Incontinence During the Cystocele Repair: 2 Years Follow‐up

Cited by 3 publications

References 0 publications

Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta‐analysis of randomised trials

Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta‐analysis of randomised trials

Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis—Brazilian Guidelines

Avaliação do impacto do tratamento da incontinência urinária oculta na correção de prolapso genital estádio 3 e 4: revisão sistemática e metanálise

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