Traditional suburethral sling operations for urinary incontinence in women

Abstract

Analysis 4.4. Comparison 4 Traditional suburethral sling operation versus injectables, Outcome 4 Number of women cured a er first year (women's observations

Gynaecologic surgery from uncertainty to science: evidence-based surgery is no passing fad

“…Thirty completed reviews assessing surgical interventions, from a total of 371 reviews and protocols in gynaecologic oncology, urogynaecology, fertility regulation, menstrual disorders and subfertility, were published on the Cochrane Library. These comprised: (i) two of 84 reviews (n ¼ 47) and protocols (n ¼ 37) from the Gynaecological Cancer Group (Ansink and van der Velden, 2000), only one of which included any RCTs (Martin-Hirsch et al, 2000); (ii) six of 69 reviews (n ¼ 51) and protocols (n ¼ 18) from the Incontinence Group Cooper, 2001, 2004;Moehrer et al, 2002;Maher et al, 2004;Bezerra et al, 2005;Lapitan et al, 2005); (iii) four of 53 reviews (n ¼ 46) and protocols (n ¼ 7) from the Fertility Regulation Group (Kulier et al 2001(Kulier et al , 2004Nardin et al 2003;Say et al, 2005); (iv) eighteen of 165 reviews (n ¼ 113) and protocols (n ¼ 52) from the Menstrual Disorders and Subfertility Group, including three menstrual disorders surgery reviews (Lethaby et al, 2000(Lethaby et al, , 2005Marjoribanks et al, 2006), six subfertility surgery reviews (Johnson and Watson, 1999;Jacobson et al, 2002;Johnson et al, 2004;Farquhar et al, 2005;Ahmad et al, 2006;Van Peperstraten et al, 2006) and nine otherwise uncategorized reviews of benign gynaecologic surgery (Farquhar et al, 2000;Jacobson et al, 2001;Hart et al, 2005;Medeiros et al, 2005;Proctor et al, 2005;Johnson et al, 2006;Lethaby et al, 2006;Metwally et al, 2006;Hajenius et al, 2007) The findings of these reviews of gynaecologic surgery and our extracted conclusions are summarized in Tables I -VI. Overall, from the 30 gynaecologic surgery reviews, there was evidence of effectiveness (or relative effectiveness) of the interventions from primary trial data or from meta-analysis of trial data for our a priori defined primary outcomes in seven reviews where clear answers to the clinical questions posed were found (evidence category ...…”

Gynaecologic surgery from uncertainty to science: evidence-based surgery is no passing fad

“…Thirty completed reviews assessing surgical interventions, from a total of 371 reviews and protocols in gynaecologic oncology, urogynaecology, fertility regulation, menstrual disorders and subfertility, were published on the Cochrane Library. These comprised: (i) two of 84 reviews (n ¼ 47) and protocols (n ¼ 37) from the Gynaecological Cancer Group (Ansink and van der Velden, 2000), only one of which included any RCTs (Martin-Hirsch et al, 2000); (ii) six of 69 reviews (n ¼ 51) and protocols (n ¼ 18) from the Incontinence Group Cooper, 2001, 2004;Moehrer et al, 2002;Maher et al, 2004;Bezerra et al, 2005;Lapitan et al, 2005); (iii) four of 53 reviews (n ¼ 46) and protocols (n ¼ 7) from the Fertility Regulation Group (Kulier et al 2001(Kulier et al , 2004Nardin et al 2003;Say et al, 2005); (iv) eighteen of 165 reviews (n ¼ 113) and protocols (n ¼ 52) from the Menstrual Disorders and Subfertility Group, including three menstrual disorders surgery reviews (Lethaby et al, 2000(Lethaby et al, , 2005Marjoribanks et al, 2006), six subfertility surgery reviews (Johnson and Watson, 1999;Jacobson et al, 2002;Johnson et al, 2004;Farquhar et al, 2005;Ahmad et al, 2006;Van Peperstraten et al, 2006) and nine otherwise uncategorized reviews of benign gynaecologic surgery (Farquhar et al, 2000;Jacobson et al, 2001;Hart et al, 2005;Medeiros et al, 2005;Proctor et al, 2005;Johnson et al, 2006;Lethaby et al, 2006;Metwally et al, 2006;Hajenius et al, 2007) The findings of these reviews of gynaecologic surgery and our extracted conclusions are summarized in Tables I -VI. Overall, from the 30 gynaecologic surgery reviews, there was evidence of effectiveness (or relative effectiveness) of the interventions from primary trial data or from meta-analysis of trial data for our a priori defined primary outcomes in seven reviews where clear answers to the clinical questions posed were found (evidence category ...…”

Quality Indicators for the Screening and Care of Urinary Incontinence in Vulnerable Elders

“…A systematic review 52 identified 13 trials comparing the efficacy of suburethral slings with that of other surgical procedures and did not find any significant differences in cure rates or complications for stress UI, although CIs were wide, reflecting small sample sizes. A critical review of the TVT procedure found comparable cure rates with retropubic colposuspension, 85% to 95%, for subjective and objective measures 53 .…”

Obesidade como fator de risco para a falha da cirurgia de Burch

“…Após 24 meses de acompanhamento, as taxas de sucesso foram discretamente superiores no grupo submetido à cirurgia de sling (66 versus 49%). Entretanto, os autores consideram esta taxa baixa quando comparada à de estudos prévios 2,6,7 . Além disso, as pacientes do grupo submetido à técnica de sling apresentaram maior incidência de IU, sintomas obstrutivos e incontinência de urgência no pós-operatório, demonstrando que uma técnica não é superior a outra quando analisadas as diversas variáveis e complicações 6 .…”

Gynaecologic surgery from uncertainty to science: evidence-based surgery is no passing fad

“…Thirty completed reviews assessing surgical interventions, from a total of 371 reviews and protocols in gynaecologic oncology, urogynaecology, fertility regulation, menstrual disorders and subfertility, were published on the Cochrane Library. These comprised: (i) two of 84 reviews (n ¼ 47) and protocols (n ¼ 37) from the Gynaecological Cancer Group (Ansink and van der Velden, 2000), only one of which included any RCTs (Martin-Hirsch et al, 2000); (ii) six of 69 reviews (n ¼ 51) and protocols (n ¼ 18) from the Incontinence Group Cooper, 2001, 2004;Moehrer et al, 2002;Maher et al, 2004;Bezerra et al, 2005;Lapitan et al, 2005); (iii) four of 53 reviews (n ¼ 46) and protocols (n ¼ 7) from the Fertility Regulation Group (Kulier et al 2001(Kulier et al , 2004Nardin et al 2003;Say et al, 2005); (iv) eighteen of 165 reviews (n ¼ 113) and protocols (n ¼ 52) from the Menstrual Disorders and Subfertility Group, including three menstrual disorders surgery reviews (Lethaby et al, 2000(Lethaby et al, , 2005Marjoribanks et al, 2006), six subfertility surgery reviews (Johnson and Watson, 1999;Jacobson et al, 2002;Johnson et al, 2004;Farquhar et al, 2005;Ahmad et al, 2006;Van Peperstraten et al, 2006) and nine otherwise uncategorized reviews of benign gynaecologic surgery (Farquhar et al, 2000;Jacobson et al, 2001;Hart et al, 2005;Medeiros et al, 2005;Proctor et al, 2005;Johnson et al, 2006;Lethaby et al, 2006;Metwally et al, 2006;Hajenius et al, 2007) The findings of these reviews of gynaecologic surgery and our extracted conclusions are summarized in Tables I -VI. Overall, from the 30 gynaecologic surgery reviews, there was evidence of effectiveness (or relative effectiveness) of the interventions from primary trial data or from meta-analysis of trial data for our a priori defined primary outcomes in seven reviews where clear answers to the clinical questions posed were found (evidence category ...…”

Quality Indicators for the Screening and Care of Urinary Incontinence in Vulnerable Elders

“…A systematic review 52 identified 13 trials comparing the efficacy of suburethral slings with that of other surgical procedures and did not find any significant differences in cure rates or complications for stress UI, although CIs were wide, reflecting small sample sizes. A critical review of the TVT procedure found comparable cure rates with retropubic colposuspension, 85% to 95%, for subjective and objective measures 53 .…”

Obesidade como fator de risco para a falha da cirurgia de Burch

“…Após 24 meses de acompanhamento, as taxas de sucesso foram discretamente superiores no grupo submetido à cirurgia de sling (66 versus 49%). Entretanto, os autores consideram esta taxa baixa quando comparada à de estudos prévios 2,6,7 . Além disso, as pacientes do grupo submetido à técnica de sling apresentaram maior incidência de IU, sintomas obstrutivos e incontinência de urgência no pós-operatório, demonstrando que uma técnica não é superior a outra quando analisadas as diversas variáveis e complicações 6 .…”

Gynaecologic surgery from uncertainty to science: evidence-based surgery is no passing fad

“…Thirty completed reviews assessing surgical interventions, from a total of 371 reviews and protocols in gynaecologic oncology, urogynaecology, fertility regulation, menstrual disorders and subfertility, were published on the Cochrane Library. These comprised: (i) two of 84 reviews (n ¼ 47) and protocols (n ¼ 37) from the Gynaecological Cancer Group (Ansink and van der Velden, 2000), only one of which included any RCTs (Martin-Hirsch et al, 2000); (ii) six of 69 reviews (n ¼ 51) and protocols (n ¼ 18) from the Incontinence Group Cooper, 2001, 2004;Moehrer et al, 2002;Maher et al, 2004;Bezerra et al, 2005;Lapitan et al, 2005); (iii) four of 53 reviews (n ¼ 46) and protocols (n ¼ 7) from the Fertility Regulation Group (Kulier et al 2001(Kulier et al , 2004Nardin et al 2003;Say et al, 2005); (iv) eighteen of 165 reviews (n ¼ 113) and protocols (n ¼ 52) from the Menstrual Disorders and Subfertility Group, including three menstrual disorders surgery reviews (Lethaby et al, 2000(Lethaby et al, , 2005Marjoribanks et al, 2006), six subfertility surgery reviews (Johnson and Watson, 1999;Jacobson et al, 2002;Johnson et al, 2004;Farquhar et al, 2005;Ahmad et al, 2006;Van Peperstraten et al, 2006) and nine otherwise uncategorized reviews of benign gynaecologic surgery (Farquhar et al, 2000;Jacobson et al, 2001;Hart et al, 2005;Medeiros et al, 2005;Proctor et al, 2005;Johnson et al, 2006;Lethaby et al, 2006;Metwally et al, 2006;Hajenius et al, 2007) The findings of these reviews of gynaecologic surgery and our extracted conclusions are summarized in Tables I -VI. Overall, from the 30 gynaecologic surgery reviews, there was evidence of effectiveness (or relative effectiveness) of the interventions from primary trial data or from meta-analysis of trial data for our a priori defined primary outcomes in seven reviews where clear answers to the clinical questions posed were found (evidence category ...…”

Quality Indicators for the Screening and Care of Urinary Incontinence in Vulnerable Elders

“…A systematic review 52 identified 13 trials comparing the efficacy of suburethral slings with that of other surgical procedures and did not find any significant differences in cure rates or complications for stress UI, although CIs were wide, reflecting small sample sizes. A critical review of the TVT procedure found comparable cure rates with retropubic colposuspension, 85% to 95%, for subjective and objective measures 53 .…”

Obesidade como fator de risco para a falha da cirurgia de Burch

“…Após 24 meses de acompanhamento, as taxas de sucesso foram discretamente superiores no grupo submetido à cirurgia de sling (66 versus 49%). Entretanto, os autores consideram esta taxa baixa quando comparada à de estudos prévios 2,6,7 . Além disso, as pacientes do grupo submetido à técnica de sling apresentaram maior incidência de IU, sintomas obstrutivos e incontinência de urgência no pós-operatório, demonstrando que uma técnica não é superior a outra quando analisadas as diversas variáveis e complicações 6 .…”