Two new mini‐slings compared with transobturator tension‐free vaginal tape for treatment of stress urinary incontinence: A 1‐year follow‐up randomized controlled trial

Gaber, Mohamed; Borg, Tamer Farouk; Samour, Hazem; Nawara, Maii; Reda, Ahmed

doi:10.1111/jog.13143

Cited by 13 publications

(18 citation statements)

References 25 publications

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“…The same manoeuvre is performed on the contralateral side to complete the sling insertion without twisting the tape. The surgeon can decrease the support by pulling on the two sutures in the middle of the mesh, leaving a space between the mesh and the urethra and allowing a surgical forceps to be interposed between them, thus avoiding any tension on the mesh [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Patients may have different expectations regarding treatment after surgery for SUI, and some postoperative complications may also affect the subjective cure rate. Notably, four studies [17,24,25,27] included patients with pelvic organ prolapse (POP). Because of the pelvic structure, SUI and POP are often comorbid diseases.…”

Section: Discussionmentioning

confidence: 99%

“…After the searches and screens, seven articles [17,[23][24][25][26][27][28] were ultimately included. The selection or exclusion of literature at each stage is presented in a flowchart (Fig.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

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Contasure-needleless single incision slings versus transobturator slings (TOT/TVT-O) for female patients with stress urinary incontinence: a systematic review and meta-analysis

et al. 2020

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Background To assess the current evidence on the effectiveness and safety of Contasure-Needleless (C-NDL) versus transobturator slings (TOT/TVT-O) in the management of female stress urinary incontinence (SUI). Methods A comprehensive literature review of articles that investigated the efficacy and safety of C-NDL and TOT/TVT-O was performed based on studies published before June 2019 and retrieved from PubMed, Embase, CNKI and the Cochrane Library. Two reviewers searched the literature, independently extracted the data and evaluated the quality of the data according to the inclusion and exclusion criteria. A meta-analysis was performed by using Review Manager 5.3 software. Results Seven studies with 1188 SUI female patients without intrinsic sphincter deficiency (ISD) or mixed urinary incontinence were included. Our meta-analysis showed that the clinical efficacy of C-NDL is statistically non-inferior to that of TOT / TVT-O in terms of subjective cure rate [OR = 0.77, 95% confidence interval (CI) (0.53 to 1.10), p = 0.15] and objective cure rate [OR = 0.78, 95% CI (0.53 to 1.13), p = 0.19]. In addition, operating times were statistically shorter with C-NDL compared to TOT / TVT-O [mean difference (MD) = − 7.38, 95% CI (− 10.73 to − 4.04), p < 0.0001]. In terms of the postoperative visual analogue scale (VAS) and the incidence of postoperative pain, C-NDL has a greater advantage [MD = − 1.71, 95% CI (− 2.91 to − 0.50), p = 0.005]; [OR = 0.21, 95% CI (0.05 to 0.96), p = 0.04]. Complication rates were statistically similar between the groups, except for groin pain which was higher in TOT / TVT-O. Conclusion Our data suggest that C-NDL slings have similar short-term efficacy as TOT/TVT-O in curing SUI patients. Compared with TOT/TVT-O, C-NDL is associated with a shorter operative time, and the incidence of postoperative pain is decreased. Nevertheless, these findings should be further confirmed through large-volume, well-designed prospective randomized controlled trials (RCTs) with long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Contasure-needleless single incision slings versus transobturator slings (TOT/TVT-O) for female patients with stress urinary incontinence: a systematic review and meta-analysis

et al. 2020

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“…Data searches were performed in Google Scholar, PubMed, Medline, Embase, Scopus, Web of Science and the Cochrane Database of Systematic Reviews. Finally, 29 studies , including a total of 2 986 women, were selected for the meta‐analysis. An SIMS was defined as a midurethral sling placed through a single vaginal incision without skin incision, and included the Mini‐Arc, Contasure‐Needleless, Ophira, tissue fixation system (TFS) and Ajust.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcome of single‐incision slings, excluding TVT‐Secur, vs standard slings in the surgical management of stress incontinence: an updated systematic review and meta‐analysis

Kim

Park

et al. 2018

BJU International

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The aim of the present paper was to assess and compare the long-term efficacy and safety of single-incision mini-slings (SIMSs), except tension-free vaginal tape (TVT)-Secur, with standard midurethral slings (SMUSs) for female stress urinary incontinence through an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing these two surgical methods. A literature review of all RCTs comparing SIMSs (Mini-Arc, Contasure-Needleless, Ophira, Tissue Fixation System and Ajust), except TVT-Secur, with SMUSs was performed. The Medline, Embase, Scopus, Web of Science and Cochrane Controlled Trial Register databases were reviewed. We retrieved 29 RCTs (including a total of 2 986 patients) that compared SIMSs, except TVT-Secur, with SMUSs. Meta-analysis of long-term results showed no significant difference in the patient-reported cure rate (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.44-1.60); however, we found that SMUSs had a significantly superior objective cure rate (OR 0.68, 95% CI 0.47-0.99; P = 0.04). SIMSs were associated with a significantly shorter operation time, lower immediate postoperative pain based on a visual analogue scale score, lower intra-operative blood loss, and lower postoperative voiding dysfunction. The meta-analysis showed clear evidence of the superiority of SMUSs over SIMSs, except TVT-Secur, in terms of the objective cure rate, after long-term follow-up; however, SIMSs were superior with respect to immediate postoperative pain, intra-operative blood loss, and postoperative voiding dysfunction.

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“…To assess objective cure, the authors used the pad test 52,57 and stress test. [52][53][54][55][56] For subjective cure, the authors used the satisfaction test 52 and quality of life questionnaires, including the KHQ, 51 I-QOL, 52 UDI, 52 International Consultation on Incontinence Questionnaire/ Urinary Incontinence Short Form (ICIQ-UIFS), [53][54][55] International Consultation on Incontinence Questionnaire/ Overactive Bladder (ICIQ OAB), 55 IIQ-7, 55 PGII, [53][54][55][56] UDI-6, 56 Patient Global Impression Severity (PGI-S), 56 and Patient Perception of Intensity of Urgency Scale (PPIUS). 54 The meta-analysis showed no significant difference between minislings and other slings for objective cure (OR, 0.72; 95% CI, 0.47-1.10) ►Fig.…”

Section: Minisling Versus Any Other Slingmentioning

confidence: 99%

Surgical Treatment for Stress Urinary Incontinence in Women: A Systematic Review and Meta-analysis

Oliveira

Dias

Martins

et al. 2018

Rev Bras Ginecol Obstet

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Objective To compare surgical treatments for stress urinary incontinence in terms of efficiency and complications. Data Sources We searched the MEDLINE and COCHRANE databases using the terms stress urinary incontinence, surgical treatment for stress urinary incontinence and sling. Selection of Studies Forty-eight studies were selected, which amounted to a total of 6,881 patients with scores equal to or higher than 3 in the Jadad scale. Data Collection Each study was read by one of the authors, added to a standardized table and checked by a second author. We extracted data on intervention details, follow-up time, the results of treatment and adverse events. Data Synthesis Comparing retropubic versus transobturator slings, the former was superior for both objective (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.05-1.54) and subjective (OR, 1.23; 95% CI, 1.02-1.48) cures. Between minislings versus other slings, there was a difference favoring other slings for subjective cure (OR, 0.58; 95% CI, 0.39-0.86). Between pubovaginal sling versus Burch surgery, there was a difference for both objective (OR, 2.04; 95% CI, 1.50-2.77) and subjective (OR, 1.64; 95% CI, 1.10-2.44) cures, favoring pubovaginal sling. There was no difference in the groups: midurethral slings versus Burch, pubovaginal sling versus midurethral slings, transobturator slings, minislings versus other slings (objective cure). Retropubic and pubovaginal slings are more retentionist. Retropubic slings have more bladder perforation, and transobturator slings, more leg and groin pain, neurological lesion and vaginal perforation. Conclusion Pubovaginal slings are superior to Burch colposuspension surgery but exhibit more retention. Retropubic slings are superior to transobturator slings, with more adverse events. Other slings are superior to minislings in the subjective aspect. There was no difference in the comparisons between midurethral slings versus Burch colposuspension surgery, pubovaginal versus midurethral slings, and inside-out versus outside-in transobturator slings.

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Two new mini‐slings compared with transobturator tension‐free vaginal tape for treatment of stress urinary incontinence: A 1‐year follow‐up randomized controlled trial

Abstract: The new single-incision mini-slings showed similar efficacy and patient acceptance to that of the standard TVT-O for up to 12 months postoperatively with no difference in the complications rate. The C-NDL is associated with shorter operative time and less blood loss.

Cited by 13 publications

References 25 publications

Contasure-needleless single incision slings versus transobturator slings (TOT/TVT-O) for female patients with stress urinary incontinence: a systematic review and meta-analysis

Contasure-needleless single incision slings versus transobturator slings (TOT/TVT-O) for female patients with stress urinary incontinence: a systematic review and meta-analysis

Clinical outcome of single‐incision slings, excluding TVT‐Secur, vs standard slings in the surgical management of stress incontinence: an updated systematic review and meta‐analysis

Surgical Treatment for Stress Urinary Incontinence in Women: A Systematic Review and Meta-analysis

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