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Slings in surgery of genuine stress incontinence

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Abstract

Purpose

To summarize the available evidence concerning efficacy and safety of standard mid-urethral sling (SMUS) operations for the treatment of stress urinary incontinence (SUI).

Methods and results

A non-systematic literature review was carried out in order to collect the available evidence concerning efficacy and safety of SMUS operations for the treatment of SUI. According to the data of our prior meta-analysis, patients receiving SMUS had significantly higher overall and objective cure rates than those receiving Burch colposuspension, although they had a higher risk of bladder perforations. Patients undergoing SMUS and pubovaginal slings had similar cure rates, although the latter were slightly more likely to experience storage lower urinary tract symptoms and had a higher reoperation rate. Patients treated with retropubic SMUS had slightly higher objective cure rates than those treated with transobturator tape (TOT); however, subjective cure rates were similar, and patients treated with TOT had a much lower risk of some complications. Meta-analysis demonstrated similar outcomes for TOTs. With regard to the novel mini-sling, another meta-analysis from Abdel-fattah et al. demonstrated that repeat continence surgery and de novo urgency incontinence were significantly higher in the patients treated with mini-slings.

Conclusion

Patients treated with retropubic tape (RT) experienced slightly higher continence rates than those treated with Burch colposuspension, but they faced a much higher risk of intraoperative complications. RT and pubovaginal slings were similarly effective. The use of RT was followed by objective cure rates slightly higher than TOT and by higher risk of complications. The novel mini-slings do not seem to be more effective than the SMUS.

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Conflict of interest

The authors declare that they have no conflict of interest to disclose. The study did not receive any founding.

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Authors and Affiliations

  1. Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Monoblocco Ospedaliero, IV Floor, Via Giustiniani 2, 35128, Padua, Italy

    Silvia Secco, Alessandro Crestani, Francesco Cattaneo, Vincenzo Ficarra, Filiberto Zattoni & Giacomo Novara

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  1. Silvia Secco
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  2. Alessandro Crestani
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  3. Francesco Cattaneo
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  4. Vincenzo Ficarra
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  5. Filiberto Zattoni
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  6. Giacomo Novara
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Corresponding author

Correspondence to Giacomo Novara.

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Secco, S., Crestani, A., Cattaneo, F. et al. Slings in surgery of genuine stress incontinence. World J Urol 30, 465–470 (2012). https://doi.org/10.1007/s00345-011-0781-1

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  • DOI: https://doi.org/10.1007/s00345-011-0781-1

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