Document Detail


A randomised trial of a retropubic tension-free vaginal tape versus a mini-sling for stress incontinence.
MedLine Citation:
PMID:  20175874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare a mini-sling with a retropubic tension-free vaginal tape (TVT) in the treatment of stress urinary incontinence (SUI) and urodynamic stress incontinence (USI).
DESIGN: Randomised trial.
SETTING: Urogynaecology unit in large UK district general hospital.
POPULATION: Women with USI resistant to conservative management and requiring a suburethral sling.
METHODS: A total of 71 women with SUI and confirmed USI were randomised to undergo treatment with either a retropubic TVT or mini-sling. Follow-up was at 6 weeks, with a history, examination and quality of life questionnaire, and at 6 months with further subjective evaluation and twin-channel subtraction cystometry and pressure-flow studies.
MAIN OUTCOME MEASURES: The presence of SUI at 6 weeks and 6 months after treatment.
RESULTS: The mini-sling was associated with a significantly higher rate of persistent SUI at 6 weeks (OR 9.49, 95% CI 2.8-32.6) and 6 months (OR 8.14, 95% CI 2.7-24.7), and of USI at 6 months (OR 7.58, 95% CI 2.7-24.7). The rate of complication was similar in the two groups.
CONCLUSIONS: The mini-sling is associated with a higher failure rate than a retropubic TVT. Longer term and multicentre outcome data are necessary to explore these findings further. Until this is available, the mini-sling should be used with caution.
Authors:
M Basu; J Duckett
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-02-22
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-16     Revised Date:  2010-12-23    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  730-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent, UK. mayabasu@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Middle Aged
Prospective Studies
Prosthesis Design
Recurrence
Suburethral Slings*
Treatment Outcome
Urinary Incontinence, Stress / physiopathology,  surgery*
Urodynamics
Comments/Corrections
Comment In:
BJOG. 2011 Jan;118(1):99; author reply 99-100   [PMID:  21143746 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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