Surgical Slings Effective for Stress Incontinence

Women with stress urinary incontinence (SUI) obtained similarly high rates of improvement with both the transobturator route (TOR) and retropubic route (RPR), according to a new study.

Researchers at University Hospitals of Morecambe Bay (UHMB; Cumbria, United Kingdom) and Bradford Royal Infirmary (United Kingdom) searched the Cochrane Incontinence Group Specialized Register to identify trials that assessed the clinical effects of mid-urethral sling (MUS) operations for the treatment of SUI, urodynamic stress incontinence (USI), or mixed urinary incontinence (MUI) in women, and compared TOR to RPR. In all, the researches included 81 trials that evaluated 12,113 women.

The results showed that irrespective of the routes traversed, mid-urethral slings had one-year cure rates of about 80%, declining to about 70% after five years, with mounting evidence of their long term effectiveness. With the exception of groin pain, fewer adverse events occur with employment of TOR, and a lower rate of reoperation with TOR when compared to RPR. Rates of tape erosion were similar with the two approaches. The study was published on July 1, 2015, in the Cochrane Database of Systematic Reviews.

“Mid-urethral sling operations have been the most extensively researched surgical treatment for stress urinary incontinence in women and have a good safety profile,” said lead author Joseph Ogah, MD, of UHMB, and colleagues. “Irrespective of the routes traversed, they are highly effective in the short and medium term, and accruing evidence demonstrates their effectiveness in the long term.”

SUI is the loss of bladder control or involuntary loss of urine when coughing, laughing, sneezing, or during heavy lifting, or simply getting up from a chair. SUI is the most common type of incontinence suffered by women, especially older women. In addition, women who have given birth are more likely to have stress incontinence. Causes include weak pelvic muscles or a weak sphincter muscle; chronic cough, smoking, and obesity may also lead to SUI.

Related Links:
University Hospitals of Morecambe Bay
Bradford Royal Infirmary