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

Abstract

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.

Resumo

Objetivo comparar tratamentos cirúrgicos para incontinência urinária de esforço (IUE), quanto à eficiência e complicações, por meio de revisão sistemática seguida de metanálise.

Fonte dos dados Fizemos busca nas bases de dados MEDLINE e COCHRANE, utilizando os termos stress urinary incontinence, surgical treatment for stress urinary incontinence e sling.

Seleção dos estudos Selecionamos 48 estudos, totalizando 6.881 pacientes com pontuação igual ou maior do que 3 na escala de Jadad.

Coleta de dados Cada estudo foi lido por um autor, colocado em tabela, e checado por outro autor. Extraímos dados como detalhes das intervenções, tempo de seguimento, resultados do tratamento e eventos adversos.

Síntese dos dados Não houve diferença nas comparações: sling de uretra média versus cirurgia de Burch, quanto às curas objetiva (razão de chances [RC]: 1,29; intervalo de confiança de 95% [IC95%]: 0,76–2,20) e subjetiva (RC: 1,16; IC95%: 0,67–2,00); sling de uretra média transobturatório outside-in versus inside-out quanto às curas objetiva (RC: 0,78; IC95%: 0,45–1,35) e subjetiva (RC: 0,83; IC95%: 0,58–1,18); sling pubovaginal e de uretra média quanto à cura objetiva (RC: 1,64; IC 95%: 0,52–5,15). Comparando sling retropúbico com transobturatório, o retropúbico foi superior quanto às curas objetiva (RC: 1,27; IC95%: 1,05–1,54) e subjetiva (RC: 1,23; IC95%: 1,02–1,48). Entre minislings e outros slings, houve diferença favorável a outros slings quanto à cura subjetiva (RC: 0,58; IC95%: 0,39–0,86) mas não quanto à cura objetiva (RC: 0,72; IC95%: 0,47–1,10). No grupo sling pubovaginal e Burch, houve diferença quanto à cura objetiva (RC: 2,04; IC95%: 1,50–2,77) e subjetiva (RC: 1,64; IC95%: 1,10–2,44). Slings de uretra média apresentam mais erosão, enquanto a cirurgia de Burch tem mais complicações na ferida operatória e infecção do trato urinário. Slings retropúbicos e pubovaginais são mais retencionistas. Slings retropúbicos estão mais associados a lesão vascular, hematomas e perfuração vesical, e transobturatórios, à dor na perna e virilha, lesão neurológica e perfuração vaginal.

Conclusão Slings pubovaginais são superiores à cirurgia de Burch, porém mais retencionistas. Slings retropúbicos são superiores aos transobturatórios, embora tenham mais eventos adversos. Outros slings são superiores aos minislings em relação ao aspecto subjetivo. Não houve diferença nas comparações entre slings de uretra média e cirurgia de Burch, slings pubovaginais, transobturatórios inside-out e inside-in.

Keywords

stress urinary incontinence - Burch surgery - midurethral sling - pubovaginal sling - meta-analysis

Palavras-chave

incontinência urinária de esforço - cirurgia de Burch - sling de uretra média - sling pubovaginal - metanálise

• References

• 1 Abrams P, Cardozo L, Fall M. , et al; Standardisation Sub-Committee of the International Continence Society. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003; 61 (01) 37-49 . Doi: 10.1016/S0090-4295(02)02243-4
• 2 Irwin DE, Milsom I, Hunskaar S. , et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006; 50 (06) 1306-1314 , discussion 1314–1315. Doi: 10.1016/j.eururo.2006.09.019
• 3 Botlero R, Urquhart DM, Davis SR, Bell RJ. Prevalence and incidence of urinary incontinence in women: review of the literature and investigation of methodological issues. Int J Urol 2008; 15 (03) 230-234 . Doi: 10.1111/j.1442-2042.2007.01976.x
• 4 Coyne KS, Sexton CC, Thompson CL. , et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int 2009; 104 (03) 352-360 . Doi: 10.1111/j.1464-410X.2009.08427.x
• 5 Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7 (02) 81-85 , discussion 85–86. Doi: 10.1007/BF01902378
• 6 Celebi I, Güngördük K, Ark C, Akyol A. Results of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence: a 5-year follow-up study. Arch Gynecol Obstet 2009; 279 (04) 463-467 . Doi: 10.1007/s00404-008-0805-2
• 7 Olsson I, Abrahamsson AK, Kroon UB. Long-term efficacy of the tension-free vaginal tape procedure for the treatment of urinary incontinence: a retrospective follow-up 11.5 years post-operatively. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21 (06) 679-683 . Doi: 10.1007/s00192-009-1083-7
• 8 Karram MM, Segal JL, Vassallo BJ, Kleeman SD. Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol 2003; 101 (5 Pt 1): 929-932 . Doi: 10.1016/S0029-7844(03)00122-4
• 9 Sander P, Sørensen F, Lose G. Does the tension-free vaginal tape procedure (TVT) affect the voiding function over time? Pressure-flow studies 1 year and 3(1/2) years after TVT. Neurourol Urodyn 2007; 26 (07) 995-997 . Doi: 10.1002/nau.20401
• 10 Delorme E. [Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women]. Prog Urol 2001; 11 (06) 1306-1313
• 11 de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 2003; 44 (06) 724-730 . Doi: 10.1016/j.eururo.2003.09.003
• 12 Hazewinkel MH, Hinoul P, Roovers JP. Persistent groin pain following a trans-obturator sling procedure for stress urinary incontinence: a diagnostic and therapeutic challenge. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20 (03) 363-365 . Doi: 10.1007/s00192-008-0714-8
• 13 Mostafa A, Lim CP, Hopper L, Madhuvrata P, Abdel-Fattah M. Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: an updated systematic review and meta-analysis of effectiveness and complications. Eur Urol 2014; 65 (02) 402-427 . Doi: 10.1016/j.eururo.2013.08.032
• 14 Jadad AR, Moore RA, Carroll D. , et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996; 17 (01) 1-12 . Doi: 10.1016/0197-2456(95)00134-4
• 15 Bai SW, Sohn WH, Chung DJ, Park JH, Kim SK. Comparison of the efficacy of Burch colposuspension, pubovaginal sling, and tension-free vaginal tape for stress urinary incontinence. Int J Gynaecol Obstet 2005; 91 (03) 246-251 . Doi: 10.1016/j.ijgo.2005.08.023
• 16 Jelovsek JE, Barber MD, Karram MM, Walters MD, Paraiso MFR. Randomised trial of laparoscopic Burch colposuspension versus tension-free vaginal tape: long-term follow up. BJOG 2008; 115 (02) 219-225 , discussion 225. Doi: 10.1111/j.1471-0528.2007.01592.x
• 17 Liapis A, Bakas P, Creatsas G. Burch colposuspension and tension-free vaginal tape in the management of stress urinary incontinence in women. Eur Urol 2002; 41 (04) 469-473
• 18 Paraiso MFR, Walters MD, Karram MM, Barber MD. Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial. Obstet Gynecol 2004; 104 (06) 1249-1258 . Doi: 10.1097/01.AOG.0000146290.10472.b3
• 19 Persson J, Teleman P, Etén-Bergquist C, Wølner-Hanssen P. Cost-analyzes based on a prospective, randomized study comparing laparoscopic colposuspension with a tension-free vaginal tape procedure. Acta Obstet Gynecol Scand 2002; 81 (11) 1066-1073 . Doi: 10.1034/j.1600-0412.2002.811112.x
• 20 Ward KL, Hilton P. ; UK and Ireland TVT Trial Group. Tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5-year follow up. BJOG 2008; 115 (02) 226-233 . Doi: 10.1111/j.1471-0528.2007.01548.x
• 21 Valpas A, Ala-Nissilä S, Tomas E, Nilsson CG. TVT versus laparoscopic mesh colposuspension: 5-year follow-up results of a randomized clinical trial. Int Urogynecol J Pelvic Floor Dysfunct 2015; 26 (01) 57-63 . Doi: 10.1007/s00192-014-2454-2
• 22 Albo ME, Richter HE, Brubaker L. , et al; Urinary Incontinence Treatment Network. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 2007; 356 (21) 2143-2155 . Doi: 10.1056/NEJMoa070416
• 23 Culligan PJ, Goldberg RP, Sand PK. A randomized controlled trial comparing a modified Burch procedure and a suburethral sling: long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14 (04) 229-233 , discussion 233. Doi: 10.1007/s00192-003-1057-0
• 24 Guerrero KL, Emery SJ, Wareham K, Ismail S, Watkins A, Lucas MG. A randomised controlled trial comparing TVT, Pelvicol and autologous fascial slings for the treatment of stress urinary incontinence in women. BJOG 2010; 117 (12) 1493-1502 . Doi: 10.1111/j.1471-0528.2010.02696.x
• 25 Sharifiaghdas F, Mortazavi N. Tension-free vaginal tape and autologous rectus fascia pubovaginal sling for the treatment of urinary stress incontinence: a medium-term follow-up. Med Princ Pract 2008; 17 (03) 209-214 . Doi: 10.1159/000117794
• 26 Angioli R, Plotti F, Muzii L, Montera R, Panici PB, Zullo MA. Tension-free vaginal tape versus transobturator suburethral tape: five-year follow-up results of a prospective, randomised trial. Eur Urol 2010; 58 (05) 671-677 . Doi: 10.1016/j.eururo.2010.08.004
• 27 Araco F, Gravante G, Sorge R. , et al. TVT-O vs TVT: a randomized trial in patients with different degrees of urinary stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19 (07) 917-926 . Doi: 10.1007/s00192-007-0554-y
• 28 Barber MD, Kleeman S, Karram MM. , et al. Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 2008; 111 (03) 611-621 . Doi: 10.1097/AOG.0b013e318162f22e
• 29 Costantini E, Kocjancic E, Lazzeri M. , et al. Long-term efficacy of the trans-obturator and retropubic mid-urethral slings for stress urinary incontinence: update from a randomized clinical trial. World J Urol 2016; 34 (04) 585-593 . Doi: 10.1007/s00345-015-1651-z
• 30 Deffieux X, Daher N, Mansoor A, Debodinance P, Muhlstein J, Fernandez H. Transobturator TVT-O versus retropubic TVT: results of a multicenter randomized controlled trial at 24 months follow-up. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21 (11) 1337-1345 . Doi: 10.1007/s00192-010-1196-z
• 31 Freeman R, Holmes D, Hillard T. , et al. What patients think: patient-reported outcomes of retropubic versus trans-obturator mid-urethral slings for urodynamic stress incontinence--a multi-centre randomised controlled trial. Int Urogynecol J Pelvic Floor Dysfunct 2011; 22 (03) 279-286 . Doi: 10.1007/s00192-010-1343-6
• 32 Karateke A, Haliloglu B, Cam C, Sakalli M. Comparison of TVT and TVT-O in patients with stress urinary incontinence: short-term cure rates and factors influencing the outcome. A prospective randomised study. Aust N Z J Obstet Gynaecol 2009; 49 (01) 99-105 . Doi: 10.1111/j.1479-828X.2009.00957.x
• 33 Krofta L, Feyereisl J, Otcenásek M, Velebil P, Kasíková E, Krcmár M. TVT and TVT-O for surgical treatment of primary stress urinary incontinence: prospective randomized trial. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21 (02) 141-148 . Doi: 10.1007/s00192-009-1027-2
• 34 Laurikainen E, Valpas A, Aukee P. , et al. Five-year results of a randomized trial comparing retropubic and transobturator midurethral slings for stress incontinence. Eur Urol 2014; 65 (06) 1109-1114 . Doi: 10.1016/j.eururo.2014.01.031
• 35 Lee KS, Han DH, Choi YS. , et al. A prospective trial comparing tension-free vaginal tape and transobturator vaginal tape inside-out for the surgical treatment of female stress urinary incontinence: 1-year followup. J Urol 2007; 177 (01) 214-218 . Doi: 10.1016/j.juro.2006.08.063
• 36 Richter HE, Albo ME, Zyczynski HM. , et al; Urinary Incontinence Treatment Network. Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 2010; 362 (22) 2066-2076 . Doi: 10.1056/NEJMoa0912658
• 37 Rinne K, Laurikainen E, Kivelä A. , et al. A randomized trial comparing TVT with TVT-O: 12-month results. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19 (08) 1049-1054 . Doi: 10.1007/s00192-008-0581-3
• 38 Ross S, Robert M, Swaby C. , et al. Transobturator tape compared with tension-free vaginal tape for stress incontinence: a randomized controlled trial. Obstet Gynecol 2009; 114 (06) 1287-1294 . Doi: 10.1097/AOG.0b013e3181c2a151
• 39 Ross S, Tang S, Eliasziw M. , et al. Transobturator tape versus retropubic tension-free vaginal tape for stress urinary incontinence: 5-year safety and effectiveness outcomes following a randomised trial. Int Urogynecol J Pelvic Floor Dysfunct 2016; 27 (06) 879-886 . Doi: 10.1007/s00192-015-2902-7
• 40 Scheiner DA, Betschart C, Wiederkehr S, Seifert B, Fink D, Perucchini D. Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings. Int Urogynecol J Pelvic Floor Dysfunct 2012; 23 (02) 197-206 . Doi: 10.1007/s00192-011-1543-8
• 41 Schierlitz L, Dwyer PL, Rosamilia A. , et al. Three-year follow-up of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency. Obstet Gynecol 2012; 119 (2 Pt 1): 321-327 . Doi: 10.1097/AOG.0b013e31823dfc73
• 42 Teo R, Moran P, Mayne C, Tincello D. Randomized trial of tension-free vaginal tape and tension-free vaginal tape-obturator for urodynamic stress incontinence in women. J Urol 2011; 185 (04) 1350-1355 . Doi: 10.1016/j.juro.2010.11.064
• 43 Wadie BS, El-Hefnawy AS. TVT versus TOT, 2-year prospective randomized study. World J Urol 2013; 31 (03) 645-649 . Doi: 10.1007/s00345-012-0956-4
• 44 Wang F, Song Y, Huang H. Prospective randomized trial of TVT and TOT as primary treatment for female stress urinary incontinence with or without pelvic organ prolapse in Southeast China. Arch Gynecol Obstet 2010; 281 (02) 279-286 . Doi: 10.1007/s00404-009-1098-9
• 45 Wang W, Zhu L, Lang J. Transobturator tape procedure versus tension-free vaginal tape for treatment of stress urinary incontinence. Int J Gynaecol Obstet 2009; 104 (02) 113-116 . Doi: 10.1016/j.ijgo.2008.09.013
• 46 Zhang Z, Zhu L, Xu T, Lang J. Retropubic tension-free vaginal tape and inside-out transobturator tape: a long-term randomized trial. Int Urogynecol J Pelvic Floor Dysfunct 2016; 27 (01) 103-111 . Doi: 10.1007/s00192-015-2798-2
• 47 Abdel-Fattah M, Ramsay I, Pringle S. , et al. Randomised prospective single-blinded study comparing ‘inside-out’ versus ‘outside-in’ transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study. BJOG 2010; 117 (07) 870-878 . Doi: 10.1111/j.1471-0528.2010.02544.x
• 48 Houwert RM, Renes-Zijl C, Vos MC, Vervest HAM. TVT-O versus Monarc after a 2-4-year follow-up: a prospective comparative study. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20 (11) 1327-1333 . Doi: 10.1007/s00192-009-0943-5
• 49 Liapis A, Bakas P, Creatsas G. Monarc vs TVT-O for the treatment of primary stress incontinence: a randomized study. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19 (02) 185-190 . Doi: 10.1007/s00192-007-0432-7
• 50 Park YJ, Kim DY. Randomized controlled study of MONARC® vs. tension-free vaginal tape obturator (TVT-O®) in the treatment of female urinary incontinence: comparison of 3-year cure rates. Korean J Urol 2012; 53 (04) 258-262 . Doi: 10.4111/kju.2012.53.4.258
• 51 Basu M, Duckett J. Three-year results from a randomised trial of a retropubic mid-urethral sling versus the Miniarc single incision sling for stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2013; 24 (12) 2059-2064 . Doi: 10.1007/s00192-013-2125-8
• 52 Djehdian LM, Araujo MP, Takano CC. , et al. Transobturator sling compared with single-incision mini-sling for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 2014; 123 (03) 553-561 . Doi: 10.1097/AOG.0000000000000148
• 53 Gaber ME, Borg T, Samour H, Nawara M, Reda A. 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. J Obstet Gynaecol Res 2016; 42 (12) 1773-1781 . Doi: 10.1111/jog.13143
• 54 Jurakova M, Huser M, Belkov I. , et al. Prospective randomized comparison of the transobturator mid-urethral sling with the single-incision sling among women with stress urinary incontinence: 1-year follow-up study. Int Urogynecol J Pelvic Floor Dysfunct 2016; 27 (05) 791-796 . Doi: 10.1007/s00192-015-2895-2
• 55 Lee JK, Rosamilia A, Dwyer PL, Lim YN, Muller R. Randomized trial of a single incision versus an outside-in transobturator midurethral sling in women with stress urinary incontinence: 12 month results. Am J Obstet Gynecol 2015; 213 (01) 35.e1-35.e9 . Doi: 10.1016/j.ajog.2015.01.040
• 56 Schellart RP, Oude Rengerink K, Van der Aa F. , et al. A randomised comparison of single-incision versus traditional transobturator midurethral sling in women with stress urinary incontinence: results of a 24-month follow-up. Int Urogynecol J Pelvic Floor Dysfunct 2016; 27 (06) 871-877 . Doi: 10.1007/s00192-015-2898-z
• 57 Sivaslioglu AA, Unlubilgin E, Aydogmus S, Keskin L, Dolen I. A prospective randomized controlled trial of the transobturator tape and tissue fixation mini-sling in patients with stress urinary incontinence: 5-year results. J Urol 2012; 188 (01) 194-199 . Doi: 10.1016/j.juro.2012.02.2564
• 58 Borestein M, Hedges LV, Higgins JP, Rothstein HR. Introduction to Meta-Analysis . Hoboken, NJ: John Wiley & Sons; 2009
• 59 DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7 (03) 177-188 . Doi: 10.1016/0197-2456(86)90046-2
• 60 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21 (11) 1539-1558 . Doi: 10.1002/sim.1186
• 61 Sutton AJ, Abrams KR, Jones DR, Sheldon TA, Song F. Methods for Meta-Analysis in Medical Research . Hoboken, NJ: John Wiley & Sons; 2000
• 62 Haab F, Sananes S, Amarenco G. , et al. Results of the tension-free vaginal tape procedure for the treatment of type II stress urinary incontinence at a minimum followup of 1 year. J Urol 2001; 165 (01) 159-162 . Doi: 10.1097/00005392-200101000-00038
• 63 Lebret T, Lugagne PM, Hervé JM. , et al. Evaluation of tension-free vaginal tape procedure. Its safety and efficacy in the treatment of female stress urinary incontinence during the learning phase. Eur Urol 2001; 40 (05) 543-547
• 64 Black NA, Downs SH. The effectiveness of surgery for stress incontinence in women: a systematic review. Br J Urol 1996; 78 (04) 497-510 . Doi: 10.1046/j.1464-410X.1996.01422.x
• 65 Jarvis GJ. Surgery for genuine stress incontinence. Br J Obstet Gynaecol 1994; 101 (05) 371-374 . Doi: 10.1111/j.1471-0528.1994.tb11907.x
• 66 Long CY, Hsu CS, Lo TS, Liu CM, Chen YH, Tsai EM. Ultrasonographic assessment of tape location following tension-free vaginal tape and transobturator tape procedure. Acta Obstet Gynecol Scand 2008; 87 (01) 116-121 . Doi: 10.1080/00016340701797765
• 67 Ford AA, Ogah JA. Retropubic or transobturator mid-urethral slings for intrinsic sphincter deficiency-related stress urinary incontinence in women: a systematic review and meta-analysis. Int Urogynecol J Pelvic Floor Dysfunct 2016; 27 (01) 19-28 . Doi: 10.1007/s00192-015-2797-3
• 68 Tseng LH, Wang AC, Lin YH, Li SJ, Ko YJ. Randomized comparison of the suprapubic arc sling procedure vs tension-free vaginal taping for stress incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 2005; 16 (03) 230-235 . Doi: 10.1007/s00192-004-1248-3
• 69 Novara G, Galfano A, Boscolo-Berto R. , et al. Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol 2008; 53 (02) 288-308 . Doi: 10.1016/j.eururo.2007.10.073
• 70 Whiteside JL, Walters MD. Anatomy of the obturator region: relations to a trans-obturator sling. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15 (04) 223-226 . Doi: 10.1007/s00192-004-1143-y
• 71 Ford AA, Rogerson L, Cody JD, Ogah J. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev 2015; (07) CD006375 . Doi: 10.1002/14651858.CD006375.pub3
• 72 Novara G, Artibani W, Barber MD. , et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol 2010; 58 (02) 218-238 . Doi: 10.1016/j.eururo.2010.04.022