Adjustable slings versus other surgical methods in female stress urinary incontinence: a systematic review and meta-analysis
Introduction and hypothesis The objective of this study was to evaluate the efficacy and safety of different adjustable slings compared to other surgical methods for the treatment of stress urinary incontinence (SUI) among women. Methods The inclusion criteria were as follows: randomized controlled...
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| Veröffentlicht in: | International Urogynecology Journal 2023-07, Vol.34 (7), p.1351-1367 |
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| creator | Grigoryan, Bagrat Shadyan, Gor Kasyan, George Pushkar, Dmitry |
| description | Introduction and hypothesis
The objective of this study was to evaluate the efficacy and safety of different adjustable slings compared to other surgical methods for the treatment of stress urinary incontinence (SUI) among women.
Methods
The inclusion criteria were as follows: randomized controlled trials (RCTs) and non-RCTs assessing adult women with SUI. The exclusion criteria were as follows: other types of urinary incontinence, studies that combined conservative interventions and pharmacological treatment, pregnant and lactating patients. Databases were searched up to November 2022 to identify articles evaluating the effectiveness and safety of different adjustable slings compared to other surgical methods for the treatment of SUI among women. The systematic review was conducted in accordance with the PRISMA 2020 checklist and registered in PROSPERO. Risk-of-bias assessment tools recommended by the Cochrane Society were used to evaluate the risk of bias in the included studies.
Results
Eighteen clinical trials were included in this systematic review, and 11 studies were included in the meta-analysis. Fourteen studies were RCTs, and four were retrospective studies. Only RCTs were included in the meta-analyses. There was no statistically significant difference in the objective cure rate, subjective cure rate, or long-term postoperative complication rate between Ajust single-incision mini-slings (SIMS) and standard mid-urethral slings (SMUS) or MiniArc SIMS. However, the operation time in the adjustable SIMS group was significantly shorter (RR = −4.20, 95% CI: [−7.51, −0.89],
p
= 0.01).
Conclusions
This systematic review and meta-analysis revealed that adjustable SIMS is equally effective when compared with SMUS for the treatment of SUI among women. Moreover, the operation time for the adjustable SIMS was shorter. However, additional well-designed studies with standard outcome measures and complete follow-up periods will help to increase confidence in the choice of different options for treating SUI among women. |
| doi_str_mv | 10.1007/s00192-023-05535-z |
| format | Article |
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The objective of this study was to evaluate the efficacy and safety of different adjustable slings compared to other surgical methods for the treatment of stress urinary incontinence (SUI) among women.
Methods
The inclusion criteria were as follows: randomized controlled trials (RCTs) and non-RCTs assessing adult women with SUI. The exclusion criteria were as follows: other types of urinary incontinence, studies that combined conservative interventions and pharmacological treatment, pregnant and lactating patients. Databases were searched up to November 2022 to identify articles evaluating the effectiveness and safety of different adjustable slings compared to other surgical methods for the treatment of SUI among women. The systematic review was conducted in accordance with the PRISMA 2020 checklist and registered in PROSPERO. Risk-of-bias assessment tools recommended by the Cochrane Society were used to evaluate the risk of bias in the included studies.
Results
Eighteen clinical trials were included in this systematic review, and 11 studies were included in the meta-analysis. Fourteen studies were RCTs, and four were retrospective studies. Only RCTs were included in the meta-analyses. There was no statistically significant difference in the objective cure rate, subjective cure rate, or long-term postoperative complication rate between Ajust single-incision mini-slings (SIMS) and standard mid-urethral slings (SMUS) or MiniArc SIMS. However, the operation time in the adjustable SIMS group was significantly shorter (RR = −4.20, 95% CI: [−7.51, −0.89],
p
= 0.01).
Conclusions
This systematic review and meta-analysis revealed that adjustable SIMS is equally effective when compared with SMUS for the treatment of SUI among women. Moreover, the operation time for the adjustable SIMS was shorter. However, additional well-designed studies with standard outcome measures and complete follow-up periods will help to increase confidence in the choice of different options for treating SUI among women.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-023-05535-z</identifier><identifier>PMID: 37067572</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Gynecology ; Medicine ; Medicine & Public Health ; Meta-analysis ; Review Article ; Systematic review ; Urinary incontinence ; Urology</subject><ispartof>International Urogynecology Journal, 2023-07, Vol.34 (7), p.1351-1367</ispartof><rights>The International Urogynecological Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The International Urogynecological Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-8c1210c332118dd7603bade62c1d70c56ae2eb2b0e6a3d1b4d4f53db8ce24a763</citedby><cites>FETCH-LOGICAL-c375t-8c1210c332118dd7603bade62c1d70c56ae2eb2b0e6a3d1b4d4f53db8ce24a763</cites><orcidid>0000-0002-7698-0653</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-023-05535-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-023-05535-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37067572$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grigoryan, Bagrat</creatorcontrib><creatorcontrib>Shadyan, Gor</creatorcontrib><creatorcontrib>Kasyan, George</creatorcontrib><creatorcontrib>Pushkar, Dmitry</creatorcontrib><title>Adjustable slings versus other surgical methods in female stress urinary incontinence: a systematic review and meta-analysis</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
The objective of this study was to evaluate the efficacy and safety of different adjustable slings compared to other surgical methods for the treatment of stress urinary incontinence (SUI) among women.
Methods
The inclusion criteria were as follows: randomized controlled trials (RCTs) and non-RCTs assessing adult women with SUI. The exclusion criteria were as follows: other types of urinary incontinence, studies that combined conservative interventions and pharmacological treatment, pregnant and lactating patients. Databases were searched up to November 2022 to identify articles evaluating the effectiveness and safety of different adjustable slings compared to other surgical methods for the treatment of SUI among women. The systematic review was conducted in accordance with the PRISMA 2020 checklist and registered in PROSPERO. Risk-of-bias assessment tools recommended by the Cochrane Society were used to evaluate the risk of bias in the included studies.
Results
Eighteen clinical trials were included in this systematic review, and 11 studies were included in the meta-analysis. Fourteen studies were RCTs, and four were retrospective studies. Only RCTs were included in the meta-analyses. There was no statistically significant difference in the objective cure rate, subjective cure rate, or long-term postoperative complication rate between Ajust single-incision mini-slings (SIMS) and standard mid-urethral slings (SMUS) or MiniArc SIMS. However, the operation time in the adjustable SIMS group was significantly shorter (RR = −4.20, 95% CI: [−7.51, −0.89],
p
= 0.01).
Conclusions
This systematic review and meta-analysis revealed that adjustable SIMS is equally effective when compared with SMUS for the treatment of SUI among women. Moreover, the operation time for the adjustable SIMS was shorter. However, additional well-designed studies with standard outcome measures and complete follow-up periods will help to increase confidence in the choice of different options for treating SUI among women.</description><subject>Gynecology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Review Article</subject><subject>Systematic review</subject><subject>Urinary incontinence</subject><subject>Urology</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU1v1DAQhi1ERZeWP8ABWeLCxTC24zjLrar4kipxac-WY89uvUqc4kmKtuLH42ULSBw4jeR55p2RH8ZeSngrAew7ApBrJUBpAcZoIx6esJVstBa6vj1lK1hrK3TTqlP2nGgHAA0YeMZOtYXWGqtW7MdF3C00-35ATkPKW-L3WGghPs23WDgtZZuCH_iI8-0UiafMNzj6Az4XJOJLSdmXfW2EKc8pYw74nntOe5orOKfAC94n_M59jocYL3z2w54SnbOTjR8IXzzWM3bz8cP15Wdx9fXTl8uLKxG0NbPoglQSgtZKyi5G24LufcRWBRktBNN6VNirHrD1Osq-ic3G6Nh3AVXjbavP2Jtj7l2Zvi1IsxsTBRwGn3FayKkOVKPUem0r-vofdDctpd57oFRnVGOtqZQ6UqFMRAU37q6ksf6Ck-AObtzRjase3C837qEOvXqMXvoR45-R3zIqoI8A1VbeYvm7-z-xPwFdo5zR</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Grigoryan, Bagrat</creator><creator>Shadyan, Gor</creator><creator>Kasyan, George</creator><creator>Pushkar, Dmitry</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7698-0653</orcidid></search><sort><creationdate>20230701</creationdate><title>Adjustable slings versus other surgical methods in female stress urinary incontinence: a systematic review and meta-analysis</title><author>Grigoryan, Bagrat ; Shadyan, Gor ; Kasyan, George ; Pushkar, Dmitry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-8c1210c332118dd7603bade62c1d70c56ae2eb2b0e6a3d1b4d4f53db8ce24a763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Gynecology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Review Article</topic><topic>Systematic review</topic><topic>Urinary incontinence</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grigoryan, Bagrat</creatorcontrib><creatorcontrib>Shadyan, Gor</creatorcontrib><creatorcontrib>Kasyan, George</creatorcontrib><creatorcontrib>Pushkar, Dmitry</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grigoryan, Bagrat</au><au>Shadyan, Gor</au><au>Kasyan, George</au><au>Pushkar, Dmitry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adjustable slings versus other surgical methods in female stress urinary incontinence: a systematic review and meta-analysis</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>34</volume><issue>7</issue><spage>1351</spage><epage>1367</epage><pages>1351-1367</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
The objective of this study was to evaluate the efficacy and safety of different adjustable slings compared to other surgical methods for the treatment of stress urinary incontinence (SUI) among women.
Methods
The inclusion criteria were as follows: randomized controlled trials (RCTs) and non-RCTs assessing adult women with SUI. The exclusion criteria were as follows: other types of urinary incontinence, studies that combined conservative interventions and pharmacological treatment, pregnant and lactating patients. Databases were searched up to November 2022 to identify articles evaluating the effectiveness and safety of different adjustable slings compared to other surgical methods for the treatment of SUI among women. The systematic review was conducted in accordance with the PRISMA 2020 checklist and registered in PROSPERO. Risk-of-bias assessment tools recommended by the Cochrane Society were used to evaluate the risk of bias in the included studies.
Results
Eighteen clinical trials were included in this systematic review, and 11 studies were included in the meta-analysis. Fourteen studies were RCTs, and four were retrospective studies. Only RCTs were included in the meta-analyses. There was no statistically significant difference in the objective cure rate, subjective cure rate, or long-term postoperative complication rate between Ajust single-incision mini-slings (SIMS) and standard mid-urethral slings (SMUS) or MiniArc SIMS. However, the operation time in the adjustable SIMS group was significantly shorter (RR = −4.20, 95% CI: [−7.51, −0.89],
p
= 0.01).
Conclusions
This systematic review and meta-analysis revealed that adjustable SIMS is equally effective when compared with SMUS for the treatment of SUI among women. Moreover, the operation time for the adjustable SIMS was shorter. However, additional well-designed studies with standard outcome measures and complete follow-up periods will help to increase confidence in the choice of different options for treating SUI among women.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37067572</pmid><doi>10.1007/s00192-023-05535-z</doi><tpages>17</tpages><orcidid>https://orcid.org/0000-0002-7698-0653</orcidid></addata></record> |
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| title | Adjustable slings versus other surgical methods in female stress urinary incontinence: a systematic review and meta-analysis |
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