Five-Years Outcomes of Different Procedures for The Treatment of Female Stress Urinary Incontinence: A Systematic Review and Network Meta-Analysis | ||||
| International Journal of Medical Arts | ||||
| Article 6, Volume 3, Issue 3, July 2021, Page 1530-1549 PDF (2.33 MB) | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/ijma.2021.79651.1323 | ||||
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| Authors | ||||
Doaa Mahmoud Effat  1; Mona Alsayed Alkafrawy1; Hanaa Farouk Ahmed2; Amany Ahmed Soliman3
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| 1Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Egypt | ||||
| 2Department of Obstetrics and Gynecology, Faculty of Medicine for Ggirls, Al-Azhar University, Egypt | ||||
| 3Department of Urology, Faculty of Medicine, Al-Azhar University, Egypt | ||||
| Abstract | ||||
| Introduction: The current body of evidence is limited regarding the long-term outcomes of different modalities for stress urinary incontinence (SUI). We conducted this systematic review and network meta-analysis to compare the long-term follow-up outcomes of mid-urethral slings (MUS), Burch colpo-suspension, pubo-vaginal sling (PVS), anterior colporrhaphy with Kelly’s plication, and laser therapy in the treatment of SUI Methods: In this systematic review and network meta-analysis, we included prospective and retrospective studies that assessed the long-term outcomes of modalities for the management of SUI. We performed an online, bibliographic, search in four bibliographic databases: Cochrane Central Register of Controlled Trials (CENTRAL), Medline via PubMed, Web of Science, and Scopus. Results: A total of 42 studies were included. For the subjective cure rate, five different interventions were compared; pooling direct and indirect comparisons revealed an advantage of tension-free vaginal tape (TVT) intervention over TVT-obturator (TVT-O), laparoscopic Burch colpo-suspension, trans-obturator tape (TOT), and TVT-sling (TVT-S). Concerning objective cure rate, the pooling direct and indirect comparisons showed an obvious advantage of TOT, followed by TVT, and then TVT-O, Burch lap, and TVT-S. For repeated surgery, four different interventions were compared, and the comparisons revealed an advantage of TVT intervention over TVT-O, PVS, and TOT. The comparisons revealed the advantage of TVT and TVT-O over other procedures for lower urinary symptoms and postoperative complications. Conclusion: In conclusion, MUS appears to be the most effective and safe procedure for SUI at long-term follow-up. However, these findings should be interpreted with caution as there is scarcity in the published reports assessing long-term outcomes of other modalities, especially PVS and laser therapy. | ||||
| Keywords | ||||
| Stress urinary incontinence; Mid-urethral slings; Burch colpo-suspension; Laser therapy; Meta-analysis | ||||
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