Volume 64, Issue 2, Pages (August 2013)

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Volume 64, Issue 2, Pages 323-336 (August 2013) Surgical Treatment of Recurrent Stress Urinary Incontinence in Women: A Systematic Review and Meta-analysis of Randomised Controlled Trials Wael Agur, Mohamed Riad, Silvia Secco, Heather Litman, Priya Madhuvrata, Giacomo Novara, Mohamed Abdel-Fattah European Urology Volume 64, Issue 2, Pages 323-336 (August 2013) DOI: 10.1016/j.eururo.2013.04.034 Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 1 Study flow diagram. RCT = randomised controlled trial; R-SUI = recurrent stress urinary incontinence; SUI = stress urinary incontinence. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 2 Transobturator tape tension-free vaginal tape (TO-TOT) versus retropubic tension-free vaginal tape (RT-TVT). (a) Patient-reported cure/improvement; (b) objective cure/improvement; (c) repeated continence surgery; (d) bladder/urethral injury; (e) tape erosion; (f) voiding dysfunction; (g) quality of life (QoL): Urogenital Distress Inventory; (h) QoL: Incontinence Impact Questionnaire; (i) sexual function: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire; (j) de novo detrusor overactivity. CI = confidence interval; M-H = Mantel-Haenszel [test]. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 2 Transobturator tape tension-free vaginal tape (TO-TOT) versus retropubic tension-free vaginal tape (RT-TVT). (a) Patient-reported cure/improvement; (b) objective cure/improvement; (c) repeated continence surgery; (d) bladder/urethral injury; (e) tape erosion; (f) voiding dysfunction; (g) quality of life (QoL): Urogenital Distress Inventory; (h) QoL: Incontinence Impact Questionnaire; (i) sexual function: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire; (j) de novo detrusor overactivity. CI = confidence interval; M-H = Mantel-Haenszel [test]. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 3 Fascial sling versus synthetic retropubic tension-free vaginal tape (TVT). (a) Patient-reported cure/improvement; (b) objective cure/improvement; (c) bladder/urethral injury; (d) voiding dysfunction. CI = confidence interval; M-H = Mantel-Haenszel [test]; MUS = midurethral tension-free vaginal sling. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 4 Burch colposuspension versus retropubic tension-free vaginal tape (RP-TVT). (a) Patient-reported cure/improvement; (b) objective cure/improvement; (c) Urogenital Distress Inventory; (d) Incontinence Impact Questionnaire; (e) operating time; (f) blood loss. CI = confidence interval; Lap = laparoscopic; SD = standard deviation. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 5 Burch colposuspension versus autologous fascial sling. (a) Objective* cure/improvement; (b) repeat continence surgery; (c) voiding dysfunction; (d) quality of life (QoL): Urogenital Distress Inventory. (e) QoL: Incontinence Impact Questionnaire; (f) Sexual function: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12. CI = confidence interval; M-H = Mantel-Haenszel [test]; MUS = midurethral tension-free vaginal sling. *Because the subjective cure/improvement outcome was not defined separately, the objective outcomes were analysed here instead. We defined this as stress urinary incontinence (SUI)-specific treatment success and included a negative stress test, no self-reported stress-type urinary incontinence symptoms, and no retreatment for SUI. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 6 Inside-out versus outside-in transobturator tapes. (a) Patient-reported cure/improvement; (b) objective cure/improvement; (c) bladder/urethral injury; (d) voiding dysfunction. CI = confidence interval; M-H = Mantel-Haenszel [test]. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions

Fig. 7 Risk of bias. European Urology 2013 64, 323-336DOI: (10.1016/j.eururo.2013.04.034) Copyright © 2013 European Association of Urology Terms and Conditions