In a nutshell
This study compared the effectiveness of two retropubic slings used to treat urinary incontinence (UI) in women. They found that both slings are effective, but cure rates can vary with different materials and techniques used.
Some background
Urinary incontinence (UI) is a lack of control of urination. It is more common in women of older age. There are several strategies to treat UI. One option involves surgery to raise the bladder. The bladder tends to drop as we age. To improve this, a retropubic ‘sling’ can be implanted. It is placed at the neck of the bladder which attaches to the urethra. This can reduce urine leaking from the bladder.
There are several types of slings. In some cases, they are implanted in different ways. The TVT exact® and the RetroArc® are two types of slings used to treat UI. Which sling is more effective remains under investigation.
Methods & findings
This study included 303 women with UI. Patients were randomly assigned to either TVT exact (152) or the RetroArc (151) groups. Follow-up was performed at 3 and 12 months. Objective and subjective cure was measured in patients. Objective cure (OC) is determined by a clinical test. In this case it was a negative cough test. Subjective cure (SC) is determined by the patient. They are asked to monitor UI symptoms using a questionnaire.
The OC rate was similar at 12 months in the TVT exact and RetroArc patients (92% vs 85.8%). However, TVT exact patients reported better SC rates (76.1%) compared to the RetroArc group (54.3%). Less significant pain was found in RetroArc patients. There were no major side effects associated with either sling.
The bottom line
The authors concluded that both slings are effective, but the objective and subjective cure rates can vary with the materials and techniques used.
The fine print
Some factors were not accounted for in this trial. The surgical procedure is different for each sling. Quality of life was not measured. Further investigation is needed to determine if one sling is better than the other.
What’s next?
If you have any concerns regarding urinary incontinence, please consult with your physician.
Published By :
Archives of Gynecology and Obstetrics
Date :
Feb 25, 2019
