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Comparison of retropubic midurethral slings in the treatment of female stress urinary incontinence

  • Hjalmar A. SchiøtzEmail author
  • Rune Svenningsen
  • Sigurd Kulseng-Hanssen
Original Article
  • 15 Downloads

Abstract

Introduction and hypothesis

Over 50 different types of midurethral slings have been marketed. They have generally been considered comparable in performance. Many studies have compared retropubic with obturator slings, but few have compared different makes of retropubic slings with each other. We have compared the performance of retropubic slings using data from the Norwegian Female Incontinence Registry.

Methods

From June 2015 through 2017, 2843 women underwent a retropubic sling procedure, with 6–12-month follow-up data available for 2612 (92%). Results for six different types of slings used in this time period are presented: TVT Exact, TVT Classic, Advantage, Advantage Fit, TVT A.M.I. and RetroArc. The TVT Exact was the most prevalent sling, and the outcomes were compared with this sling as reference using chi-square and Dunnet’s tests with significance at 0.05.

Results

There were only small differences among the four slings, TVT Exact, TVT Classic, Advantage and Advantage Fit, with subjective cure rates from 77.7 to 81.9% and objective cure rates from 90.8 to 96.6%. The TVT A.M.I. sling had a high cure rate but significantly fewer satisfied patients and less improvement in urgency bother. The Retro Arc’s results were clearly inferior. There was little difference in terms of obstruction or de novo urgency incontinence among the six slings. Most complication rates were not statistically different.

Conclusions

At 6–12-month follow-up there was no significant difference in clinical results between the TVT Exact, TVT Classic, Advantage and Advantage Fit slings, while RetroArc and to some extent TVT A.M.I. slings underperformed.

Keywords

De novo urgency incontinence Female Follow-up studies Midurethral slings Urinary incontinence, stress 

Notes

Acknowledgements

We are grateful for the help given us by statistician Petter Mowinkel, MSc, Oslo University Hospital.

Compliance with ethical standards

Conflicts of interest

None.

Supplementary material

192_2019_4080_MOESM1_ESM.docx (18 kb)
Supplementary Table 1 (DOCX 18 kb)

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyVestfold Hospital TrustTønsbergNorway
  2. 2.Department of GynecologyOslo University HospitalOsloNorway
  3. 3.The Norwegian Female Incontinence RegistryOslo University HospitalOsloNorway

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