Study Preview
Study Title and Description
What patients think: Patient reported outcomes of retropubic versus transobturator mid-urethral slings for urodynamic stress incontinence - a multicentre randomised controlled trial
Key Questions Addressed
1 | Sling vs Comparator RCT outcomes (excluding AEs) | |
2 | Sling Adverse Events |
Primary Publication Information
Title | What patients think: Patient reported outcomes of retropubic versus transobturator mid-urethral slings for urodynamic stress incontinence - a multicentre randomised controlled trial |
Author | Freeman, Holmes, Hillard, Smith, James, Sultan, Morley, Yang, Abrams |
Country | |
Year | 2011 |
Numbers |
Pubmed ID: 21222114 2413 (internal) |
Secondary Publication Information
There are currently no secondary publications defined for this study.
Extraction Form: Sling vs Comparator RCT outcomes (excluding AEs)
Arms
Number | Title | Description | Comments |
---|---|---|---|
1 | Monarc | ||
2 | TVT |
Question... Follow Up | Answer | Follow-up Answer | |
---|---|---|---|
Country | UK | ||
Population (reason for surgery etc.) | Symptomatic SUI | ||
Urodynamic SUI | |||
Mixed incontinence | |||
RCT Comparison Category | Retropubic vs. Obturator | ||
Multicenter | Yes | ||
Institution Type | Unclear/Not reported | ||
Number of surgeons performing procedures ... | Other ... | many | |
Surgeons' Training | Not reported | ||
Residents or fellows performing surgery? | Unclear/Not reported | ||
Overall Study Notes | non-inferiority design; did meet power; did not always provide between-arm p values (OR time for example) | ||
Study Sponsor/Funding ... | Other ... | not stated |
Baseline Characteristics
Question | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Total | Comments | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
Answer | Follow-up | Answer | Follow-up | Answer | Follow-up | Answer | Follow-up | Answer | Follow-up | ||
No. Randomized | 100 | 93 | 193 | ||||||||
Mean Age | 54 (median) | 50 (median) | |||||||||
Post-Op Follow-Up Interval (Maximum) | 12 mos | 12 mos |
Results & Comparisons
Results Data
Outcome: Sexual function Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 94 | 85 | ||||
Mean | |||||||
Counts | 1 | 1 | not significant difference | ||||
Percentage | 1.1% | 1.2% |
Outcome: SUI cure Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Enrolled | 95 | 85 | ||||
Counts | 59 | 55 | -13.88-9.80 | ||||
Percentage | 63.4% | 65.5% |
Outcome: SUI objective Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Enrolled | 95 | 85 | no difference, p value not given | |||
Percentage | 10% | 12% |
Outcome: UUI Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | Monarc vs. TVT |
12 months |
N Enrolled | 85 | 95 | Fisher's exact | |||
Percentage | 62.4% | 60.7% | |||||
0.88 |
Outcome: SUI want retreatment Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | ||||||
Mean | |||||||
Counts | not significant diff | ||||||
Percentage | 10.% | 15.3% |
Outcome: EBL Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
0 days |
N Analyzed | 96 | 83 | ||||
Mean | 48.7 | 61.7 | 0.037 |
Outcome: de novo ugency Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 95 | 85 | ||||
Mean | |||||||
Counts | 4 | 4 | no p value given |
Outcome: voiding difficulty requiring catheterization Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 95 | 85 | ||||
Mean | |||||||
Counts | 5 | 5 | no p value - stated not different | ||||
ISC at 1 yr | 2 | 1 |
Outcome: Pain Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
6 hours |
N Analyzed | 76 | 68 | ||||
Mean | 3.1 | 3.7 | 0.06 | ||||
Standard Deviation |
Outcome: Pain Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
24 hours |
N Analyzed | 88 | 75 | ||||
Mean | 1.9 | 2.4 | 0.031 | ||||
Standard Deviation |
Outcome: QOL Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 91 | 83 | ||||
Mean | 3.1 | 3.3 | .70 | ||||
Mann-Whitney |
Outcome: SUI treatment meets expectations Population: All Participants | |||||
---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic |
12 months |
N Analyzed | 85 | 71 | ||
Mean | |||||
Counts | 56 | 58 | |||
Percentage | 58.9% | 68.2% |
Extraction Form: Sling Adverse Events
Arms
Number | Title | Description | Comments |
---|---|---|---|
1 | Retropubic synthetic | ||
2 | Transobturator synthetic |
Question... Follow Up | Answer | Follow-up Answer | |
---|---|---|---|
Study Type | RCT | ||
Study Country | UK | ||
Sling Category | Retropubic synthetic | ||
Obturator synthetic | |||
Adverse Event Ascertainment | Active | ||
Was the Clavien-Dindo Classification of Surgical Complications system used? | No / Not reported | ||
Was a data safety monitoring board used? | No / Not reported |
Results & Comparisons
Results Data
Outcome: Sexual function Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 94 | 85 | ||||
Mean | |||||||
Counts | 1 | 1 | not significant difference | ||||
Percentage | 1.1% | 1.2% |
Outcome: SUI cure Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Enrolled | 95 | 85 | ||||
Counts | 59 | 55 | -13.88-9.80 | ||||
Percentage | 63.4% | 65.5% |
Outcome: SUI objective Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Enrolled | 95 | 85 | no difference, p value not given | |||
Percentage | 10% | 12% |
Outcome: UUI Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | Monarc vs. TVT |
12 months |
N Enrolled | 85 | 95 | Fisher's exact | |||
Percentage | 62.4% | 60.7% | |||||
0.88 |
Outcome: SUI want retreatment Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | ||||||
Mean | |||||||
Counts | not significant diff | ||||||
Percentage | 10.% | 15.3% |
Outcome: EBL Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
0 days |
N Analyzed | 96 | 83 | ||||
Mean | 48.7 | 61.7 | 0.037 |
Outcome: de novo ugency Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 95 | 85 | ||||
Mean | |||||||
Counts | 4 | 4 | no p value given |
Outcome: voiding difficulty requiring catheterization Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 95 | 85 | ||||
Mean | |||||||
Counts | 5 | 5 | no p value - stated not different | ||||
ISC at 1 yr | 2 | 1 |
Outcome: Pain Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
6 hours |
N Analyzed | 76 | 68 | ||||
Mean | 3.1 | 3.7 | 0.06 | ||||
Standard Deviation |
Outcome: Pain Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
24 hours |
N Analyzed | 88 | 75 | ||||
Mean | 1.9 | 2.4 | 0.031 | ||||
Standard Deviation |
Outcome: QOL Population: All Participants | Between-Arm Comparisons | ||||||
---|---|---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic | Comparison Measure | ERROR vs. ERROR |
12 months |
N Analyzed | 91 | 83 | ||||
Mean | 3.1 | 3.3 | .70 | ||||
Mann-Whitney |
Outcome: SUI treatment meets expectations Population: All Participants | |||||
---|---|---|---|---|---|
Time Point | Measure | Monarc | TVT | Retropubic synthetic | Transobturator synthetic |
12 months |
N Analyzed | 85 | 71 | ||
Mean | |||||
Counts | 56 | 58 | |||
Percentage | 58.9% | 68.2% |
Adverse Events
Arm or Total | Title | Description | Follow-up time | In-hospital or After discharge | Is event serious? | Reported definition of serious event | Number affected | Number at risk (analyzed) | Difference between 2 slings (eg, OR/RR or %, with 95% CI) | Reported P value between slings | Comments |
---|---|---|---|---|---|---|---|---|---|---|---|
Retropubic synthetic | Organ injury in OR (urethra, bladder, bowel) | bladder perforation | 12 mos | OR | no | not given | 2 | 85 | not different | none given | |
Transobturator synthetic | 12 mos | OR | no | not given | 0 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | Organ injury in OR (urethra, bladder, bowel) | vaginal perforation | 12 mos | OR | no | not given | 0 | 85 | not different | none given | |
Transobturator synthetic | 12 mos | OR | no | not given | 4 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | Pain, groin (new or different after surgery) | 12 mos | postop | no | not given | 1 | 85 | not different | none given | ||
Transobturator synthetic | 12 mos | postop | no | not given | 8 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | removal for pain | removal of tape for pain | 12 mos | postop | somewhat | not given | 0 | 85 | not different | none given | |
Transobturator synthetic | 12 mos | postop | somewhat | not given | 1 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | removal for exposure | removal for mesh exposure | 12 mos | postop | no | not given | 0 | 85 | not different | none given | |
Transobturator synthetic | 12 mos | postop | no | not given | 1 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | Mesh erosion/extrusion/exposure/granulation tissue | 12 mos | postop | no | not given | 3 | 85 | not different | none given | ||
Transobturator synthetic | 12 mos | postop | no | not given | 2 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | Infection, UTI | required antibiotic therapy | 12 mos | postop | no | not given | 7 | 85 | not different | none given | |
Transobturator synthetic | 12 mos | postop | no | not given | 2 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | Infection, other | vaginal infection/discharge | 12 mos | postop | no | not given | 0 | 85 | not different | none given | |
Transobturator synthetic | 12 mos | postop | no | not given | 4 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | Infection, surgical site/wound | 12 mos | postop | no | not given | 0 | 85 | not different | none given | ||
Transobturator synthetic | 12 mos | postop | no | not given | 2 | 95 | not different | none given | |||
Total | |||||||||||
Retropubic synthetic | |||||||||||
Transobturator synthetic | |||||||||||
Total |