Bladder neck needle suspension for urinary incontinence in women

Cathryn MA Glazener; Kevin Cooper

doi:10.1002/14651858.CD003636.pub3

Bladder neck needle suspension for urinary incontinence in women

Contraer todo Desplegar todo

Referencias

References to studies included in this review

Ir a:

estudios excluidos
otras referencias
otras versiones publicadas

Athanassopoulos A, Barbalias G. Burch colposuspension versus Stamey endoscopic bladder neck suspension: a urodynamic appraisal. Urologia Internationalis 1996;56(1):23‐7.

Athanassopoulos A, Liatsikos EN, Perimenis P, Barbalias GA. Female stress urinary incontinence: predictive factors for the operative correction (Abstract). International Urogynecology Journal and Pelvic Floor Dysfunction 1999;10(Suppl 1):S140.

Google Scholar

Bergman A, Ballard CA, Koonings PP. Comparison of three different surgical procedures for genuine stress incontinence: prospective randomized study. American Journal of Obstetrics & Gynecology 1989;160(5 Pt 1):1102‐6.

Bergman A, Elia G. Three surgical procedures for genuine stress incontinence: five‐year follow‐up of a prospective randomized study. American Journal of Obstetrics & Gynecology 1995;173(1):66‐71.

Elia G, Bergman A. Prospective randomized comparison of three surgical procedures for stress urinary incontinence: five year follow‐up (Abstract). Neurourology & Urodynamics 1994;13(4):498‐500.

Google Scholar

Elia G, Bergman J, Klutke JJ, Klutke CG. Urethral resistance after surgery for stress urinary incontinence: do we obstruct to have a successful outcome?. Urodinamica 2000;10(1):32‐7.

Google Scholar

Bergman A, Ballard CA, Koonings PP. Primary stress urinary incontinence and pelvic relaxation: prospective randomised comparison of 3 different operations (Abstract). Neurourology and Urodynamics 1989;8(4):334‐5.

Google Scholar

Bergman A, Koonings PP, Ballard CA. Primary stress urinary incontinence and pelvic relaxation: prospective randomized comparison of three different operations. American Journal of Obstetrics & Gynecology 1989;161(1):97‐101.

Klutke JJ, Klutke CG, Bergman J, Elia G. Urodynamics changes in voiding after anti‐incontinence surgery: an insight into the mechanism of cure. Urology 1999;54(6):1003‐7.

Di Palumbo VS. Four‐corner bladder and urethral retropubic suspension versus anterior colporrhaphy in the correction of stress urinary incontinence with urethrocystocele 3‐4. Randomized clinical trial. Urogynaecologia International Journal 2003;17(2):57‐68.

Google Scholar

German K, Goodman C, Haynes R, Stephenson TP. A randomised trial comparing a modified needle suspension procedure with the vagina/obturator shelf procedure for genuine stress incontinence. Proceedings of the 22nd Annual Meeting of the International Continence Society; Sept 1‐4; Halifax, UK. Bristol: International Continence Society, 1992.

Google Scholar

German KA, Kynaston H, Weight S, Stephenson TP. A prospective randomized trial comparing a modified needle suspension procedure with the vagina/obturator shelf procedure for genuine stress incontinence. British Journal of Urology 1994;74(2):188‐90.

Gilja I, Puskar D, Mazuran B, Radej M. Comparative analysis of bladder neck suspension using Raz, Burch and transvaginal Burch procedures. A 3‐year randomized prospective study. European Urology 1998;33:298‐302.

Hilton P. A clinical and urodynamic study comparing the Stamey bladder neck suspension and suburethral sling procedures in the treatment of genuine stress incontinence. British Journal of Obstetrics & Gynaecology 1989;96(2):213‐20.

Mundy AR. A trial comparing the Stamey bladder neck suspension procedure with colposuspension for the treatment of stress incontinence. British Journal of Urology 1983;55(6):687‐90.

Mundy AR. The role of the Stamey bladder neck suspension procedure in the treatment of stress incontinence of urine. Proceedings of the International Continence Society (ICS); 1982; Leiden, Germany.1982:137.

Google Scholar

Palma P, David S, Pinotti JA. Comparative study between the Marshall‐Marchetti‐Krantz operation and the endoscopic suspension of the bladder neck for surgical correction of stress urinary incontinence (Abstract). Archives of Gynecology 1985;237 (Suppl):402.

Google Scholar

Palma PC, Soffiatti SA, Almeida SC, Pinotti JA. Stress urinary incontinence: a comparative study of surgical treatment by the Marshall‐Marchetti‐Krantz technique with endoscopic suspension of the bladder neck. Second report. Asia Oceania Journal of Obstetrics & Gynaecology 1988;14(1):31‐6.

Palma PCR, Suely A, Soffiatti D, Pinotti JA. Stress urinary incontinence: a comparative study of the surgical treatment by the Marshall‐Marchetti‐Krantz technique with endoscopic suspension of the bladder neck. Second report. Ginecologia and Obstetricia (Sociedad Peruana de Obstetricia y Ginecologia) 1986;30(2):15‐9.

Google Scholar

Stein M, Weinberg JJ. Polytetrafluoroethylene versus polypropylene suture for endoscopic bladder neck suspension. Urology 1991;38(2):119‐22.

References to studies excluded from this review

Ir a:

estudios incluidos
otras referencias
otras versiones publicadas

Bump RC, Hurt WG, Elser DM, Theofrastous JP, Fantl JA, McClish DK. Reliability of intra‐operative anatomic, endoscopic and urodynamic measurements and their correlation with post‐operative pressure transmission in women undergoing bladder neck suspension surgery (Abstract). Neurourology & Urodynamics 1995;14(5):490‐1.

Google Scholar

Bump RC, Hurt WG, Theofrastous JP, Addison WA, Fantl JA, Wyman JF, et al. Randomized prospective comparison of needle colposuspension versus endopelvic fascia plication for potential stress incontinence prophylaxis in women undergoing vaginal reconstruction for stage III or IV pelvic organ prolapse. The Continence Program for Women Research Group. American Journal of Obstetrics & Gynecology 1996;175(2):326‐35.

Google Scholar

Colombo M, Maggioni A, Scalambrino S, Vitobello D, Milani R. Surgery for genitourinary prolapse and stress incontinence: a randomized trial of posterior pubourethral ligament plication and Pereyra suspension. American Journal of Obstetrics & Gynecology 1997;176(2):337‐43.

Colombo M, Milani R, Vitobello D, Maggioni A. A randomized comparison of Burch colposuspension and abdominal paravaginal defect repair for female stress urinary incontinence. American Journal of Obstetrics & Gynecology 1996;175(1):78‐84.

Milani R, Vitobello D, Teruzzi M, Colombo M. Comparison of Burch colposuspension and paravaginal defects repair for patients with genuine stress urinary incontinence (Abstract). Proceedings of the International Continence Society (ICS), 25th Annual Meeting; 1995 Oct 17‐20; Sydney, Australia. 1995:475.

Google Scholar

Corcos J, Collet JP, Shapiro S, Herschorn S, Radomski SB, Schick E, et al. Multicenter randomized clinical trial comparing surgery and collagen injections for treatment of female stress urinary incontinence. Urology 2005;65(5):898‐904.

Corcos J, Collet JP, Shapiro S, Schick E, Herschorn S, Radomski S, et al. Surgery versus collagen for the treatment of female stress urinary incontinence (SUI): 1 year follow‐up results of a multicentric randomised trial (RCT) (Abstract). Proceedings of the International Continence Society (ICS), 31st Annual Meeting; 2001 Sept 18‐21; Seoul, Korea. 2001:Abstract 248.

Google Scholar

Corcos J, Collet JP, Shapiro S, Schick E, Macramallah E, Tessier J, et al. Surgery versus collagen for the treatment of female stress urinary incontinence (SUI): results of a multicentric randomized trial (Abstract). Journal of Urology 2001;165(5 (Suppl)):198.

Google Scholar

Goldberg RP, Koduri S, Lobel RW, Culligan PJ, Tomezsko JE, Winkler HA, et al. Long‐term effects of three different anti‐incontinence procedures on the posterior compartment (Abstract). Proceedings of the International Continence Society (ICS), 31st Annual Meeting; 2001 Sept 18‐21; Seoul, Korea. 2001:Abstract 243.

Google Scholar

Ishenko AI, Slobodenyuk AI, Chushkov YV. Modified Pereyra and sling procedures in combined surgical treatment in patients with uterine prolapse and stress urinary incontinence ‐ randomized study. European Journal of Obstetrics, Gynecology, & Reproductive Biology 1999;86(Suppl):S15.

Google Scholar

Jongen VH, Brouwer WK. Comparison of the modified Pereyra procedure using permanent suture material and Burch urethropexy. European Journal of Obstetrics Gynecology and Reproductive Biology 1999;84(1):7‐11.

Jongen VHWM, Brouwer WK. Comparison of the modified Pereyra procedure and Burch urethropexy. Subjective results of a one to six years follow‐up survey (Abstract). International Urogynecology Journal and Pelvic Floor Dysfunction 1997;8:S3.

Google Scholar

Koonings P, Bergman A, Ballard CA. Combined detrusor instability and stress urinary incontinence: where is the primary pathology?. Gynecologic & Obstetric Investigation 1988;26(3):250‐6.

Morley R, Cumming J, Birch BRP. Staple colpofixation: a new minimally invasive treatment for stress incontinence (Abstract). Proceedings of the International Continence Society (ICS), 25th Annual Meeting; 1995 Oct 17‐20; Sydney, Australia. 1995:471.

Google Scholar

Ramon J, Mekras J, Webster GD. Transvaginal needle suspension procedures for recurrent stress incontinence. Urology 1991;308(6):519‐22.

Salinas Casado J, Virseda Chamorro M, Ramirez Fernandez JC, Rapariz Gonzalez M, Esteban Fuertes M, Resel Estevez L. Comparative results of different types of urethropexy in the treatment of stress urinary incontinence in women [Spanish]. Archivos Espanoles de Urologia 1994;47(8):761‐8.

Salinas Casado J, Virseda Chamorro M, Ramirez Fernandez JC, Rapariz Gonzalez M, Esteban Fuertes M, Samblas Garcia R, et al. Effects of urethropexy on urination. A price to pay? [Spanish]. Archivos Espanoles de Urologia 1995;48(7):709‐16.

Virseda Chamorro M, Salinas Casado J, Ramirez Fernandez JC, Rapariz Gonzalez M, Esteban Fuertes M, Nacarino Corbacho L, et al. Impact of bladder irritative symptoms and detrusor instability on the outcome of urethropexy [Spanish]. Archivos Espanoles de Urologia 1995;48(6):595‐601.

Vordermark JS, Brannen GE, Wettlaurfer JN, Modarelli RO. Suprapubic endoscopic vesical neck suspension. Journal of Urology 1979;122(2):165‐7.

Zivkovic F, Tamussino K, Ralph G, Schied G, Auer‐Grumbach M. Neurourodynamic effects of anterior vaginal repair with or without needle suspension at 1 year (Abstract). Proceedings of the International Continence Society (ICS), 24th Annual Meeting;1994; Prague, Czech Republic. 1994:332.

Google Scholar

Additional references

Ir a:

estudios incluidos
estudios excluidos
otras versiones publicadas

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub‐committee of the International Continence Society. Neurourology and Urodynamics 2002;21(2):167‐78.

Black NA, Downs SH. The effectiveness of surgery for stress incontinence in women: a systematic review. British Journal of Urology 1996;78(4):497‐510.

Black N, Griffiths J, Pope C, Bowling A, Abel P. Impact of surgery for stress incontinence on morbidity: cohort study. BMJ 1997;315(7121):1493‐8.

Bump RC, Copeland WE, Hurt WG, Fantl JA. Dynamic urethral pressure/profilometry pressure transmission ratio determinations in stress‐incontinent and stress‐continent subjects. American Journal of Obstetrics & Gynecology 1988;159(3):749‐55.

Dean NM, Ellis G, Wilson PD, Herbison GP. Laparoscopic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD002239.pub2]

Downs S, Black N. Systematic review of the literature on the effectiveness of surgery for stress incontinence in women. Report 21. Public Health and Policy Publications. London: Department of Public Health and Policy Publications, London School of Hygiene and Tropical Medicine, 1996:1‐93. [ISSN 0962‐6115]

Google Scholar

Fantl JA, Newman DK, Colling J, DeLancey JOL, Keeys C, Loughery R, et al. Urinary Incontinence in Adults: Acute and Chronic Management. 2. Washington: Agency for Health Care Policy and Research, US Government Printing Office, 1996.

Glazener CMA, Cooper K. Anterior vaginal repair for urinary incontinence in women. Cochrane Database of Systematic Reviews 2001, Issue 1. [DOI: 10.1002/14651858.CD001755]

Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327:557‐60.

Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org. Chichester, UK: John Wiley & Sons, Ltd.

Hilton P, Stanton SL. Urethral pressure measurement by microtransducer: the results in symptom‐free women and in those with genuine stress incontinence. British Journal of Obstetrics & Gynaecology 1983;90(10):919‐33.

Jarvis GJ. Surgery for genuine stress incontinence. British Journal of Obstetrics & Gynaecology 1994;101(5):371‐4.

Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. British Journal of Obstetrics & Gynaecology 1997;104(12):1374‐9.

Kirchin V, Page T, Keegan PE, Atiemo K, Cody JD, McClinton S. Urethral injection therapy for urinary incontinence in women. Cochrane Database of Systematic Reviews 2012, Issue 2. [DOI: 10.1002/14651858.CD003881.pub3]

Lapitan MCM, Cody JD. Open retropubic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews 2012, Issue 6. [DOI: 10.1002/14651858.CD002912.pub5]

Leach GE, Dmochowski RR, Appell RA, Blaivas JG, Hadley HR, Luber KM, et al. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence. The American Urological Association. Journal of Urology 1997;158(3 Pt 1):875‐80.

Lose G, Fantl JA, Victor A, Walter S, Wells TL. Outcome measures for research in adult women with symptoms of lower urinary tract dysfunction. Neurourology and Urodynamics 1998;17(3):255‐62.

Meyer S, De Grandi P, Schmidt N, Sanzeni W, Spinosa JP. Urodynamic parameters in patients with slight and severe genuine stress incontinence: is the stress profile useful?. Neurourology and Urodynamics 1994;13(1):21‐8.

Thomson Reuters. Reference Manager Professional Edition. Version 12. New York: Thomson Reuters, 2012.

Rehman H, Bezerra CCB, Bruschini H, Cody JD. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database of Systematic Reviews 2011, Issue 1. [DOI: 10.1002/14651858.CD001754.pub3]

Swift SE, Ostergard DR. Evaluation of current urodynamic testing methods in the diagnosis of genuine stress incontinence. Obstetrics and Gynecology 1995;86(1):85‐91.

References to other published versions of this review

Ir a:

estudios incluidos
estudios excluidos
otras referencias

Glazener CMA, Cooper K. Bladder neck needle suspension for urinary incontinence in women. Cochrane Database of Systematic Reviews 2004, Issue 2. [DOI: 10.1002/14651858.CD003636.pub2]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

estudios excluidos

Athanassopoulos 1996

Methods	Quasi‐randomised RCT (by birth date) Blinding not mentioned No power calculation ITT analysis Follow‐up 8 to 27 months
Participants	n = 51. No withdrawals mentioned Inclusion criteria: GSI (urodynamic diagnosis); combined primary and recurrent. Includes those with previous surgery and with prolapse Mean age: 50 years (20 to 78), 50.9% menopausal, 14% with previous pelvic operations No baseline comparison of treatment groups Single‐centre, university‐based hospital, Greece
Interventions	(I) Burch (27) (II) Stamey (24) Description of both procedures referenced. All performed by 1 surgeon
Outcomes	Cure = complete freedom from SUI at 8 to 27 months Failure = persistent or recurrent SUI at 8 to 27 months Urinary retention not defined Failure rate: (I) 7/27; (II) 7/24 Number not improved: (I) 3/27; (I): 4/24 Length of stay: (I) 5.8 days (range 4 to 11); (I): 3 (6 to 12) Complications (haematoma, abscess): (I) 6/27; (II) 4/24 Urinary retention: (I) 2/27; (II) 3/24 Urgency: (I) 3/27; (II) 1/24 Urodynamic data also given
Notes	—
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Date of birth
Allocation concealment (selection bias)	High risk	C ‐ Inadequate
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	No drop‐outs reported

Bergman 1989a

Methods	RCT Patients and surgeons randomly allocated (using randomisation tables) to 1 of 3 operations. Follow‐up at 3 and 12 months, and 5 years 20 women lost to follow‐up at 12 months were not reported
Participants	127 women recruited, results reported for 107 at 12 months. Results for 64 at 5 years out of 78 cured at 1 year Groups stated to be comparable in mean age, parity and menopausal status but data not given 53 pre‐menopausal, 74 post‐menopausal Inclusion: GSI (urodynamic diagnosis); minor cystocele only; postmenopausal women given oestrogens before and after surgery Exclusion criteria: significant prolapse, other gynaecological disease or operations; previously failed incontinence surgery Single‐centre, university‐based hospital, urogynaecology unit, USA
Interventions	(I) Anterior vaginal repair (colporrhaphy) (35) (n = 30 at 5 years) (II) Needle (modified Pereyra procedure) (34) (n = 30 at 5 years) (III) Colposuspension (Burch urethropexy) (38) (n = 33 at 5 years)
Outcomes	Cure defined as no loss of urine in history or on urodynamic investigation Failure rate: (I) at 3 months 7/35, at 12 months 13/35, at 5 years 19/30 (II) at 3 months 6/34, at 12 months 12/34, at 5 years 17/30 (III) at 3 months 3/38, at 12 months 4/38, at 5 years 6/33 Failure rate (sensitivity analysis): (I) 24/35; (II) 21/34; (III) 11/38 No subsequent voiding problems in any patient Postoperative bacteriuria equally frequent in all groups 3 developed detrusor instability (groups not specified); 6 developed prolapse ((I) 3; (II) 2; (III) 1) Urodynamic measurements reported before and 12 months and 5 years after operation
Notes	Sensitivity analysis at 5 years for 107 assuming missing 14 were failures and including 29 already failed at 1 year
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation tables
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	High risk	20 women lost to follow‐up at 1 year, 43 at 5 years

Bergman 1989b

Methods	RCT Follow‐up at 3 and 12 months Patients and surgeons randomly allocated (using randomisation tables) to 1 of 3 operations 3 women excluded for technical reasons, 41 lost to follow‐up: 298 women reported in the study
Participants	342 women (298 reported) Mean age 57 years (range 31 to 80); parity 3 (1 to 13); 191 postmenopausal, 151 premenopausal. Groups comparable at baseline but data not given Postmenopausal women given oestrogens before and after surgery Inclusion criteria: urodynamic diagnosis of primary GSI, stable bladder and pelvic relaxation (prolapse) Exclusion criteria: previous incontinence surgery, detrusor instability, gynaecological complications other than prolapse Single‐centre, university‐based hospital, urogynaecology unit, USA
Interventions	(I) Anterior vaginal repair (99) (II) Needle (revised Pereyra procedure) (98) (III) Colposuspension (Burch retropubic urethropexy) (101)
Outcomes	Failure rate: (I) at 3 months 20/99, at 12 months 31/99 (II) at 3 months 19/98, at 12 months 29/98 (III) at 3 months 11/101, at 12 months 13/101 No postoperative voiding problems Urodynamic measurements reported before and 12 months after operation
Notes	Tertiary referral centre. No power calculation
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation tables
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	High risk	44 women lost to follow‐up

Di Palumbo 2003

Methods	RCT 2:1 randomisation using sealed envelopes Follow‐up: 280 to 1670 days (at 1, 3, 6, 12, 18 and 24 months, then yearly)
Participants	80 women with SUI + urethrocystocele (anterior prolapse) grade 3 or 4 Age: (I) mean 59.8 years (range 41 to 79), (II) 60.6 (39 to 78) Concomitant vaginal hysterectomy: (I) 47/52, (II) 26/28 Inclusion criteria: prolapse defect assessed (apical, central, lateral), SUI, UUI, mixed incontinence and overactive bladder diagnosed with Q tip test, stress test, 1‐hour pad test and urodynamics. If urgency, bladder training and anticholinergic treatment before surgery.
Interventions	(I) Anterior repair (Nicholls) (52) (II) 4‐corner bladder and urethral retropubic suspension (Raz) with thin polypropylene mesh in the spiral suture (28)
Outcomes	SUI (failed): (I) 14/52, (II) 4/28 (assumed to be after first year) New rectocoele at 6 months: (I) 3/52, (II) 5/28 Urge incontinence: (I) 12/52, (II) 5/28 Frequency of urination: (I) 10/52, (II) 2/28 Urinary retention in first 10 days: (I) 1/52, (II) 1/28 Long‐term retention: (I) 0/52, (II) 0/28 Time to spontaneous voiding: (I) 3.62 days (range 2 to 9), (II) 4.78 (3 to 9) Postoperative hospital stay: (I) mean 6 days (range 4 to 20), (II) 5 (4 to 34) (NS) Adverse effects: (I) 0/52, (II) 1/28 (sepsis, removal of stitches and prolonged hospital stay)
Notes	Women comparable at baseline for age, diabetes, respiratory problems, obstetric history, concomitant vaginal hysterectomy
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	RCT
Allocation concealment (selection bias)	Low risk	A ‐ Adequate (sealed envelopes)
Incomplete outcome data (attrition bias) All outcomes	Low risk	No drop‐outs reported

German 1992

Methods	RCT. Method not described. 2 arms Blinding not mentioned ITT analysis Follow‐up mean 2 years (12 to 44 months)
Participants	n = 50. No withdrawals Inclusion criteria: GSI (urodynamic diagnosis); both primary and recurrent UI. No mixed UI Mean age: 50/53; mean weight: 68.4/70.9 kg Baseline comparison of groups matched to age and weight Previous surgery: (I) 11; (II) 10 Single‐centre, Department of Urology, UK
Interventions	(I) Colposuspension (vagina/obturator shelf repair) (24) (II) Needle suspension, modified Stamey (26) Both techniques described Surgeon not mentioned
Outcomes	Success = complete dryness or occasional incontinence Failure rate at 12 to 44 months: (I) 7/24; (II) 11/26 Length of stay: (I) 8.3 days; (II) 7 days Peri‐operative infection: I: 6/24; II: 3/26 Postoperative pain: (I) 11/24; (II) 19/26 Voiding problems (short‐term): (I) 4/24; (II) 0/26 Voiding problems (long‐term): (I) 0/24; (II) 0/26 Time to normal activity: (I) 10.4 weeks; (II) 7.9 weeks New urgency: (I) 1/24; (II) 2/26
Notes	Separate analysis of primary and recurrent cases possible
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	RCT
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	No drop‐outs reported

Gilja 1998

Methods	RCT by open randomisation list (3 arms) Blinding not mentioned Not ITT Follow‐up 3 years
Participants	n = 204, 58 lost to follow‐up due to war Inclusion criteria: GSI (urodynamic diagnosis) Exclusion criteria: previous urological or gynaecological operations for incontinence Mean age 36 years (28 to 48); mean parity 3.1 (1 to 8) Number premenopausal: 63 Baseline comparison of groups similar in age and parity Single‐centre, general hospital, Department of Urology, Croatia
Interventions	(I) Colposuspension (Burch) (56) (II) Needle (transvaginal Burch/Gilja) (44) (III) Needle (Raz) (46) Burch and Raz described and referenced. Gilja = combination of open abdominal suspension and needle but classed as a needle suspension Single surgeon for all
Outcomes	Subjective UI in 1st year: (I) 2/56; (II) 1/44; (III) 3/46 Subjective UI at 3 years: (I) 4/56; (II) 4/44; (III) 7/46 Objective UI in 1st year: (I) 3/56; (II) 5/44; (III) 6/46 Objective UI in 3rd year: (I) 6/56; (II) 6/44; (III) 9/46 Urge incontinence at 3 years: (I) 2/56; (II) 3/44; (III) 5/46
Notes	With additional information from author Author emphasised strict evaluation of results for cure
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Open randomisation list
Allocation concealment (selection bias)	High risk	C ‐ Inadequate (open list)
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	High risk	58 drop‐outs (due to war)

Hilton 1989

Methods	RCT. Follow‐up at 2, 3, 12 and 24 months. Women allocated to 1 of 2 interventions by random tables. All women available at follow‐up
Participants	20 women recruited, 10 in each arm of the study Inclusion criteria: GSI (urodynamic diagnosis), vaginal narrowing, postsurgical scar, unsuitable for colposuspension Exclusion criteria: not stated Groups comparable for age, parity and number of previous surgical incontinence procedures Age: mean 57 to 54 years (range 42 to 75) Menopausal status not reported Single‐centre, Department of Obstetrics and Gynaecology, UK
Interventions	(I) Needle suspension (Stamey) (10) (II) Sling (porcine dermis) (10)
Outcomes	Cure = objective (urodynamic diagnosis, pad test) at 3 months and subjective at 24 months Failure rate (objective) at 3 months: (I) 2/10; (II) 1/10 Failure rate (subjective) at 24 months: (I) 3/10; (II) 1/10 Postoperative complications: (I) 2/10; (II) 9/10 (operative blood loss, pyrexia, infective complications, permanent suprapubic catheter) Hospital stay: (I) 7 days (0.3); (II) 20 (12.9) Voiding problems at 3 months: (I) 2/10; (II) 4/10 Urge incontinence: (I) 3/10; (II) 5/10 Detrusor instability: (I) 1/10; (II) 2/10 Late complications not reported Urodynamic data also given
Notes	Pad test at 12 and 24 months stated but not reported
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Random tables
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	No drop‐outs

Mundy 1983

Methods	Quasi‐randomised RCT (alternate allocation) Stratification between primary and recurrent GSI. 2 arms Blinding not mentioned No power calculation ITT analysis Follow‐up minimum 1 year
Participants	n = 51. No withdrawals Inclusion criteria: GSI (urodynamic diagnosis), combined primary and recurrent UI. No mixed UI Mean age 48 years (29 to 70). No baseline comparison of groups Single‐centre, Department of Urology, UK
Interventions	(I) Colposuspension (Burch) (26) (II) Needle (modified Stamey) (25) Colposuspension referenced; modified Stamey described Single surgeon for all cases
Outcomes	Subjective cure = not defined Objective cure = negative nappy test and video UDS Failure rate (subjective) at 12 months: (I) 3/26; (II) 6/25 Failure rate (objective) at 12 months: (I) 6/26; (II) 15/25 DI: (I) 2/26; (II) 5/25 Voiding difficulty: (I) 3/26; (II) 6/25 Peri‐operative complications (UTI, stitch removal, Dacron sheath removal): (I) 0/26; (II) 10/25 (II) 3 of the 10 needed removal of suprapubic Dacron buffer
Notes	Colposuspension described as Burch Cannot do separate analysis for recurrent GSI alone
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Alternation
Allocation concealment (selection bias)	High risk	C ‐ Inadequate
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	No withdrawals

Palma 1985

Methods	RCT, method not described Author replied patients, care givers and assessors were blinded Not mentioned if ITT analysis Follow‐up: (I) mean 34 months, (range 19 to 56); (II) 21 (2 to 44)
Participants	n = 70. No withdrawals mentioned Previous surgery (Kelly or MMK): (I) 3/30, (II) 10/40 Urodynamics used to confirm SUI if in doubt Age: (I) mean 46 years (range 28 to 69); (II) 44 (26 to 67) Inclusion/exclusion not mentioned No statistical baseline comparisons of groups Single‐centre. Department of Obstetrics and Gynaecology, university‐based hospital, Campinas, Brazil
Interventions	(I) MMK (30) (II) Needle suspension (Stamey) (40) Procedures described Surgeon not mentioned
Outcomes	Not cured in first year: (I) 4/30, (II) 1/20 Not cured after first year: (I) 7/30, (II) 10/20 Not improved in first year: (I) 2/30, (II) 1/20 New urge or urge incontinence: (I) 0/30, (II) 2/20 New detrusor overactivity: (I) 0/30, (II) 1/20 Operating time: (I) 30 minutes, (II) 35 minutes Length of stay: (I) 3 days, (II) 2 days Voiding dysfunction: (I) 0/30, (II) 1/20
Notes	Abstract Correspondence from author to clarify if randomised. Extra data also obtained
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	RCT
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	High risk	20 participants not reported

Stein 1991

Methods	RCT of 2 different suture materials. Method of randomisation not described 2 arms, blinding not mentioned, no power calculation Follow‐up 6 months
Participants	24 women, 4 excluded because not followed up Inclusion criteria: GSI (urodynamic diagnosis), no urinary tract infection, undergoing needle suspension Exclusion criteria: previous incontinence surgery, pelvic pain Groups stated to be comparable (socioeconomic, race, age) Age (I) 46 years (range 30 to 59); (II) 49 (35 to 67)
Interventions	(I) CV‐0 polytetrafluoro‐ethylene (Goretex) suture (9) (II) #1 polypropylene suture (11)
Outcomes	Pain and continence. Cure defined as no incontinence, no use of pads or medication, good = slight incontinence, improved = occasional pad or drug use, failed = unimproved or worse Pain (n, mean score, SD) at 1 month: I: 9, 1 (SD 1.5); II: 10, 1.6 (1.31) Pain (n, mean score, SD) at 3 months: I: 9, 0.33 (0.71); II: 11, 1.25 (1.2) Failed at 3 months: (I) 0/9; (II) 3/11 Not improved at 3 months: (I) 0/9; (II) 1/11 Urge incontinence: (I) 0/9; (II) 2/11 Cost of Goretex (I) very high compared to (II)
Notes	Type of operation stated not to have affected randomisation or outcomes but data not given to assess this. Raz urethropexy, Raz 4‐corner repair or Gittes urethropexy
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	RCT
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	High risk	4 excluded because not followed up

BMI = body mass index; DI = detrusor instability (now DO = detrusor overactivity); GSI = genuine stress incontinence (now USI = urodynamic stress incontinence); ITT = intention‐to‐treat; kg = kilograms; MMK = Marshall‐Marchetti‐Krantz; NS = not significant; PFMT = pelvic floor muscle training; RCT = randomised controlled trial; SUI = stress urinary incontinence (symptom diagnosis); TVT = tension‐free vaginal tape; w = week(s); SD = standard deviation; UDS = urodynamics; UI = urinary incontinence; UUI= Urgency Urinary Incontinence; UTI = urinary tract infection; VAS = visual analogue score

Characteristics of excluded studies [ordered by study ID]

Ir a:

estudios incluidos

Study	Reason for exclusion
Bump 1995	RCT, but women had prolapse and NO incontinence Interventions: anterior repair versus needle suspension
Bump 1996	RCT, but women were not incontinent Interventions: needle versus endopelvic fascia plication
Colombo 1997	RCT, but women did not all have incontinence Interventions: needle (Pereyra) versus posterior pubourethral ligament plication
Corcos 2001	RCT, but data not presented separately for each type of surgery Interventions: injectables versus surgery (6 needle bladder neck suspensions, 24 sling, 24 Burch)
Goldberg 2001	RCT, but of mesh versus no mesh for prolapse. This paper reports outcomes of women who had concomitant incontinence procedures, but were not randomised to these operations
Ishenko 1999	Randomisation and groups unclear ("randomised by age"). Excluded as attempts to contact authors unsuccessful and insufficient information given in abstract Interventions: vaginal hysterectomy, modified Pereyra procedure, anterior and posterior repair versus vaginal hysterectomy, sling procedure with Mersilene mesh, anterior and posterior repair
Jongen 1999	Not RCT Interventions: colposuspension (Burch) versus needle suspension (Pereyra) for stress incontinence
Koonings 1988	RCT, but trial not focused on needle suspension alone Intervention: surgery (mixed types, including needle suspensions) plus drugs versus surgery (mixed) alone
Morley 1995	RCT of 54 women with urodynamic stress urinary incontinence Interventions: Stamey endoscopic bladder neck suspension (needle) versus staple colpofixation, described as a new technique Excluded as attempts to obtain more information from authors unsuccessful, and insufficient data given in abstract
Ramon 1991	Not RCT Interventions: Stamey, Raz. Operation chosen by surgeon's preference
Salinas 1994	Not RCT Interventions: Kelly, Raz, Marshall‐Marchetti‐Krantz, Burch, simplified Ramirez
Vordermark 1979	Not RCT Interventions: needle (Pereyra/Stamey/Mason) versus open abdominal retropubic suspension (Marshall‐Marchetti‐Krantz)
Zivkovic 1994	Not RCT Interventions: anterior vaginal repair with or without needle suspension

RCT = randomised controlled trial

Data and analyses

Open in table viewer

Comparison 1. Needle suspension versus open abdominal retropubic suspension

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number not cured (worse, unchanged or improved) within first year Show forest plot

5

517

Risk Ratio (M‐H, Fixed, 95% CI)

1.70 [1.11, 2.60]

Analysis 1.1

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

1.1 Objective/genuine stress incontinence (only)

5

517

Risk Ratio (M‐H, Fixed, 95% CI)

1.70 [1.11, 2.60]

1.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Number not cured (worse, unchanged or improved) after first year Show forest plot

7

610

Risk Ratio (M‐H, Fixed, 95% CI)

2.00 [1.47, 2.72]

Analysis 1.2

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 2 Number not cured (worse, unchanged or improved) after first year.

2.1 Objective/genuine stress incontinence (only)

7

610

Risk Ratio (M‐H, Fixed, 95% CI)

2.00 [1.47, 2.72]

2.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Number not improved (worse or unchanged) within first year Show forest plot

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.07, 7.73]

Analysis 1.3

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 3 Number not improved (worse or unchanged) within first year.

3.1 Objective/genuine stress incontinence (only)

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.07, 7.73]

3.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Number not improved (worse or unchanged) after first year Show forest plot

1

51

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.37, 6.04]

Analysis 1.4

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 4 Number not improved (worse or unchanged) after first year.

4.1 Objective/genuine stress incontinence (only)

1

51

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.37, 6.04]

4.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Urge symptoms or urge incontinence Show forest plot

4

297

Risk Ratio (M‐H, Fixed, 95% CI)

1.80 [0.71, 4.56]

Analysis 1.5

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 5 Urge symptoms or urge incontinence.

5.1 Objective/genuine stress incontinence (only)

4

297

Risk Ratio (M‐H, Fixed, 95% CI)

1.80 [0.71, 4.56]

5.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Voiding dysfunction after 3 months Show forest plot

4

202

Risk Ratio (M‐H, Fixed, 95% CI)

2.12 [0.81, 5.55]

Analysis 1.6

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 6 Voiding dysfunction after 3 months.

6.1 Objective/genuine stress incontinence (only)

4

202

Risk Ratio (M‐H, Fixed, 95% CI)

2.12 [0.81, 5.55]

6.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Detrusor overactivity (objective diagnosis by urodynamics) Show forest plot

2

101

Risk Ratio (M‐H, Fixed, 95% CI)

2.91 [0.73, 11.58]

Analysis 1.7

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 7 Detrusor overactivity (objective diagnosis by urodynamics).

7.1 Objective/genuine stress incontinence (only)

2

101

Risk Ratio (M‐H, Fixed, 95% CI)

2.91 [0.73, 11.58]

7.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 New or persistent prolapse Show forest plot

1

72

Risk Ratio (M‐H, Fixed, 95% CI)

2.24 [0.21, 23.57]

Analysis 1.8

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 8 New or persistent prolapse.

8.1 Objective/genuine stress incontinence (only)

1

72

Risk Ratio (M‐H, Fixed, 95% CI)

2.24 [0.21, 23.57]

8.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 Peri‐operative surgical complications Show forest plot

3

152

Risk Ratio (M‐H, Fixed, 95% CI)

1.44 [0.73, 2.83]

Analysis 1.9

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 9 Peri‐operative surgical complications.

9.1 Objective/genuine stress incontinence (only)

3

152

Risk Ratio (M‐H, Fixed, 95% CI)

1.44 [0.73, 2.83]

9.2 Subjective stress incontinence (only)

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.3 Mixed incontinence

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 Length of stay/time to return to normal function Show forest plot

Other data

No numeric data

Analysis 1.10


Study	Needle suspension	Abdominal suspension
Athanassopoulos 1996	Mean length of stay: 3 days (range 6 to 12)	Mean length of stay: 5.8 days (range 4 to 11)
German 1992	Mean length of stay: 7 days Time to return to normal activity: 7 weeks	Mean length of stay: 8.3 days Time to return to normal activity: 10.4 weeks

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 10 Length of stay/time to return to normal function.

Open in table viewer

Comparison 2. Needle suspension versus open abdominal retropubic suspension (no previous surgery)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	3	417	Risk Ratio (M‐H, Fixed, 95% CI)	2.05 [1.20, 3.50]
Open in figure viewer Analysis 2.1 Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 1 Number not cured (worse, unchanged or improved) within first year.
1.1 Objective/genuine stress incontinence (only)	3	417	Risk Ratio (M‐H, Fixed, 95% CI)	2.05 [1.20, 3.50]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	3	408	Risk Ratio (M‐H, Fixed, 95% CI)	2.37 [1.54, 3.66]
Open in figure viewer Analysis 2.2 Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 2 Number not cured (worse, unchanged or improved) after first year.
2.1 Objective/genuine stress incontinence (only)	3	408	Risk Ratio (M‐H, Fixed, 95% CI)	2.37 [1.54, 3.66]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Urge symptoms or urge incontinence Show forest plot	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	2.49 [0.55, 11.30]
Open in figure viewer Analysis 2.3 Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 3 Urge symptoms or urge incontinence.
3.1 Objective/genuine stress incontinence (only)	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	2.49 [0.55, 11.30]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 New or persistent prolapse Show forest plot	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [0.21, 23.57]
Open in figure viewer Analysis 2.4 Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 4 New or persistent prolapse.
4.1 Objective/genuine stress incontinence (only)	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [0.21, 23.57]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 3. Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	2	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.55, 2.29]
Open in figure viewer Analysis 3.1 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 1 Number not cured (worse, unchanged or improved) within first year.
1.1 Objective/genuine stress incontinence (only)	2	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.55, 2.29]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.61 [1.04, 2.49]
Open in figure viewer Analysis 3.2 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 2 Number not cured (worse, unchanged or improved) after first year.
2.1 Objective/genuine stress incontinence (only)	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.61 [1.04, 2.49]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved (worse or unchanged) within first year Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.07, 7.73]
Open in figure viewer Analysis 3.3 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 3 Number not improved (worse or unchanged) within first year.
3.1 Objective/genuine stress incontinence (only)	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.07, 7.73]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved (worse or unchanged) after first year Show forest plot	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.37, 6.04]
Open in figure viewer Analysis 3.4 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 4 Number not improved (worse or unchanged) after first year.
4.1 Objective/genuine stress incontinence (only)	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.37, 6.04]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Urge symptoms or urge incontinence Show forest plot	3	151	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.42, 4.59]
Open in figure viewer Analysis 3.5 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 5 Urge symptoms or urge incontinence.
5.1 Objective/genuine stress incontinence (only)	3	151	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.42, 4.59]
5.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Voiding dysfunction after 3 months Show forest plot	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	2.12 [0.81, 5.55]
Open in figure viewer Analysis 3.6 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 6 Voiding dysfunction after 3 months.
6.1 Objective/genuine stress incontinence (only)	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	2.12 [0.81, 5.55]
6.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Detrusor overactivity (objective diagnosis by urodynamics) Show forest plot	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	2.91 [0.73, 11.58]
Open in figure viewer Analysis 3.7 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 7 Detrusor overactivity (objective diagnosis by urodynamics).
7.1 Objective/genuine stress incontinence (only)	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	2.91 [0.73, 11.58]
7.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Peri‐operative surgical complications Show forest plot	3	152	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.73, 2.83]
Open in figure viewer Analysis 3.8 Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 8 Peri‐operative surgical complications.
8.1 Objective/genuine stress incontinence (only)	3	152	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.73, 2.83]
8.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 4. Needle suspension versus suburethral sling operations

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.21, 18.69]
Open in figure viewer Analysis 4.1 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 1 Number not cured (worse, unchanged or improved) within first year.
1.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.21, 18.69]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.37, 24.17]
Open in figure viewer Analysis 4.2 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 2 Number not cured (worse, unchanged or improved) after first year.
2.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.37, 24.17]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Urge symptoms or urge incontinence Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.19, 1.86]
Open in figure viewer Analysis 4.3 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 3 Urge symptoms or urge incontinence.
3.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.19, 1.86]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Voiding dysfunction after 3 months Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.12, 2.14]
Open in figure viewer Analysis 4.4 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 4 Voiding dysfunction after 3 months.
4.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.12, 2.14]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Detrusor overactivity (objective diagnosis by urodynamics) Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 4.67]
Open in figure viewer Analysis 4.5 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 5 Detrusor overactivity (objective diagnosis by urodynamics).
5.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 4.67]
5.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Peri‐operative surgical complications Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.22 [0.06, 0.78]
Open in figure viewer Analysis 4.6 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 6 Peri‐operative surgical complications.
6.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.22 [0.06, 0.78]
6.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Length of inpatient stay Show forest plot	1	20	Mean Difference (IV, Fixed, 95% CI)	‐13.0 [‐19.00, ‐5.00]
Open in figure viewer Analysis 4.7 Comparison 4 Needle suspension versus suburethral sling operations, Outcome 7 Length of inpatient stay.
7.1 Objective/genuine stress incontinence (only)	1	20	Mean Difference (IV, Fixed, 95% CI)	‐13.0 [‐19.00, ‐5.00]
7.2 Subjective stress incontinence (only)	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed incontinence	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 5. Needle suspension versus anterior vaginal repair

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	2	266	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.63, 1.46]
Open in figure viewer Analysis 5.1 Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 1 Number not cured (worse, unchanged or improved) within first year.
1.1 Objective/genuine stress incontinence (only)	2	266	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.63, 1.46]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	3	337	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.64, 1.16]
Open in figure viewer Analysis 5.2 Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 2 Number not cured (worse, unchanged or improved) after first year.
2.1 Objective/genuine stress incontinence (only)	2	257	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.68, 1.26]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	1	80	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.19, 1.46]
3 Urge symptoms or urge incontinence Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 5.3 Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 3 Urge symptoms or urge incontinence.
3.1 Objective/genuine stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Voiding dysfunction after 3 months Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 5.4 Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 4 Voiding dysfunction after 3 months.
4.1 Objective/genuine stress incontinence (only)	2		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Peri‐operative surgical complications Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 5.5 Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 5 Peri‐operative surgical complications.
5.1 Objective/genuine stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 New or persistent prolapse Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected
Open in figure viewer Analysis 5.6 Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 6 New or persistent prolapse.
6.1 Objective/genuine stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 6. One type of needle suspension versus another type of needle suspension

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	2.87 [0.31, 26.56]
Open in figure viewer Analysis 6.1 Comparison 6 One type of needle suspension versus another type of needle suspension, Outcome 1 Number not cured (worse, unchanged or improved) within first year.
1.1 Raz versus transvaginal Burch (Gilja)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	2.87 [0.31, 26.56]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.53, 5.32]
Open in figure viewer Analysis 6.2 Comparison 6 One type of needle suspension versus another type of needle suspension, Outcome 2 Number not cured (worse, unchanged or improved) after first year.
2.1 Raz versus transvaginal Burch (Gilja)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.53, 5.32]
3 Urge symptoms or urge incontinence Show forest plot	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.59 [0.40, 6.28]
Open in figure viewer Analysis 6.3 Comparison 6 One type of needle suspension versus another type of needle suspension, Outcome 3 Urge symptoms or urge incontinence.
3.1 Raz versus transvaginal Burch (Gilja)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.59 [0.40, 6.28]

Open in table viewer

Comparison 7. One type of suture versus another type of suture

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.17 [0.01, 2.94]
Open in figure viewer Analysis 7.1 Comparison 7 One type of suture versus another type of suture, Outcome 1 Number not cured (worse, unchanged or improved) within first year.
2 Number not improved (worse or unchanged) within first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.4 [0.02, 8.78]
Open in figure viewer Analysis 7.2 Comparison 7 One type of suture versus another type of suture, Outcome 2 Number not improved (worse or unchanged) within first year.
3 Urge symptoms or urge incontinence Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.01, 4.44]
Open in figure viewer Analysis 7.3 Comparison 7 One type of suture versus another type of suture, Outcome 3 Urge symptoms or urge incontinence.
4 Pain score Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 7.4 Comparison 7 One type of suture versus another type of suture, Outcome 4 Pain score.
4.1 At one month	1	19	Mean Difference (IV, Fixed, 95% CI)	‐0.60 [‐1.87, 0.67]
4.2 At three months	1	20	Mean Difference (IV, Fixed, 95% CI)	‐0.92 [‐1.77, ‐0.07]

Analysis 1.1

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 2 Number not cured (worse, unchanged or improved) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 3 Number not improved (worse or unchanged) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 4 Number not improved (worse or unchanged) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 5 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 6 Voiding dysfunction after 3 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 7 Detrusor overactivity (objective diagnosis by urodynamics).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 8 New or persistent prolapse.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 9 Peri‐operative surgical complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva


Study	Needle suspension	Abdominal suspension
Athanassopoulos 1996	Mean length of stay: 3 days (range 6 to 12)	Mean length of stay: 5.8 days (range 4 to 11)
German 1992	Mean length of stay: 7 days Time to return to normal activity: 7 weeks	Mean length of stay: 8.3 days Time to return to normal activity: 10.4 weeks

Analysis 1.10

Comparison 1 Needle suspension versus open abdominal retropubic suspension, Outcome 10 Length of stay/time to return to normal function.

Ir a la figura de la revisión

Analysis 2.1

Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 2 Number not cured (worse, unchanged or improved) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 3 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 Needle suspension versus open abdominal retropubic suspension (no previous surgery), Outcome 4 New or persistent prolapse.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 2 Number not cured (worse, unchanged or improved) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 3 Number not improved (worse or unchanged) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.4

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 4 Number not improved (worse or unchanged) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.5

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 5 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.6

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 6 Voiding dysfunction after 3 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.7

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 7 Detrusor overactivity (objective diagnosis by urodynamics).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.8

Comparison 3 Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery), Outcome 8 Peri‐operative surgical complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 2 Number not cured (worse, unchanged or improved) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.3

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 3 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.4

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 4 Voiding dysfunction after 3 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.5

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 5 Detrusor overactivity (objective diagnosis by urodynamics).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.6

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 6 Peri‐operative surgical complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.7

Comparison 4 Needle suspension versus suburethral sling operations, Outcome 7 Length of inpatient stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.2

Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 2 Number not cured (worse, unchanged or improved) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.3

Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 3 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.4

Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 4 Voiding dysfunction after 3 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.5

Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 5 Peri‐operative surgical complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.6

Comparison 5 Needle suspension versus anterior vaginal repair, Outcome 6 New or persistent prolapse.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.1

Comparison 6 One type of needle suspension versus another type of needle suspension, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.2

Comparison 6 One type of needle suspension versus another type of needle suspension, Outcome 2 Number not cured (worse, unchanged or improved) after first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.3

Comparison 6 One type of needle suspension versus another type of needle suspension, Outcome 3 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.1

Comparison 7 One type of suture versus another type of suture, Outcome 1 Number not cured (worse, unchanged or improved) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.2

Comparison 7 One type of suture versus another type of suture, Outcome 2 Number not improved (worse or unchanged) within first year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.3

Comparison 7 One type of suture versus another type of suture, Outcome 3 Urge symptoms or urge incontinence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.4

Comparison 7 One type of suture versus another type of suture, Outcome 4 Pain score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1. Needle suspension versus open abdominal retropubic suspension

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	5	517	Risk Ratio (M‐H, Fixed, 95% CI)	1.70 [1.11, 2.60]

1.1 Objective/genuine stress incontinence (only)	5	517	Risk Ratio (M‐H, Fixed, 95% CI)	1.70 [1.11, 2.60]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	7	610	Risk Ratio (M‐H, Fixed, 95% CI)	2.00 [1.47, 2.72]

2.1 Objective/genuine stress incontinence (only)	7	610	Risk Ratio (M‐H, Fixed, 95% CI)	2.00 [1.47, 2.72]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved (worse or unchanged) within first year Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.07, 7.73]

3.1 Objective/genuine stress incontinence (only)	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.07, 7.73]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved (worse or unchanged) after first year Show forest plot	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.37, 6.04]

4.1 Objective/genuine stress incontinence (only)	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.37, 6.04]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Urge symptoms or urge incontinence Show forest plot	4	297	Risk Ratio (M‐H, Fixed, 95% CI)	1.80 [0.71, 4.56]

5.1 Objective/genuine stress incontinence (only)	4	297	Risk Ratio (M‐H, Fixed, 95% CI)	1.80 [0.71, 4.56]
5.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Voiding dysfunction after 3 months Show forest plot	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	2.12 [0.81, 5.55]

6.1 Objective/genuine stress incontinence (only)	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	2.12 [0.81, 5.55]
6.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Detrusor overactivity (objective diagnosis by urodynamics) Show forest plot	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	2.91 [0.73, 11.58]

7.1 Objective/genuine stress incontinence (only)	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	2.91 [0.73, 11.58]
7.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 New or persistent prolapse Show forest plot	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [0.21, 23.57]

8.1 Objective/genuine stress incontinence (only)	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [0.21, 23.57]
8.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Peri‐operative surgical complications Show forest plot	3	152	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.73, 2.83]

9.1 Objective/genuine stress incontinence (only)	3	152	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.73, 2.83]
9.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Length of stay/time to return to normal function Show forest plot			Other data	No numeric data

Comparison 1. Needle suspension versus open abdominal retropubic suspension

Ir a la tabla de la revisión

Comparison 2. Needle suspension versus open abdominal retropubic suspension (no previous surgery)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	3	417	Risk Ratio (M‐H, Fixed, 95% CI)	2.05 [1.20, 3.50]

1.1 Objective/genuine stress incontinence (only)	3	417	Risk Ratio (M‐H, Fixed, 95% CI)	2.05 [1.20, 3.50]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	3	408	Risk Ratio (M‐H, Fixed, 95% CI)	2.37 [1.54, 3.66]

2.1 Objective/genuine stress incontinence (only)	3	408	Risk Ratio (M‐H, Fixed, 95% CI)	2.37 [1.54, 3.66]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Urge symptoms or urge incontinence Show forest plot	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	2.49 [0.55, 11.30]

3.1 Objective/genuine stress incontinence (only)	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	2.49 [0.55, 11.30]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 New or persistent prolapse Show forest plot	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [0.21, 23.57]

4.1 Objective/genuine stress incontinence (only)	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	2.24 [0.21, 23.57]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Needle suspension versus open abdominal retropubic suspension (no previous surgery)

Ir a la tabla de la revisión

Comparison 3. Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	2	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.55, 2.29]

1.1 Objective/genuine stress incontinence (only)	2	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.55, 2.29]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.61 [1.04, 2.49]

2.1 Objective/genuine stress incontinence (only)	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.61 [1.04, 2.49]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number not improved (worse or unchanged) within first year Show forest plot	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.07, 7.73]

3.1 Objective/genuine stress incontinence (only)	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.07, 7.73]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number not improved (worse or unchanged) after first year Show forest plot	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.37, 6.04]

4.1 Objective/genuine stress incontinence (only)	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.37, 6.04]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Urge symptoms or urge incontinence Show forest plot	3	151	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.42, 4.59]

5.1 Objective/genuine stress incontinence (only)	3	151	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.42, 4.59]
5.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Voiding dysfunction after 3 months Show forest plot	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	2.12 [0.81, 5.55]

6.1 Objective/genuine stress incontinence (only)	4	202	Risk Ratio (M‐H, Fixed, 95% CI)	2.12 [0.81, 5.55]
6.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Detrusor overactivity (objective diagnosis by urodynamics) Show forest plot	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	2.91 [0.73, 11.58]

7.1 Objective/genuine stress incontinence (only)	2	101	Risk Ratio (M‐H, Fixed, 95% CI)	2.91 [0.73, 11.58]
7.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Peri‐operative surgical complications Show forest plot	3	152	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.73, 2.83]

8.1 Objective/genuine stress incontinence (only)	3	152	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.73, 2.83]
8.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 3. Needle suspension versus open abdominal retropubic suspension (mixed population, some after previous surgery)

Ir a la tabla de la revisión

Comparison 4. Needle suspension versus suburethral sling operations

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.21, 18.69]

1.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.21, 18.69]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.37, 24.17]

2.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.37, 24.17]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Urge symptoms or urge incontinence Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.19, 1.86]

3.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.19, 1.86]
3.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Voiding dysfunction after 3 months Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.12, 2.14]

4.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.12, 2.14]
4.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Detrusor overactivity (objective diagnosis by urodynamics) Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 4.67]

5.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 4.67]
5.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Peri‐operative surgical complications Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.22 [0.06, 0.78]

6.1 Objective/genuine stress incontinence (only)	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.22 [0.06, 0.78]
6.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Length of inpatient stay Show forest plot	1	20	Mean Difference (IV, Fixed, 95% CI)	‐13.0 [‐19.00, ‐5.00]

7.1 Objective/genuine stress incontinence (only)	1	20	Mean Difference (IV, Fixed, 95% CI)	‐13.0 [‐19.00, ‐5.00]
7.2 Subjective stress incontinence (only)	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed incontinence	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Needle suspension versus suburethral sling operations

Ir a la tabla de la revisión

Comparison 5. Needle suspension versus anterior vaginal repair

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	2	266	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.63, 1.46]

1.1 Objective/genuine stress incontinence (only)	2	266	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.63, 1.46]
1.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed incontinence	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	3	337	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.64, 1.16]

2.1 Objective/genuine stress incontinence (only)	2	257	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.68, 1.26]
2.2 Subjective stress incontinence (only)	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed incontinence	1	80	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.19, 1.46]
3 Urge symptoms or urge incontinence Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Objective/genuine stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Voiding dysfunction after 3 months Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 Objective/genuine stress incontinence (only)	2		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Peri‐operative surgical complications Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

5.1 Objective/genuine stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 New or persistent prolapse Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6.1 Objective/genuine stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Subjective stress incontinence (only)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed incontinence	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 5. Needle suspension versus anterior vaginal repair

Ir a la tabla de la revisión

Comparison 6. One type of needle suspension versus another type of needle suspension

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	2.87 [0.31, 26.56]

1.1 Raz versus transvaginal Burch (Gilja)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	2.87 [0.31, 26.56]
2 Number not cured (worse, unchanged or improved) after first year Show forest plot	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.53, 5.32]

2.1 Raz versus transvaginal Burch (Gilja)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.53, 5.32]
3 Urge symptoms or urge incontinence Show forest plot	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.59 [0.40, 6.28]

3.1 Raz versus transvaginal Burch (Gilja)	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.59 [0.40, 6.28]

Comparison 6. One type of needle suspension versus another type of needle suspension

Ir a la tabla de la revisión

Comparison 7. One type of suture versus another type of suture

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number not cured (worse, unchanged or improved) within first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.17 [0.01, 2.94]

2 Number not improved (worse or unchanged) within first year Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.4 [0.02, 8.78]

3 Urge symptoms or urge incontinence Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.01, 4.44]

4 Pain score Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

4.1 At one month	1	19	Mean Difference (IV, Fixed, 95% CI)	‐0.60 [‐1.87, 0.67]
4.2 At three months	1	20	Mean Difference (IV, Fixed, 95% CI)	‐0.92 [‐1.77, ‐0.07]

Comparison 7. One type of suture versus another type of suture

Ir a la tabla de la revisión

	Idioma de la Revisión Cochrane Escoja su idioma de preferencia para las revisiones Cochrane y otros contenidos. Las secciones sin una traducción aparecerán en inglés.

	Idioma de la web Escoja su idioma de preferencia para la web de la Biblioteca Cochrane.

Idioma de la Revisión Cochrane

Idioma de la web

Referencias

References to studies included in this review

Athanassopoulos 1996 {published data only}

Bergman 1989a {published data only}

Bergman 1989b {published data only}

Di Palumbo 2003 {published data only}

German 1992 {published data only}

Gilja 1998 {published data only}

Hilton 1989 {published data only}

Mundy 1983 {published data only}

Palma 1985 {published and unpublished data}

Stein 1991 {published data only}

References to studies excluded from this review

Bump 1995 {published data only}

Bump 1996 {published data only}

Colombo 1997 {published data only}

Corcos 2001 {published data only}

Goldberg 2001 {published data only}

Ishenko 1999 {published data only}

Jongen 1999 {published data only}

Koonings 1988 {published data only}

Morley 1995 {published data only}

Ramon 1991 {published and unpublished data}

Salinas 1994 {published data only}

Vordermark 1979 {published data only}

Zivkovic 1994 {published data only}

Additional references

Abrams 2002

Black 1996

Black 1997

Bump 1988

Dean 2006

Downs 1996

Fantl 1996

Glazener 2001

Higgins 2003

Higgins 2011

Hilton 1983

Jarvis 1994

Kelleher 1997

Kirchin 2012

Lapitan 2012

Leach 1997

Lose 1998

Meyer 1994

Reference Manager 2012 [Computer program]

Rehman 2011

Swift 1995

References to other published versions of this review

Glazener 2004

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Characteristics of excluded studies [ordered by study ID]

Data and analyses

Copiar o descargar referencia

Idioma de la Revisión Cochrane

Idioma de la web

Instituciones a las que se accedió previamente

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso