Pubovaginal sling versus transurethral Macroplastique for stress urinary incontinence and intrinsic sphincter deficiency: a prospective randomised controlled trial

Maher, Christopher F., O'Reilly, Barry A., Dwyer, Peter L., Carey, Marcus P., Cornish, Anne and Schluter, Philip (2005) Pubovaginal sling versus transurethral Macroplastique for stress urinary incontinence and intrinsic sphincter deficiency: a prospective randomised controlled trial. BJOG: An international journal of obstetrics and gynaecology, 112 6: 797-801. doi:10.1111/j.1471-0528.2005.00547.x


Author Maher, Christopher F.
O'Reilly, Barry A.
Dwyer, Peter L.
Carey, Marcus P.
Cornish, Anne
Schluter, Philip
Title Pubovaginal sling versus transurethral Macroplastique for stress urinary incontinence and intrinsic sphincter deficiency: a prospective randomised controlled trial
Journal name BJOG: An international journal of obstetrics and gynaecology   Check publisher's open access policy
ISSN 1470-0328
1471-0528
Publication date 2005-01-01
Sub-type Article (original research)
DOI 10.1111/j.1471-0528.2005.00547.x
Open Access Status Not Open Access
Volume 112
Issue 6
Start page 797
End page 801
Total pages 5
Editor J. Thornton
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Subject C1
730201 Women's health
321014 Obstetrics and Gynaecology
Abstract Objective To compare the pubovaginal sling and transurethral Macroplastique in the treatment of female stress urinary incontinence (SUI) and intrinsic sphincter deficiency (ISD). Design A prospective randomised controlled trial comparing two surgical treatments for SUI and ISD. Setting Tertiary referral urogynaecology unit in Australia. Population Women with SUI and ISD who were suitable for either surgical technique. Methods Forty-five women with SUI and ISD were randomly allocated the pubovaginal sling (n = 22) or transurethral Macroplastique (n = 23). Subjective and objective success rates, patient satisfaction and cost measurements at six months and one year following surgery were the primary outcome measures. A telephone questionnaire survey was performed at a mean follow up period of 62 months (43-71). Main outcome measure Comparison of success rates, complications and costs. Results The symptomatic and patient satisfaction success rates were similar following the sling and Macroplastique with the objective success rate being significantly greater (P < 0.001) following the sling (81% vs 9%). Macroplastique had significantly lower morbidity but was more expensive than the sling (P < 0.001). Response rate at 62 months follow up was 60% in both groups with the sling group reporting better continence success (69% vs 21%) and satisfaction rates (69% vs 29%, P = 0.057). Conclusions The pubovaginal sling was more effective and economical than transurethral Macroplastique for the treatment of SUI and ISD. However, transurethral Macroplastique remains an appropriate treatment in selected cases of SUI and ISD.
Keyword Obstetrics and Gynecology
Burch Retropubic Urethropexy
Low-pressure Urethra
Silicone Microimplants
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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Created: Wed, 15 Aug 2007, 16:07:57 EST