Surgical Intervention for Stress Urinary Incontinence: Comparison of Midurethral Sling Procedures

Joseph M. Novi, DO, and Beth H.K. Mulvihill, DO
Notes and Affiliations
Notes and Affiliations

Received: September 2, 2005

Accepted: December 20, 2005

Published: November 1, 2008

J Osteopath Med; 108(11): 634-638

Context: The synthetic, tension-free midurethral sling was introduced in the 1990s as a surgical treatment for women with stress urinary incontinence (SUI). Several similar products are now available. The authors generated data comparing clinical outcomes of two midurethral sling procedures.

Objectives: To compare clinical outcomes of two midurethral sling procedures currently used for the treatment of women with SUI: Gynecare Tension-free Vaginal Tape (TVT; Ethicon Women’s Health & Urology, Somerville, NJ) and Uretex Self-Anchoring Urethral Support System (CR Bard Inc, Covington, Ga).

Methods: A nonrandomized, prospective study was conducted at a urogynecology practice with women who had preoperative urodynamically proven SUI. The study consisted of two phases: 100 consecutive cases using the TVT midurethral sling, then 100 consecutive cases using the Uretex midurethral sling. Symptom improvement was evaluated at 12-month postoperative follow-up by measuring rates of prolonged intermittent self-catheterization, urinary tract infection, urinary retention requiring urethrolysis, and new-onset urge incontinence.

Results: The TVT and Uretex groups were similar with respect to age, parity, and incidence of prior anti-incontinence surgery. There was no significant difference in outcomes measured between the two groups in symptom improvement at 12-month follow-up.

Conclusions: The TVT and Uretex midurethral slings demonstrate similar short-term improvement and complication rates in a nonrandomized population of women with SUI.

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