The Efficacy and Safety of Single-Incision Mini-Slings for Stress Urinary Incontinence: A Network Meta-Analysis.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urology Journal Pub Date : 2023-07-26 DOI:10.22037/uj.v20i.7218

Yuxin Chen, Jiecheng Zhang, Yankai Zeng, Weidong Chen, Fei Liu, Jinchun Xing, Bili Zhang, Yuedong Chen

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引用次数: 1

Abstract

Purpose: To evaluate the efficacy and safety of single-incision mini-sling for stress urinary incontinence based on network Meta-analysis.

Materials and methods: We searched PubMed, Embase, and Cochrane libraries from August 2008 to August 2019. Randomized controlled trials comparing two or more indicators of Miniarc (Single Incision Mini-slings), Ajust (Adjustable Single-Incision Sling), C-NDL (Contasure-Needleless), TFS (Tissue Fixation System), Ophria (Transobturator Vaginal Tap), TVT-O (Transobturator Vaginal Tape), and TOT (Trans-obturatortape) in treating female stress urinary incontinence were collected.

Results: Totally, 3,428 patients from 21 studies were included. Ajust had the highest subjective cure rate (Rank=0.52), while Ophira had the worst (Rank=0.67). TFS had the highest objective cure rate, and the worst was found in Ophira. TFS required the shortest operating time (Rank=0.40), while TVT-O required the longest operating time (Rank=0.47). Miniarc had the least bleeding (Rank=0.47), while TVT-O had the most bleeding (Rank=0.37). C-NDL had the shortest postoperative hospital stay (Rank=0.77), while Ajust had the longest postoperative hospital stay (Rank=0.36). For postoperative complications, TFS performed best in groin pain (Rank=0.84), urinary retention (Rank=0.78), and repeat surgery (Rank=0.45). TVT-O performed worst in groin pain (Rank=0.36), and urinary retention (Rank=0.58). Miniarc had the highest repeat surgery rate (Rank=0.35). Ajust had the lowest probability of tap erosion (Rank=0.30), while Ophira had the highest tap erosion level (Rank=0.45). Miniarc showed the greatest advantage in urinary tract infections (Rank=0.84) and de novo urgency (Rank=0.60), while C-NDL had the highest incidence of urethral infections (Rank=0.51). Ophira performed worst in de novo urgency (Rank=0.60). C-NDL performed the best in sexual intercourse pain (Rank=0.79) while Ajust was the worst (Rank=0.49).

Conclusions: In view of comprehensive efficacy and safety, we recommend that TFS or Ajust should be selected first for single-incision sling and the application of Ophria should be minimized.

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单切口微型吊带治疗压力性尿失禁的有效性和安全性:一项网络荟萃分析。

目的:通过网络meta分析，评价单切口迷你吊带治疗压力性尿失禁的疗效和安全性。材料和方法:我们检索了2008年8月至2019年8月的PubMed、Embase和Cochrane图书馆。收集比较Miniarc(单切口迷你吊带)、Ajust(可调节单切口吊带)、C-NDL(无针接触)、TFS(组织固定系统)、Ophria(经闭口阴道抽头)、TVT-O(经闭口阴道带)和TOT(经闭口带)治疗女性压力性尿失禁的两种或两种以上指标的随机对照试验。结果:共纳入21项研究的3428例患者。Ajust主观治愈率最高(Rank=0.52)， Ophira主观治愈率最低(Rank=0.67)。TFS的客观治愈率最高，而Ophira的客观治愈率最低。TFS手术时间最短(Rank=0.40)， TVT-O手术时间最长(Rank=0.47)。Miniarc出血最少(Rank=0.47)， TVT-O出血最多(Rank=0.37)。C-NDL术后住院时间最短(Rank=0.77)，而Ajust术后住院时间最长(Rank=0.36)。对于术后并发症，TFS在腹股沟疼痛(Rank=0.84)、尿潴留(Rank=0.78)和重复手术(Rank=0.45)方面表现最好。TVT-O在腹股沟疼痛(Rank=0.36)和尿潴留(Rank=0.58)方面表现最差。Miniarc的重复手术率最高(Rank=0.35)。Ajust的水龙头侵蚀概率最低(Rank=0.30)，而Ophira的水龙头侵蚀程度最高(Rank=0.45)。Miniarc在尿路感染(Rank=0.84)和新生尿急(Rank=0.60)方面优势最大，而C-NDL在尿道感染发生率方面优势最大(Rank=0.51)。Ophira在新发急症中表现最差(Rank=0.60)。C-NDL对性交疼痛表现最好(Rank=0.79)，而Ajust最差(Rank=0.49)。结论:从综合疗效和安全性考虑，建议单切口悬吊时优先选择TFS或Ajust，尽量减少使用Ophria。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology Journal UROLOGY & NEPHROLOGY-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： As the official journal of the Urology and Nephrology Research Center (UNRC) and the Iranian Urological Association (IUA), Urology Journal is a comprehensive digest of useful information on modern urology. Emphasis is on practical information that reflects the latest diagnostic and treatment techniques. Our objectives are to provide an exceptional source of current and clinically relevant research in the discipline of urology, to reflect the scientific work and progress of our colleagues, and to present the articles in a logical, timely, and concise format that meets the diverse needs of today’s urologist. Urology Journal publishes manuscripts on urology and kidney transplantation, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. Accordingly, original articles, case reports, and letters to editor are encouraged.