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Meta-Analysis
. 2007 Jul;197(1):3-11.
doi: 10.1016/j.ajog.2006.09.025.

Comparison of retropubic vs transobturator approach to midurethral slings: a systematic review and meta-analysis

Vivian W Sung  1 , Mark D Schleinitz, Charles R Rardin, Renee M Ward, Deborah L Myers
Affiliations
Meta-Analysis

Comparison of retropubic vs transobturator approach to midurethral slings: a systematic review and meta-analysis

Vivian W Sung et al. Am J Obstet Gynecol. 2007 Jul.

Abstract

To systematically review the literature and to quantitatively compare outcomes and complications following retropubic vs transobturator approach to midurethral slings. We searched PUBMED, OVID, EMBASE, CINAHL, POPLINE, Web of Science, Cochrane Collaboration resources, TRIP, Global Health databases, and abstracts from relevant meetings from 1990 to 2006. We included all studies that compared retropubic and transobturator approaches to midurethral slings and that defined outcomes. We used random-effects models to estimate pooled odds ratios and 95% confidence intervals for objective and subjective failure, complications, and de novo irritative voiding symptoms. Six randomized trials and 11 cohort studies compared transobturator and retropubic approaches to midurethral slings. There was insufficient evidence to support if one approach leads to better objective outcomes. We found no difference in subjective failure between the 2 approaches after pooling data from randomized trials (pooled odds ratio OR 0.85, confidence interval 95% CI 0.38-1.92). The transobturator approach was associated with a decreased risk of complications (pooled OR 0.40, 95% CI 0.19-0.83]). The transobturator approach to midurethral slings is associated with a lower risk of complications; however, it is still unclear if one approach results in superior objective or subjective outcomes.

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Figures

Figure 1
Figure 1
Study selection flow chart
Figure 2
Figure 2
Risk of subjective failure after transobturator versus retropubic midurethral slings Abbreviations: TO, transobturator approach; RP, retropubic approach
Figure 3
Figure 3
Risk of complications after transobturator versus retropubic midurethral slings
Figure 4
Figure 4
Risk of de novo irritative voiding symptoms after transobturator versus retropubic midurethral slings
See this image and copyright information in PMC

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