Table 3.
Results for number of women with cure of stress urinary incontinence symptoms
| Intervention 1 | Intervention 2 | Direct evidence | Network meta-analysis | GRADE quality of evidence | ||
|---|---|---|---|---|---|---|
| No of trials | Odds ratio (95% CI) | Odds ratio (95% Crl) | ||||
| Transobturator MUS | Retropubic MUS | 36* | 0.83 (0.71 to 0.97) | 0.74 (0.59 to 0.92) | Moderate | |
| Open colposuspension | Retropubic MUS | 6* | 0.95 (0.68 to 1.32) | 0.85 (0.54 to 1.33) | Low | |
| Laparoscopic colposuspension | Retropubic MUS | 2 | 0.40 (0.11 to 1.45) | 0.58 (0.31 to 1.05) | Low | |
| Traditional sling | Retropubic MUS | 6* | 0.87 (0.58 to 1.29) | 1.06 (0.62 to 1.85) | Very low | |
| Single incision | Retropubic MUS | 6* | 0.42 (0.20 to 0.87) | 0.50 (0.36 to 0.70) | Low | |
| Bladder neck needle suspension | Retropubic MUS | 0.34 (0.15 to 0.75) | Low | |||
| Anterior repair | Retropubic MUS | 0.22 (0.10 to 0.45) | Very low | |||
| Pelvic floor muscle training | Retropubic MUS | 0.12 (0.04 to 0.32) | Low | |||
| Open colposuspension | Transobturator MUS | 1 | 0.90 (0.30 to 2.69) | 1.16 (0.72 to 1.86) | Low | |
| Laparoscopic colposuspension | Transobturator MUS | 0.79 (0.42 to 1.46) | Low | |||
| Traditional sling | Transobturator MUS | 1 | 2.00 (0.17 to 23.96) | 1.44 (0.81 to 2.62) | Very low | |
| Single incision | Transobturator MUS | 21* | 0.74 (0.54 to 1.00) | 0.68 (0.51 to 0.91) | Low | |
| Bladder neck needle suspension | Transobturator MUS | 0.46 (0.21 to 1.02) | Very low | |||
| Anterior repair | Transobturator MUS | 1 | 0.50 (0.15 to 1.62) | 0.30 (0.14 to 0.62) | Very low | |
| Pelvic floor muscle training | Transobturator MUS | 1 | 0.20 (0.12 to 0.33) | 0.16 (0.06 to 0.43) | Low | |
| Laparoscopic colposuspension | Open colposuspension | 9 | 0.74 (0.43 to 1.30) | 0.68 (0.42 to 1.08) | Low | |
| Traditional sling | Open colposuspension | 3* | 2.47 (0.73 to 8.40) | 1.24 (0.66 to 2.45) | Very low | |
| Single incision | Open colposuspension | 0.59 (0.34 to 1.01) | Low | |||
| Bladder neck needle suspension | Open colposuspension | 3* | 0.41 (0.25 to 0.68) | 0.40 (0.20 to 0.78) | Low | |
| Anterior repair | Open colposuspension | 3* | 0.20 (0.07 to 0.60) | 0.26 (0.14 to 0.48) | Very low | |
| Pelvic floor muscle training | Open colposuspension | 1 | 0.08 (0.01 to 0.51) | 0.14 (0.05 to 0.39) | Low | |
| Traditional sling | Laparoscopic colposuspension | 1.83 (0.86 to 4.04) | Very low | |||
| Single incision | Laparoscopic colposuspension | 0.87 (0.44 to 1.70) | Low | |||
| Bladder neck needle suspension | Laparoscopic colposuspension | 0.59 (0.26 to 1.33) | Very low | |||
| Anterior repair | Laparoscopic colposuspension | 0.38 (0.18 to 0.82) | Very low | |||
| Pelvic floor muscle training | Laparoscopic colposuspension | 0.21 (0.07 to 0.63) | ||||
| Single incision | Traditional sling | 0.47 (0.25 to 0.88) | Very low | |||
| Bladder neck needle | Traditional sling | 1 | 1.00 (0.05 to 18.57) | 0.32 (0.13 to 0.79) | Very low | |
| Anterior repair | Traditional sling | 0.21 (0.09 to 0.49) | Very low | |||
| Pelvic floor muscle training | Traditional sling | 0.11 (0.04 to 0.34) | Very low | |||
| Bladder neck needle suspension | Single incision | 0.67 (0.29 to 1.56) | ||||
| Anterior repair | Single incision | 0.44 (0.20 to 0.96) | Very low | |||
| Pelvic floor muscle training | Single incision | 0.24 (0.08 to 0.65) | Low | |||
| Anterior repair | Bladder neck needle suspension | 1* | 0.92 (0.55 to 1.55) | 0.65 (0.30 to 1.36) | Very low | |
| Pelvic floor muscle training | Bladder neck needle suspension | 0.35 (0.10 to 1.17) | Low | |||
| Pelvic floor muscle training | Anterior repair | 0.55 (0.17 to 1.77) | Very low | |||
MUS=mid-urethral sling.
*
These analyses are also informed by three arm trials, including one comparing retropubic MUS, transobturator MUS, and single incision, one comparing retropubic MUS, open colposuspension, and traditional sling, and two comparing open colposuspension, bladder neck needle, and anterior repair.
An odds ratio >1 favours the first treatment—ie, more events (cure) occur. An odds ratio <1 favours the second treatment—ie, fewer events.