Table 4.
Results for number of women with improvement of stress urinary incontinence symptoms
| Treatment 1 | Treatment 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 | 40* | 0.86 (0.70 to 1.06) | 0.76 (0.59 to 0.98) | Moderate |
| Open colposuspension | Retropubic MUS | 6* | 0.83 (0.55 to 1.24) | 0.65 (0.41 to 1.02) | Low |
| Laparoscopic colposuspension | Retropubic MUS | 4 | 0.49 (0.18 to 1.35) | 0.52 (0.29 to 0.91) | Low |
| Traditional sling | Retropubic MUS | 6* | 0.62 (0.38 to 1.02) | 0.69 (0.39 to 1.26) | Low |
| Single incision | Retropubic MUS | 6* | 0.42 (0.20 to 0.89) | 0.50 (0.35 to 0.71) | Moderate |
| Bladder neck needle suspension | Retropubic MUS | 0.25 (0.11 to 0.58) | Low | ||
| Anterior repair | Retropubic MUS | 0.18 (0.08 to 0.39) | Very low | ||
| Pelvic floor muscle training | Retropubic MUS | 0.43 (0.14 to 1.37) | Low | ||
| Open colposuspension | Transobturator MUS | 1 | 0.90 (0.30 to 2.69) | 0.85 (0.52 to 1.41) | Low |
| Laparoscopic colpo | Transobturator MUS | 0.69 (0.37 to 1.26) | Low | ||
| Traditional sling | Transobturator MUS | 1 | 2.00 (0.17 to 23.96) | 0.91 (0.49 to 1.72) | Very low |
| Single incision | Transobturator MUS | 28* | 0.74 (0.57 to 0.96) | 0.66 (0.49 to 0.89) | Moderate |
| Bladder neck needle suspension | Transobturator MUS | 0.33 (0.14 to 0.79) | Very low | ||
| Anterior repair | Transobturator MUS | 1 | 1.00 (0.26 to 3.89) | 0.24 (0.10 to 0.53) | Very low |
| Pelvic floor muscle training | Transobturator MUS | 1 | 0.18 (0.10 to 0.33) | 0.56 (0.19 to 1.78) | Low |
| Laparoscopic colposuspension | Open colposuspension | 9 | 0.93 (0.58 to 1.48) | 0.81 (0.49 to 1.31) | Low |
| Traditional sling | Open colposuspension | 3* | 2.47 (0.73 to 8.40) | 1.07 (0.54 to 2.15) | Low |
| Single incision | Open colposuspension | 0.78 (0.44 to 1.36) | Low | ||
| Bladder neck needle suspension | Open colposuspension | 3* | 0.38 (0.22 to 0.63) | 0.38 (0.18 to 0.81) | Low |
| Anterior repair | Open colposuspension | 3* | 0.20 (0.07 to 0.60) | 0.28 (0.14 to 0.55) | Very low |
| Pelvic floor muscle training | Open colposuspension | 1 | 8.87 (1.66 to 47.25) | 0.66 (0.21 to 2.16) | Low |
| Traditional sling | Laparoscopic colposuspension | 1.32 (0.62 to 2.98) | Low | ||
| Single incision | Laparoscopic colposuspension | 0.97 (0.50 to 1.87) | Low | ||
| Bladder neck needle suspension | Laparoscopic colposuspension | 0.47 (0.20 to 1.17) | Very low | ||
| Anterior repair | Laparoscopic colposuspension | 0.34 (0.15 to 0.79) | Very low | ||
| Pelvic floor muscle training | Laparoscopic colposuspension | 0.82 (0.25 to 2.88) | Very low | ||
| Single incision | Traditional sling | 1 | 1.92 (0.65 to 5.64) | 0.73 (0.37 to 1.39) | Low |
| Bladder neck needle suspension | Traditional sling | 1 | 1.00 (0.05 to 18.57) | 0.36 (0.13 to 0.95) | Very low |
| Anterior repair | Traditional sling | 0.26 (0.10 to 0.65) | Very low | ||
| Pelvic floor muscle training | Traditional sling | 0.62 (0.18 to 2.18) | Very low | ||
| Bladder neck needle suspension | Single incision | 0.49 (0.20 to 1.24) | Very low | ||
| Anterior repair | Single incision | 0.36 (0.15 to 0.82) | Very low | ||
| Pelvic floor muscle training | Single incision | 0.84 (0.28 to 2.78) | Low | ||
| Anterior repair | Bladder neck needle suspension | 1* | 0.92 (0.55 to 1.55) | 0.72 (0.31 to 1.63) | Very low |
| Pelvic floor muscle training | Bladder neck needle suspension | 1.72 (0.45 to 6.89) | Low | ||
| Pelvic floor muscle training | Anterior repair | 2.38 (0.65 to 9.30) | Very low | ||
MUS=mid-urethral slings.
*
These analyses are also informed by two three arm trials comparing retropubic MUS, transobturator MUS, and single incision.
An odds ratio >1 favours the first treatment—ie, more events (improvement) occur. An odds ratio <1 favours the second treatment—ie, fewer events.