Suburethral slingplasty evaluation study in North Queensland, Australia: the SUSPEND trial

Lim, Yik Nyok, Muller, Reinhold, Corstiaans, Audrey, Dietz, Hans P., Barry, Christopher , and Rane, Ajay (2005) Suburethral slingplasty evaluation study in North Queensland, Australia: the SUSPEND trial. Australian and New Zealand Journal of Obstetrics and Gynaecology, 45 (1). pp. 52-59.

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Objective: To compare the safety and efficacy of three types of suburethral slings for the treatment of urodynamic stress incontinence.

Methods: Following ethics approval, 195 (3 × 65) patients with urodynamic stress incontinence were randomly assigned to undergo suburethral slingplasty with the Tension-free Vaginal Tape (TVT; Gynecare, Ethicon, Somerville, NJ, USA), Intravaginal Sling (IVS; Tyco Healthcare, Mansfield, MA, USA), or Suprapubic Arc Sling (SPARC; American Medical Systems, Minnetonka, MN, USA). The patients were blinded to the type of sling implanted.

Main outcome measures were: (1) operative and short-term complications; (2) pre- and postoperative symptomatology; and (3) pre- and postoperative urodynamic findings.

Results: There was a statistically significant increased rate of sling protrusion (13.1% vs. 3.3% and 1.7%; P = 0.04) in the SPARC group when compared to TVT and IVS. Otherwise, there were no significant differences between the groups with respect to the incidences of other operative complications, patients' main subjective outcomes, satisfaction rates, or postoperative urodynamic findings. The overall objective stress incontinence cure rates were 87.9%, 81.5% and 72.4% for the TVT, IVS, SPARC groups respectively (P = 0.11).

Conclusions: All three slings appear quite successful for the treatment of stress incontinence. The SPARC tapes showed more sling protrusion complications and a trend towards lower objective cure rates; probably as a result of the insertion method used in this study which favoured a loose SPARC sling placement. The authors recommend that the SPARC slings be left tighter than TVT, or for the cough test to be carried out.

Item ID: 5856
Item Type: Article (Research - C1)
ISSN: 1479-828X
Keywords: complications; polypropylene; stress incontinence; surgery; suburethral sling
Date Deposited: 24 Dec 2009 01:44
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 100%
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