Two types of urinary incontinence sling surgeries are comparable

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Two types of ‘sling’ surgeries are popular for treating female urinary incontinence. According to a study published Monday, both operations show satisfactory results 12 months after surgery, although each approach has unique side effects and complications that women and their doctors should consider.

Urinary incontinence affects as many as half of all women, to varying degrees. An estimated 4% to 10% of these women seek surgery to treat the problem, although exercises, medications and non-surgical treatments are available. Sling surgery uses strips of synthetic material, mesh or natural tissue to keep the urethra closed. The study, released today in the New England Journal of Medicine, compared the retropubic sling surgery to the transobturator midurethral sling. Basically, the surgeries vary in how they’re performed.

Almost 600 women were assigned to undergo one of the two procedures. They were followed for one year and underwent subjective and objective tests to gage the surgery effectiveness. The study found subjective success scores of 62.2% for the retropubic sling group and 55.8% for the transobturator sling. But 2.7% of the first group reported voiding problems that required surgery compared to no such cases in the transobturator group. Women in the transobturator group were more likely to report numbness and weakness from the sling.

Surgery success also depends on the surgeon’s experience, said Dr. Rebecca G. Rogers, of the University of New Mexico Health Science Center, writing in a commentary accompanying the study. Moreover, more information is needed on the long-term success of slings. ‘Up to a third of women who have surgery for stress incontinence undergo a second procedure during their lifetime, and data regarding the long-term effectiveness and equivalence of these two procedures are critical to decision making,’ she noted.

— Shari Roan