Joseph K-S Lee1, Anna Rosamilia2, Peter L Dwyer3, Yik N Lim4, Reinhold Muller5. 1. Department of Urogynecology, Mercy Hospital for Women, Heidelberg, VIC, Australia; Pelvic Floor Clinic, Monash Medical Center, Moorabbin, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia. Electronic address: joseph.lee@monashhealth.org. 2. Pelvic Floor Clinic, Monash Medical Center, Moorabbin, VIC, Australia; Faculty of Medicine, Monash University, Melbourne, VIC, Australia. 3. Department of Urogynecology, Mercy Hospital for Women, Heidelberg, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia. 4. Department of Urogynecology, Mercy Hospital for Women, Heidelberg, VIC, Australia. 5. School of Public Health and Tropical Medicine, James Cook University, Townsville, QLD, Australia.
Abstract
OBJECTIVE: The objective of the study was to evaluate objective and subjective outcomes of MiniArc and Monarc (American Medical Systems, Minnetonka, MN) midurethral sling (MUS) in women with stress incontinence at 12 months. STUDY DESIGN:A total of 225 women were randomized to receive MiniArc or Monarc. Women with intrinsic sphincter deficiency, previous MUS, or untreated detrusor overactivity were excluded. Objective cure was defined as negative cough stress test with a comfortably full bladder. Subjective cure was defined as no report of leakage with coughing or exercise on questionnaire. Validated questionnaires, together with urodynamic and clinical cough stress test, were used to evaluate the objective and subjective outcomes following surgery. Participants and clinicians were not masked to treatment allocation. Outcomes were compared with exact binomial tests (eg, Fisher exact test for dichotomous data) for categorical data and Student t tests or exact versions of Wilcoxon tests for numerical data as appropriate. RESULTS: There was no statistically significant difference in the subjective (92.2% vs 94.2%; P = .78; difference, 2.0%; 95% confidence interval, -2.7% to +6.7%) or objective (94.4% vs 96.7%; P = .50; difference, 2.3%; 95% confidence interval, -1.5% to +6.1%) cure rates between MiniArc and Monarc at 12 m, respectively, with a significant improvement in overactive bladder outcomes and incontinence impact from baseline in both arms. CONCLUSION: MiniArc outcomes are not inferior to Monarc MUS outcomes at 12 months' follow-up in women without intrinsic sphincter deficiency.
RCT Entities:
OBJECTIVE: The objective of the study was to evaluate objective and subjective outcomes of MiniArc and Monarc (American Medical Systems, Minnetonka, MN) midurethral sling (MUS) in women with stress incontinence at 12 months. STUDY DESIGN: A total of 225 women were randomized to receive MiniArc or Monarc. Women with intrinsic sphincter deficiency, previous MUS, or untreated detrusor overactivity were excluded. Objective cure was defined as negative cough stress test with a comfortably full bladder. Subjective cure was defined as no report of leakage with coughing or exercise on questionnaire. Validated questionnaires, together with urodynamic and clinical cough stress test, were used to evaluate the objective and subjective outcomes following surgery. Participants and clinicians were not masked to treatment allocation. Outcomes were compared with exact binomial tests (eg, Fisher exact test for dichotomous data) for categorical data and Student t tests or exact versions of Wilcoxon tests for numerical data as appropriate. RESULTS: There was no statistically significant difference in the subjective (92.2% vs 94.2%; P = .78; difference, 2.0%; 95% confidence interval, -2.7% to +6.7%) or objective (94.4% vs 96.7%; P = .50; difference, 2.3%; 95% confidence interval, -1.5% to +6.1%) cure rates between MiniArc and Monarc at 12 m, respectively, with a significant improvement in overactive bladder outcomes and incontinence impact from baseline in both arms. CONCLUSION: MiniArc outcomes are not inferior to Monarc MUS outcomes at 12 months' follow-up in women without intrinsic sphincter deficiency.
Authors: René P Schellart; Sandra E Zwolsman; Jean-Philippe Lucot; Dirk J M K de Ridder; Marcel G W Dijkgraaf; Jan-Paul W R Roovers Journal: Int Urogynecol J Date: 2017-06-02 Impact factor: 2.894
Authors: Michaela Jurakova; Martin Huser; Ivan Belkov; Petr Janku; Robert Hudecek; Petr Stourac; Jiri Jarkovsky; Pavel Ventruba Journal: Int Urogynecol J Date: 2015-12-02 Impact factor: 2.894
Authors: Aimee L Tieu; Aparna Hegde; Peter A Castillo; G Willy Davila; Vivian C Aguilar Journal: Int Urogynecol J Date: 2016-10-06 Impact factor: 2.894