CESA/VASA 59 Risk of bias in studies The one RCT106 had a high overall risk of bias. One NRS37 was considered to have a moderate overall risk of bias and six NRS107-110,123,124 had a serious overall risk of bias. One article was considered to have a critical risk of bias and was yet excluded from this review.122 Table 2: Patient characteristics Age (years) a BMI (kg/m2) a Race Indication for surgery Co-morbidity Jäger 2012 (n=135) 63 (13) n.r. Caucasian UI or MUI n.r. Jäger 2016 (n=76) 63 (13) 25.1 (3.9) n.r. POP n.r. Ludwig 2016 (n=133) 63 (8) 28.5 (5.4) n.r. UI or MUI n.r. Elmantwe 2016 (n=10) 48 (9) 29.5 (3.5) Egyptian POP n.r. Rexhepi 2018 (n=120) 63 (11) 28.3 (4.1) n.r. POP and UI n.r. Ludwig 2019 (n=96) 63 (10) 27.0 (5.0) n.r. UUI or MUI n.r. Cassis 2019 (n=93) 64 (9) 26.4 (2.4) n.r. POP n.r. Jäger 2021 (n=224) n.r. n.r. n.r. SUI or MUI n.r. aContinuous data are presented as mean (SD); n.r., not reported; UI, urinary incontinence; UUI, urinary urge incontinence; MUI, mixed urinary incontinence; POP, pelvic organ prolapse; SUI, stress urinary incontinence. Outcomes Urinary symptoms Six studies reported urinary symptoms.37,106-110 The overall cure rates for urinary incontinence are displayed in Table 3. Five case series report on UI cure rates in 686 women. Mean cure rate for UUI is 73,8% (95% CI: 61,9-85,7) and mean cure rate for MUI is 47.5% (95% CI: 42.4-57.7). In one case series (n=133), cure rates for each type of UI are reported in all women, yet in 91 participants this was after a subsequent Trans-Obturator Tape (TOT) procedure for persistent or de novo SUI.107 Overall (UUI and MUI) cure without a TOT was 32% (42/133) compared to 77% (102/133) after a subsequent TOT procedure. In another case series, additional TOT placement led to improvement in cure rates from 36% (31/87) to 76% (66/87) for MUI and from 71% (22/31) to 84% (26/31) for UUI.108 Ludwig et al. reported a cure rate of 41.8% (23/55) compared to 9.8% (4/41) by solifenacin administration (RR 4.3).106 Two papers reported on patient-reported outcomes in 216 patients.37,106 A significant improvement in International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF; scale 0 to 21) scores was observed 4 months after surgery; the median score after surgery was 8 (range 0–21) compared to 15 (range 5–21) before surgery.37,106
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