Chapter 4.1 60 In one case series of 133 women, 11 (8.3%) patients whose symptoms were cured or improved, developed recurrence of their primary symptoms during a follow-up period of 1 year.107 In 5 of these women, who agreed to further surgery, the tape was found released from the side of the vaginal vault. After refixation, they were continent again. Another six participants refused second-look laparoscopy; so the reason for recurrence could not be assessed. Therefore, recurrence of MUI or UUI postoperatively based on tape disruptions is at best 3.7% (5/133) and 8.3% (11/133) in worst case scenario. Considering further incontinence reinterventions, five case series reported on 216/555 (38.9%) subsequent TOT procedures for persisting, worsening, or de novo SUI.37,107,108,110,124 Certainty assessment of the five NRS reporting on urinary incontinence led to a moderate level of evidence, and the one RCT comparing CESA or VASA to solifenacin administration was of low quality. Table 3. Postoperative cure rates following CESA or VASA in studies where the persistence of urinary incontinence was the primary or co-primary outcome CI. Confidence Interval; MUI. Mixed Urinary Incontinence; UUI. Urge Urinary Incontinence; SUI. Stress Urinary Incontinence; n.r.. not reported; n.s.. not significant; aCure rates for MUI and UUI are only reported after a subsequent sling procedure (TOT) for persistent or de novo SUI was offered. bCure rates displayed in this table are after CESA or VASA only. When an additional TOT was performed cure rates improved to76% (66/87) for MUI and 84% (26/31) for UUI. Prolapse symptoms Four studies reported on prolapse symptoms.37,110,123,124 One case series including 93 women reported on prolapse symptoms at 1-year follow-up.124 The mean ICIQ-VS score for vaginal symptoms improved from 27.9 at baseline to 5.8 (mean difference = -22.05, CI95%: -23.63-20.47). The mean effect on quality-of-life score improved from 8.4 to 1.4 (mean difference = -6.96, CI95%: -6.47-7.44) and 56% of women had a global impression much better or very much better at 1-year follow-up. Three further case series110,123,124 reported anatomical success. All patients used the MUI UUI SUI n (%) 95% CI p-value n (%) 95% CI p-value n (%) 95% CI p-value Jäger 2012a 49/64 (76.5) 59.7-93.4 n.s. 53/69 (76.8) 60.6-93.0 n.s. n.r. n.r. n.r. Jäger 2016 34/49 (69.4) 50.5-88.2 <0.01 n.r. n.r. n.r. n.r. n.r. Ludwig 2016b 31/87 (35.6) 24.0-45.2 n.r. 22/31 (71.0) 47.2-94.7 n.r. n.r. n.r. n.r. Rexhepi 2018 60/94 (63.8) 50.5-77.2 <0.001 18/26 (69.2) 43.4-95.1 <0.001 n.r. n.r. n.r. Ludwig 2019 23/55 (41.8) 26.6-57.0 <0.001 n.r. n.r. n.r. n.r. n.r. Jäger 2021 75/183 (41.0) 32.7-49.2 n.r. n.r. n.r. n.r. n.r. n.r.
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