Urinary stress incontinence

doi:10.1136/bmj.325.7368.789

BMJ 2002;325:789-790 ( 12 October )

Editorials

Urinary stress incontinence

Benefits of using tension-free vaginal tape remain unproved

The first 150 words of the full text of this article appear below.

New minimal access surgical sling procedures such as the tension-free vaginal tape procedure are now being used to treat urinarystress incontinence in women. These procedures use minimal tension $---$ urethralsupport is perhaps achieved from a tissue reaction to the tape,which produces a collagen scar along the length of the tape andincreases support of the bladder when the rectus muscle contracts.The tension-free vaginal tape procedure is often carried out underregional or local anaesthesia. Many women would undoubtedly welcomethe choice of a less invasive procedure than open retropubic colposuspension $---$ aslong as the minimal procedure cures urinary incontinence and doesnot result in majorcomplications.

What does the currently available evidence say? Two recent systematic reviews concluded that, although the minimal accesssurgical sling procedures (and particularly tension-free vaginaltape) may be promising, the quality of the evidence availableso far is not conclusive. ¹ ² So far . . . [Full text of this article]