Mikos Themistoklis, Roussos Nikolaos, Theodoulidis Iakovos, Anthoulakis Christos, Grimbizis Grigoris F
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Periferiaki Odos Thessalonikis, 56403, Thessaloniki, Nea Efkarpia, Greece.
Int Urogynecol J. 2025 Sep 24. doi: 10.1007/s00192-025-06275-y.
It is not known whether assessment of severity of stress urinary incontinence (SUI) is important before any attempt at the correction of it. The aim of this study is to identify the success rates and/or dry rates following interventional treatment in patients with mild, moderate, and severe SUI, and compare the results among the various treatments.
This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the Prospective Register of Systematic Reviews System (ID: CRD420251017900), by searching PubMed, Scopus, and Cochrane Library Database from inception to December 2024. The Population, Intervention, Comparison, Outcomes, and Study design criteria were as follows: the 'Population' were adult women who underwent an interventional procedure for SUI and had pre- and post-interventional classification of SUI severity. As 'Intervention' was considered any type of interventional procedure: colposuspensions, mid-urethral slings (MUS), pubo-vaginal slings, energy-based devices (EBD), and injectables. 'Comparison' was considered between either single or comparative interventions according to the pre- and post-operative grade of SUI severity. 'Outcomes' were the success rates and/or dry rates according to pre- and post-operative grade of SUI severity.
From a total of 11,535 studies, 24 (4380 patients) were included for further analysis: in 13 studies (n = 3599) a graft was used and in 11 studies (n = 781) other interventions. Successful treatment of mild incontinence was achieved in 84.7% (MUS = 89.6%, EBD = 66.7%, p < 0.001), of moderate incontinence in 88.3% (MUS = 92.0%, EBD = 52.5%, p < 0.001), and of severe/very severe incontinence in 75.7% (MUS = 83.9%, EBD = 44.3%, p < 0.001).
The success rates of any incontinence procedure depend largely on the pre-operative severity of SUI, and they are significantly lower with increasing severity of the SUI. MUS appear to have improved treatment rates compared with EBD, independently of the severity of SUI.
在尝试纠正压力性尿失禁（SUI）之前，评估其严重程度是否重要尚不清楚。本研究的目的是确定轻度、中度和重度SUI患者介入治疗后的成功率和/或干爽率，并比较不同治疗方法的结果。
本系统评价按照系统评价和Meta分析的首选报告项目指南进行，并在系统评价前瞻性注册系统（ID：CRD420251017900）中注册，通过检索PubMed、Scopus和Cochrane图书馆数据库，检索时间从建库至2024年12月。人群、干预措施、对照、结局和研究设计标准如下：“人群”为接受SUI介入治疗且有介入治疗前后SUI严重程度分类的成年女性。“干预措施”为任何类型的介入治疗：阴道前壁悬吊术、中段尿道吊带术（MUS）、耻骨后阴道吊带术、能量装置（EBD）和注射治疗。“对照”根据SUI严重程度的术前和术后分级，考虑单一干预或比较干预之间的对照。“结局”为根据SUI严重程度的术前和术后分级得出的成功率和/或干爽率。
在总共11535项研究中，纳入24项（4380例患者）进行进一步分析：13项研究（n = 3
