Association between levator ani avulsion and urinary incontinence in women: a systematic review and meta‐analysis

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.

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Correction to: The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis

International Urogynecology Journal ◽

10.1007/s00192-021-04794-y ◽

2021 ◽

Author(s):

Kobra Falah-Hassani ◽

Joanna Reeves ◽

Rahman Shiri ◽

Duane Hickling ◽

Linda McLean

Keyword(s):

Systematic Review ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Meta Analysis ◽

Link Type

A correction to this paper has been published: 10.1007/s00192-021-04794-y

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Can reducing the number of stitches compromise the outcome of laparoscopic Burch surgery in the treatment of stress urinary incontinence? Systematic review and meta-analysis

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912017006011 ◽

2017 ◽

Vol 44 (6) ◽

pp. 649-654 ◽

Cited By ~ 2

Author(s):

RICARDO JOSÉ SOUZA ◽

JOSÉ ANACLETO DUTRA RESENDE JÚNIOR ◽

CLARICE GUIMARÃES MIGLIO ◽

LEILA CRISTINA SOARES BROLLO ◽

MARCO AURÉLIO PINHO OLIVEIRA ◽

...

Keyword(s):

Systematic Review ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

P Value ◽

Open Technique ◽

Control Series ◽

One Year ◽

Cure Rates

ABSTRACT The retropubic colposuspension in the treatment of stress urinary incontinence has been rescued with the laparoscopic route. Some authors have reduced the number of stitches, from two to one, due to the difficulty of suturing by this route. To what extent can this modification compromise outcome? To answer this question, we performed a systematic review and meta-analysis on the MEDLINE/PubMed and LILACS/SciELO databases between 1990 and 2015. We included randomized clinical trials, cohort studies and case-control series comparing laparoscopic versus open Burch, and two versus one stitch in laparoscopic Burch, with a minimum follow-up of one year. Fourteen studies compared laparoscopic versus open Burch, in which we found no differences between the two techniques using one stitch (Relative Risk - RR - of 0.94, 95% CI 0.79-1.11) and two stitches (RR of 1.03, 95% CI 0.97-1.10). Only one study compared one stitch versus two stitches in laparoscopic Burch, with cure rates of 68% versus 87%, respectively (p-value= 0.02). We did not identify differences when compared open technique with two stitches versus laparoscopic with one stitch and open technique with two stitches versus laparoscopic with two. The study comparing one versus two laparoscopic stitches demonstrated superior results with the latter. Although there is no robust evidence, when Burch surgery is performed laparoscopically, the use of two stitches seems to be the best option.

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