Meta-analysis of female stress urinary

incontinence treatments with adjustable

single-incision mini-slings and
transobturator tension-free vaginal tape
surgeries

Critical Appraised of Topic

INTERNAL VALIDITY
Was the assignment of patients to
treatments randomised?
Answer: YES
Comment: By searching the Medline, Embase,
Scopus, and Web of Science databases and the
Cochrane Database of Systematic Reviews
combined with manual searches, all reports on
randomized controlled trials (RCTs) of singleincision mini-sling (SIMS-Ajust) and transobturator
tension-free vaginal tape (TVT-O/TOT) surgeries
were collected.

 Were the groups similar at the start of the

trial?
Answer: UNCLEAR
Comment: The journal article did not mention it.

 Aside from the allocated treatment, were

groups treated equally?
Answer: YES
Comment: All patients underwent SIMS-Ajust and
TVT-O/TOT

 Were all patients who entered the trial

accounted for?
Answer: YES
Comment: A total of 13 (less than 20%) people
were lost to follow-up (SIMS Ajust: n = 3, TVTO/TOT: n = 10).
Were they analysed in the groups to which
they were randomised?
Answer: YES
Comment: subgroup analysis was performed

 Were measures objective or were the

patients and clinicians kept blind to which
treatment was being received?
Answer: UNCLEAR
Comment: The journal article did not mention it.

How large was the treatment effect?

The results show that the objective cure rate of the two
groups has no significant difference in the patient-reported
cure rate in the treatment of female stress urinary
incontinence between SIMS-Ajust and TVT-O/TOT [RR =
0.95, P > 0.05].
The results show that there is no significant difference in the
incidence rate of postoperative pain between SIMS-Ajust
and TVT-O/TOT [RR= 0.50, P > 0.05].
The statistics on five postoperative complications show that
the incidence rate of postoperative groin pain by SIMS-Ajust
is significantly less than for TVT-O/TOT [RR = 0.30, P <0.05]
The results showed no significant difference in the incidence
rate of repeated continence surgery between these two
groups [RR = 1.64, P > 0.05]

 How precise was the estimate of the treatment effect?

The results show that the objective cure rate of the two groups
has 95 % CI (0.87 to 1.04)
The results show that the incidence rate of postoperative pain
between SIMS-Ajust and TVT-O/TOT has 95 % CI (0.18 to 1.43)
The statistics on five postoperative complications show that
the incidence rate of postoperative groin pain by SIMS-Ajust
and TVT-O/TOT has 95 % CI (0.11 to 0.85)
The results show that the incidence rate of repeated
continence surgery between these two groups has 95 % CI
(0.41 to 6.61)
If the confidence interval is fairly narrow then we can be
confident that our point estimate is a precise reflection of the
population value