***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To test the hypothesis that preoperative Valsalva leak point pressure ( VLPP ) predicts long-term outcome of mid-urethra slings for female stress urinary incontinence ( SUI ) . MATERIAL S AND METHODS One hundred and forty-five patients with SUI were prospect ively r and omized to two mid-urethra sling treatments : Tension free vaginal tape ( TVT ) or transobturator tape ( TOT ) . They were followed-up at 3 , 6 , 12 months post-operatively and then annually for the primary outcome variable , i.e. dry or wet and secondary outcome variables such as scores on the urogenital distress inventory ( UDI-6 ) and the impact of incontinence on quality of life ( IIQ-7 ) question naire as well as patient satisfaction as scored on a visual analogue scale ( VAS ) . Preoperative VLPP was correlated with primary and secondary outcome variables . RESULTS Mean follow-ups were 32 + /- 12 months ( range 12 - 55 ) for TVT and 31 + /- 15 months ( range 12 - 61 ) for TOT . When patients were analyzed according to VLPP stratification , 95 ( 65.5 % ) patients showed a VLPP > 60 cm H2O and 50 ( 34.5 % ) patients had a VLPP < or = 60 cm H2O . The overall objective cure rates were 75.8 % for patients with VLPP > 60 cm H2O and 72 % for those with VLPP < or = 60 cm H2O ( p < 0.619 ) . No significant differences in objective cure rates emerged when patients were stratified for pre-operative VLPP and matched for TOT or TVT procedures : VLPP > 60 cm H2O ( 82 % vs. 68.9 % p < 0.172 ) ; VLPP < or = 60 cm H2O ( 68 % vs. 76 % p < 0.528 ) . CONCLUSIONS When patients were stratified for preoperative VLPP ( < or = or > of 60 cm H2O ) , preoperative VLPP was not linked to outcome after TVT or TOT procedures INTRODUCTION The purpose of this study was to compare transobturator tape ( MONARC ) with tension-free vaginal tape in patients with borderline low maximum urethral closure pressure . STUDY DESIGN Historical cohort analysis of 3-month outcomes in 145 subjects ( MONARC = 85 ; tension-free vaginal tape = 60 ) . A cut-off point of 42 cm H2O for preoperative maximum urethral closure pressure was identified as predictor of success in the entire cohort . The cohort was stratified by sling type and analyzed . Outcome variables included urodynamic stress incontinence , urethral pressure profiles , subjective stress incontinence symptoms , and complications . RESULTS The relative risk of postoperative urodynamic stress incontinence 3 months after surgery in patients with a preoperative maximum urethral closure pressure of 42 cm or less H2O was 5.89 ( 1.02 to 33.90 , 95 % confidence interval ) when we compared MONARC with tension-free vaginal tape . Subjects in the MONARC and tension-free vaginal tape groups did not differ significantly in baseline characteristics . We defined subjects as failures if they demonstrated postoperative objective stress incontinence on multichannel urodynamic testing . CONCLUSION In subjects with maximum urethral closure pressure of 42 cm or less H2O , the MONARC was nearly 6 times more likely to fail than tension-free vaginal tape at 3 months after surgery . Long-term follow-up and r and omized controlled trials are needed The objective of this study is to determine the outcomes for the Lynx ® midurethral sling system in the treatment of urodynamic stress incontinence ( USI ) . Prospect i ve study of 118 subjects who underwent a Lynx ® midurethral sling procedure for USI . Subjects were considered cured if they were subjectively dry by history and objective ly dry by st and ing stress test . Intraoperative and postoperative complications were documented . Complete information was available on 102 ( 86 % ) subjects at 1 year . Ninety-two patients were considered cured , and ten were failures . There were four intraoperative bladder perforations and five ( 4.2 % ) erosions . Two patients developed urinary retention with one resolving at 31 days and the other undergoing subsequent takedown at 6 months . Both remain dry at 12 months . The Lynx ® midurethral sling system shows high subjective and objective success rates for the treatment of USI at 1 year with low rates of intraoperative and postoperative complications The goals of this study were to assess the efficacy of inside-out transobturator vaginal tape ( TVT-O ) as a treatment of urodynamic stress incontinence ( USI ) and to explore the possible factors determining surgical success and failure . Each woman had a 20-min pad test and urodynamic study including uroflowmetry , cystometry , and stress urethral pressure profile before and after treatment . Forty-six of the 54 women ( 85 % ) were cured of the disease , and two ( 4 % ) showed clinical improvement ; TVT-O had failed to treat USI in six patients ( 11 % ) during the 9-month follow-up period . We assessed the relationship between clinical features , urodynamic parameters , and treatment outcome . Of these , only age and previous anti-incontinence surgery were significant risk factors for surgical failure . The success rate during the 9-month follow-up period decreased significantly in women ≧60 years and in women with previous anti-incontinence surgery . Women with USI can be treated by the TVT-O procedure BACKGROUND There is a lack of information on the long-term outcomes of transobturator tension-free vaginal tape ( TO-TVT ) in the surgical treatment of female stress urinary incontinence ( SUI ) . OBJECTIVES To assess the 3-yr outcomes following TO-TVT and to compare the effectiveness of inside-out versus outside-in approaches . DESIGN , SETTING , AND PARTICIPANTS A 3-yr follow-up study of the Evaluation of Transobturator Tapes ( E-TOT ) trial , a r and omised controlled trial ( RCT ) conducted with women undergoing TO-TVT as a sole procedure between April 2005 and April 2007 in a tertiary urogynaecology centre in the United Kingdom . INTERVENTION Patients ( n=341 ) were r and omised to undergo either TVT-O ( Ethicon Inc. , Somerville , NJ , USA ) for the inside-out approach or TOT-Aris ( Coloplast Corp. , Minneapolis , MN , USA ) for the outside-in approach . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was patient-reported success rate . Secondary outcomes included further treatment for SUI , improvement in quality of life , late complications , and risk factors for late failures . Categorical variables were compared using the chi-square or Fisher exact test . Within-group comparison was undertaken using Wilcoxon and Mann-Whitney tests . Risk factors for late failures were assessed in a multivariate regression model . All statistical analysis was performed using SPSS v.18.0 ( IBM Corp. , Armonk , NY , USA ) . RESULTS AND LIMITATIONS The 3-yr follow-up was completed by 238 of the 341 women ( 70 % ) . The overall success rate , based on Patient 's Global Impression of Improvement response , was 73.1 % , with no significant difference between the inside-out and the outside-in TO-TVT ( 73.18 % vs 72.3 % ; odds ratio : 0.927 ; 95 % confidence interval , 0.552 - 1.645 ; p=0.796 ) . Compared with the 1-yr follow-up , there was a significant reduction in the patient-reported success rate ( p=0.005 ) ; however , no independent risk factors were identified . A clinical ly significant improvement ( ≥10 points ) was seen in 80 % ( n=191 ) of women , with no significant difference between both groups ( p=0.113 ) . Twenty-two women ( 6 % ) underwent further surgical treatment within 3 yr . The lack of an objective outcome assessment is a potential limitation of this RCT . CONCLUSIONS The E-TOT RCT showed a 73 % patient-reported success rate for TO-TVT at 3-yr follow-up , with no significant differences between inside-out and outside-in approaches . There was a significant drop in patient-reported success rates between 1 and 3 yr Abstract Aims To determine surgeons ' views on invasive urodynamic testing ( IUT ) prior to surgery for stress ( SUI ) or stress predominant mixed urinary incontinence ( MUI ) . Methods Members of British Society of Urogynaecology ( BSUG ) and British Association of Urological Surgeons Section of Female , Neurological and Urodynamic Urology ( BAUS-SFNUU ) were sent an email invitation to complete an online “ SurveyMonkey ® ” question naire regarding their current use of IUT prior to surgical treatment of SUI , their view about the necessity for IUT in various clinical scenarios , and their willingness to r and omize patients into a future trial of IUT . A purposive sample of respondents was invited for telephone interview to explore further how they use IUT to inform clinical decisions , and to context ualize question naire responses . Results There were 176/517 ( 34 % ) responses , 106/332 ( 32 % ) from gynecologists/urogynecologists and 67/185 ( 36 % ) from urologists ; all respondents had access to IUT , and 89 % currently arrange IUT for most women with SUI or stress predominant MUI . For a variety of scenarios with increasingly complex symptoms the level of individual equipoise ( “ undecided ” about IUT ) was very low ( 1–6 % ) and community equipoise was , at best , 66:34 ( IUT “ essential ” vs. “ unnecessary ” ) even for the simplest scenario . Nevertheless , 70 % rated the research question underlying the proposed studies “ very important ” or “ extremely important ; ” 60 % recorded a “ willingness to r and omize ” score ≥8/10 . Conclusions Most urogynecologists and urologists consider IUT essential before surgery in SUI with or without other symptoms . Most however recognize the need for further research , and indicated a willingness to recruit into multicenter trials addressing this question . Neurourol . Urodynam . 31:?– ? , 2012 . © 2012 Wiley Periodicals , BACKGROUND Few series comparing the clinical efficacy of retropubic slings versus transobturator slings for the treatment of female stress urinary incontinence ( SUI ) are available . OBJECTIVE To compare clinical efficacy of retropubic tape operations and transobturator suburethral tape operations for the surgical treatment of female SUI . DESIGN , SETTING , AND PARTICIPANTS From January 2003 to December 2005 , 611 patients underwent clinical and urodynamic evaluation before surgical treatment for SUI . Patients with advanced urogenital prolapse ( pelvic organ prolapse-quantification scale [ POP-Q ] scale grade > 1 ) were excluded , and 537 patients were included in this study . After 18 mo , 398 women were available for follow-up efficacy evaluation at a tertiary academic center . INTERVENTION All patients underwent either a retropubic sling procedure or a transobturator sling procedure . Patients were r and omly allocated into two study groups at a ratio of 1:1 . MEASUREMENTS After 18 mo all enrolled patients were clinical ly checked for clinical efficacy of both procedures . RESULTS AND LIMITATIONS Demographic and urodynamic parameters of patients were similar in both groups . No bladder injury occurred in the transobturator sling group ( IVS-04 ) , whereas 13 intraoperational bladder perforations ( 6.5 % ) occurred in the retropubic sling group ( IVS-02 ) ( p<0.001 ) . The tape erosion rate was < 2.5 % in both groups ( p=0.7 ) . After 18 mo , 398 patients ( 201 in the IVS-02 group and 197 in the IVS-04 group ) were evaluated in terms of clinical efficacy of the procedures . We found out that there was no statistically significant difference in clinical efficacy between these two procedures ( chi(2)=1.88 , p=0.39 ) . In the IVS-02 group , 75.1 % of patients ( n=151 ) remained dry ( cured ) , 16.9 % of patients ( n=34 ) reported significant improvement , and 8.0 % of patients ( n=16 ) were considered as failures . In the IVS-04 group , 74.1 % of patients ( n=146 ) remained dry , 14.2 % of patients ( n=28 ) reported significant improvement , and 11.7 % ( n=23 ) were considered as failures . CONCLUSIONS Based on an 18-mo follow-up , the efficacies of both techniques are comparable ; however , the retropubic route appears to be more efficient in the intrinsic sphincter deficiency ( ISD ) group BACKGROUND Data about the use of tension-free vaginal tape ( TVT ) in the management of recurrent urodynamic stress incontinence ( R 
    Output:
    
Concluding , preoperative MUCP and VLPP could be used as predictors for postoperative outcome after mid-urethral sling surgery for SUI