***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: Abstract Objectives : To present the first experience in Iraq of autologous rectus fascia sling ( RFS ) procedures and transobturator tape ( TOT ) for treating female stress urinary incontinence ( SUI ) , and to review the validity of the RFS in the era of synthetic tapes . Patients and methods : From December 2004 to July 2012 , 80 female patients with SUI were enrolled in the study , and r and omly assigned into two types of surgery , with 40 treated by RFS ( retropubic route ) and 40 by TOT . The surgical results were compared between the groups and with those from previous studies . Results : The mean operative duration was 80 min for RFS vs. 20 min for TOT . The early cure rate was 98 % for RFS ( with one failure due to prolonged urinary retention ) and 95 % for TOT ( with two failures due to persistent incontinence ) . The early complications were mainly abdominal wound problems ( 20 % ) for RFS , and groin and upper thigh pain ( 13 % ) for TOT . The late complications were the development of postvoid residual urine ( 8 % in RFS vs. 5 % in TOT ) and de novo detrusor overactivity ( 5 % in each group ) . There were no vaginal or urethral erosions up to the end of the study . Conclusions : RFS and TOT have comparable efficacy and safety in treating SUI . Nevertheless RFS , with its more invasive nature and long operative duration , should only be used when synthetic tapes are not available or not preferable Introduction and hypothesisSynthetic mid-urethral slings are currently considered the treatment of choice for stress urinary incontinence ( SUI ) . In this study , two types of slings are compared : TVT vs. TOT . Methods In a prospect i ve r and omized study , 40 patients underwent either TVT ( 19 patients ) or TOT ( 21 patients ) .  Stress-specific and overall success was evaluated . Perioperative complications were classified according to Clavien ’s classification . Results Mean duration of follow-up was 20 months . At last follow-up , stress-specific success rate was 94.6 % in TVT vs. 81 % in TOT . No significant difference was detected in terms of post-void residual urine , symptom score , and filling and voiding parameters . Thigh pain represented the main complication in the TOT group . Conclusions Both TVT and TOT are effective procedures for treatment of SUI . When compared to each other , TOT seems to be inferior to TVT in terms of efficacy , causing less serious complications 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 Purpose To evaluate in a comprehensive way TVT in comparison with TOT , the results of a single-center RCT are presented . Many studies addressed efficacy and safety of TVT and TOT . Methods Women included were adults having predominant SUI with positive stress test . They were r and omized to get either TVT ( Gynecare ® ) or TOT ( Aris ® ) . All women were seen 1 week , 3 , 6 , 12 , 18 , and 24 months . Results Seventy-one women completed 2-year follow-up . Median age was 47 ( range 33–60 years ) . Mean ± SD BMI in TVT group was 34 ± 5 while in TOT group was 32 ± 5 kg/m2 . POP of any degree was seen in 50 % ( 35 women ) . At 1 year , pad test – negative women were 31 and 29 for TVT and TOT , respectively . At 2 years , figures became 28 in TVT group and 27 in TOT . At 1 year , UDI 6 and IIQ 7 decreased by 78.5 and 81 % for TVT and by 69 % and 75 % for TOT group . At 2 year , comparable percentages were 73 and 79 % for TVT and 69 and 82 % for TOT . Fifteen unique patients had adverse events , 10 of them had TOT . Conclusions Both tapes have similar efficacy , regarding cure of incontinence . TVT is more effective , albeit insignificantly , than TOT at 2 years . However , serious adverse events were more frequent with TVT , yet TOT has more unique adverse events Purpose Transobturator approaches to midurethral sling surgery are one of the most commonly performed operations for female stress urinary incontinence throughout the world . However , very few results of r and omized clinical trials of transobturator midurethral sling surgery ( MONARC vs. TVT-O ) for the treatment of female urinary incontinence have been reported . In this study , we compared the 3-year follow-up cure rates of these two procedures . Material s and Methods From July 2006 to June 2008 , 74 patients who had undergone MONARC ( 35 patients ) or TVT-O ( 39 patients ) were included in the study and were analyzed prospect ively . The mean follow-up duration of both groups was 39.2 months . Preoperative and postoperative evaluations included physical examination , uroflowmetry and postvoid residual measurement , involuntary urine loss with physical activity , and urinary symptoms . Cure of female urinary incontinence was defined as patient report of no loss of urine upon physical activity . The patients ' satisfaction after treatment was rated as very satisfied , satisfied , equivocal , and unsatisfied . Very satisfied and satisfied were considered as the satisfied rate . Results There were no significant differences in preoperative patient characteristics , postoperative complications , or success rate between the two groups . The cure rate of the MONARC and TVT-O groups was 85.7 % and 84.6 % , respectively . The patient satisfaction ( very satisfied , satisfied ) rate of the MONARC and TVT-O groups was 82.8 % and 82.1 % , respectively . Conclusions The MONARC and TVT-O procedures were equally efficient for the treatment of female urinary incontinence , with maintenance of high cure rates for 3 years . Longer follow-up is needed to confirm these results Introduction and hypothesisA prospect i ve study comparing the effect of the tension-free vaginal tape ( TVT ) to the Monarc sling on sexual function in women with urodynamic stress incontinence ( USI ) and intrinsic sphincter deficiency ( ISD ) is presented . Methods Eighty-seven sexually active women with USI and ISD were enrolled . Sexual function was assessed pre-operatively and at 6 and 12 months post-operatively by history , PISQ-12 , UDI-6 and IIQ-7 question naires . Results A significant increase was detected in PISQ-12 score following both TVT and Monarc insertion . This score was greater in the TVT group at 6 months but not at 12 months when compared to the Monarc group . A significant decrease in UDI-6 and IIQ-7 score was detected . Specifically , coital incontinence and fear of leakage were reduced in both groups , and no change in dyspareunia or orgasm intensity was found . Conclusions Sexual function improves 6 months after TVT or Monarc sling , and this benefit is maintained at 12 months BACKGROUND Many studies have assessed the equivalent effectiveness of tension-free vaginal tape ( TVT ) and transobturator suburethral tape ( TVT-O ) at short- to medium-term follow-up , but no long-term r and omised trials appear in the literature . OBJECTIVE We compared the use of TVT to TVT-O , providing a longer follow-up than currently appears in the literature . DESIGN , SETTING , AND PARTICIPANTS Seventy-two consecutive patients affected by stress urinary incontinence ( SUI ) were included in this r and omised , controlled trial . Patients were r and omly allocated to the TVT or TVT-O procedure using a predetermined , computer-generated r and omisation code . INTERVENTION After preoperative assessment , patients were r and omly allocated to the TVT or TVT-O procedure . MEASUREMENTS This 5-yr study represents the extension of our original r and omised trial , which was design ed to assess the incidence of long-term complications ( primary end point ) and successes ( secondary end point ) for both techniques . RESULTS AND LIMITATIONS At 60-mo follow-up , 52 patients ( 72 % ) were objective ly cured of SUI ( 72.9 % after TVT-O and 71.4 % after TVT ) , but only 44 patients ( 61 % ) were satisfied . The late complication rate was 16.6 % ( 10 women ) : five women ( 16.1 % ) in the TVT-O group and five women ( 17.2 % ) in the TVT group ( p=1 ) . In this follow-up , 62 % of the patients from the TVT-O group and 60 % from the TVT group ( p=1 ) expressed that they were satisfied or very satisfied with the results . The mean cause of dissatisfaction was the development of sexual dysfunction result ing from dyspareunia or incontinence during intercourse , which was found in 6 of 16 dissatisfied patients ( 37.5 % ) . The limitations of our study included the adequate but small sample size and the lack of question naires . CONCLUSIONS Both surgical techniques are safe , with similar results ( 72.9 % and 71 % of patients objective ly cured after TVT-O and TVT , respectively ) and low complication rates ( 16.6 % : 16.1 % and 17.2 % , respectively , for TVT-0 and TVT ) , even after 5-yr follow-up Purpose To evaluate long-term ( over 4 years ) functional outcomes and quality of life of transobturator ( TOR ) and retropubic ( RPR ) routes in the cure of stress urinary incontinence ( SUI ) . Methods Prospect i ve , r and omized multicentre study involving 88 women with SUI from March 2004 to May 2005 ( RPR group ( n = 42 ) , TOR group ( n = 46 ) ) .  Long-term functional results and quality of life were evaluated using vali date d question naires and compared with those observed at the first year . Results Eight patients ( 19 % ) in the RPR group and 9 patients ( 19.5 % ) in the TOR group were lost to follow-up ( NS ) . The mean follow-up in the RPR and the TOR groups was 52.7 months and 53.1 months , respectively . In intention to treat , the success rate at 4 years was 64.3 % in the RPR group and 69.5 % in the TOR group ( NS ) . At 4 years , no significant differences in the IIQ scores were observed in either group compared to the preoperative scores with no difference between the groups ( RPR group : 32 vs. 14.9 ( NS ) , TOR group : 25.7 vs. 21.4 ( NS ) ) . Compared to 1 year UDIQ and IIQ scores , a 
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The present analysis confirms the superiority of MUS over Burch colposuspension .
The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding lower urinary tract symptoms .
Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar , although the risk of vaginal perforation was lower in the inside-to-out TO-TVT .
PATIENT SUMMARY Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence .
The available literature suggest that those slings are either more effective or safer than other older surgical procedures .
Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra- and postoperative complications