***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 
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    Input: OBJECTIVE To compare peri-operative complications , pain , and the immediate functional results of the sub-urethral sling procedure for urinary stress incontinence by the retropublic and transobturator routes , using a non-elastic polypropylene sub-urethral sling . PATIENTS AND METHODS This prospect i ve , multicentre study involved 88 women undergoing the sub-urethral sling procedure for stress urinary incontinence ( SUI ) . The retropubic route ( RPR ) and the transobturator route ( TOR ) were used in respectively 42 and 46 cases . The characteristics of the women in the RPR and TOR groups were as follows : mean age ( + /-st and ard deviation ) 56.8+/-12 years and 53.4+/-10 years , respectively ; mean BMI : 25+/-4 and 26+/-4 ; mean parity : 2.1+/-0.9 and 2+/-1 children ; post-menopausal status : 66.7 % and 58.7 % ; prior surgery for SUI : 7.1 % and 6.5 % ; and prior hysterectomy : 21.4 % and 26.1 % . None of these characteristics differed significantly between the groups . Likewise , pre-operative urinary functional status ( SUI stage , and pollakiuria , nocturia and urgency rates ) was similar in the two groups . RESULTS Mean hospital stay and overall morbidity rate were not significantly different between the RPR and TOR groups . Mean operating time was longer in the RPR group . Bladder injury was significantly more frequent in the RPR group and vaginal injury was significantly more frequent in the TOR group . Pain scores were significantly lower in the TOR group . The objective functional results at one month did not differ between the groups . Quality of life , evaluated with question naires and numerical rating scales , was similarly improved in the two groups . DISCUSSION The suburethral sling procedure was less painful by the TOR route than by the RPR route . Bladder injury , haematomas and abscesses were only observed in the RPR group , while vaginal injury only occurred in the TOR group . The immediate functional results of the two approaches were similar Introduction and hypothesisThis study aims to analyze comparatively the efficacy and safety of synthetic transobturatory and aponeurotic retropubic slings , in the treatment of stress urinary incontinence ( SUI ) in women . Methods Patients were separated in a r and omized way . Twenty-one patients were su bmi tted to the operatory correction by the transobturatory sling technique , whereas 20 patients were operated by the retropubic sling technique . All patients were su bmi tted to complete physical exam and urodynamic test . The “ T ” test and the Mann – Whitney U test were applied to establish comparisons between the two groups . Patients were followed-up for 12 months . Results Healing rate was 90.5 % ( 19/21 ) and 95 % ( 19/20 ) , respectively after 12 months . The transobturatory group presented lesser complications rate than the retropubic group . Conclusions The transobturatory and the aponeurotic slings techniques were equally effective for the treatment of SUI . The transobturatory sling has shown fewer complications and lesser surgical time than the aponeurotic sling technique Introduction and hypothesisThe aim of this study is to compare a modified inside-out transobturator procedure with its original counterpart [ inside-out transobturator ( TVT-O ) ] for the treatment of female stress urinary incontinence ( SUI ) . Methods A prospect i ve , r and omized trial in women suffering from SUI was used . The modified procedure consisted of a shorter tape whilst the scissors or guide no longer perforated the obturator membrane . The primary outcome was the resolution of subjective and objective SUI at 1 year . Secondary outcome measures included adverse events , quality of life measures , and groin pain . Results One hundred seventy-five patients were r and omized . No intraoperative complications were recorded . The SUI cure rate was 91.7 % versus 90.7 % ( original versus modified , respectively ; p = 0.824 ) . Incidence and intensity of groin pain was higher in the original TVT-O group on day 0 and 1 ( p < 0.05 ) , requiring more analgesics ( p = 0.015 ) but not thereafter . Conclusions At 1 year follow-up , the modified inside-out transobturator tape procedure was as efficient and safe as the original technique but associated with less immediate postoperative groin pain OBJECTIVE The purpose of this study was to prospect ively and r and omly compare tension-free vaginal tape ( TVT ) with transobturator suburethral tape ( T.O.T. ) for the surgical treatment of stress urinary incontinence ( SUI ) in women . STUDY DESIGN Sixty-one women with SUI were r and omly assigned to either TVT ( n=31 ) or T.O.T. ( n=30 ) . The preoperative evaluation included a quality -of-life question naire and a comprehensive urodynamic examination . The 1-year outcome included a detrusor pressure-uroflow study to compare bladder outlet obstruction . RESULTS Patient characteristics , preoperative quality of life , and urodynamic evaluation were similar in the 2 groups . Mean operative time was significantly shorter in the T.O.T. group ( 15 min+/-4 vs 27 min+/-8 , P<.001 ) . No bladder injury occurred in the T.O.T. group versus 9.7 % ( n=3 ) in the TVT group ( P>.05 ) . The rate of postoperative urinary retention was 25.8 % ( n=8 ) in the TVT group versus 13.3 % ( n=4 ) in the T.O.T. group ( P>.05 ) . The rates of cure ( 83.9 % vs 90 % ) , improvement ( 9.7 % vs 3.3 % ) , and failure ( 6.5 % vs 6.7 % ) were similar for the TVT and T.O.T. groups , respectively . The 1-year outcome data were collected in 29 women of the TVT group and 27 women of the T.O.T. group . No vaginal erosion occurred in either of the groups . In terms of bladder outlet obstruction , no differences were found after TVT and T.O.T. CONCLUSION T.O.T. appears to be equally efficient as TVT for surgical treatment of stress urinary incontinence in women , with no reduction of bladder outlet obstruction at 1-year follow-up The purpose of our study was to compare the two st and ard routes of urethral bulking injection in a prospect i ve r and omized trial . Forty women with genuine stress incontinence ( n=36 ) , or mixed incontinence with a minor and controlled urge component ( n=4 ) , participated in a urethral bulking agent trial . All patients had a st and ardized preoperative evaluation which included history , physical examination , assignment of incontinence status on a Stamey grading scale , postvoid residual ( PVR ) determination , Valsalva leak-point pressure , maximal urethral closure pressure , functional urethral length , Q-tip excursion angle , quantitative pad test , and completion of a quality of life question naire . On the day of injection they were r and omly assigned to a periurethral or transurethral route of injection based on a computer-generated block r and omization scheme . An ultrasound-determined PVR was obtained on all patients after injection . If self-catheterization was necessary , and the PVR was > 200 ml , urinary retention was diagnosed . Postoperative assessment included a patient interview , subjective assessment of improvement , PVR , voiding diary , and assignment of incontinence grade . At the screening visit there were no significant differences between the groups for any variables except type of stress incontinence . With short-term follow-up both transurethral and periurethral routes of injection seem to be equally efficacious . In the periurethral injection group there was a higher rate of postoperative retention ; this group had a significantly higher volume of injectable agent used . There was no significant difference in risk of urinary tract infections between the two groups . We conclude that both periurethral and transurethral methods of bulking agent injection for stress urinary incontinence are equally efficacious , with minimal morbidity OBJECTIVE The treatment of women with mixed urinary incontinence still poses a great challenge . This study evaluated surgical outcomes of combined trans-obturator tension-free vaginal tape ( TVT-O ) and modified Ingelman-Sundberg ( IS ) procedure for the treatment of mixed urinary incontinence . METHODS A r and omized controlled trial was conducted . Ninety-six women diagnosed with mixed incontinence were r and omized , with 49 allocated to TVT-O plus IS  and 47 to TVT-O alone . A baseline urodynamic study and evaluation of quality of life ( QOL ) was conducted . The primary outcome measure was objective assessment of surgical outcomes , and the secondary outcome measure was warning time . RESULTS Objective surgical response rate was significantly higher in the TVT-O plus IS group than in the TVT-O alone group ( 84.8 % vs. 62.8 % ; p=0.019 ) . Furthermore , a significant increase in warning time was observed in the TVT-O plus IS group ( from 3.9 to 9.4 min ; p=0.006 ) , but the increase in warning time within the TVT-O alone group was not statistically significant ( from 4.3 to 4.5 min ; p=0.695 ) . Postoperative complications were similar in the two study groups with respect to pelvic hematoma , nerve injury , sepsis , mesh erosion , and fistula formation . However , fever occurred more frequently in the TVT-O plus IS group ( 30.4 % vs. 20.9 % ; p=0.026 ) . CONCLUSIONS Mixed urinary incontinence can potentially be treated with a one-step combined surgery using trans-obturator sling plus modified IS procedure . Although surgical time and blood loss were significantly increased in the TVT-O plus IS group , overall morbidity was not significantly increased The aim of this study was to prospect ively compare the efficacy and safety of ‘ inside – out ’ ( TVT-O ) and ‘ outside – in ’ ( TOT ) transobturator tape procedures for treatment of female stress urinary incontinence ( SUI ) . One hundred women with SUI were alternately assigned to TVT-O ( n = 50 ) or TOT ( n = 50 ) . About 1 year after surgery , we compared surgical outcomes in the two groups . TVT-O and TOT showed similar rates of cure ( 86 vs 92 % ) . Approximately 1 year after surgery , Incontinence Quality of Life question naire parameters improved significantly in both groups ( p < 0.05 ) , but the two groups did not differ ( p > 0.05 ) . The rates of patient satisfaction with TVT-O and TOT ( 96 vs 98 % ) were similar . These preliminary results suggest that TVT-O and TOT are equally effective and safe procedures for women with SUI . However , this study was unable to identify a difference between the two procedures due to the underpowered nature of the study 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 Our objective was to compare monofilament and multifilament tapes positioned without tension at the midurethra for postoperative complications and cure rate .  One hundred patients with stress urinary incontinence were r and omly allocated into two study groups . Using identical surgical methodology , 50 patients had a monofilament tape inserted at the midurethra using the TVT delivery instrument , and another 50 a multifilament tape using the IVS delivery instrument . The only significant difference between the groups was in the incidence of postoperative urinary retention ( p=0.023 ) . Ten patients from the monofilament group required longer than normal ( ‘ normal ’ means to the morning of the next day ) catheterization , in contrast to only two from the multifilament group . The clinical efficacy of both procedures was equally high . Conclusions were that both tapes appear to be equally effective in the surgical treatment of SUI . The higher incidence of postoperative urinary retention in the monofilament group was most likely caused by the elastic feature of this tape OBJECTIVES The aim of this study was to compare the long-term success rates , complication rates and patient satisfaction rates for Pelvicol pubovaginal sling ( Bard ) versus TVT ( Gynecare ) in surgical treatment of urodynamic stress incontinence ( USI ) in women . DESIGN Prospect i ve r and omized cohort trial . SETTING District General Hospital , South West of Engl and . METHODS One hundred and forty-two women with urodynamic stress incontinence were r and omized to either surgical procedure ( Pelvicol = 74 , TVT = 68 ) with median follow-up of 36 month . A postal question naire was sent to all 
    Output:
    
This meta- analysis shows no evidence of a significant difference in patient-reported and objective cure/improvement rates between RP-TVT and TO-TVT in the surgical treatment of women with R-SUI .