***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 Objective : To compare tension-free vaginal tape with colposuspension as primary treatment for stress incontinence .  Design : Multicentred r and omised comparative trial . Setting : Gynaecology or urology departments in 14 centres in the United Kingdom and Eire , including university teaching hospitals and district general hospitals . Participants : 344 women with urodynamic stress incontinence ; 175 r and omised to tension-free vaginal tape and 169 to colposuspension  Main outcome measures : Assessment before treatment and at six months postoperatively with the SF-36 , the Bristol female lower urinary tract symptoms question naire , the EQ-5D health question naire , a one week urinary diary , one hour perineal pad test , cystometry , and , in some centres , urethral profilometry . Results : 23 women in the colposuspension group and 5 in the vaginal tape group withdrew before surgery . No significant difference was found between the groups for cure rates : 115 ( 66 % ) women in the vaginal tape group and 97 ( 57 % ) in the colposuspension group were objective ly cured ( 95 % confidence interval for difference in cure −4.7 % to 21.3 % ) . Bladder injury was more common during the vaginal tape procedure ; postoperative complications , in particular delayed resumption of micturition , were more common after colposuspension . Operation time , duration of hospital stay , and return to normal activity were all longer after colposuspension than after the vaginal tape procedure . Conclusion : Surgery with tension-free vaginal tape is associated with more operative complications than colposuspension , but colposuspension is associated with more postoperative complications and longer recovery .  Vaginal tape shows promise for the treatment of urodynamic stress incontinence because of minimal access and rapid recovery times ; cure rates at six months were comparable with colposuspension . What is already known on this topic Few r and omised trials exist on surgery for stress incontinence Systematic review s suggest that colposuspension is associated with cure rates of up to 90 % Case series of tension-free vaginal tape suggest cure rates of about 85 % , with rapid return to normal activity What this study adds At six months the tension-free vaginal tape procedure is as effective as colposuspension for the primary treatment of stress incontinence Operative complications were more common with vaginal tape , but duration of hospital stay and return to normal activity were shorter than with colposuspension  Postoperative complications were more common after OBJECTIVE Objective of the study was to compare the efficacy and the complications of tension-free vaginal tape ( TVT ) and Burch colposuspension in the treatment of female genuine stress incontinence ( GSI ) . METHODS In this controlled , prospect i ve , r and omized study , participated 35 patients who underwent Burch colposuspension and 36 patients that underwent TVT procedure . Patients with prolapse more than first degree , previous surgical treatment of stress urinary incontinence ( SUI ) and detrusor instability were excluded from the study . RESULTS The operative time for TVT was significantly shorter compared to BC . The severity and duration of postoperative pain for TVT was significantly less compared to BC . The necessary time for return to normal activity was 10 days for TVT and 21 days for BC . The cure rate after 24 months of follow-up was as follows : TVT : 84 % and BC : 86 % , while the improvement was 7 % for TVT and 6 % for BC . CONCLUSIONS TVT and Burch colposuspension are equally effective in the management of female GSI at two years follow-up . TVT procedure requires much less operative time , has much shorter hospitalization time , with significantly less postoperative pain and faster return to normal daily activities than Burch colposuspension OBJECTIVE The aim of this study was to compare a modified Burch procedure with a suburethral sling for the treatment of stress incontinence complicated by a low-pressure urethra . STUDY DESIGN Thirty-six women with stress incontinence , low-pressure urethra , and urethral hypermobility ( straining cotton swab angle > /=30 degrees ) were r and omly assigned to undergo either a modified Burch procedure ( n = 19 ) or a suburethral sling ( n = 17 ) . Objective and subjective cure rates at 3 months after the operation were the primary outcome measures . Comparisons of group means were performed with the Student t test for independent groups , and proportions were compared with the Fisher exact test . RESULTS After the operation the 2 groups had statistically similar cure rates and voiding function . Urethral closure pressure , pressure transmission ratios , and maximum detrusor pressure during voiding were significantly higher in the sling group . CONCLUSION At 3 months there were no clinical ly significant differences between the groups treated with suburethral sling and modified Burch procedures Objective To determine the sensitivity and specificity of several urodynamic testing methods in the diagnosis of genuine stress urinary incontinence ( GSI ) . Methods One hundred eight consecutive patients were evaluated prospect ively by history and physical examination , cough stress test , and single and multichannel urodynamics . Sensitivities and specificities in detecting genuine stress incontinence were calculated for : a positive cough stress test with a negative cystometrogram , equalization throughout a cough urethral pressure profile , a positive stress leak-point pressure determination , observed urine loss with cough during multichannel urodynamics , and a pressure transmission ratio of less than 90 % for each third of the urethra . Results Sixty-five patients ( 60 % ) were found to have GSI .  Observed urine loss with cough during multichannel studies was 91 % sensitive and 100 % specific . A positive stress leak-point pressure determination had a 78 % sensitivity and was 100 % specific . A positive cough stress test with a negative cystometrogram was 77 % sensitive and 100 % specific . Pressure equalization throughout the length of the urethra during a cough urethral pressure profile was 49 % sensitive and 98 % specific . A pressure transmission ratio of less than 90 % in the distal , middle , and proximal urethra had sensitivities and specificities of 54 and 79 % , 51 and 65 % , and 45 and 58 % , respectively . A pressure transmission ratio of less than 90 % along the entire length of the urethra was 22 % sensitive and 93 % specific . Conclusion Observed urine loss with cough during multichannel urodynamics was the best examination for diagnosing GSI in our population Abstract We compared morbidity and success rate of pubovaginal sling with Burch colposuspension operations in Type I/type II genuine stress urinary incontinence ( GSI ) . The study included patients who had no preoperative detrusor instability ( DI ) , no recurrent GSI , no severe pelvic prolapsus and whose Valsalva leak point pressure ( VLPP ) values were higher than 90 cm water . Twenty three of free-rectus fascial sling and 23 of Burch colposuspension operations were performed r and omly on the patients by a single surgeon . There was no statistical difference between patients in terms of age , BMI , parity , number of daily pads used and preoperative bladder neck mobility . Operation time , change in hematocrit , spontaneous voiding time , length of hospitalization and urinary infection were not different in 2 procedures . 17 patients from both groups could be compared after one year . The bladder neck mobility of both groups were similar . One surgical failure , 1 DI , 1 severe cystocele and 1 enterocele were found in the Burch group while only 1 DI was found in the pubovaginal sling group . When pubovaginal sling operation was performed as the primary surgery on the patients with type I/II GSI , the morbidity , complications and 1 year success rate are the same as Burch procedure Objective To assess the effectiveness and late postoperative morbidity of the Burch procedure and the sling procedure for the treatment of recurrent urinary stress incontinence after vaginal hysterectomy and anterior repair . Methods Clinical , urodynamic , and sonographic examinations were done on 77 women suffering with recurrent urinary stress incontinence . The women were r and omized to two groups , modified Burch colposuspension and lyophilized dura mater sling surgery ;  72 women were reexamined 32–48 months after these procedures . Results The cure rate at 32–48 months ' follow-up was 86 % for the Burch procedure and 92 % for the sling . Women who had had the sling procedure demonstrated a clear decrease in maximal bladder capacity , from 330 to 240 mL ( P < .05 ) . In both groups , stress profiles demonstrated a shift of maximal pressure point toward the proximal urethra and a significant improvement in pressure transmission ( P < .05 ) . The post-operative patients who had persistent incontinence were found to have insufficient elevation of the bladder neck ( less than 10 mm ) . The uroflow examination showed an increase of urination time in both groups . The incidence of bladder problems was 10 % with the Burch procedure and 29 % with the sling procedure ; however , 13 % of the Burch group developed rectoceles . Conclusion Both procedures offer a high rate of success . We believe that the sling surgery should be used only in certain special cases because of its higher rate of complications , but that posterior vaginal repair should be considered after modified Burch colposuspension because of the possibility of rectocele and enterocele OBJECTIVE To determine the method ological quality of studies evaluating surgery for stress incontinence , the effectiveness of different procedures and the frequency of complications associated with each procedure . MATERIAL S AND METHODS Eleven r and omized controlled trials , 20 non-r and omized trials/ prospect i ve cohort studies and 45 retrospective cohort studies were review ed systematic ally . RESULTS The method ological quality of the 31 prospect i ve studies was generally poor . The considerable variation in inclusion criteria , surgical management and assessment of outcome precluded any statistical meta- analysis . Evidence as to the effectiveness of surgery for stress incontinence is weak ; therefore , any conclusions are speculative . It appears that colposuspension may be more effective and the effect more long-lasting than that following anterior colporrhaphy and needle suspension . There is little information on the value of sling procedures . Comparisons of different ways of performing each procedure show no significant differences in outcome but this may reflect the method ological weaknesses of the studies . Valid and reliable data on the frequency of complications following surgery are lacking so the safety of the procedures is unclear . Repeat operations to correct stress incontinence are less successful than first procedures but this finding may be subject to confounding . CONCLUSIONS There is an urgent need for some large , rigorous , prospect i ve studies of high quality . Until such studies have been completed , recommendations as to the best clinical practice can not be based on scientific evidence . Studies need to define cases according to widely accepted criteria , including st and ard measures of the severity of stress incontinence , and surgical terminology for the procedures performed needs to be st and ardized and outcomes need to be clearly defined , valid and reliable , not confined to short-term assessment and include patients ' views along with the surgeon 's assessment It is difficult to make a choice among the many surgical procedures design ed for the correction of stress urinary incontinence by the vaginal route because their results have not been correctly compared . The Bologna ( B ) operation uses two flaps from the anterior vaginal wall that are anchored to the abdominal wall ; the Ingelman-Sundberg ( IS ) operation is a suburethral sling made from two transplants from the pubococcygeus muscle . A prospect i ve r and omized study has been carried out in order to compare these two procedures . A selection of cases has been based upon the presence of genuine or potential stress incontinence , genital prolapse and available tissues ( anterior vaginal wall excess and palpable pubococcygeus muscles ) for both procedures . No significant difference was noted for clinical results ( 91.7 % and 93.7 % of patients cured by the B and IS operations , respectively ) or for transmission rate gain at 3 months and 1 year . Maximum urethral closing pressure was maintained in both treatment arms . No significant postoperative complication or persistent dysuria occurred . The Bologna procedure is best indicated in case of frank anterior vaginal excess , and the Ingelman-Sundberg procedure when strong anterior parts of pubococcygeus muscles are available . Both are excellent in the cure of stress incontinence associated with genital prolapse OBJECTIVE Our purpose was to evaluate and compare the long-term results of the Bologna and the Ingelman-Sundberg procedures for the treatment of stress urinary incontinence in women with genital prolapse . PATIENTS AND METHODS Forty-seven women underwent surgery at the gynecologic division at Dunkirk Hospital , France between January 1989 and August 1990 . All patients presented a genital prolapse with a cystocele of at least degree 2 associated with urinary stress incontinence . The subjects were r and omly allocated to one of the two procedures . In the clinical incontinence group ( 28 patients ) , 12 procedures were Bologna operations and 16 were Ingelman-Sundberg operations . In the potential incontinence group ( 19 patients ) , 11 procedures were Bologna operations and 8 were Ingelman-Sundberg operations .  Physical examination and urodynamic explorations  were performed preoperatively , and 3 months and 1 year postoperatively . A question naire was sent to all participating women during the tenth year of follow-up . We obtained 46 answers . RESULTS Mean follow-up was 9.7 years . The result of the 1-year postoperative evaluation has been previously published . 
    Output:
    
There is not enough evidence on which to judge whether suburethral slings are better or worse than other surgical or non surgical managements