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RCOG/BSUG statement on the Cochrane review of mid-urethral sling operations

News 1 July 2015

The new Cochrane systematic review ‘Mid-urethral sling operations for stress urinary incontinence in women (Review)’ published today (1 July 2015) has found that mid-urethral slings (tapes) to treat stress urinary incontinence (SUI) have been shown to be effective with low complication rates both immediately and up to five years.

The authors recommend that their findings are used to counsel women on the risks and benefits of these surgical operations, including the use of less invasive procedures as the first form of treatment where appropriate.

Both the Royal College of Obstetricians and Gynaecologists (RCOG) and British Society of Urogynaecology (BSUG) are aware of the problems that some patients have reported and have communicated to our members the safeguards needed to ensure high quality care.

These include

  • The standardisation of consent processes so that all patients are informed of potential side effects from these procedures
  • The development of a national registry so that all forms of urogynaecological surgery are recorded
  • The reporting of all mesh complications resulting from pelvic organ prolapse (POP) and SUI surgery to the MHRA
  • Only suitably trained and qualified gynaecologists and urological surgeons should perform these operations

Additionally, we are working with NHS England, the British Association of Urological Surgeons (BAUS) and colleagues in the devolved nations on establishing accredited NHS centres for the removal of mesh for SUI and POP. In the short to medium term, care should be organised via specialist commissioning.

This will enable the monitoring and audit of outcomes in the NHS. It will also enable better multidisciplinary team working between qualified urogynaecologists, urologists, colorectal surgeons and pain management services.

Reference

Ford AA, Rogerson L, Cody JD, Ogah J. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD006375. DOI: 10.1002/14651858.CD006375.pub3.

An editorial to accompany the publication of the review has also been published.
Cathryn MA Glazener. What is the role of mid-urethral slings in the management of stress incontinence in women? [editorial]. Cochrane Database of Systematic Reviews 2015;(7): 10.1002/14651858.ED000101 

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