Midurethral-sling surgery resulted in significantly better outcomes at 12 months than did physiotherapy.
Treatment options for stress urinary incontinence consist of pelvic-floor muscle training (physiotherapy) and/or surgery; however, success rates vary for both approaches and direct comparisons have been limited. Dutch investigators conducted a 12-month, multicenter, randomized trial to compare physiotherapy with midurethral-sling surgery (retropubic or transobturator polypropylene tape) for moderate-to-severe stress-predominant urinary incontinence in 417 women. Crossing over between groups was permitted.
Among women in the surgery group, rates of subjective improvement (91%), subjective cure (85%), and objective cure (76%) were significantly higher than in the women initially assigned to physiotherapy (subjective improvement, 64%; subjectiv…