Incontinence Op 'Relatively Safe'

A large-scale review of controversial surgery for stress urinary incontinence (SUI), a common condition which affects around 170,000 women in the UK, shows it has been found to be relatively safe'' health experts have said.

Some of those who have received the procedure suffered painful and debilitating complications, with reports of women suffering internal lacerations that have made their quality of life worse than it was before.

The problems led Scottish Health Secretary Shona Robison to ask health boards to suspend the operation until an independent inquiry has been published, while court action is being taken in the UK, the United States and Canada.

A Cochrane review published today found that the procedure, which involves inserting a mesh sling to support the muscles of the bladder by either the groin or abdomen, results in similar cure rates of 70%-80%.

The groin procedure, known as transobturator insertion, carried a lower risk of bladder damage during the operation with around six women in 1,000 experiencing this compared with 50 in 1,000 who had the abdomen procedure, known as the retropubic route.

But the analysis of 81 trials found that the transobturator operation led to more short-term groin pain and there was some evidence that women who had it were more likely to need a repeat operation later.

Professor Cathryn Glazener of the University of Aberdeen, who has carried out previous research on the surgery and is part of the independent review, said: Overall the operations have been found to be relatively safe and relatively effective.''

She added this would suggest these operations would or should be available to women given choice and adequate information about it''.

Lead author Dr Abigail Ford, from Bradford Teaching Hospitals NHS Foundation Trust, said: This is a very significant review informing women about the minimally invasive surgical options available for the treatment of this very debilitating condition.

It helps to clarify the pre-existing evidence on the effectiveness of these approaches and their side-effects in the short term, as well as introducing longer term evidence of efficacy and safety.

It helps to give women more information to make an informed choice.''

The independent review is due to be published in the autumn, with today's findings forming part of it.