The SISTER trial compared Burch colposuspension with pubovaginal sling for stress urinary incontinence. At 2-year follow-up, the primary outcome of complete continence showed which result?
- A Burch colposuspension had superior success rates (85% vs 78%)
- B Pubovaginal sling had higher success rate (66% vs 49%) but more adverse events ✓
- C Both procedures had equivalent success rates (~70%)
- D Pubovaginal sling was superior only in older women (> 60 years)
Correct answer: B. Pubovaginal sling had higher success rate (66% vs 49%) but more adverse events
Explanation
The SISTER trial (Stress Incontinence Surgical Treatment Efficacy Trial) found that pubovaginal sling had significantly higher overall success rates at 2 years (66.2% vs 48.6%) compared to Burch colposuspension. However, the sling group had higher rates of adverse events including urinary tract infections, difficulty voiding, and urge incontinence. This informed practice toward mid-urethral slings (TVT/TOT) as a less morbid option with similar or better efficacy.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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