The SISTER trial compared Burch colposuspension to autologous fascia lata pubovaginal sling for stress urinary incontinence. What was the key finding at 2-year follow-up?
- A Burch colposuspension had superior overall success rates
- B Both procedures had equivalent success rates with equivalent adverse events
- C Pubovaginal sling had higher overall success but more voiding dysfunction and urge incontinence ✓
- D Mid-urethral sling was superior to both procedures in this trial
Correct answer: C. Pubovaginal sling had higher overall success but more voiding dysfunction and urge incontinence
Explanation
The SISTER trial (Albo et al., NEJM 2007) compared autologous fascia pubovaginal sling to Burch colposuspension and found the fascial sling had a higher overall success rate (66% vs 49%) at 2 years. However, the sling group had significantly more urge urinary incontinence, urinary tract infections, and voiding dysfunction requiring catheterization. Mid-urethral slings (TVT/TOT) were not included — SISTER predated their widespread adoption. The sling advantage in objective success came at the cost of greater morbidity.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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