PFDN Landmark Trials — Visual Abstract Collection

Stress Urinary Incontinence

Albo et al., 2007 · n=655 · 2 years

Autologous fascial sling vs Burch colposuspension. Sling superior (47% vs 38%) but higher morbidity.

Richter et al., 2010 · n=597 · 1 year

Retropubic vs transobturator midurethral sling. Equivalent objective success at 12 months.

Nager et al., 2012 · n=630 · 12 months

Urodynamics vs office evaluation alone before SUI surgery. Noninferiority demonstrated — UDS unnecessary for uncomplicated SUI.

Richter et al., 2010 · n=446 · 12 months

Pessary vs behavioral therapy vs combined for SUI. Behavioral modestly better at 3 months; all groups equalize by 12 months.

Prolapse — Sacrocolpopexy

Brubaker et al., 2006 · n=322 · 3 months

Sacrocolpopexy ± Burch. Prophylactic Burch halved postop SUI (NNT≈4). Stopped early for efficacy.

Nygaard et al., 2013 · n=215 · 7 years

7-year follow-up. Burch delays SUI 3.3× but doesn't eliminate it. Mesh erosion 10.5% at 7 years.

Wei et al., 2012 · n=337 · 1 year

Prophylactic midurethral sling at vaginal prolapse repair. Reduced SUI but increased adverse events.

Prolapse — Vaginal Apical Suspension

Barber et al., 2014 · n=374 · 2 years

ULS vs SSLF. Equivalent at 2 years (~60% composite success). Perioperative BPMT did not improve outcomes.

Jelovsek et al., 2018 · n=285 · 5 years

5-year follow-up. High composite failure (61–70%) but sustained QoL gains. One-third of “failures” later meet success criteria.

Nager et al., 2019 · n=175 · 3 years

Mesh hysteropexy vs hysterectomy+USLS. Trend favoring hysteropexy (24% vs 36%) but P=.06 at 3 years.

Nager et al., 2021 · n=175 · 5 years

5-year follow-up. Mesh hysteropexy significantly superior (37% vs 54%, P=.03). Only RCT showing mesh hysteropexy superiority.

Urgency Urinary Incontinence / OAB

Visco et al., 2012 · n=249 · 6 months

Anticholinergics vs Botox 100U. Equivalent UUI reduction. Botox: more complete resolution (27% vs 13%) but more UTIs.

Amundsen et al., 2016 · n=364 · 6 months

Botox 200U vs sacral neuromodulation for refractory UUI. Small statistical superiority for Botox; higher UTI rate (35% vs 11%).

Conservative Management

Cundiff et al., 2007 · n=134 · 3 months/pessary

Ring vs Gellhorn pessary crossover for POP. Both equally effective for symptom relief; no clinically significant difference.

Subak et al., 2009 · n=338 · 6 months

Weight loss (8%) reduced UI episodes 47% vs 28% in controls. Greatest benefit for stress incontinence.