Do the Advantage slings work as well as the tension-free vaginal tapes?

There is currently no data on the safety and efficacy of the Advantage sling despite its widespread use. We compared the efficiency and safety outcome data of 556 tension-free vaginal tape (TVT) and 108 Advantage slings after assessing for potential confounding factors. The two groups proved comparable. Bladder injury rates were 4.6% for the Advantage group and 2.9% for the TVT group (p = 0.36). Subjective stress incontinence cure were 83.3% and 85.3%, respectively (p = 0.66). Incidences of de novo urgency, urge incontinence, and voiding difficulties were 22.2% vs 14.7% (p = 0.06), 9.3% vs 7.4% (p = 0.55), and 11.1% vs 6.7% (p = 0.11), respectively. No major differences between the two slings were observed apart from a non-significant trend towards more de novo urgency and voiding difficulty symptoms with the Advantage group. It may be possible that due to its different biomechanical properties, the Advantage slings should be left looser.