Randomization and treatment
Before surgery, all eligible patients completed a short International Consultation on Incontinence Questionnaire (ICIQ-SF) to measure the impact of patient’s symptoms on quality of life, where ratings ranged from 0 (no reduction in life quality) to 21 points 2. Patients were randomized by envelope technique at the time of surgery to either a TOT or SIS anti-incontinence procedure. For the TOT procedure, the inside-out Gynecare TVT Obturator System (Ethicon) was used. The SIS procedure was performed with an Ophira (Promedon) surgical kit. Patients in both TOT and SIS study groups were treated with standardized surgical techniques in accordance with manufacturer instructions12. All TOT surgeries were performed by one senior surgeon with the experience of more than 200 previous surgeries. All SIS surgeries were undertaken by another specialist with practice of more than 200 previous MUS surgeries including at least 30 SIS insertions. Every procedure was carried out under general anesthesia. The urinary Foley catheter was removed six hours after surgery, and patients were discharged the next day. No planned concomitant surgery or routine intraoperative cystoscopy were performed.