The Mid-Urethral Sling Tensioning (MUST) Trial

The MUST trial was a multi-centred randomized controlled trial that recruited from September 2015 to December 2017. With collaborators at 4 sites in Western Canada, 318 women were randomized to have their retropubic mid-urethral sling tensioned by either a Mayo Scissor spacer or fixed-loop help by a Babcock clamp. The primary outcome was rate of abnormal bladder outcomes – a composite of urinary retention, persistent incontinence, and repeat surgery.

The study found that abnormal bladder outcomes were 12.9% less common in the group of women who had their mid-urethral sling tensioned with a Babcock clamp. This was primarily due to higher rates of urinary retention in the group of women whose cases were tensioned by Scissor spacer. There was no difference in rates of cure of stress incontinence between the two groups. Rates of vaginal mesh erosion where statistically higher at 12 months in the group of women tensioned by Babcock clamp.

The study was presented at the September 2019 joint AUGS/IUGA Meeting in Nashville, Tennessee. The study was published in the September 2020 issue of Obstetrics & Gynecology and featured in the Green Journal’s Editor Pick podcast by an interview with the Principal Investigator, Dr. Erin Brennand. The article can be downloaded free of charge as an Open Access publication.

The study authors would like to acknowledge the women who participated in this trial. Your time and willingness to take part allowed us to contribute a meaningful piece of information for clinicians who treat women with pelvic floor disorders. Thank you!