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Evidence to Improve Care

Midurethral Slings for Women with Stress Urinary Incontinence


Ontario Health Technology Advisory Committee Recommendations

Please note the Notice to Hospitals from Health Canada that highlights the need for physicians to:

  1. review warnings on devices;

  2. inform patients of adverse events;

  3. watch for signs of intraoperative and postoperative complications; and

  4. maintain training for procedure and management of complications.

Read the full OHTAC Recommendation report



Stress urinary incontinence happens when the muscles controlling the bladder and urethra don’t work properly. Urine travels from the bladder through the urethra and leaks to the outside. When the muscles are weak, urine can leak out when a person coughs, sneezes, laughs, exercises or lifts something heavy. Stress urinary incontinence can be treated with muscle exercises, drugs, or surgery.


Health Quality Ontario Reviews Midurethral Slings for Women with Stress Urinary Incontinence

One of the surgery options is called a midurethral sling. The surgeon implants a sling to hold up the weak muscles and help stop urine from leaking out.



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The Ministry of Health and Long-Term Care endorses these recommendations.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with these recommendations. New Canadian Classification of Health Interventions codes were added in 2006 and 2009 for midurethral sling insertion, management, and removal to allow for better tracking of the use of this intervention and its complication rates.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.



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