The objective was to describe the choice of subsequent surgery after failure of synthetic midurethral slings (MUS) based on a nationwide background population.
We used the Danish National Patient Registry to identify women who had undergone first-time synthetic MUS from 1998 through 2007.
The outcome was repeat surgery with any subsequent procedure code for urinary incontinence within a 5-year period of the first procedure.
A total of 5,820 women (mean age 55. 4 years, ± 12. 1) were registered with a synthetic MUS, and 354 (6 %) underwent reoperation. The first-choice treatment for reoperation was a synthetic MUS (45. 5 %) followed by urethral injection therapy (36. 7 %) and miscellaneous operations (13. 8 %). Pubovaginal slings (2. 8 %) and Burch colposuspension (1. 1 %) were seldom used. At reoperation, 289 women (82 %) were treated at the department where they had undergone their primary synthetic MUS.
In this nationwide cohort study of synthetic MUS a repeat synthetic MUS was the first choice and urethral injection therapy a frequent second choice. The majority of reoperations (82 %) took place in the same department as the primary operation.
International urogynecology journal. 2015 Dec 28 [Epub ahead of print]
Margrethe Foss Hansen, Gunnar Lose, Ulrik Schiøler Kesmodel, Kim Oren Gradel
Center for Clinical Epidemiology, South, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.Herlev Hospital, Department of Obstetrics and Gynaecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. , Herlev Hospital, Department of Obstetrics and Gynaecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. , Center for Clinical Epidemiology, South, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.