Incidence of Midurethral Sling Revision or Removal by Its Timing with Prolapse Surgery

Objective The aim of the study was to evaluate incidence of midurethral sling removal/revision based on timing with surgery for pelvic organ prolapse. Methods This was a retrospective cohort study of women who underwent midurethral sling placement in a claims-based database of women 65 years or older. Three groups were identified using the Current Procedural Terminology codes: (1) isolated sling, (2) concomitant sling, and (3) prolapse surgery and staged sling after prolapse surgery. In the staged group, placement of sling was identified within 18 months after index prolapse surgery. Fascial grafts were excluded. Sling removal/revision was identified across 3 years after sling surgery using Current Procedural Terminology code 57287. Rates of sling removal/revision were calculated by group. Comparisons were made using the χ2 test and analysis of variance. Cumulative incidence of removal/revision was evaluated using the Kaplan-Meier curves. Cox proportional hazards was performed to evaluate factors influencing removal/revision. Results We identified 39,381 isolated MUSs, 25,389 concomitant, and 886 staged. The rate of sling removal/revision was 3.52%. Rates of removal/revision differed between groups (7% staged vs 3.94% concomitant vs 3.17% isolated sling, P < 0.001). Compared with the staged group, the rate of removal/revision was lower in the isolated sling group (relative risk, 0.4550; 95% confidence interval [CI], 0.358-0.568) and the concomitant group (relative risk, 0.5666; 95% CI, 0.4450-0.7287). After adjusting for patient characteristics, sling revision or removal remained significantly less in the isolated MUS (hazard ratio, 0.50; 95% CI, 0.39-0.65) and concomitant (odds ratio, 0.55; 95% CI, 0.43-0.71) groups. Conclusions Sling removal/revision is higher when it is staged after prolapse surgery compared with isolated and concomitant placement. Future studies are needed to confirm these findings in a controlled population.

Files

Metadata

Work Title Incidence of Midurethral Sling Revision or Removal by Its Timing with Prolapse Surgery
Access
Open Access
Creators
  1. Sarah Samuel Boyd
  2. Jaime B. Long
  3. Edeanya Agbese
  4. Douglas Leslie
Keyword
  1. Midurethral sling
  2. Complications
  3. Surgical outcomes
  4. Pelvic organ prolapse
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Female Pelvic Medicine & Reconstructive Surgery
Publication Date June 1, 2022
Publisher Identifier (DOI)
  1. https://doi.org/10.1097/SPV.0000000000001138
Deposited February 17, 2023

Versions

Analytics

Collections

This resource is currently not in any collection.

Work History

Version 1
published

  • Created
  • Added Incidence_of_Midurethral_Sling_Revision_or_Removal_by_Its_Timing_With_Prolapse_Surgery.pdf
  • Added Creator Sarah Samuel Boyd
  • Added Creator Jaime B. Long
  • Added Creator Edeanya Agbese
  • Added Creator Douglas Leslie
  • Published
  • Updated Keyword, Publisher Show Changes
    Keyword
    • Midurethral sling, Complications, Surgical outcomes, Pelvic organ prolapse
    Publisher
    • Journal of Pelvic Surgery
    • Female Pelvic Medicine & Reconstructive Surgery
  • Updated