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07.01.2019 | Original Article

Outcome of surgical management for midurethral sling complications: a multicentre retrospective cohort study

verfasst von: Victoria Kershaw, Rachel Nicholson, Paul Ballard, Aethele Khunda, Santhosh Puthuraya, Elaine Gouk

Erschienen in: International Urogynecology Journal

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Abstract

Introduction and hypothesis

Suspension of midurethral sling (MUS) surgery in the UK has led to a call for further evidence regarding long-term morbidity and the efficacy of treatments when mesh complications are encountered. We reviewed how many patients who underwent MUS surgery in Teesside, UK, returned to theatre due to a complication and what the outcomes were following this surgical intervention.

Methods

All patients coded to have undergone an MUS procedure between 1 January 2010 and 31 December 2014 in Teesside were reviewed retrospectively (n = 924). Case notes were analysed for patients who returned to theatre up until December 2017 due to complications related to their original MUS.

Results

Seventy-one of 924 (7.7%) women returned to theatre for some form of surgical intervention. There was a statistically significant difference in return-to-theatre rate between the transobturator and retropubic approach groups (63/661; 9.5%; confidence interval (CI) 7.3–11.8% v 8/263; 3.0%; CI 0.96%, 5.1%, odds ratio (OR) 3.35, p = 0.001); 2.8% (26/924) underwent shortening, reburying, incision or MUS excision; 1.0% (9/924) underwent steroid injection along the MUS tract; 1.7% (16/924) underwent surgical treatment of detrusor overactivity; 3.0% (28/924) required further stress incontinence surgery. The risk of unresolved chronic pain post-MUS surgery following treatment of complications was 0.2% (2/924).

Conclusions

Our results show a reassuringly low rate of mesh removal following MUS surgery. Furthermore, outcomes were good following surgical management of MUS complications. We advocate compulsory registration of all MUS procedures, follow-up data and complications to provide robust long-term evidence for the future.
Literatur
Metadaten
Titel
Outcome of surgical management for midurethral sling complications: a multicentre retrospective cohort study
verfasst von
Victoria Kershaw
Rachel Nicholson
Paul Ballard
Aethele Khunda
Santhosh Puthuraya
Elaine Gouk
Publikationsdatum
07.01.2019
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-018-3853-6

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