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Risk factors leading to midurethral sling revision: a multicenter case-control study |
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| Authors: | Stephanie Molden Danielle Patterson Megan Tarr Tatiana Sanses Jessica Bracken Aimee Nguyen Heide S Harvie Amanda White Sarah A Hammil Miles Murphy Rebecca G Rogers |
| Institution: | 1. The Institute for Female Pelvic Medicine & Reconstructive Surgery, Allentown, PA, USA 10. The Female Pelvic Health Center, 1205 Langhorne-Newtown Rd., Suite 400, Langhorne, PA, 19047, USA 2. Brigham and Women’s Hospital, Boston, MA, USA 3. Loyola University, Chicago, IL, USA 4. Greater Baltimore Medical Center, Baltimore, MD, USA 5. Scott & White, Temple, TX, USA 6. Evanston Northshore Hospital, Evanston, IL, USA 7. University of Pennsylvania, Philadelphia, PA, USA 8. University of Texas Southwestern Medical Center, Dallas, TX, USA 9. University of New Mexico, Albuquerque, NM, USA |
| Abstract: | Introduction and hypothesisTo determine risk factors for sling revision after midurethral sling (MUS) placement.MethodsThis multicenter case-control study included patients who underwent MUS placement and subsequent revision secondary to voiding dysfunction from January 1999–2007 from nine Urogynecology centers across the USA. Direct logistic regression analysis was used to determine which diagnostic variables predicted sling revision.ResultsOf the patients, 197 met the study criteria. Patient demographics, urodynamic findings, and operative differences did not increase the risk for sling revision. Risk factors for sling revision did include: pre-existing voiding symptoms (OR 2.76, 95% CI 1.32–5.79; p?=?0.004) retropubic sling type (OR?=?2.28, 95% CI 1.08–4.78; p?=?0.04) and concurrent surgery (OR?=?4.88, 95% CI 2.16–11.05; p?<?0.001)ConclusionsThis study determined that pre-existing obstructive voiding symptoms, retropubic sling type, and concurrent surgery at the time of sling placement are risk factors for sling revision. |
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