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Population based trends in procedures following sling surgery for urinary incontinence

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International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

To investigate practice patterns and variation associated with sling removal/revision and urethrolysis on a population level.

Methods

We used CPT 4 codes and the State Ambulatory Surgery Database (SASD) to identify all ambulatory procedures for sling removal/revision and urethrolysis from 2004 to 2009 in Florida. Next, we calculated adjusted rates for these procedures and measured regional variation in rates at the level of the Hospital Service Area (HSA).

Results

During this time period, rates of secondary procedures following slings more than doubled from 3.2 per 100,000 to 6.5 per 100,000 population (p < 0.001). There was a large amount of regional variation, with rates of these procedures varying more than 5-fold across HSAs. Regions that placed more slings did not necessarily have higher rates of secondary procedures following sling placement.

Conclusions

The large amount of variability in rates of secondary procedures following slings signifies considerable uncertainty about the indications for these procedures. Further research is warranted to better explain potential sources for this variation in order to improve the quality of care surrounding midurethral sling placement and the recognition and treatment of its complications.

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Conflicts of interest

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Authors and Affiliations

  1. Dow Division of Health Services Research, Department of Urology, University of Michigan, Building 520, 3rd Floor, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA

    Anne M. Suskind, Samuel R. Kaufman, Rodney L. Dunn, J. Quentin Clemens & Brent K. Hollenbeck

  2. Division of Neurourology and Pelvic Reconstructive Urology, University of Michigan, Ann Arbor, MI, USA

    Anne M. Suskind, John T. Stoffel & J. Quentin Clemens

Authors
  1. Anne M. Suskind
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  2. Samuel R. Kaufman
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  3. Rodney L. Dunn
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  4. John T. Stoffel
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  5. J. Quentin Clemens
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  6. Brent K. Hollenbeck
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Corresponding author

Correspondence to Anne M. Suskind.

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Suskind, A.M., Kaufman, S.R., Dunn, R.L. et al. Population based trends in procedures following sling surgery for urinary incontinence. Int Urogynecol J 24, 775–780 (2013). https://doi.org/10.1007/s00192-012-1930-9

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  • DOI: https://doi.org/10.1007/s00192-012-1930-9

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