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A Danish national population-based cohort study of synthetic midurethral slings, 2007–2011

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Abstract

Introduction and hypothesis

Synthetic midurethral slings (MUSs) have shown similar cure rates in several short- and medium-term follow-up studies. Recently, long-term follow-up studies have indicated that the cure rate is higher following the retropubic midurethral sling (RPMUS) compared with the transobturator midurethral sling (TOMUS) procedure.

The aim was to evaluate the efficacy of synthetic MUSs and to examine the influence of department and surgeon volume and patient-related factors on the cure rate of synthetic MUSs.

Methods

A retrospective cohort study based on a national population over a 5-year period (2007–2011) using data from the Danish Urogynaecological Database (DugaBase).

Results

A total of 4519 women with first-time MUS were registered in the DugaBase. Cure was achieved in 1242/1639 (75.78%) at a 3-month follow-up. RPMUSs were more frequently in use in high-volume departments compared with the other departments and more often implanted by high- than low-volume surgeons. Women treated by a medium- (adjusted OR 1.82; 95% CI 1.01–3.28, “frequency”) or high-volume surgeon (1.98; 1.18–3.32, “frequency”) had an increased probability of cure compared with women treated by a low-volume surgeon. The difference was only significant for women who received a TOMUS.

Conclusions

This national population-based cohort study confirmed a high cure rate of synthetic MUSs at short-term follow-up. It is the largest study to indicate a learning curve for TOMUS. Patients were not actively involved in which synthetic MUS was to be performed as the choice of surgical option was made at the departmental level.

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Author information

Authors and Affiliations

  1. Nordsjællands Hospital, Department of Obstetrics and Gynecology, Hillerød, Denmark

    Margrethe Foss Hansen

  2. Herlev and Gentofte Hospital, Department of Obstetrics and Gynecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Margrethe Foss Hansen, Gunnar Lose & Hrefna Bóel Sigurdardòttir

  3. Center for Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Kim Oren Gradel

Authors
  1. Margrethe Foss Hansen
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  2. Gunnar Lose
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  3. Hrefna Bóel Sigurdardòttir
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  4. Kim Oren Gradel
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Corresponding author

Correspondence to Margrethe Foss Hansen.

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None.

Additional information

Gunnar Lose received a consultant fee from Contura.

Appendix

Appendix

Table 6 Information on material of synthetic midurethral slings used in Denmark 2006–2011
Full size table
Table 7 Patient characteristics for women with tension-free vaginal tape and transobturator tape, 2007–2011, Denmark
Full size table

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Hansen, M.F., Lose, G., Sigurdardòttir, H.B. et al. A Danish national population-based cohort study of synthetic midurethral slings, 2007–2011. Int Urogynecol J 30, 733–741 (2019). https://doi.org/10.1007/s00192-018-3719-y

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  • DOI: https://doi.org/10.1007/s00192-018-3719-y

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