Risk factors leading to midurethral sling revision: a multicenter case-control study
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Introduction and hypothesis
To determine risk factors for sling revision after midurethral sling (MUS) placement.
This 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.
Of 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)
This 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.
KeywordsVoiding dysfucntion Midurethral sling Sling revision
Conflicts of interest
S. Molden, MD: Ethicon consultant/instructor
M. Murphy, MD, MSPH: Ethicon/AMS/Bard consultant/instructor
R. Rogers, MD: Pfizer research grant, NBC speaker’s bureau/consultant.
- 4.Nitti VW, Fleischman N (2007) Voiding dysfunction and urinary retention. In: Walters MD, Karram MM (eds) Urogynecology and reconstructive pelvic surgery. Mosby Elsevier, Philadelphia, pp 390–399Google Scholar
- 15.Kawashima H, Hirai K, Okada N et al (2004) The importance of studying pressure flow for predicting post-operative voiding difficulties in women with stress urinary incontinence: a preliminary study that correlates low Pdet × Qave with post-operative residual urine. Urol Res 32:84–88CrossRefPubMedGoogle Scholar