(HealthDay News) — The long-term risk for women with stress urinary incontinence needing surgical revision or removal after initial placement of synthetic midurethral slings is low, according to a study published in the November issue of Obstetrics & Gynecology.
Alexander A. Berger, MD, MPH, from the University of California in San Diego, and colleagues performed a retrospective cohort study of 17,030 patients who had previously received midurethral slings between 2005 and 2016.
The researchers found that the rate of mesh removal or revision at 1 year after surgery was 0.7% (95% confidence interval [CI], 0.6 to 0.8%); at 5 years, the rate was 1.0% (95% CI, 0.8 to 1.1%), and at 9 years, the rate was 1.1% (95% CI, 0.9 to 1.3%). Reoperation rates due to recurrent stress urinary incontinence after mesh placement were 1.6% at 1 year (95% CI, 1.4 to 1.8%), 3.9% at 5 years (95% CI, 3.5 to 4.2%), and 5.2% at 9 years (95% CI, 4.7 to 5.7%). The type of sling had an impact on the risk for reoperation for recurrent stress urinary incontinence, with reoperation more common after a single-incision versus retropubic sling (adjusted hazard ratio 1.5; 95% CI, 1.06 to 2.11).
“In the current polarized environment of mesh litigation, removal by several manufacturers of midurethral sling products from the market, and prohibition of midurethral sling use in other countries, our study offers information on long-term safety and efficacy data that will help guide surgeons and patients in making informed, evidence-based decisions regarding care for women with stress urinary incontinence,” the authors write.
The authors disclosed financial ties to UpToDate.
Berger AA, Tan-Kim J, Menefee SA. Long-term Risk of Reoperation After Synthetic Mesh Midurethral Sling Surgery for Stress Urinary Incontinence. Obst & Gynec. November 2019. 134(5):1047-1055. doi:10.1097/AOG.0000000000003526