Outcomes studied for surgical Tx of stress urinary incontinence

(HealthDay)—Among women undergoing midurethral mesh sling insertion, the rate of mesh sling removal at nine years is estimated to be 3.3 percent, according to a study published online Oct. 23 in the Journal of the American Medical Association.

Ipek Gurol-Urganci, Ph.D., from the London School of Hygiene & Tropical Medicine, and colleagues examined long-term mesh removal and reoperation rates in 95,057 women (median age, 51 years) who had a first-ever midurethral mesh sling insertion for stress urinary incontinence in the National Health Service hospitals in England from April 1, 2006, through Dec. 31, 2015. Median follow-up was 5.5 years.

The researchers found that the rate of midurethral mesh sling removal was 1.4 percent at one year, 2.7 percent at five years, and 3.3 percent at nine years. There was a decline in risk for removal with age. The nine-year removal risk was lower after transobturator insertion than after retropubic insertion (subdistribution hazard ratio, 0.72). For stress urinary incontinence, the rate of reoperation was 1.3 percent at one year, 3.5 percent at five years, and 4.5 percent at nine years. Including mesh removal, the rate of any reoperation was 2.6 percent at one year, 5.5 percent at five years, and 6.9 percent at nine years.

"These findings may guide women and their surgeons when making decisions about surgical treatment of stress urinary incontinence," the authors write.

One author disclosed ties to the medical device industry.

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