• About Us
    • Contact Us
    • Login
    • ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
About Us Contact Us Login ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
Grand Rounds

How Common is Midurethral Mesh Slings Replacement at 9 years Out?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Gurol-Urganci et al. (JAMA, 2018) sought to determine mesh removal and reoperation rates for midurethral mesh sling insertion in women with stress urinary incontinence (SUI)

METHODS:

  • Population-based retrospective cohort study
    • Women ≥18 years
    • Midurethral mesh sling insertion (first) for SUI
  • Received either
    • Retropubic mesh sling insertions
    • Transobturator mesh sling insertions
  • Primary outcome
    • Risk of midurethral mesh sling removal (partial or total)
  • Secondary outcomes
    • Reoperation for SUI
    • Any reoperation that included mesh removal

RESULTS:

  • 95,057 patients
    • Retropubic: 60,194 were
    • Transobturator: 34,863 
  • Median age: 51 years (interquartile range, 44-61 years)
  • Median follow-up time: 5.5 years (interquartile range, 3.2-7.5 years)
  • Rate of midurethral mesh sling removal
    • 1 year: 1.4% (95% CI, 1.3%-1.4%)
    • 5 years: 2.7% (95% CI, 2.6%-2.8%)
    • 9 years: 3.3% (95% CI, 3.2%-3.4%)
  • Removal risk higher with retropubic vs transobturator insertion (9 year)
    • Transobturator insertion: 2.7% (95% CI, 2.4%-2.9%)
    • Retropubic insertion: 3.6% (95% CI, 3.5%-3.8%)
    • Hazard ratio, 0.72 (95% CI, 0.62-0.84)
  • Rate of reoperation for stress urinary incontinence
    • 1 year: 1.3% (95% CI, 1.3%-1.4%)
    • 5 years: 3.5% (95% CI, 3.4%-3.6%) 
    • 9 years: 4.5% (95% CI, 4.3%-4.7%)
  • The rate of any reoperation including mesh removal
  • 1 year: 2.6% (95% CI, 2.5%-2.7%)
  • 5 years: 5.5% (95% CI, 5.4%-5.7%)
  • 9 years: 6.9% (95% CI, 6.7%-7.1%)
  • Risks of removal and any reoperation (mesh removal and/or reoperation for SUI) were higher for
    • Younger age groups
    • White racial/ethnic background
    • Did not appear to be associated with socioeconomic deprivation

CONCLUSION:

  • Use of sling has decreased substantially due to concerns regarding complications
  • The authors suggest that the data from this large cohort study may be helpful when discussing treatment options for SUI

Learn More – Primary Sources:

Long-term Rate of Mesh Sling Removal Following Midurethral Mesh Sling Insertion Among Women With Stress Urinary Incontinence

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone

Learn More  »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Practical info for your gynecology practice
Surgery for Urinary Incontinence – When the Sling’s the Thing
Urinary Incontinence – How to Make the Diagnosis in Your Office and When to Refer
Prolapse and Stress Incontinence: Burch Procedure vs Midurethral Sling

Sections

  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • COVID-19

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site