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Reoperations for Female Stress Urinary Incontinence: A Finnish National Register Study.
Eur Urol Focus. 2018 09; 4(5):754-759.EU

Abstract

BACKGROUND

Subjective and objective cure rates after primary surgery for female stress urinary incontinence are good. Still, some women will undergo repeated operations for incontinence.

OBJECTIVE

To study the reoperation rate after incontinence surgery and to compare the reoperation rates between different surgery types.

DESIGN, SETTING, AND PARTICIPANTS

This national register-based study included all Finnish women who had surgery for stress urinary incontinence during a 23-yr study period (1987-2009), both in inpatient and outpatient hospital settings. Subcohorts for follow-up times of 5-yr and 10-yr were evaluated separately.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Primary operations, reoperation rate, patient age, time until reoperation.

RESULTS AND LIMITATIONS

A total of 38 500 women had surgery for stress urinary incontinence from 1987 to 2009. Two thousand and seventy-six women (7.2%) had a reoperation with a rate of 7.8/1000 woman-yr. The reoperation rate was 8.3/1000 women-yr after a Burch colposuspension and 4.8/1000 after a retropubic midurethral sling. In the 10-yr follow-up, reoperation was more common after a Burch compared with a retropubic midurethral sling (odds ratio: 1.6, 95% confidence interval: 1.3-1.9). There was no difference in the reoperation rate between retropubic and transobturator midurethral slings in the 5-yr follow-up.

CONCLUSIONS

Reoperation rate is lower after midurethral slings compared with Burch colposuspension.

PATIENT SUMMARY

Mesh slings are surgically effective treatments for stress urinary incontinence. There are fewer reoperations after implanting these slings compared with older methods that do not use synthetic material. Different mesh slings have equally good results.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Obstetrics and Gynecology, University of Turku, Medical Faculty, Clinical Division, Turku, Finland. Electronic address: kaisa.kurkijarvi@utu.fi.Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Obstetrics and Gynecology, University of Turku, Medical Faculty, Clinical Division, Turku, Finland.National Institute for Health and Welfare, Helsinki, Finland; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Family Medicine, Stockholm, Sweden.Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Obstetrics and Gynecology, University of Turku, Medical Faculty, Clinical Division, Turku, Finland.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28753896

Citation

Kurkijärvi, Kaisa, et al. "Reoperations for Female Stress Urinary Incontinence: a Finnish National Register Study." European Urology Focus, vol. 4, no. 5, 2018, pp. 754-759.
Kurkijärvi K, Aaltonen R, Gissler M, et al. Reoperations for Female Stress Urinary Incontinence: A Finnish National Register Study. Eur Urol Focus. 2018;4(5):754-759.
Kurkijärvi, K., Aaltonen, R., Gissler, M., & Mäkinen, J. (2018). Reoperations for Female Stress Urinary Incontinence: A Finnish National Register Study. European Urology Focus, 4(5), 754-759. https://doi.org/10.1016/j.euf.2017.05.005
Kurkijärvi K, et al. Reoperations for Female Stress Urinary Incontinence: a Finnish National Register Study. Eur Urol Focus. 2018;4(5):754-759. PubMed PMID: 28753896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reoperations for Female Stress Urinary Incontinence: A Finnish National Register Study. AU - Kurkijärvi,Kaisa, AU - Aaltonen,Riikka, AU - Gissler,Mika, AU - Mäkinen,Juha, Y1 - 2017/06/10/ PY - 2017/02/16/received PY - 2017/04/18/revised PY - 2017/05/17/accepted PY - 2017/7/30/pubmed PY - 2019/4/24/medline PY - 2017/7/30/entrez KW - Burch colposuspension KW - Midurethral sling KW - Stress urinary incontinence KW - Surgery SP - 754 EP - 759 JF - European urology focus JO - Eur Urol Focus VL - 4 IS - 5 N2 - BACKGROUND: Subjective and objective cure rates after primary surgery for female stress urinary incontinence are good. Still, some women will undergo repeated operations for incontinence. OBJECTIVE: To study the reoperation rate after incontinence surgery and to compare the reoperation rates between different surgery types. DESIGN, SETTING, AND PARTICIPANTS: This national register-based study included all Finnish women who had surgery for stress urinary incontinence during a 23-yr study period (1987-2009), both in inpatient and outpatient hospital settings. Subcohorts for follow-up times of 5-yr and 10-yr were evaluated separately. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary operations, reoperation rate, patient age, time until reoperation. RESULTS AND LIMITATIONS: A total of 38 500 women had surgery for stress urinary incontinence from 1987 to 2009. Two thousand and seventy-six women (7.2%) had a reoperation with a rate of 7.8/1000 woman-yr. The reoperation rate was 8.3/1000 women-yr after a Burch colposuspension and 4.8/1000 after a retropubic midurethral sling. In the 10-yr follow-up, reoperation was more common after a Burch compared with a retropubic midurethral sling (odds ratio: 1.6, 95% confidence interval: 1.3-1.9). There was no difference in the reoperation rate between retropubic and transobturator midurethral slings in the 5-yr follow-up. CONCLUSIONS: Reoperation rate is lower after midurethral slings compared with Burch colposuspension. PATIENT SUMMARY: Mesh slings are surgically effective treatments for stress urinary incontinence. There are fewer reoperations after implanting these slings compared with older methods that do not use synthetic material. Different mesh slings have equally good results. SN - 2405-4569 UR - https://www.unboundmedicine.com/medline/citation/28753896/Reoperations_for_Female_Stress_Urinary_Incontinence:_A_Finnish_National_Register_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2405-4569(17)30123-2 DB - PRIME DP - Unbound Medicine ER -