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A Danish national population-based cohort study of synthetic midurethral slings, 2007-2011.
Int Urogynecol J. 2019 05; 30(5):733-741.IU

Abstract

INTRODUCTION AND HYPOTHESIS

Synthetic midurethral slings (MUSs) have shown similar cure rates in several short- and medium-term follow-up studies. Recently, long-term follow-up studies have indicated that the cure rate is higher following the retropubic midurethral sling (RPMUS) compared with the transobturator midurethral sling (TOMUS) procedure. The aim was to evaluate the efficacy of synthetic MUSs and to examine the influence of department and surgeon volume and patient-related factors on the cure rate of synthetic MUSs.

METHODS

A retrospective cohort study based on a national population over a 5-year period (2007-2011) using data from the Danish Urogynaecological Database (DugaBase).

RESULTS

A total of 4519 women with first-time MUS were registered in the DugaBase. Cure was achieved in 1242/1639 (75.78%) at a 3-month follow-up. RPMUSs were more frequently in use in high-volume departments compared with the other departments and more often implanted by high- than low-volume surgeons. Women treated by a medium- (adjusted OR 1.82; 95% CI 1.01-3.28, "frequency") or high-volume surgeon (1.98; 1.18-3.32, "frequency") had an increased probability of cure compared with women treated by a low-volume surgeon. The difference was only significant for women who received a TOMUS.

CONCLUSIONS

This national population-based cohort study confirmed a high cure rate of synthetic MUSs at short-term follow-up. It is the largest study to indicate a learning curve for TOMUS. Patients were not actively involved in which synthetic MUS was to be performed as the choice of surgical option was made at the departmental level.

Authors+Show Affiliations

Nordsjællands Hospital, Department of Obstetrics and Gynecology, Hillerød, Denmark. margrethefoss@hotmail.com. Herlev and Gentofte Hospital, Department of Obstetrics and Gynecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. margrethefoss@hotmail.com.Herlev and Gentofte Hospital, Department of Obstetrics and Gynecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.Herlev and Gentofte Hospital, Department of Obstetrics and Gynecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.Center for Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30073484

Citation

Hansen, Margrethe Foss, et al. "A Danish National Population-based Cohort Study of Synthetic Midurethral Slings, 2007-2011." International Urogynecology Journal, vol. 30, no. 5, 2019, pp. 733-741.
Hansen MF, Lose G, Sigurdardòttir HB, et al. A Danish national population-based cohort study of synthetic midurethral slings, 2007-2011. Int Urogynecol J. 2019;30(5):733-741.
Hansen, M. F., Lose, G., Sigurdardòttir, H. B., & Gradel, K. O. (2019). A Danish national population-based cohort study of synthetic midurethral slings, 2007-2011. International Urogynecology Journal, 30(5), 733-741. https://doi.org/10.1007/s00192-018-3719-y
Hansen MF, et al. A Danish National Population-based Cohort Study of Synthetic Midurethral Slings, 2007-2011. Int Urogynecol J. 2019;30(5):733-741. PubMed PMID: 30073484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Danish national population-based cohort study of synthetic midurethral slings, 2007-2011. AU - Hansen,Margrethe Foss, AU - Lose,Gunnar, AU - Sigurdardòttir,Hrefna Bóel, AU - Gradel,Kim Oren, Y1 - 2018/08/02/ PY - 2018/03/23/received PY - 2018/07/10/accepted PY - 2018/8/4/pubmed PY - 2020/1/31/medline PY - 2018/8/4/entrez KW - Department volume KW - Learning curve KW - Midurethral slings KW - Retropubic midurethral sling KW - Surgeon volume KW - Transobturator midurethral sling SP - 733 EP - 741 JF - International urogynecology journal JO - Int Urogynecol J VL - 30 IS - 5 N2 - INTRODUCTION AND HYPOTHESIS: Synthetic midurethral slings (MUSs) have shown similar cure rates in several short- and medium-term follow-up studies. Recently, long-term follow-up studies have indicated that the cure rate is higher following the retropubic midurethral sling (RPMUS) compared with the transobturator midurethral sling (TOMUS) procedure. The aim was to evaluate the efficacy of synthetic MUSs and to examine the influence of department and surgeon volume and patient-related factors on the cure rate of synthetic MUSs. METHODS: A retrospective cohort study based on a national population over a 5-year period (2007-2011) using data from the Danish Urogynaecological Database (DugaBase). RESULTS: A total of 4519 women with first-time MUS were registered in the DugaBase. Cure was achieved in 1242/1639 (75.78%) at a 3-month follow-up. RPMUSs were more frequently in use in high-volume departments compared with the other departments and more often implanted by high- than low-volume surgeons. Women treated by a medium- (adjusted OR 1.82; 95% CI 1.01-3.28, "frequency") or high-volume surgeon (1.98; 1.18-3.32, "frequency") had an increased probability of cure compared with women treated by a low-volume surgeon. The difference was only significant for women who received a TOMUS. CONCLUSIONS: This national population-based cohort study confirmed a high cure rate of synthetic MUSs at short-term follow-up. It is the largest study to indicate a learning curve for TOMUS. Patients were not actively involved in which synthetic MUS was to be performed as the choice of surgical option was made at the departmental level. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/30073484/A_Danish_national_population_based_cohort_study_of_synthetic_midurethral_slings_2007_2011_ L2 - https://dx.doi.org/10.1007/s00192-018-3719-y DB - PRIME DP - Unbound Medicine ER -