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. 2013 Jan;208(1):73.e1-7.
doi: 10.1016/j.ajog.2012.10.006. Epub 2012 Oct 5.

Sling revision/removal for mesh erosion and urinary retention: long-term risk and predictors

Michele Jonsson Funk  1 , Nazema Y Siddiqui, Virginia Pate, Cindy L Amundsen, Jennifer M Wu
Affiliations

Sling revision/removal for mesh erosion and urinary retention: long-term risk and predictors

Michele Jonsson Funk et al. Am J Obstet Gynecol. 2013 Jan.

Abstract

Objective: The objective of the study was to estimate the long-term risk of sling revision/removal after an initial sling and to assess indications (mesh erosion and urinary retention) and predictors of sling revision/removal.

Study design: Using a population-based cohort of commercially insured individuals, we identified women 18 years old or older who underwent a sling (Current Procedural Terminology code 57288) between 2001 and 2010 and any subsequent sling revision/removal (Current Procedural Terminology code 57287). We estimated the cumulative risk of revision/removal annually and evaluated predictors of sling revision/removal using Kaplan-Meier survival curves and Cox proportional hazards models, respectively.

Results: We identified 188,454 eligible women who underwent an index sling. The 9 year cumulative risk of sling revision/removal was 3.7% (95% confidence interval [CI], 3.5-3.9). At 1 year, this risk was already 2.2% and then increased to 3.2% at 4 years before plateauing. With regard to the indication for the sling revision/removal, a greater proportion was due to mesh erosion compared with urinary retention, with a 9 year risk of 2.5% (95% CI, 2.3-2.6) for mesh erosion vs 1.3% (95% CI, 1.2-1.4) for urinary retention. Age had an effect on the revision/removal rates for both mesh erosion and urinary retention, with the higher risks among those aged 18-29 years. The risk of revision/removal for mesh erosion and urinary retention was also elevated among women who had a concomitant anterior or apical prolapse procedure.

Conclusion: In this population-based analysis, the 9 year risk of sling revision/removal was relatively low at 3.7%, with 60% of revisions/removals caused by mesh erosion.

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Conflict of interest statement

Disclosure: None of the authors have any relevant conflicts of interest

Figures

Figure 1
Figure 1
Cumulative one-year risk of sling revision for any indication, retention or mesh erosion, stratified by year of index sling
See this image and copyright information in PMC

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