Reoperations for Female Stress Urinary Incontinence: A Finnish National Register Study

Abstract

BackgroundSubjective and objective cure rates after primary surgery for female stress urinary incontinence are good. Still, some women will undergo repeated operations for incontinence. ObjectiveTo study the reoperation rate after incontinence surgery and to compare the reoperation rates between different surgery types. Design, setting, and participantsThis 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 analysisPrimary operations, reoperation rate, patient age, time until reoperation. Results and limitationsA 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. ConclusionsReoperation rate is lower after midurethral slings compared with Burch colposuspension. Patient summaryMesh 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.