Reply by the Author

Abstract

The authors bring up a relevant point, in that structured follow-up of patients after a midurethral sling procedure is lacking. It is challenging to do, as most patients do well postoperatively, and wonder why they must attend repeated physician's appointment. However, if a “higher-risk” group could be identified, that would make systematic follow-up more significant for physicians, cost-effective for the medical system, and pertinent to the patient. In our previous work, we found that a large number of women have their midurethral sling complication treated by a different physician, highlighting a potential problem with accessing their prior surgeon. 1 Welk B. Al-Hothi H. Winick-Ng J. Removal or revision of vaginal mesh used for the treatment of stress urinary incontinence. JAMA Surg. 2015; 150: 1167-1175https://doi.org/10.1001/jamasurg.2015.2590 Crossref PubMed Scopus (74) Google Scholar The use of administrative data to identify potential risk factors is a useful adjunct to follow-up data from prospective studies. These data may be more representative of the skills and practice patterns of the average physicians performing midurethral slings, and allows the efficient collection of a very large number of patients to identify rare risk factors and postoperative complications. Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh ComplicationsUrologyVol. 99PreviewTo determine if postoperative urinary retention and urinary tract infections (UTIs) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). Full-Text PDF Re: Punjani et al.: Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications (Urology 2017;99:42-48)UrologyVol. 104PreviewWe read this manuscript with great interest. Although the midurethral sling (MUS) is considered by many to be the gold standard treatment for stress urinary incontinence, it is also associated with notable mesh-related complications. Research has sought to evaluate predictive factors for MUS complications. The majority of available investigation focuses on risk factors for postoperative voiding dysfunction, de novo irritative symptoms, or surgical failure.1-3 Although these data are important, similar investigation is lacking to help understand risk factors for the most severe adverse events following MUS, including urethral or bladder perforation and fistula. Full-Text PDF