Readmission and reoperation after midurethral sling

  • Erik D. Hokenstad
  • Amy E. Glasgow
  • Elizabeth B. Habermann
  • John A. Occhino
Original Article
  • 62 Downloads

Abstract

Introduction and hypothesis

We aimed to determine the rate of readmission and reoperation for patients undergoing midurethral sling (MUS) placement for stress urinary incontinence (SUI).

Methods

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify all isolated MUS placed from 2012 through 2015 using the Current Procedural Terminology 4 (CPT-4) code for MUS with or without cystoscopy (57,288 ± 52,000). The cohort was then reviewed for unplanned, related readmissions and reoperations within 30 days of MUS placement.

Results

Isolated MUS was placed in 9910 patients. Fifty-eight (0.59%) patients were readmitted and 81 (0.82%) had reoperation. The most common indications for readmission were related to the urinary tract, i.e., urinary retention (27.6%), non-surgical-site-related infection (15.5%), and medical related issues (15.5%) The most common indications for reoperation were urinary tract (60.5%), gastrointestinal (7.4%), and gynecologic, i.e., examination under anesthesia (6.2%). Body mass index (BMI) was less (p = 0.001), and operative time (p = 0.014) and length of stay (LOS) (p = 0.001) longer in patients who were readmitted. Those who underwent reoperation had longer LOS than those who did not have reoperation (p < 0.001). Upon multivariate analysis, BMI <25 (all p < 0.05) and longer LOS maintained statistical significance as risk factors for those who experienced readmission or reoperation (p = 0.0406, p < 0001).

Conclusions

Isolated MUS placement has low 30-day readmission and reoperation rates. Increased LOS was associated with readmission, while increased LOS and BMI <25 were associated with reoperation within 30 days.

Keywords

Quality improvement readmission Reoperation Sling Urinary incontinence 

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Erik D. Hokenstad
    • 1
  • Amy E. Glasgow
    • 2
  • Elizabeth B. Habermann
    • 2
  • John A. Occhino
    • 1
  1. 1.Division of UrogynecologyMayo ClinicRochesterUSA
  2. 2.Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryMayo ClinicRochesterUSA

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