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.
Similar content being viewed by others
References
Wu JM, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014;123(1):141–8.
Wu JM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6.
Jonsson Funk M. P.J. Levin, and J.M. Wu, Trends in the surgical management of stress urinary incontinence. Obstet Gynecol. 2012;119(4):845–51.
Nager C, et al. Position statement on mesh midurethral slings for stress urinary incontinence. Female Pelvic Med Reconstr Surg. 2014;20(3):123–5.
Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418–28.
Zuckerman RB, et al. Readmissions, observation, and the hospital readmissions reduction program. N Engl J Med. 2016;374(16):1543–51.
Surgeons, A.C.o. User Guide for the 2014 ACS NSQIP Participant Use Data File (PUF). 2015.
Ford AA, et al. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2015;7:CD006375.
Suskind AM, et al. Ambulatory surgery centers and outpatient urologic surgery among Medicare beneficiaries. Urology. 2014;84(1):57–61.
Unger CA, Rizzo AE, Ridgeway B. Indications and risk factors for midurethral sling revision. Int Urogynecol J. 2016;27(1):117–22.
Ripperda CM et al. Predictors of early postoperative voiding dysfunction and other complications following a midurethral sling. Am J Obstet Gynecol. 2016;215(5).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None.
Rights and permissions
About this article
Cite this article
Hokenstad, E.D., Glasgow, A.E., Habermann, E.B. et al. Readmission and reoperation after midurethral sling. Int Urogynecol J 29, 1367–1370 (2018). https://doi.org/10.1007/s00192-017-3551-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-017-3551-9