Incidence and risk factors for reoperation of surgically treated urinary incontinence.

Dällenbach, P; Luyet, Cédric; Jungo Nancoz, C; Boulvain, M (2013). Incidence and risk factors for reoperation of surgically treated urinary incontinence. International urogynecology journal, 24(6), pp. 991-997. Springer 10.1007/s00192-012-1969-7

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Introduction and hypothesis
The objective of our study was to estimate the incidence and to identify the risk factors for reoperation of surgically treated stress urinary incontinence (SUI).

Methods
We conducted a nested case-control study among 1,132 women who underwent SUI surgery from January 1988 to June 2007. Cases (n = 35) were women who required reoperation for SUI following the first intervention up to December 2008. Controls (n = 89) were women randomly selected from the same cohort who did not require reoperation.

Results
The cumulative incidence of SUI reoperation was 3.1 % with a mean follow-up of 10.9 years (range 1.7–21.0). The main risk factor was the history of more than one vaginal delivery [adjusted odds ratio (OR) 3.5; 95 % confidence interval (CI) 1.0–12.6]. The use of synthetic midurethral slings was a protective factor compared to other surgical procedures for urinary incontinence (adjusted OR 0.1; 95 % CI 0.0–0.6).

Conclusions
The risk of reoperation after SUI surgery appears to be low and associated with multiple vaginal deliveries. Synthetic slings at index surgery are associated with a lower risk of reoperation.

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