Readmission and reoperation after midurethral sling.

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.

journal_name

Int Urogynecol J

authors

Hokenstad ED,Glasgow AE,Habermann EB,Occhino JA

doi

10.1007/s00192-017-3551-9

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

1367-1370

issue

9

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-017-3551-9

journal_volume

29

pub_type

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