[Urinary incontinence surgery in Denmark 2001-2003]

The centralisation of surgical activity is an important aspect of the ongoing planning of the Danish Healthcare System. Knowledge of the actual status is crucial in the process of decision. In this article incontinence surgery in Denmark, including the frequency of complications, during a three year period is outlined.

This was a retrospective study, where data were extracted from the Danish National Patient Register (LPR) from 2001 to 2003. Data were supported by discharge letters and chart operation descriptions for women readmitted within 30 days after primary operation or if the hospital stays were prolonged.

In total 2678 incontinence operations were performed in the period by 51 different departments. Seven departments carried out 51% of all the procedures, while 33 departments carried out 14% of all the procedures. The frequency of postoperative complications was 33.9% after an abdominal procedure, 10.8% after a Tension free Vaginal Tape (TVT) like procedure and 2.3% after urethral injection therapy. For abdominal procedures, "high volume" departments (> 45 operations/3 years) had significantly fewer complications compared to "low volume" departments (<15 operations/3 years), while no difference was found in the TVT-like group. Registration of complications and reoperations was incomplete and incorrect, especially in the TVT-like group. Mortality within 30 days was 0.

This study shows a decentralised organisation of surgical incontinence activity in Denmark. Many departments carried out very few operations. There is a need for better registration, especially of TVT slings, and there is a need to reliably monitor the quality of incontinence surgery in Denmark. Surgical incontinence activity should be more centralised.