Readmission and reoperation after midurethral sling

Area of Science:

• Urology
• Female Pelvic Medicine and Reconstructive Surgery
• Surgical Outcomes Research

Background:

• Stress urinary incontinence (SUI) affects a significant portion of women.
• Midurethral sling (MUS) procedures are a common surgical treatment for SUI.
• Understanding complication rates such as readmission and reoperation is crucial for patient counseling and quality improvement.

Purpose of the Study:

• To determine the 30-day readmission and reoperation rates following isolated midurethral sling (MUS) placement for stress urinary incontinence (SUI).
• To identify risk factors associated with readmission and reoperation after MUS procedures.

Main Methods:

• A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.
• Identification of patients undergoing isolated MUS placement between 2012 and 2015 using CPT-4 codes.
• Review of the cohort for unplanned, related readmissions and reoperations within 30 days of surgery.

Main Results:

• A total of 9910 patients underwent isolated MUS placement.
• The 30-day readmission rate was 0.59% (58 patients), and the reoperation rate was 0.82% (81 patients).
• Common reasons for readmission included urinary retention; common reasons for reoperation included urinary tract issues. Increased length of stay (LOS) and lower body mass index (BMI <25) were significant risk factors for readmission and reoperation.

Conclusions:

• Isolated MUS placement is associated with low 30-day readmission and reoperation rates.
• Increased LOS was linked to readmission, while increased LOS and BMI <25 were associated with reoperation.
• These findings highlight the importance of considering patient BMI and optimizing hospital LOS in managing patients undergoing MUS procedures.