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Previous obstetrical history does not impact short-term mid-urethral sling outcomes
Ole Aleksander Dyrkorn1,2, Anne Cathrine Staff3,4, Sigurd Kulseng-Hanssen5
1Division of Obstetrics and Gynaecology, Oslo University Hospital, Ullevål, PB 4950, Nydalen, 0424, Oslo, Norway. oldyrk@ous-hf.no.
International Urogynecology Journal
|May 14, 2021
Summary
Childbirth history does not impact mid-urethral sling (MUS) surgery outcomes in parous women. However, nulliparous women may have a higher risk of objective failure after MUS surgery for stress urinary incontinence.
Area of Science:
- Urogynecology
- Female pelvic medicine and reconstructive surgery
- Surgical outcomes research
Background:
- Pregnancy and childbirth are recognized risk factors for stress and mixed urinary incontinence.
- Mid-urethral sling (MUS) surgery is a common surgical intervention for urinary incontinence.
Purpose of the Study:
- To investigate the influence of obstetrical history on short-term subjective and objective failure rates following MUS surgery.
- To identify specific obstetrical factors impacting surgical outcomes for stress urinary incontinence.
Main Methods:
- A registry-based cohort study utilizing data from the Norwegian Medical Birth Registry and the Norwegian Female Incontinence Registry.
- Included 14,787 women undergoing MUS surgery between 1998 and 2016.
- Multivariate logistic regression analyzed the impact of obstetrical and constitutional factors on 6-12 month postoperative failure rates.
Main Results:
- No obstetrical variables significantly impacted subjective failure rates in multivariate analysis.
- Being nulliparous prior to MUS surgery was a significant risk factor for objective failure [aOR 1.60].
- High BMI, non-retropubic slings, preoperative urgency, and surgical complications were associated with poor outcomes.
Conclusions:
- Childbirth does not appear to affect MUS outcomes in parous women.
- Nulliparous women with stress urinary incontinence may exhibit different underlying pathophysiology compared to parous women.
