Patient-reported health and quality-of-life after midurethral sling: A comparative analysis from VIGI-MESH registry

Our aim was to evaluate medium-term patient-reported health and quality-of-life after midurethral sling (MUS) insertion and to compare outcomes between retropubic and obturator approaches using data from the French VIGI-MESH registry.

In the prospective cohort linked to the registry, 1789 participants who had undergone midurethral sling insertion responded to a health questionnaire that assessed impression of improvement, self-rated health, and quality of life. Self-rated health in our sample was compared to surveys in the French population. A multivariate analysis including an inverse probability of treatment weighting approach was used to balance baseline differences.

A total of 1230 participants received a retropubic sling and 559 received an obturator sling placed by 139 surgeons in 27 French centers. Median follow-up was 34 months. Overall, 78.6% of women reported that they were "much better" or "very much better", and 69.6% reported "good" or "very good" health (13.5% higher than observed in the general population of the same age). The mean quality of life scale was 76.0/100 (3.8 points higher than observed in the general population of the same age). We were unable to demonstrate a difference in patient-reported outcomes between the retropubic and obturator approaches. After adjustment, serious MUS complications were associated with poorer improvement but not with poorer global self-rated health.

In the medium term following MUS insertion, women participating in the VIGI-MESH registry tended to report good self-rated health and quality-of-life. Patient-reported outcomes did not significantly differ between retropubic and obturator approaches.