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Long-term outcomes after stress urinary incontinence surgery.

Publication ,  Journal Article
Jonsson Funk, M; Siddiqui, NY; Kawasaki, A; Wu, JM
Published in: Obstet Gynecol
July 2012

OBJECTIVES: To compare the long-term risk of repeat stress urinary incontinence (SUI) surgery after different types of initial SUI surgery and to identify predictors of time to repeat SUI surgery in a large, population-based cohort. METHODS: We used de-identified, adjudicated health care claims data from approximately 100 employer-based plans across the United States from 2000 to 2009. We identified the index SUI surgery in women aged 18 to 64 years. Kaplan-Meier survival curves were used to estimate cumulative incidence of repeat surgery through 9 years. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for factors associated with recurrent SUI surgery. RESULTS: Over 10 years, we identified 155,458 eligible women who underwent one or more SUI surgeries, with a total of 294,855 person-years of follow-up. Of these index surgeries, 127,848 (82.2%) were slings. The 9-year cumulative incidence of repeat surgery after any SUI surgery was 14.5% (95% CI 13.4-15.5). As expected, bulking agents had the highest cumulative incidence of repeat surgery (61.2%, 95% CI 56.3-66.0) followed by needle suspension (22.2%, 95% CI 16.5-27.9); the lowest 9-year incidences were for Burch (10.8%, 95% CI 9.3-12.3) and sling (13.0%, 95% CI 11.7-14.3). In a Cox proportional hazards model that adjusted for age, year of index surgery, and region of the United States, the rate of repeat surgery was 28% higher for slings compared with Burch (adjusted HR 1.28, 95% CI 1.19-1.37). CONCLUSION: In this population-based analysis of women aged 18 to 64 years, Burch procedures had the lowest 9-year cumulative incidence of repeat SUI surgery.

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Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

July 2012

Volume

120

Issue

1

Start / End Page

83 / 90

Location

United States

Related Subject Headings

  • Young Adult
  • Urologic Surgical Procedures
  • Urinary Incontinence, Stress
  • United States
  • Treatment Outcome
  • Suburethral Slings
  • Reoperation
  • Proportional Hazards Models
  • Obstetrics & Reproductive Medicine
  • Middle Aged
 

Citation

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Jonsson Funk, M., Siddiqui, N. Y., Kawasaki, A., & Wu, J. M. (2012). Long-term outcomes after stress urinary incontinence surgery. Obstet Gynecol, 120(1), 83–90. https://doi.org/10.1097/AOG.0b013e318258fbde
Jonsson Funk, Michele, Nazema Y. Siddiqui, Amie Kawasaki, and Jennifer M. Wu. “Long-term outcomes after stress urinary incontinence surgery.Obstet Gynecol 120, no. 1 (July 2012): 83–90. https://doi.org/10.1097/AOG.0b013e318258fbde.
Jonsson Funk M, Siddiqui NY, Kawasaki A, Wu JM. Long-term outcomes after stress urinary incontinence surgery. Obstet Gynecol. 2012 Jul;120(1):83–90.
Jonsson Funk, Michele, et al. “Long-term outcomes after stress urinary incontinence surgery.Obstet Gynecol, vol. 120, no. 1, July 2012, pp. 83–90. Pubmed, doi:10.1097/AOG.0b013e318258fbde.
Jonsson Funk M, Siddiqui NY, Kawasaki A, Wu JM. Long-term outcomes after stress urinary incontinence surgery. Obstet Gynecol. 2012 Jul;120(1):83–90.

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

July 2012

Volume

120

Issue

1

Start / End Page

83 / 90

Location

United States

Related Subject Headings

  • Young Adult
  • Urologic Surgical Procedures
  • Urinary Incontinence, Stress
  • United States
  • Treatment Outcome
  • Suburethral Slings
  • Reoperation
  • Proportional Hazards Models
  • Obstetrics & Reproductive Medicine
  • Middle Aged