Factors Influencing the Rate of Lost to Followup after Suburethral Synthetic Sling Removal

Introduction: We report on variables associated with lost to followup in women undergoing suburethral synthetic sling removal for complications of mid urethral slings. Methods: Following institutional review board approval a prospectively maintained database of consecutive women with nonneurogenic bladder who underwent 1 synthetic sling removal only was reviewed. Data reviewed by a third party investigator included distance traveled for appointment, marital status, employment status, if the patient received primary care from the institution, if patient's last followup visit was routine or for ongoing urological treatment, type of insurance coverage and UDI-6 (Urogenital Distress Inventory Short Form) questionnaire scores. Patients who did not reach a minimum followup length of 6 months were contacted via phone and interviewed using a standardized script. Results: From 2005 to 2015, 129 patients had a mean followup of 25 months (range 6 to 114). Of the 38 women lost to followup 19 could not be reached and there was 1 nonrecoverable loss due to death. There was a significant increase in patients returning for followup if they had ongoing treatment (p=0.0035). The most commonly reported reasons for lost to followup were distance to the care center and the patient being content with the postoperative outcome. UDI-6 total score decreased significantly after synthetic sling removal in the lost to followup population by an average of 4.2 points (p=0.0337). Conclusions: Geographical factors and ongoing treatment may explain lost to followup in women referred to a tertiary care center for complications of mid urethral slings.