Risk factors leading to midurethral sling revision: A multicenter case-control study

Introduction and hypothesis: To determine risk factors for sling revision after midurethral sling (MUS) placement. Methods: This multicenter case-control study included patients who underwent MUS placement and subsequent revision secondary to voiding dysfunction from January 1999-2007 from nine Urogynecology centers across the USA. Direct logistic regression analysis was used to determine which diagnostic variables predicted sling revision. Results: Of the patients, 197 met the study criteria. Patient demographics, urodynamic findings, and operative differences did not increase the risk for sling revision. Risk factors for sling revision did include: pre-existing voiding symptoms (OR 2.76, 95% CI 1.32-5.79; p=0.004) retropubic sling type (OR=2.28, 95% CI 1.08-4.78; p=0.04) and concurrent surgery (OR=4.88, 95% CI 2.16-11.05; p<0.001) Conclusions: This study determined that pre-existing obstructive voiding symptoms, retropubic sling type, and concurrent surgery at the time of sling placement are risk factors for sling revision.