Unplanned hospital visits among women who undergo urethral sling placement
An unplanned hospital visit within 30 days of urethral sling placement may occur in one in 18 females, with 81 percent being emergency department visits, according to a study.
Researchers examined the medical records of 28,635 women who underwent urethral sling placement without concomitant surgery, besides cystoscopy, in an outpatient setting. They identified any subsequent emergency department visit, inpatient admission or sling revision operation within 30 days of the original procedure.
At least one unplanned hospital visit occurred within 30 days in 1,630 women (5.7 percent). These visits included those in the emergency department (n=1,327; 4.7 percent), requiring inpatient admission (n=295; 1 percent) and involving a sling revision (n=79; 0.28 percent).
The most common diagnoses established during emergency department visits included urinary retention and Foley catheter problems (18.7 percent) and urinary tract infection (9.3 percent).
Mid-urethral sling operations are commonly performed in the management of stress urinary incontinence, which is characterized by involuntary leakage of urine on effort or exertion, or on sneezing, coughing or laughing. The procedure is suitable for women having their first surgery to prevent incontinence, as well as for those who have had a previously unsuccessful surgery. [Cochrane Database Syst Rev 2015;doi:10.1002/14651858.CD006375.pub3]
Procedure-related complications include bladder perforation, haemorrhage, bowel injury, vaginal extrusion, de novo urgency and urge incontinence, urinary tract infections and voiding dysfunction. Awareness of these complications may promote patient counselling improvements and further investigation of the underlying mechanisms. Future clinical studies of mid-urethral sling should consider reductions in complications as their outcomes. [J Urol 2008;180:1890–7]