Dataset Information

Pregnancy and delivery after mid-urethral sling operation.

ABSTRACT:

Introduction and hypotheses

There is no consensus regarding pregnancy after mid-urethral sling (MUS) operation, and some clinicians recommend postponing the MUS operation if a woman considers further pregnancies or routinely suggest cesarean section as the delivery method after MUS operations. Our primary aim was to assess the risk for stress urinary incontinence (SUI) re-procedure after delivery in women with a MUS operation prior to pregnancy. We also analyzed SUI re-visits and MUS-related complications during pregnancy and postpartum.

Methods

We conducted a register-based case-control study of women with a MUS operation in Finland during 1996-2016. We identified 94 cases with a subsequent pregnancy and 330 controls without subsequent pregnancies matched by age, operation type and year.

Results

The median follow-up time was 10.7 years (IQR 7.1-13.7). The number of SUI re-procedures did not differ between the cases (n?=?3, 3.2%) and controls (n?=?17, 5.2%; OR 0.6, 95% CI 0.2-2.1). There was no significant difference in re-visits for stress or mixed urinary incontinence between the cases (n?=?23, 24.5%) and controls (n?=?86, 26.1%; OR 0.9, 95% CI 0.5-1.6), but 35% of the re-visits in the case group occurred already before the delivery after MUS. The rate of vaginal delivery was lower after MUS operation (57%) than in deliveries before MUS (91%, P?ConclusionsPregnancy after MUS did not increase the odds for SUI re-procedure or re-visit. Considering on our results, future pregnancy does not need to be viewed as an absolute contraindication for MUS operation.

SUBMITTER: Tulokas SA

PROVIDER: S-EPMC7788014 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Pregnancy and delivery after mid-urethral sling operation.

Tulokas Sari A SA Rahkola-Soisalo Päivi P Gissler Mika M Mikkola Tomi S TS Mentula Maarit J MJ

International urogynecology journal 20200825 1

<h4>Introduction and hypotheses</h4>There is no consensus regarding pregnancy after mid-urethral sling (MUS) operation, and some clinicians recommend postponing the MUS operation if a woman considers further pregnancies or routinely suggest cesarean section as the delivery method after MUS operations. Our primary aim was to assess the risk for stress urinary incontinence (SUI) re-procedure after delivery in women with a MUS operation prior to pregnancy. We also analyzed SUI re-visits and MUS-rel ...[more]

PMID: 32840660

Similar Datasets

Project description:BackgroundThe primary aims of this trial are to determine whether the use of a concomitant prophylactic anti-incontinence procedure may prevent stress urinary incontinence symptom development in women undergoing vaginal prolapse surgery and to evaluate the cost-effectiveness of this prophylactic approach.PurposeTo present the rationale and design of a randomized controlled surgical trial (RCT), the Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) Trial highlighting the challenges in the design and implementation.MethodsThe challenges of implementing this surgical trial combined with a cost-effectiveness study and patient preference group are discussed including the study design, ethical issues regarding use of sham incision, maintaining the masking of study staff, and pragmatic difficulties encountered in the collection of cost data. The trial is conducted by the NICHD-funded Pelvic Floor Disorders Network.ResultsThe ongoing OPUS trial started enrollment in May 2007 with a planned accrual of 350. The use of sham incision was generally well accepted but the collection of cost data using conventional billing forms was found to potentially unmask key study personnel. This necessitated changes in the study forms and planned timing for collection of cost data. To date, the enrollment to the patient preference group has been lower than the limit established by the protocol suggesting a willingness on the part of women to participate in the randomization.LimitationsGiven the invasive nature of surgical intervention trials, potential participants may be reluctant to accept random assignment, potentially impacting generalizability.ConclusionFindings from the OPUS trial will provide important information that will help surgeons to better counsel women on the benefits and risks of concomitant prophylactic anti-incontinence procedure at the time of vaginal surgery for prolapse. The implementation of the OPUS trial has necessitated that investigators consider ethical issues up front, remain flexible with regards to data collection and be constantly aware of unanticipated opportunities for unmasking. Future surgical trials should be aware of potential challenges in maintaining masking and collection of cost-related information.

Dataset Information

Pregnancy and delivery after mid-urethral sling operation.

Introduction and hypotheses

Methods

Results

Publications

Pregnancy and delivery after mid-urethral sling operation.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets